The paper focuses on the (Primary Diagnosis at Grassroots Level,PDGL),and the current pilot situation and consequence of PDGL,analyzes the problems during the progresses,and dissects the conflicts of interest among the relative stakeholders.At last,the paper provides the corresponding countermeasures to the future development of PDGL.

AIM:To study the parameters of supercritical CO_2 extraction of essential oil from valeriana efficinalis by orthogonal design. METHODS: Four factors,such as extraction pressure,extraction temperature,extraction time and separation temperature were chosen by the observation of orthogonal design,each factor was assigned to three levels.Bornyl acetate content was selected as a marker in a position to determine optimal extraction. RESULTS: Pressure and temperature were the main factors in effecting the extraction of bornyl acetate,extraction time was minor factor relatively. CONCLUSION: The optimal extraction is as follow,parameters were extraction pressure:12 MPa,extraction temperature:45 ℃,extraction time:1 hour,separation temperature:35 ℃,it gave the best recoveries of essential oils and bornylacetate.

BACKGROUND: Amnesic shellfish poisoning(ASP) is caused by consumption of seafood contaminated by marine neurotoxins, mainly domoic acid (DA).OBJECTIVE: To ensure the safety of shellfish consumption by determining DA in shellfish by means of liquid chromatography(LC) combined with quadrupole time-of-flight mass spectrometry(Q-TOF MS).DESIGN: A self-controlled prospective study SETTING: The experiment was carried out in the Center for Animal, Plant and Food Inspection and Quarantine, Shanghai Exit-Entry Inspection and Quarantine Bureau.MATERIALS: MUS-1B, a nominal sample of homogenized mussel tissue (containing 36 ± 1μg DA per gram, Batch No. MUS-1B 0159) and the standard DA solution (100 mg/L, Batch No. DACS-1C 352) were purchased from National Research Council of Canada (Halifax, Canada). Positive musscl samples were collected from the waters during the occurrence of red tide in China East Sea, and blank mussel samples were obtained from local seafood market. LC system (Waters 2695) combined with Q-TOF MS (Qultima, Micromass) and ultravilet (UV) detection (Waters 2487 ) was employed for analysis of ASP toxins.METHODS: The shellfish tissue samples were extracted with methanol-water (1: 1, V/V) and cleansed with a SAX solid-phase extraction cartridge. Separation was carried out on a Zorbax Eclipse XDB-18 column (250×2.1 mm, 3.5μm) with gradient elution of CAN-H20 containing 0.05% formic acid at a flow rate of 0.20 mL per minute. In a positive electrospray ionization DA was ionized effectively, and collision-induced dissociation(CID) produced predominant characteristic ions[M + H] +allowing sensitive TOF MS detection.MAIN OUTCOME MEASURES: ① Limit of quantification(LOQ); ②Accuracy and precision of LC/Q-TOF MS method.RESULTS: The average recoveries of DA spiked to tissue homogenates through the complete cleanse procedure ranged from 87.8% to 94.6%, and the relative standard deviations(RSD) ranged from 8.4% to 11.9%. TheLOQ in the shellfish tissue was 0.1 μg/g.CONCLUSION: LC/Q-TOF MS suits well the purpose of detecting and identifying ASP toxins in shellfish with high sensitivity and specificity, and may provide reference values for monitoring the safety of consumption of shellfish.

Objectives:To formulate the specific basic medical services package that adapts to China’s health-care situations. Methods:With the optional items which are covered by medical insurance and the medical services price regulation in 2012 , the 2 phase and 5 steps experts consultation methods were applied according to the princi-ples of meeting characteristics and the floor level of basic medical services. Results:1343 items are included in the basic medical service package and finally 713 items in the supplementary package. Discussion and suggestion: The screening strategy combining medical insurance system ensures the chosen items’ economical efficiency. The basic medical service providers are not just restricted in primary medical institutions. The government responsibility should be highlighted and the basic medical insurance system should be developed to be the main financial subsidy re-sources.

The establishment of basic medical service system is the premise to realize that everyone will have access to basic healthcare rights. This study puts forward the basic medical services concept according to the evolution of basic medical services connotation and status quo of research at domestic and abroad. Based on the four basic characteristics’ “necessity, fairness, accessibility and efficiency”, the paper studies the connotation and governmen-tal responsibilities, and provides policy references for practical work in the future.

In order to strengthen the management of disinfection quality of endoscopes, Quality Control Center of Digestive Endoscopy and Nosocomial Infection Control Center of Yunnan Province investigated the diagnosis, treatment, cleaning and disinfection conditions and disinfection quality of digestive endoscopes in some medical institutions of Yunnan Province by web questionnaire from April to May in 2019, and 277 valid questionnaires were finally obtained. SPSS 19.0 statistical software was used to analyze the influencing factors of cleaning and disinfection process and the infection control implementation of digestive endoscopes in 227 secondary and tertiary hospitals. The results showed that the number of decontamination people who had received systematic training in Yunnan Province was significantly lower than that in other areas of China. The hospital level, the number of decontamination personnel, and decontamination methods affected the implementation of cleaning and decontamination process and infection control, while the allocation of decontamination supplies had no effects. It is important to establish an effective mechanism for the normalized implementation of cleaning and disinfection of digestive endoscopes.

Hierarchical medical system empowers the current healthcare reform on the medical supply side in China, a key to resolving the contradictions in the healthcare sector. This study analyzed the necessity and obstacles for such a system with synergy between hospitals, insurance and pharmacy, putting forward suggestions for building a scientific and rational hierarchical system.

This paper introduced the measures to construct the hierarchical medical system in Yichang city. The authors identified problems found and proposed the city to take the following countermeasures. Such steps included service capacity building at primary level, motivating primary medical workers, attracting patients to primary care, and improving policies of hierarchical medical system.

AIM: To analyze the effect of full-femtosecond small incision lenticule extraction(SMILE)on the treatment of high myopia based on propensity score matching.METHODS: A total of 48 cases(48 eyes)of high myopia patients who underwent SMILE surgery in our hospital from May 2019 to May 2021 were selected as the observation group, and 48 cases(48 eyes)of high myopia patients who underwent FS-LASIK surgery were matched using propensity score matching as the control group. Follow up for 6mo after surgery, the changes in cylindrical, central corneal thickness, uncorrected visual acuity(UCVA), corneal endothelial cell related indicators [percentage of hexagonal endothelial cells(6A), coefficient of variation(CV)of endothelial cell area, central corneal endothelial cell density(ECD)] and corneal biomechanical indicators [simulated Goldman intraocular pressure(IOPg), corneal hysteresis(CH), corneal resistance factor(CRF), corneal compensated intraocular pressure(IOPcc)] between the two groups were compared, and the incidence of complications in both groups of patients was recorded.RESULTS: Both groups of patients showed significant improvements in cylindrical and UCVA at 3 and 6mo after surgery, as well as decreased central corneal thickness, corneal endothelial cells, and corneal biomechanics related indicators. The changes in the observation group were more significant(all P<0.05). During the follow-up period, there was no significant difference in the incidence of complications between the observation group and the control group(8% vs. 17%, P>0.05).CONCLUSION: SMILE has a definite effect on patients with high myopia and is helpful to improve visual acuity.

Synthetic burn dressing remains the central theme for burn dressing development. The advantages and disadvantages of current available dressings were reviewed. As one of the most successful dressings, the hydrogel burn dressing, its combination with other materials and related progress in researches were presented in detail. Finally, the trend in development of synthetic burn dressing was presented.
Bandages, Hydrocolloid ; Burns ; therapy