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

Advance on chemical constituents and pharmacological activities of Stellera plants have been conducted. The chemical constituents include terpenes, coumarins, flavonoids, lignans, volatile oils, and other compounds. Pharmacological studies showed that diterpenoids and biflavones showed strong activities, such as antitumor, anti-HIV, and immune regulations. This review hopes to provide a scientific basis for further research and explorations of the medicinal values of the genus.
Animals ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Molecular Sequence Data ; Molecular Structure ; Thymelaeaceae ; chemistry ; classification

OBJECTIVETo investigate the epidemiological characteristics and patterns of extra-pulmonary tuberculosis wounds in order to provide reliable data for further clinical research.

METHODSRecords of patients with extra-pulmonary tuberculosis wounds hospitalized from January 2010 to December 2012 were retrospectively analyzed, including gender, age, nationality, family background, Bacille Calmette-Guerin (BCG) vaccination, primary lesion, and history of injury.

RESULTSTuberculosis wounds were found in 235 patients among 5 863 patients with extra-pulmonary tuberculosis, accounting for 4.0%. Among the patients with tuberculosis wounds, there were 139 male and 96 female, and the ratio of male to female was 1.4: 1.0. The age of patients ranged from 1 to 87 (37 +/- 18) years old, and the highest incidence occurred in patients older than 15 and younger than or equal to 30 years old (100 cases, accounting for 42.6%). Most patients with tuberculosis wounds were Han, and only 11 patients were minorities, accounting for 4.7%. Tuberculosis wounds were more prevalent in rural areas (163 cases, accounting for 69.4%), with a smaller number in urban areas (72 cases, accounting for 30.6%). The BCG vaccination rate was 13.6%. The main primary lesions were lymph node infection (112 cases, accounting for 47.7%), among which involvement of cervical lymph nodes accounted for the highest ratio ( 99 cases, accounting for 88.4%). Twenty-one patients had the traffic accident etc. injury history recently, among which 19 were male and 2 were female.

CONCLUSIONSTuberculosis wound, with certain incidence, was more frequently found among young adults from rural areas. The BCG vaccination rate was low among the patients and the main primary lesion was tuberculosis of cervical lymph nodes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; ethnology ; statistics & numerical data ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Lymph Nodes ; microbiology ; Male ; Middle Aged ; Population Surveillance ; Prevalence ; Retrospective Studies ; Rural Population ; Tuberculosis ; epidemiology ; microbiology ; Tuberculosis, Pulmonary ; epidemiology ; Urban Population ; Wounds and Injuries ; complications ; epidemiology ; Young Adult

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.