The paper summarized the reform practice of the separated ownership/operation of public hospitals in Wuxi's health sector,with analysis and thoughts on the reform outcomes.

Objective To investigate the resistance to fluoroquinolones and amikacin in escherichia coti isolates. Methods ESBLs-producers were detected by CLSI phenotypic confirmatory test and susceptibilities were tested by agar dilution method. Results 33. 8% of 361 isolates were ESBLs-producers. The resistant rate of ciprofloxacin,levofloxacin, amikaxin was 93.4%, 90.9%, 13.1% in ESBLs-produeers, and that was 69.5%,68.6 %, 19.7 % in non-ESBLs-producers, respectively. Conclusion Amikaxin is active against most escherichia coli isolates; those isolates are highly resistant to fluoroquinolones, especially, in ESBLs-producers.

BACKGROUND:Nitric oxide can interfere with the function of mitochondria, and accelerate the intervertebral disc damage and degeneration by interfering with the release of inflammatory cytokines. Nitric oxide is an important inflammatory cel medium leading to degeneration of intervertebral disc induced by pressure and other external factors.
OBJECTIVE:To investigate the regulatory effect of nitric oxide and nitric oxide synthase inhibitor niacinamide on mitochondrial function and its association with biological behavior of rabbit nucleus pulposus.
METHODS:Cultured nucleus pulposus cel s of rabbit lumbar intervertebral disc were randomly divided into six groups:normal blank control group, 10μmol/L sodium nitroprusside group, 100μmol/L sodium nitroprusside group, 200μmol/L sodium nitroprusside group, 0.05 g/L nicotinamide group (100μmol/L sodium nitroprusside+0.05g/L nicotinamide), and 0.5 g/L nicotinamide group (100μmol/L sodium nitroprusside and 0.5 g/L nicotinamide). Different doses of nitric oxide donor sodium nitroprusside and nicotinamide were added in the medium of each group. Three days after intervention, cel proliferation activity, intracel ular ATP concentration, cel nitric oxide synthase activity, cel ular reactive oxygen species level, and mitochondrial membrane potential were detected respectively.
RESULTS AND CONCLUSION:(1) After 3 days of rabbit nucleus pulposus cel s intervened by different concentrations of sodium nitroprusside, intracel ular nitric oxide synthase content increased with sodium nitroprusside volume increase, and ATP concentration decreased along with sodium nitroprusside volume increase;there were significantly differences between the normal control group and sodium nitroprusside groups (P<0.01). (2) Reactive oxygen species could be increased in the sodium nitroprusside group. Niacinamide groups indicated a dose-dependent manner to improve the increase of cel ular reactive oxygen species levels with sodium nitroprusside intervention (P<0.01). (3) In the sodium nitroprusside groups, nucleus pulposus cel membrane potential decreased. In the niacinamide groups, sodium nitroprusside-induced decline in mitochondrial membrane potential was reduced (P<0.01). (4) Niacinamide groups also indicated a dose-dependent manner to improve the proliferative activity of nucleus pulposus cel s as compared with sodium nitroprusside groups (P<0.01). Significant differences were determined between the two groups (P<0.01). (5) Results suggest that the excess nitric oxide can damage mitochondrial metabolic function of rabbit nucleus pulposus cel s and cause cel energy metabolism. Niacinamide can reverse these damages by inhibiting nitric oxide synthesis, thereby contributing to the prevention against intervertebral disc degeneration.

Objective To observe the changes of the levels of transforming growth factor ? 1(TGF ? 1),fibronectin(FN),laminin(LN) and collagen content and myocardium ultrastructure in streptozotocin experimental diabetes mellitus rats.To study the role of TGF ? 1 and extracellar matrix(ECM) in diabetic cardiomyopathy episode.Methods Observing myocardium ultrastructure by electron microscope and assaying TGF ? 1,FN,LN by immunohistochemistric,and observing collagen content by VG staining.Results TGF ? 1,FN,LN were expressed more in STZ inroduced diabetic rats than in normal rats.The difference between two groups was significant ( P

Objective To investigate the effect of fosinopril on transforming growth factor-?1 (TGF-?1) expression in myocardial tissue of streptozotocin(STZ)-induced diatetic rats. Methods A total of 30 SD rats were enrolled in the study, 10 of them were set as normal controls, others were created the model of diabetes by injecting STZ, and then equally divided into fosinopril group and untreated group. Myocardial TGF-ft was observed in all three groups after 5 weeks. Results The expression of TGF-fi, in myocardial tissue was weakly positive in normal group, strongly positive in untreated group and positive in fosinopriol treat group, with absorbance being 0. 009 ? 0. 004,0. 198 ?0. 007 and 0. 104 ? 0. 005,respectively. Conclusion Fosinopril may partly suppress the increased TGF-?1 expression in myocardial tissue of diatetic rats. It may decrease significantly the myocardial injury of diabetic rats.

