An evaluation scale of medical services quality was developed on the basis of "patients' experience". The questionnaires were developed by, among others, searching relevant literature, collecting well-established assessment scales, measuring patients' experience and satisfaction, brain-storming, literature analysis. Delphi method was adopted for expert consultation. Scale items were screened and revised. The key indexes were converted. Field surveys were conducted for testing the reliability and validity of the scale. Our modified evaluation scale for measuring medical services quality based on "patients' experience" included 6 dimensions (tangibility, reliability, responsiveness, assurance, empathy and continuity), and 50 items. The novel scale based on "patients' experience" may better serve the purpose of assessing medical services quality.

Objective To explore the relationship between the apoptosis of cerebellar granule cell and the changes of caspases-3 and Bcl-2 in rats with methylmercury intoxication.Methods We chronologically observed the pathological changes of cerebellum in rats given methylmercury[4 mg/(kg?d)] at day 11, 15, 18 and 19. The apoptosis of cerebellar granule cell was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling (TUNEL) method, and the relationship between the apoptosis and the expression of caspases-3 and Bcl-2 was evaluated.Results At day 18, some sparse TUNEL positive granular cells could be observed, mainly in deep lamina adjacent to the white matter. At day 19, the apoptotic cells markedly increased, while the number of granular cells decreased with a well preservation of Purkinje cells demonstrated by calvindine immunostaining. MRF-1 and glial fibrillary acidic protein(GFAP) dyeing demonstrated severe microglia reaction and astrocytosis. From day 11, caspasese-3 mRNA expression up-regulated, increased gradually and reached peak at day 18, then decreased markedly at day 19. In contrast, Bcl-2 mRNA expression down-regulated from day 11, and decreased obviously at day 19. Zic-1 as a marker of granule cell decreased gradually after methylmercury administration and indicated degeneration of granule cells.Conclusion Cerebellar granular cell degeneration induced by methylmercury is related to apoptosis mediated by caspases-3 and Bcl-2 down regulated.

Humans ; Occupational Health ; Occupational Health Services

OBJECTIVE:To provide reference for benign sustainable development of traditional Chinese and ethnic medicine enterprises in Guizhou. METHODS:Taking 129 traditional Chinese and ethnic medicine enterprises of 9 city and prefecture in Gui-zhou as survey object,questionnaires survey was conducted in 55 enterprises by stratified sampling according to location. The data statistical analysis was carried out in respects of related policies familiarity,product positioning,independent innovation from 2009 to 2013. Relevant development countermeasures were put forward. RESULTS & CONCLUSIONS:45.1% of enterprises ex-pressed to know and be familiar with relevant policies,51.0% expressed to alert but only understand,and 3.9% said largely un-known. At the past five years,the annual output value and sales revenue of enterprises had risen year by year. Almost 80% produc-tion and technical personnel of enterprises had the junior title or no title;marketing department staff mainly had college and second-ary school degree,accounting for 47.5% and 25.3% respectively;research personnel mainly had bachelor and college degree,ac-counting for 57.0% and 33.7% respectively. At the past five years,independent innovation input took up 2.4% of sales revenue av-eragely. There are problems,such as small and medium enterprises occupying dominate position;enterprises lacking of sufficient understanding on related policies;strategies being adjusted slowly;independent innovation input intensity needing to increase. Countermeasures and suggestions are put forward,such as strengthening the relevant policy advocacy,guiding corporate mergers and acquisitions,closely paying attention to industry development,changing innovation ideas,and attaching importance to research of exclusive production of essential medicine.

Humans ; Nephritis ; etiology ; therapy ; Prognosis ; Purpura, Schoenlein-Henoch ; complications ; therapy ; Sjogren's Syndrome ; etiology ; therapy

Furbenicillin is a broad-spectrum semisynthetic penicillin with strong antibacterial activity against Gram-negative bacteria. Furbenicillin sodium is determined by volumetric method in current criteria. However, the criteria does not contain an assay of related substances of furbenicillin sodium. In this study, we established a method for detection and analysis of furbenicillin sodium and its related substances by HPLC. The analysis was performed with a C18 column under a gradient elution, the detection wavelength was 225 nm, and the column temperature was 35 degrees C. The reliability and accuracy of established method was validated in this study. Pure samples of furbenicillin sodium and its related substances were prepared. The structures, biological activities, and chromatographic retention behaviors of furbenicillin sodium and its related substances were identified using NMR, CLSI agar dilution method, and HPLC. All results in the current study provide ample evidence that this method is able to determine the reasonable limits in the quality-control protocol for furbenicillin sodium.
Anti-Bacterial Agents ; chemistry ; Chromatography, High Pressure Liquid ; Magnetic Resonance Spectroscopy ; Penicillins ; Quality Control ; Reproducibility of Results

