This paper introduces the background, implication and construction of the county health services community (County medical alliance) model in Anhui Province under the background of new medical reform,and briefly introduces the relationship between medical insurance, enhancing the ability to upgrade and standardize services and medical treatment integration of the typical experience.It also analyses the challenges faced in the construction of medical syndicate, such as the mechanism of regional environmental restriction, compensation and assessment mechanisms which have not been established yet, and the sustainable development of information technology that has lagged behind, and put forward the policy suggestion to improve the construction of medical community, with a view to providing reference for the next work.

To introduce the development of myelodysplastic syndrome network course.

Technological improvement for microorgnism isolation is important since isolation provides substantial materials for the exploitation of new microbial resources. In this study, a new approach, dispersion and differential cetrifugation (DDC), was applied in the isolation of acidophilic and acidoduric streptomycetes from 12 acid soil samples. Contrast with traditional method, the new approach yielded satisfying results with 2 - 20 times isolation efficiency and good selectivity. 45 representatives out of 249 streptomycetes isolates, which belonged to 12 color groups, showed morphology and cell wall type consistent with streptomycetes. The optimum pH range for their growth were between pH 4.5 - 5.5. It is proved that we succeeded in the rare-streptomycetes isolation using DDC approach.

OBJECTIVETo investigate the expression and activity of silent information regulator 1 (SIRT1) in the temporal lobe of epileptic patients and rat models and explore its role in the occurrence and progression of epilepsy.

METHODSThe temporal lobe tissue of epileptic patients and rat models (induced by lithium-pilocarpine) were examined for SIRT1 expression using immunohistochemistry and Western blotting and also for SIRT1 activity using SIRT1 Deacetylase Assay Kit.

RESULTSImmunohistochemistry detected positive SIRT1 expression mainly in the cytoplasm of the neurons in both human and rat brains, and the epileptic groups showed stronger SIRT1 immunoreactivity than the control group. Western blotting and activity assay showed that the expression and activity of SIRT1 were significantly increased in the temporal lobe of patients with refractory epilepsy as compared with the tissues samples from non-epileptic patients (P<0.05). In the rat models of epilepsy, SIRT1 expression was up-regulated at 6, 24, and 72 h and at 7, 14, 30, and 60 days after kindling (P<0.05) and SIRT1 activity was significantly increased at 6, 24, and 72 h and at 7 and 14 days (P<0.05), with the peak level of SIRT1 expression and activity occurring at 72 h.

CONCLUSIONUp-regulation of SIRT1 expression and activity in the temporal lobe of epileptic patients and rat models may play an important role in the pathogenesis of epilepsy.

Adolescent ; Adult ; Animals ; Disease Models, Animal ; Epilepsy ; metabolism ; Female ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Sirtuin 1 ; metabolism ; Temporal Lobe ; metabolism ; Young Adult

OBJECTIVETo provide the basic knowledge of wrist joint for diagnosing of these morphological change in pathological condition by measuring the posteroanterior X-ray films of different types of distal radius fracture by AO classification.

METHODSEleven radiographic indexes were measured including following 7 new parameters of 83 cases of distal radius fracture: ulnar styloid length (USL), ulnar head length (UHL), ulnar head diameter (UHD), maximal distal radius width (MDRW), proximal distal radius width (PDRW), sigmoid notch length (SNL) and sigmoid notch width (SNW) by Pacs system in standard X-ray films. The indexes were defined by the ratio of these parameters to the length of the third metacarpal. Statistical significance of indexes and correlations of parameters were analyzed by SPSS 16.0.

RESULTSIt was found that indexes of 11 parameters and 27 pairs of indexes had significantly different. Compared the indexes of 14 groups with normal group existed statistical significance, 62 pairs value of 11 parameters had correlations.

CONCLUSIONThe study provides additional radiographic index that will be helpful to more careful diagnosis and treatment of the distal radius fractures and their associated injuries such as ulnar wrist injuries or carpal instability.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Radius ; diagnostic imaging ; Radius Fractures ; diagnostic imaging ; Wrist Joint ; diagnostic imaging ; Young Adult

BACKGROUNDPulmonary hypertension (PH) is a set of pathophysiological syndromes characterized by increased pulmonary artery pressure and pulmonary vascular resistance, resulting in increased right ventricular afterload. The left and right ventricles interact through hemodynamics. What impact will PH have on synchronization and function of the left ventricle (LV)? The aim of this study was to evaluate the synchronization of the left ventricular wall motion and left ventricular function in patients with varying degrees of PH using velocity vector imaging (VVI) technology.

METHODSSixty patients with chronic PH served as the experimental group, and 20 healthy volunteers served as the control group. According to the different degrees of pulmonary artery systolic pressure, the experimental group was divided into three groups: mild, moderate, and severe PH groups. The time to peak systolic longitudinal velocity (Tvl), the peak systolic longitudinal velocity (Vsl), the peak diastolic longitudinal velocity (Vel), the peak systolic longitudinal strain (Sl), and strain rate (SRl) in 18 segments were measured in each group.

RESULTSTvl in the control group and each group with PH was reduced from basal to apical segment, and in control group Tvl in various segments of the same wall and in different walls showed no significant difference (P > 0.05). With increase in pulmonary artery pressure, Tvl values measured showed an increasing trend in groups with PH. In groups with PH, Vsl and Vel of each wall were reduced sequentially from basal to apical segments, showing gradient change; Vsl and Vel values measured showed a decreasing trend with increase in pulmonary artery pressure, in which the differences of Vel values measured in the control group and the mild PH group were statistically significant (P < 0.01), and the differences between other groups were statistically significant (P < 0.01). In groups with PH, Sl and SRl in basal segment and the middle segment of each wall were decreased; the difference between groups was statistically significant (P < 0.01).

