China′s economy has moved into a new normal stage.It features slower GDP growth, relaxed macro-control,economic structure upgrading,new powerhouses for economic growth.In such a situation,it is imperative for the society to realize,comply with and encourage the new normal for all fields of work.As for the healthcare sector,reform of public hospitals as a top priority has entered a crucial period of system reconstruction and effective operation.In the perspective of auditing governance mechanism as a key role in public hospital′s supervision and management system,this article tried to explore how to enable public hospitals′auditing to comply with the economic new normal.This paper puts forwards that public hospital auditing should reconstruct its system as follows:Auditing entity framework should strengthen the development of functionality and linkage among national auditing,internal auditing and social auditing,and public hospitals should try to set up their auditing committee system when necessary;Auditing contents should emphasize the multiple development and innovation of public welfare auditing,economic responsibility auditing,governance performance auditing,policy implementation effect auditing and more innovative auditing services.

Objective:To construct an integrated medical care service mode in hemodialysis and explore the application effect of the concept of integrated medical service in hemodialysis patients.Methods:In 2016,100 patients who had regular hemodialysis(lasting for more than 3 months) were selected from July to Septembe ras the control group,while another100 patients who had the regular hemo dialysis (lasting for more than 3 months) and received the concept of integrated medical care service were selected from October to December as the observation group.The treatment compliance,the incidence of hemodialysis complications,and patient satisfaction of twogroups were compared.Results:Both the treatment compliance and patient satisfaction of the participants in the observation group were significantly higher than those in the control group (P ＜ 0.05),while the incidence of hemodialysis complications in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion:The implementation of integrated medical careservice concept can fully deepen the service concept of people-oriented and patient-centered,carry out humanized services,improve the treatment compliance of hemodialysis patients,reduce the complications,promote the cooperation of doctors and nurses,enhance the effect of health education,and improve the patient satisfaction.

OBJECTIVE:To study the distribution characteristics of germacrone from zedoary turmeric oil (ZTO) in each tis-sue of mice,and to provide reference for further application of zedoary turmeric oil. METHODS:30 KM mice were given zedoary turmeric oil 0.5 mL;6 mice were randomly selected 1,2,4,8,12 h after medication,respectively. The contents of germacrone in heart,liver,spleen,lung and kidney tissues were determined by HPLC. 15 KM mice were selected,medication and sampling method were same as above;3 mice were collected at each time point respectively. The fluorescence intensity of germacrone in above sections were observed by fluorescence. The same number of mice were selected as control in 2 trials. RESULTS:The con-centration of germacrone in each tissue 1-4 h increased gradually as time and reached the peak value at 4 h. The contents of ger-macrone in liver and spleen were significantly higher than in heart and lung. The concentrations of germacrone in each tissue were ranked as liver>spleen>kidney>heart>lung. The results of fluorescence intensity observation was same as above results. CON-CLUSIONS:Results of 2 methods show same distribution characteristics of germacrone in mice tissues,and indicate that ger-macrone is distributed more in liver,spleen and kidney tissues and less in heart and lung.

Objective To investigate the correlation between spatial memory and sleep architecture and hippocampal volumes in patients with chronic insomnia disorder.Methods Twenty-two chronic insomnia patients and 17 normal sleepers (controls) were selected to evaluate the subjective insomnia using Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI) and the objective insomnia by polysomnography (PSG).The cognitive function was measured by Montreal Cognitive Assessment (MoCA).Spatial memory and object-memory were measured by Nine-box Maze, and object-recognition memory was detected by picture recognition test.MRI was used to detect hippocampus volumes.Results Compared with controls, a significant reduction in total sleep time (328.3 (310.4, 387.9) min vs 418.0 (375.8, 45.5) min, Z=2.607, P=0.009), sleep efficiency (%) (77.7 (73.1, 84.0) vs 93.0 (87.2, 93.9), Z=3.739,P=0.000), proportion of N3 (%) (5.5 (0.4, 14.4) vs 13.7 (7.7, 18.3), Z=2.664, P=0.008) and proportion of rapid eye movement (REM) (%) (14.4 (10.7, 17.2) vs 17.3 (15.9, 23.3), Z=2.890, P=0.004) was seen in insomnia patients, whereas sleep latency was delayed.The error numbers of spatial working-memory (4.5 (2.0, 7.3) vs 1.0 (0.0, 3.0), Z=3.007, P=0.003) in chronic insomnia patients were more than those in controls.There was no statistically significant difference in object reference memory, spatial reference memory and object recognition in two groups.A significant reduction of the left (2 818.0 (2 534.9, 3 191.8) mm3 vs 3 453.3 (3 081.2, 3 764.4) mm3, Z=3.314, P=0.001), right (2 780.5 (2 451.2, 3 191.8) mm3 vs 3 479.8 (3 024.1, 3 786.7) mm3, Z=3.484,P=0.000) and whole hippocampal volumes (5 561.7 (4 956.6, 6 396.9) mm3 vs 6 898.9 (6 017.1, 7 540.1) mm3, Z=3.455, P=0.001) was seen in chronic insomnia patients compared with controls.The hippocampal volumes were negatively correlated with sleep latency (r=-0.432, P=0.006), but positively correlated with sleep efficiency, proportion of N3 (r=0.323, 0.376;P=0.045, 0.018).There was a negative correlation between the error numbers of spatial working-memory and hippocampal volumes (r=-0.351, P=0.029).The hippocampal volumes were negatively correlated with the duration of disease in chronic insomnia patients (r=-0.734, P<0.01).Conclusion The spatial memory may be associated with decreased proportion of REM and reduced hippocampal volumes in chronic insomnia patients.

