Objective: To establish a new method and limit of detection for Flavonoids content in Fructus Crataegi. Methods: Flavonoids in Fructus Crataegi in 10 regions was determined by colorimetry. Results: Content of Flavonoids in samples selected from 10 regions ranged 0.84%～3.62%. Content of hyperoside by colorimetry is correlative to that by HPLC. Conclusion: The method is simple, quick and reproducible. Flavonoid content in Fructus Crataegi was designed no less than 1.0%, extraction must be performed under 60?C and dried to constant weight for 6 hours.

Recently, more systemic reviews and randomized controlled trials were published to prove the effectiveness of TCM,and some of those were included by Cochrane Library. But due to the potential selective reporting bias and publication bias, few trials were included in the meta analysis, which failed to prove the evidence for the TCM treatment. The difference of reported outcomes comes to the big problem of the comparison between interventions. Such problem of difference was gradually brought to the attention. Therefore, Core Outcome Sets(COS), which stands for that the minimum standardized outcome set that must be repoted, may be the solusion to that problem. In this research we've introduced the formation and development of core outcome sets in TCM.

Objective To investigate the influence of Smac to the chemosensitivity of cyclophosphamide (CTX) and doxorubicin (DOX) in MCF-7 cells.Methods MCF-7 cells were exposed to CTX,DOX and the combination of both.3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay was used to estimate the cell viability.Apoptosis was measured by acridine orange staining and Ho.33342/PI dou-ble staining.The mRNA and protein expressions of Smac were determined by RT-PCR and Western blotting.The study also analyzed the changes of pro-apoptotic proteins active caspase-3 and active caspase-9.Results CTX,DOX and the combination of both drugs reduced the cell survival rates in a concentration-dependent manner.The cell viability after being treated with 4.0 μg/ml CTX or 0.2 μg/ml DOX or 2.0 μg/ml CTX and 0.1 μg/ml DOX for 48 hours was (52.90 ± 8.78) ％,(53.35 ± 6.29) ％ and (34.19 ± 5.43) ％,respectively.The drug combination developed a stronger inhibitory effect compared to the single drugs (t =9.051,P=0.014;t =9.074,P =0.014).The Smac mRNA and protein levels in 2.0 μg/ml CTX and 0.1 μg/ml DOX group were 7.47 ± 0.82 and 4.13 ± 0.36,which were higher than those in 4.0 μg/ml CTX group (3.27 ± 0.40 and 2.28 ± 0.27;t =-50.120,P =0.000;t =-42.588,P =0.000) and 0.2 μg/ml DOXgroup (3.34±0.62and2.45±0.40;t=-46.233,P=0.000;t=-39.541,P=0.000).Furthermore,pro-apoptotic proteins active caspase-3 and active caspase-9 increased activity was confirmed by Western blotting.Conclusion Smac plays a vital role in enhancing the sensitivity of chemotherapeutic drugs CTX and DOX in MCF-7 cell line.

The paper analyzed legally the following predicaments of legitimization of rural doctors in China:no legitimacy protection for their practice,vague criteria for practicing medicine,conflicts between legal regulations for medical practice and rural realities,and lack of a liability insurance system.The authors,based on an exploration of the legislative framework for rural doctors,made four corresponding legislative proposals as follows:to clearly define the legal scope and identity of rural doctors,to establish a qualification and employment system for rural doctors,to develop practicing norms applicable for rural doctors,and to set standards for their income.

Objective To analyze influencing factors of physicians' turnover intention at public county hospitals from career stage perspective.Methods Physicians career life was divided into three stages according to professional ranks and titles.The sample was drawn using stratified multistage random methods from public county hospitals in Shandong province and 677 questionnaires were completed,giving a 90.3％ valid response rate.Data were analyzed using multi-group stepwise linear regression.Results The percentage of responders with middle and high-level turnover intention was 23.0％and 6.5％ respectively,and there was no statistically significant difference in turnover intention across three stage subgroups.In physicians at stage 1,the most important factors to predict turnover intention were superiors ' appreciation (r =-0.22,P ＜ 0.05) and payment rationality (r =-0.21,P＜0.05),while in physicians at stage 2,the most important predicting factors were autonomy (r=-0.39,P＜0.05)and learning demand(r=-0.22,P＜0.05),and in physicians at stage 3 were career development(r=-0.31,P＜0.05)and autonomy(r=-0.21,P＜0.05).Conclusion Autonomy and workload are common factors of turnover intention with different predicting power across three career stages.Physicians adjust their career needs to self-actualization with development of career stage,so welltargeted incentives should be taken to stabilize the medical staff of public county hospitals.

Objective To study the state of doctors' psychological capital in public hospitals,and to analyze the characteristics of such capital,so as to better leverage the capital as a hospital management tool.Methods A quantitative and qualitative research was made on the state of doctors＇ psychological capital.Results The doctors' task-oriented psychological capital scored 4.25,and guanxi-oriented psychological capital 4.41; “modesty and prudence”scored the highest in all dimensions of the doctors' psychological capital,“optimism and hope”lowest; the doctors with different genders,ages,seniority,and monthly average income have a difference in psychological capital.However,no significant difference was found with varying titles,hospital levels,and employment models.Conclusion The doctors were found with a strong psychological capital to cope with stress.Better psychological capital will raise quality of care in practice.