CONCLUSIONSAsynchronization of the LV and decreased left ventricular function were present in patients with chronic PH; VVI technology can accurately evaluate left ventricular function in patients with PH, and indicators such as Tvl, Vsl, and Vel are valuable.

Adult ; Aged ; Echocardiography ; Elasticity Imaging Techniques ; Female ; Heart Ventricles ; diagnostic imaging ; physiopathology ; Humans ; Hypertension, Pulmonary ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Function, Left ; physiology

Cryptosporidium andersoni ATP-binding cassette (CaABC) is an important membrane protein involved in substrate transport across the membrane. In this research, the nucleotide binding domain (NBD) of CaABC gene was amplified by PCR, and the eukaryotic expression vector of pEGFP-C1-CaNBD was reconstructed. Then, the recombinant plasmid of pEGFP-C1-CaNBD was transformed into the mouse intestinal epithelial cells (IECs) to study the iron transportation function of CaABC. The results indicated that NBD region of CaABC gene can significantly elevate the transport efficiency of Ca2+, Mg2+, K+, and HCO3 - in IECs (P<0.05). The significance of this study is to find the ATPase inhibitors for NBD region of CaABC gene and to inhibit ATP binding and nutrient transport of CaABC transporter. Thus, C. andersoni will be killed by inhibition of nutrient uptake. This will open up a new way for treatment of cryptosporidiosis.
ATP-Binding Cassette Transporters/*chemistry/*genetics/metabolism ; Adenosine Triphosphate/metabolism ; Amino Acid Sequence ; Animals ; Calcium/metabolism ; *Cloning, Molecular ; Cryptosporidiosis/parasitology ; Cryptosporidium/chemistry/genetics/*metabolism ; Humans ; Iron/metabolism ; Mice ; Molecular Sequence Data ; Protein Structure, Tertiary ; Protozoan Proteins/*chemistry/*genetics/metabolism ; Sequence Alignment

Objective To study the dynamic air quality of clean ICU so as to provide evidence for hospital infection management in clean ICU.Methods Flat natural sedimentation method,six percussive determination of planktonic bacteria and dust particle counting method were used to get samples at three different time periods,different regions for four consecutive days in 100 000 air clean ICU.Results The counts of 0.5μm,5 μm dust particles at different time ( morning,afternoon,evening) were significantly different( F =78.85,89.94 ;P ＜ 0.01 ) and the monitor results of different regions( single rooms,double rooms,hall) were significantly different( F =20.21,16.17; P ＜ 0.01 ).The number of planktonic bacteria at different time (morning,afternoon,evening) were significant different(F =14.21,P ＜0.01 ),while there was no difference in different regions ( single rooms,double rooms,hall) ( F =0.98,P ＞ 0.05 ).There was significant difference of depositing bacterial counts at different time and regions( F =5.68,17.05,P ＜ 0.01 ) and there was a positively correlation between planktonic bacterial counts and depositing bacterial counts ( r =0.612,P ＜ 0.05 ).Each level of bacterial average counts of six percussive samplers measured was significantly different (F =8.35,P ＜ 0.01 ),with fifth grade most and fourth grade following.Conclusions Air quality of ICU is not good especially when making ward round; Less than 5 μm particles dominant; the counts of planktonic bacteria and depositing bacteria is increasing when dust particles counts increase,and the air quality of single rooms and double rooms is better than that of the hall.

Objective To investigate the effect of employers' respirator and hat wearing method on class 100 000 clean ICU air quality,in order to provide basis for hospital infection management in ICU.Methods For the control group,the first day (d1) and third day (d3),every employer was demanded to wear a respirator and a hat before entering the ICU.For the observation group,the second day (d2) and forth day (d4),employers were demanded not to wear any respirator or hat.During all four days,they must wear respirator and hat before any nursing operation.Air quality was sampled by class 100 000 clean air using flat panel natural settlement method,dust planktonic bacteria method and particle counting method.The amount of dust,plankton bacterium and descending bacteria were monitored for 4 days and compared between two groups.Results The difference of 0.5 μm dust particles in ICU between the control group and the observation group were statistically significant ( F =40.95,P ＜ 0.05 ).As to 5.0 μm dust particles,there was no significant difference between two groups (F =2.86,P ＞ 0.05 ).0.5 μm dust particles in ICU was lower at d1 and d3,and the difference was statistically significant ( F =40.95,P ＜ 0.05).The number of 0.5 μm dust particles had significant difference between different periods of a day:the morning time segmcnt＞ evening ＞ afternoon ( F =80.72,P ＜0.05 ).The number of 0.5 μm dust particles in the observation group was higher than that in the control group,and the difference was statistically significant ( F =68.84,P ＜ 0.05 ).The number of 5.0 μm dust particles had significant difference between different time periods of a day:the morning time segment ＞afternoon ＞ evening ( F =98.17,P ＜ 0.01 ).The number of dust particles at hall was larger than that at single and double rooms (P ＜0.01 ),but the number had no difference between single room and double room.More subsidence bacteria and floatingbacteria was detected during dl and d3 in the control group,and the difference was statistically significant ( P ＜ 0.01 ).Besides,the difference of the number of subsidence bacteria and floating bacteria in ICU between different time periods was also statistically significant ( P ＜ 0.05 ).Conclusions The number of 0.5 μm dust particles in ICU is smaller when workers wear hats and respirators,while the number of 5.0 μm dust particles remains the same.Under the other conditions remain unchanged,the mainly cause of number increase of dusts,planktonic bacteria and sedimentation bacteria in the morning rounds is the increasing number of working staff.ICU staff has no apparent effect on dynamic class 100 000 clean ICU air quality whether they wear respirators or hats.This kind of behavior is not the key management elements in clean ICU environment.