OBJECTIVE:To optimize the technology conditions of water-soluble chitosan on Huang'e gel water extract solu-tion. METHODS:Using the comprehensive scores of transmittance ratio,impurity removal rate,naringin retention rate as indexes, Box-Behnken response surface method was used to optimize the amount of water-soluble chitosan,shocking time and temperature in clarifying technology,and verification test was conducted. RESULTS:The clarification effect was the best when the volume ra-tio of TCM extract solution with proportion ≥1.3 to amount of 0.01 g/mL water-soluble chitosan was 2.2,shocking for 100 min at 70 ℃. In the verification test,the average transmittance ratio was 87.3%,impurity removal rate was 41.5%,and naringin reten-tion rate was 131.38%. The measured values of comprehensive scores were 97.35%,98.92% and 98.04%,showing relative error of -0.87%,0.73% and -0.16% with the predicted values(98.27%),respectively. CONCLUSIONS:The method can effectively optimize the clarification technology parameters of water-soluble chitosan on Huang'e gel water extract solution.

OBJECTIVE:To provide reference for improving the drug procurement system of public hospitals in China. METH-ODS:The drug collective procurement documents in each province were retrieved after publishing the document [2015] No.7 of the State Council and the document [2015] No.70 of the National Health and Family Planning Commission,the drug bidding data was collected,and form and implementation of drug procurement with target quantity were analyzed. RESULTS:Procurement with tar-get quantity included scattered procurement with target quantity,national centralized procurement with target quantity and provin-cial centralized procurement with target quantity. In scattered procurement with target quantity,actual purchase price was opaque, and the procurement was similar to"second negotiation"in individual province. National centralized procurement with target quanti-ty was implemented well. Provincial centralized procurement with target quantity was not fully implemented,only Shanghai carried out centralized procurement with target quantity,and the pilot had good effects. CONCLUSIONS:In order to promote procurement with target quantity,it's suggested that we should definite"procurement with target quantity"in the governmental document,pub-lish actual procurement price of scattered procurement with target quantity,try to implement centralized procurement with target quantity without quality levels distinguished,improve the centralized procurement with target quantity with quality levels distin-guished and improve supporting measures,such as hospital procurement system,provincial procurement platform, pre-payment mechanism by health-care funds,and so on.