American medical colleges attach great importance to the humanistic education.The rich humanities curriculum is fully integrated into the teaching practice thus the mutual penetration of medicine and the humanities is achieved.They have specific and detailed examination evaluation system and the teaching method was more practical and participatory.By contrast,nost of the medical colleges in our country neglect the humanities construction and the cultivation of medical students' humanistic spirit.The coverage of the humanities curriculum is relatively narrow and the faculty is insufficient.We should promote the development of humanistic cducation,attach importance to the construction of medical humanities,set up appropriate curriculum system,increase the investment in faculty and reform the teaching method and examination method.

BACKGROUND:The influence of Tol-like receptor 2 (TLR2), Tol-like receptor 4 (TLR4), Tol-like receptor 6 (TLR6) signal transduction pathway and active Treg in children with Henoch-Schonlein purpura has been unknown.
OBJECTIVE:To investigate the expression of TLR2, TLR4 and TLR6 in peripheral blood mononuclear cells and Treg immune response in patients with Henoch-Schonlein purpura, and to explore the role of TLR2, TLR4, TLR6 and Treg activation in the pathogenesis of Henoch-Schonlein purpura.
METHODForty-two hospitalized children with Henoch-Schonlein purpura were enrol ed in this study. Another 15 healthy children were selected as controls. TLR2, TLR4 and TLR6 at protein level in peripheral blood mononuclear cells were detected by flow cytometey;reverse-transcription PCR and real-time PCR were used to evaluate the level of MyD88;the levels of transforming growth factor-βand interleukin-10 were measured by enzyme-linked immunosorbent assay. t-test or t’-test was used to compare the levels of these genes and proteins. Pearson’s correlation test was done for correlation analysis.
RESULTS AND CONCLUSION:Compared with the control group, the protein levels of TLR2, TLR4, TLR6 and the relative expression level of MyD88 mRNA were significantly up-regulated (P<0.01). The serum levels of transforming growth factor-βand interleukin-10 were higher in the Henoch-Schonlein purpura children than the healthy children (P<0.05). There was a significant correlation between the protein levels of TLR2, TLR4, TLR6 and mRNA level of MyD88 (P<0.01), but no relationship was found between TLRs and interleukin-10, transforming growth factor-β(P>0.05). The excessive activation of TLR2, TLR4, TLR6 may be involved in the process of Henoch-Schonlein purpura via MyD88-dependent pathway, and the compensatory activation of Treg may participate in protective immunity.

Alzheimer's disease (AD) is a neurodegenerativedisease. Ovariectomized (OVX) AD rat model has been widely used in the experimental research recently. This article reviewed the method of OVX model establishment, behaviorchange, histopathology and biochemistry. Articles published in recent 20 years were collected in the review of the development.

Objective To investigate the pathological features,diagnosis and treatment of primary malignant melanoma in esophagus (PMME).Methods The clinical data of 3 patients with PMME who were admitted to the Beijing Friendship Hospital from January 2008 to June 2009 were retrospectively analyzed.All the patients received esophageal barium radiography,electronic fiberesophagoscopy,esophageal endoscopic ultrasonography,computed tomography,and underwent surgery.Adjuvant therapy and immunotherapy were applied postoperatively.Results The results of barium radiography showed irregular filling defect presentation in the distal esophagus.The results of endoscopy showed a purple black tumor with a length of 3-8 cm in the esophagus.The results of endoscopic ultrasonography showed that the tumor was derived from the mucosal layer with low echo density.The results of computed tomography showed thickness of the lower segment of the esophagus.All the 3 patients received left thoracic approach esophagectomy and esophagogastrostomy.Histopathology and immunohistochemistry confirmed malignant melanoma.The expressions of Mart-1,HMB-45 and S-100 antigen were positive.The survival time of 2 patients was longer than 3 years,and 1 patient died of metastasis 6 months after operation.Conclusions PMME is a kind of rare and malignant tumor with dismal prognosis.Surgical management is the first choice,adjuvant chemotherapy and immunotherapy are hopeful to increase the survival time of the patients.