This paper introduced overseas experiences and theories of health systems in view of the ongoing medical and health system reform in China.It proposed the super health ministry reform,justified its necessity,and clarified key issues of such a reform,in addition to discussing how to improve the system of macro-health.

ObjectiveTo evaluate the efficacy and safety of Sirolimus (SRL) in immunosuppression following liver transplantation. Methods SRL was applied in 21 patients totally.Indication for adoption was Tac-related nephrotoxicity (4/21), suspiciously Tac-related hepatoxicity (8/21), Tac overdose (3/21), renal insufficiency pre-operation (2/21), or cancer (4/21). Median follow-up was 25. 4 months. Results SRL provided an adequate prophylaxis against rejection in all study patients, with one case of acute rejection. Sirolimus was Withdrawn in 2 cases due to its sideeffect. Tat-induced hepatoxicity in 6 cases and nephrotoxicity in 3 cases were relieved significantly.Conclusions SRL given alone appears to be an effective primary immunosuppressant regimen fororthotopic liver transplantation patients. Early conversion contributes to significant improvement of Tac-related hepatoxicity and nephrotoxicity.

The authors described the hospital group reform made by Jiangsu Kangfu Medical Group,and its main actions taken and initial success in public hospital organizational structure.Based on such studies, they recommend further clarification of the rights and responsibilities, for sectional integration;appropriate adjustment to update the supervision mechanism;building of the appointment system to speed up personnel system reform.

Objective:To investigate the prognostic significance of plasma fibrinogen (FIB) and D-dimer in elderly patients with non-small cell lung cancer (NSCLC) before any anti-cancer treatments.Methods:97 cases of patients with lung cancer (lung cancer group) and 36 healthy subjects (control group) were enrolled;the level of plasma D-dimer and FIB were compared;the relationship between their levels and clinical pathological factors of NSCLC as well as prognosis was analyzed.Results:The levels of plasma FIB and D-dimer in lung cancer group were higher than those in healthy control group (P＜0.05).FIB in lung cancer group was related to TNM stage,and D-dimer was related to lymph node metastasis and TNM stage.Univariate analysis showed that FIB,D-dimer,tumor size,lymph node metastasis and TNM staging were associated with overall survival time (OS) and progression free survival (PFS).Multivariate analysis revealed that only D-dimer and FIB were independent prognostic factors of patients with NSCLC.Conclusion:Detection of fibrinogen and D-dimer in elderly patients with NSCLC before anti-cancer treatment would be useful for prognosis and might provide a certain value for individualized therapy.

ObjectiveTo explore the morbidity rate of deviation of nasal septum about personnels who take part in physical examination in the enterprise and facilities of Qinhuangdao,and clinic symptom.MethodsTransverse questionnaire investigation and normal physical examination were adopted.2604 personnels who take part in physical examination were choiced.ResultsMorbidity rate of deviation of nasal septum was 17.6％.The rate of men' s exceeds that of women' s.ConclusionMorbidity rate of deviation of nasal septum was rather high,clinic symptom of snuffle was primary.

OBJECTIVE To analyze the isolation rate and four consecutive years′(2004-2007) antibiotic-resistance trend of extended-spectrum ?-lactamases(ESBLs) producing Escherichia coli in urinary tract infection and to provide evidence for anti-infection therapy.METHODS The anti-microbial susceptibility test results of E.coli cultured from the midstream urine of outpatients and inpatients of our hospital from 2004 to 2007 were collected.Whonet 5.4 statistical analysis software was used for analysis.RESULTS During four years,no apparent change has been shown about antibiotic resistant rate of ESBLs producing E.coli.The isolation rate of this kind of E.coli increased year by year from 31% to 44% and showed high resistance to third generation cephalosporins and quinolones antibiotics,but was 100% sensitive to imipenem.CONCLUSIONS With the ESBLs-producing E.coli increasing year by year,the antibiotic-resistance rate of E.coli isolated from urinary tract infection is apparently increased and thus screening of antibiotics sensitive to enzyme-producing bacterial is the key point when the empirical therapy especially when the third and fourth generation cephalosporins are ineffective.

Animals ; Arrhythmias, Cardiac ; chemically induced ; prevention & control ; Cats ; Endothelin-1 ; adverse effects ; Medulla Oblongata ; drug effects ; Metoprolol ; pharmacology ; gamma-Aminobutyric Acid ; pharmacology

Identification and validation of a new target is one of the most important steps for new antituberculosis (TB) drug discovery. Researches have shown that Mycobacterium tuberculosis (Mtb) encodes 20 CYP450 enzymes which play important roles in the synthesis and metabolism of lipid, cholesterol utilization, and the electron transport of respiratory chain in Mtb. With the critical roles within the organism as well as the protein structures of six Mtb CYP450 enzymes being clarified, some of them have been highlighted as potential anti-tuberculosis targets. In this paper, the phylogenetic analysis, the structural features, and the enzymatic functions of Mtb CYPs, as well as the mechanism of interactions with selective inhibitors such as azole antifungal agents for the CYPs have been reviewed and summarized. The druggability of the CYPs has also been analyzed for their further utility as targets in high throughput screening and rational design of more selective inhibitors.
Antitubercular Agents ; chemistry ; pharmacology ; Azoles ; chemistry ; pharmacology ; Cytochrome P-450 Enzyme Inhibitors ; chemistry ; pharmacology ; Cytochrome P-450 Enzyme System ; genetics ; metabolism ; Drug Delivery Systems ; methods ; Drug Discovery ; Humans ; Mycobacterium tuberculosis ; drug effects ; enzymology ; genetics ; Phylogeny ; Tuberculosis ; drug therapy ; microbiology

Objective To investigate the status of the rehabilitation service and rehabilitation medical professionals in Tianjin. Methods130 hospitals and Disabled Persons' Federations in Tianjin selected by stratified random cluster sampling were surveyed by questionnaires.Results About 49.2% institutions had carried out the rehabilitation services; there were 842 rehabilitation medical professionals in total, including237 rehabilitation physicians and 3 prosthetic orthopaedic technicians, with a gap of nearly 3000 people; most of them were in loweducation. Conclusion The rehabilitation service should be developed; the quantities and quality of the rehabilitation medical professionalsshould be improved, the classified structure and the service objects are unbalanced.