Objective To explore the preparation and identification of amyloid-β protein 1-42 (Aβ1-42) oligomers and their effect on in vitro cultured astrocytes in mice.Methods (1) Aβ1-42peptides were dissolved and 100 μ mol/L Aβ1-42 polypeptide was chosen as mother liquor;and then,they were incubated under different conditions (4 ℃ for 24 h,4 ℃ for 72 h,37 ℃ for 24 h and 37 ℃ for 72 h);the form of Aβ-42 was observed under electron microscope and the degrees of Aβ1-42 polymerization were detected by Western blotting.(2) Aβ1-42 oligomers of different concentrations (Aβ1-42 polypeptide as mother liquor being incubated under condition of 4 ℃ for 24 h) were added into the in vitro cultured astrocytes;CCK-8 assay was used to detect the effects ofAβ1-42 oligomers (0,0.1,0.5,1,5,10,50,and 100 μmol/L) on astrocytic viability;after 0,1,10,and 50 μmol/L Aβ1-42 oligomers treatment,immunofluorescence was employed to detect the morphological changes of astrocytes and Western blotting was used to detect the glial fibrillary acidic protein (GFAP) and aquaporin-4 (AQP4) expressions.Results (1) Different forms and degrees of polymerization of Aβ1-42 could be observed by electron microscope and Western blotting:100 μmol/L Aβ1-42 polypeptides could induce 10 nm granulated mixture of Aβ1-42 oligomers at 4 ℃ incubation for 24 h;proteins with relative molecular mass of 10 000 had decreased expression,and those of 15 000-25 000 had increased expression.(2) Twenty-four h after Aβ1-42oligomers treatment,the viability of astrocytes was increased gradually:as compared with the 0 μmol/L Aβ1-42 oligomer treatment group,the 10,50 and 100 μmol/L Aβ1-42 oligomer treatment groups had significantly increased viability of astrocytes (P＜0.05);immunofluorescent staining indicated that as compared with the 0 μmol/L Aβ1-42 oligomer treatment group,the one,10,and 50 μmol/L Aβ1-42 oligomer treatment groups had activated astrocytes:enlarged soma,increased cell processes and increased GFAP fluorescence intensity were noted;Western blotting indicated that following the increased oligomer concentrations,the protein expressions of GFAP and AQP4 increased:as compared with the 0 μmol/L Aβ1-42 oligomer treatment group,the 10 and 50 μmol/L Aβ1-42 oligomer treatment groups had significantly increased GFAP protein expression (P＜0.05);and as compared with the 0 μmol/L Aβ1-42 oligomer treatment group,the one,10,and 50 μmol/L Aβ1-42 oligomer treatment groups had significantly increased AQP4 protein expression (P＜0.05) Conclusions The Aβ1-42 oligomers could be prepared with 100 μmol/L peptide under 4 ℃ for 24 h.Aβ1-42 oligomers could activate astrocytes and up-regulate the AQP4 expression,which might be a self protective mechanism.

Objective:To investigate the distribution and influencing factors of the ocular biological parameters related to refractive development in school-age children.Methods:A cross-sectional study was performed.A total of 1 091 children aged 6-12 years old from July, 2017 to August, 2018, resident in downtown of Zhenjiang were enrolled in this study.The corneal radius of curvature (CR) and axial length/corneal radius of curvature ratio (AL/CR) were calculated after AL and corneal curvature (K) were measured by IOL Master.After pupillary dilatation with 0.5% tropicamide, cycloplegic retinoscopy was performed to identify refractive status.According to the spherical equivalent refraction (SER), all right eyes were classified into myopia, hyperopia and emmetropia.The comparison of the above parameters between different genders, as well as among different age groups and different refractive status groups were determined while the relative factors of the biological parameters and refractive status were analyzed by multivariate regression analysis.The study protocol was approved by the Ethics Committee of Affiliated People's Hospital of Jiangsu University (No.K-20190153-W).Results:There were statistical differences in AL, SER and AL/CR value among different age groups ( F=32.34, P<0.01; F=33.69, P<0.01; F=2.19, P=0.04), which showed that refractive status shifted to myopia as well as AL and AL/CR value were increased with age.Compared with the girls, the boys had significantly longer AL, greater CR, greater AL/CR value, and smaller K ( t=7.58, P<0.01; t=-7.48, P<0.01; t=-8.08, P<0.01; t=-2.14, P=0.03). There were statistical differences in AL and AL/CR value among different refractive status groups ( F=192.68, P<0.01; F=143.15, P<0.01). The myopia group had longer AL and greater AL/CR value than the other two groups.Children whose parents were not myopic and children who had outdoor activities more than 14 hours per week and did homework less than 20 hours per week and children who slept more than 9 hours per day had shorter AL, smaller AL/CR value, and were more inclined to hyperopia or emmetropia.The results of multivariate regression analysis suggested that children aged from 6-12 years old with older age, female, increased height, parental myopia, and more time in homework or less time in outdoor activities per week may be more likely to have myopia, and longer AL or bigger AL/CR value was correlated with older age, male, greater body mass index (BMI), increased height, myopia conditions of parents, more time of doing homework, and less time in outdoor activities. Conclusions:The SER shifts to myopia with age in 6 to 12-year-old school-age children in the downtown of Zhenjiang.And there are significant differences in AL, CR and AL/CR value between boys and girls.Female, older age, increased height, more time in homework, less time in outdoor activities, and parental myopia are associated with more negative SER.