Objective: To explore the effects of effort-reward imbalance (ERI) at work on the occupational burnout, job satisfaction and turnover intention of doctors in public hospitals. Methods: By using self-designed questionnaires to in-vestigate job attitude, this paper adopts a stratified random sampling method to select 1910 doctors from public hospitals in Jinan, Weifang and Dezhou cities based on the level of economic development in Shandong province. The data are ana-lyzed using descriptive analysis, correlation analysis, hierarchical regression analysis, etc. Results: The effort-reward imbal-ance at work exists in the surveyed public hospitals. The job effort of doctors is 1. 39 ± 0. 37 times higher than job reward. The effort-reward imbalance at work has positive predictive effects on occupational burnout, negative predictive effects on job satis-faction, and positive predictive effects on turnover intention. Conclusions:Public hospital administrators should improve the ef-fort-reward ratio of doctors in order to stabilize doctors' professional attitude at work and enhance their morale.

Objective To analyze the outcomes of the subsidy mechanism reform for China's public hospitals through a financial perspective.Methods An evaluation index system was built using data from China's health (family planning) statistics yearbooks 2009-2016, for comparison of the constituent ratio and chain relative ratio growths of public hospitals in various years.Results Year 2015 found a lower growth rate of medical revenues of these hospitals;year-by-year drop of drug income ratio, yet a gradual rise of income from examinations and materials, and a drop of technical service income growth and its ratio of the total income;a year-by-year drop of drug income surplus growth, and an expanding deficit in medical services;a slower growth of medicine expense growth, with the asset-liability ratio rising to 45.3%, and salary ratio rising to 30.6%.Conclusions The reform on compensating mechanism at public hospitals is demonstrating its impacts on public hospitals, namely slower growth of medical revenue, weakened compensating role of drug income, lower surplus, and higher asset-liability ratio among other financial risk exposure.These hospitals are encouraged to take proactive measures to control costs, including tighter medical service cost control,to secure sufficient and timely government fiscal subsidy, and other funding measures to cope with debts of the hospitals.

Objective:The present study was designed to explore the role of ER stress in cardiac hypertrophy of adult APPswe /PS1dE9 transgenic mice.Methods:10 adult APPswe/PS1dE9 transgenic mice and 10 C57BL/6 wild type (WT) mice were divided into the transgenic experimental and control group,WT experimental and control group,respectively,with 5 mice in each group.Experimental groups received a low dose ofIsoproterenol (ISO) (2 mg/kg) once a day for 4 weeks to induce cardiac hypertrophy,while control groups received the same volume of normal saline.After 4 weeks,the mice were anesthetized,followed by,electrocardiogram (ECG) recording and the measurement of the heart rate and body weight before being sacrificed.The heart was dissected out,and the masses of heart and the left ventricle were measured,the left ventricule mass index (LVW/BW) and the whole heart weight ratio (HW/BW) were calculated.HE staining was used to observe the pathological and morphological changes of cardiomyocytes,and Western Blot and immunohistochemistry were used to detect the expressions of ER stress relevant proteins-GRP78,JNK,P-JNK and CaMKII.Results:Compared with WT experimental mice,the ventricular wall in the APPswe/PS1dE9 transgenic experimental mice was apparently hypertrophic after the induction by low doses of ISO,and the HW/BW and the LVW/BW were also significantly increased in the APPswe/PS1dE9 transgenic experimental mice than those in the transgenic control mice,WT experimental and control mice (P＜0.05).HE staining showed that compared with the transgenic control mice,WT experimental and WT control mice,in the adult APPswe/PS1dE9 transgenic experimental mice,the cardiomyocyte diameter was obviously increased,cell density was decreased,the capillary density was decreased,the intercellular substance was increased,and the intercellular space was increased.Western blot showed that the expression of GRP78,p-JNK and CaMKII in the experimental group of adult APPswe / PS1dE9 transgenic mice were significantly higher than those in the transgenic control mice and WT mice (P＜0.05,P＜0.01).There were no significant difference among the control group oftransgenic mice and the two groups of WT mice.Immunohistochemistry showed that the positive rates of GRP78 and CaMKII in the cytoplasm of cardiomyocytes of the APPswe/PS1 dE9 transgenic experimental mice were significantly higher than those of experimental WT mice (80％&40 ％)(P＜0.05),and the expressions in the two control groups were negative.The positive rates of p-JNK and JNK in the APPswe/PS1dE9 transgenic experimental mice were 90％ and 40％ respectively,and the expressions were negative in other three groups.Conclusions:The adult APPswe/PSldE9 transgenic mice are more prone to cardiac hypertrophy than WT mice after the induction with a low dose of ISO.ER stress is involved in the formation of cardiac hypertrophy in adult APPswe/PS1dE9 transgenic mice.

Objective To learn the organizational management competency of state-owned hospitals and their weakness, providing references for decision makers. Methods In the principle of stratified random sampling, 5 677 doctors in hospitals of different grades from 12 cities in Shandong Province, Hubei Province, Hebei Province and Inner Mongolia were investigated with questionnaires. Factor analysis is applied to extract factors. With results of this factor analysis, an evaluation model was built, followed by a fuzzy comprehensive evaluation on the management competency. Results The total satisfaction score on the organizational management by the doctors investigated is 3. 25, and those for system building and leadership behavior are respectively 2.88 and 3.20. Conclusions Organizational management of the public hospitals needs improving, especially development of hospital management systems and implementation.