Objective To study the lab-scale simulated method of three-effect dynamic countercurrent extraction from Hedyotis diffusa by multi-index optimization and SPSS software.Methods Polyphenol content,flavonoids content,scavenging activity of samples on DPPH radicals,and extracting rate were considered as the optimization indexes.Orthogonal design method was used to optimize the four main factors of alcohol concentration,ratio of solid to solution,extracting temperature,and extracting times.Results The optimum condition is 70 min extraction time,solid to solution ratio of 1∶14,50% alcohol,extracting temperature 85 ℃.Conclusion The condition of large-scale industrialized production might be explored by studying the lab-scale simulated method of dynamic countercurrent extraction from H.diffusa.

Objective To study the effects of different enteric-coated aspirin tablets on upper gastrointestinal tract in the elderly. Methods 404 inpatients aged more than 65 years in last three years who took enteric-coated aspirin tablets (100mg/d) for more than three months were analyzed.They were divided into two groups: bayaspirin-treated group (232 cases) and control group with ordinary enteric-coated aspirin tablet treatment (172 cases). The clinical data and the results of gastroseopy were compared between two groups, and the effects of two kinds of enteric-coated aspirin tablets on upper gastrointestinal tract in the elderly were analyzed by Chi-square test. Results The upper gastrointestinal bleeding rates were 20.3% in Bayaspirin-treated group (47/232) and 32.0% in control group (55/172), and there was significant difference between two groups(χ2=7.19,P<0.01)Gastroscopy indicated that gastroduodenal inflammation occurred in 16 patients (6.9% and peptic ulcer occurred in 8 patients (3.5%) in bayaspirin-treated group, while gastroduodenal inflammation occurred in 12 patients (7.0%) and peptic ulcer occurred in 36 patients(20.9%)in control group. The difference of the incidence of peptic ulcer between two groups had statistical significance(χ2= 31.10,P<0.01). The incidences of gastrointestinal adverse reactions were 8.6% (20/232) in bayaspirin-treated group and 23.3% (40/172) in control group, and there was a statistical difference between two groups. Conclusions Compared with ordinary enteric-coated aspirin tablet, bayaspirin has less adverse effects on upper gastrointestinal tract in the elderly and is more safe for treatment.

objective To detect MRSE and resistance in staphylococcus epidermidis isolates. Methods MRSE isolates were detected by cefoxitin disk test and susceptibilities were tested by agar dilution method. Results 79.7% of 128 isolates were MRSE strains with resistance to most antimicrobial agents, but those isolates were still susceptible to vancomycin and teicoplanin. Resistant rate in MRSE was higher than that in MSSE to most antimicrobial agents except penicillins, glycopeptides and macrolides. Conclusion MRSE with multi-resistance ale highly prevalent in staphylococcus epidermidis isolates and no isolate is resistant to glycopeptides.

Objective To study the changes of serum and tissue soluble intercellular adhesion molecule(sICAM)-1 in colorectal cancer patients and their clinical significance. Methods Serum level of sICAM-1 was detected by the double antibody sandwich enzyme-linked immunosorbent assay method in 44 patients with colorectal cancer before and after operation, 28 patients with intestinal polyps and 30 controls.Simultaneously, tissue level of sICAM-1 was measured in the patients of colorectal cancer and intestinal polyps. Results The serum sICAM-1 level in colorectal cancer patients[ (693.22±276.25) mg/L]was significantly higher than that in the intestinal polyps patients [(61.99±27.39) mg/L]and healthy controls[(59.28±27.55) mg/L]. The tissue sICAM-1 level in the colorectal cancer [(706.92±286.09)mg/L ]was significantly higher than that in the intestinal polyps patients[ (63.06±27.06) mg/L,P<0.01 ]. The serum and tissue levels of sICAM-1 in Dukes C-D stages of the colorectal cancer showed significantly higher than those in Dukes A-B stages (P<0.01 ). The level of sICAM-1 declined remarkably after one month of radical operation. Conversely, it decreased illegibly after palliative operation. Conclusion Dynamic alterations of serum and tissue sICAM-1 level may be used as indicators of diagnosis, choice of operative method and judgment of prognosis in patients with colorectal cancer.

Cyclic peptide drugs have gradually become an emerging research direction due to their some favorable properties such as high-efficiency binding affinity, high selectivity, lower toxicity, and stable metabolism. In recent years, the number of cyclic peptide drugs under clinical research has continued to increase. Unlike the previous cyclic peptide drugs, which were mostly derived from natural products and their derivatives, these cyclic peptide drugs are designed by genetically encoded display technologies which are based on rational design and in vitro evolution (such as BT1718, PTG-300, POL6326, etc). Among them, phage display technology has some advantages such as mature research system, low cost, and simpler operation that make it well recognized and praised by the majority of researchers in this field. Here, we reviewed the recent progress of applying phage display technology to explore diverse cyclic peptide libraries, which, we believe, will contribute more valuable candidate cyclic peptide drugs in clinical research.