In the health service field,health resources and health service supple capacity were related with the resource and capacity in economics.Health resources,health service supple capacity and their relationships were important factors for the cooperation and benign interaction of hierarchical medical institutions.However,inversion of health resources and health dislocation of service supply capacity exacerbated the agglomeration degree of patients in the tertiary medical institutions under the impact of residents' freely searching for medical service concept.Vicious interaction and mutual competition among hierarchical medical institutions had become an important obstacle for the implementation of hierarchical medical services.Therefore,its mechanism needed to be clarified while the corresponding policy recommendations should be proposed.

Objective To establish a method for the determination of alum residual amount in Rhizoma Pinelliae Preparata from different companies,and to provide a scientific evidence for quality evaluation of Rhizoma Pinelliae Preparata.Methods Na2EDTA titration method was applied for the quantitative analysis.Results There were obvious differences in residual quantity of alum in Rhizoma Pinelliae Preparata from different companies.Conclusion The method is simple,reproducible and accurate,it can be used for the determination of alum residual amount in Rhizoma Pinelliae Preparata.

AIM:To explore the cataract suspensory ligament rupture and artificial lens implantation suture fixation into capsular bag without capsular tension ring(CTR).METHODS:We reviewed 20 cases of 20 cataract suspensory ligament rupture without CTR intraocular lens (IOL) implantation fixation in our department from Jan.2012 to Dec.2016.The needle crossed into ocular ciliary sulcus, in the equator of the eye ball which suspensory ligament rupture from, then the needle crossed out 1.5mm away from the angle of sclera.Sutures fixed on the IOL, then the artificial lens implantation in the pouch, carried out in accordance with the Z type suture, or to the beforehand prepared triangle scleral flap.The visual acuity, intraocular pressure, the anterior chamber and the IOL position were measured after operations.RESULTS:All of the postoperative visual acuity improved different level.The postoperative best corrected visual acuity(BCVA) was ≥0.8 in 4 eyes(20%), 0.5-0.6 in 7 eyes(35%), 0.3-0.4 in 8 eyes(40%), 0.1 in 1 eye(5%) because of the glaucoma optic atrophy.There were 12 cases with mild corneal endothelium edema, 4 cases exudation membrane in the pupil area, 2 cases hyphema, all of which recovered after treatment.There were 2 eyes with vitreous prolapse in the pupil, 1 case appeared mild IOL center deviation and no special treatment for the vision did not be involved.Followed up for 6mo, displaced stitches or artificial lens shift did not occur.CONCLUSION:Without CTR, the IOL implantation and suture fixation in capsular bag during cataract surgery is a surgical method for basic-level hospitals.

Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) at different frequencies on behavioral and psychological symptoms and cognitive function in patients with Alzheimer's disease.Methods Seventy-two patients were randomly divided into a high frequency group,a low frequency group and a control group (n =24 for each),and given 10 Hz,1 Hz or sham rTMS over the left and right dorsolateral prefrontal cortex at an intensity was 80％ of each patient's movement threshold.The stimulation was for 30 min a day,five days a week.During the 4 weeks of treatment,risperidone was used at a fixed dose of 1 mg per day for all patients.Before and after the treatment,all 3 groups were assessed using the behavioral pathology in Alzheimer's disease rating scale (BEHAVE-AD) and the mini-mental state examination (MMSE).Results Two weeks after the treatment,the average BEHAVE-AD score of the high frequency group had decreased significantly from (16.75±6.26) to (13.84± 6.10),significantly lower than the low frequency and the control groups' averages.Two weeks later,the average BEHAVE-AD scores of the 3 groups were significantly lower than before the treatment,but the decrease of the high frequency group was of significantly greater compared to the other 2 groups.Four weeks after the treatment the average MMSE score of the high frequency group was significantly better than before the treatment (P＜0.01),and better than the low frequency and the control group's averages.The effectiveness rates of the high frequency group,the low frequency group and the control group were 88％,58％ and 54％ respectively,all significantly different.Conclusion High frequency (10 Hz) rTMS combined with risperidone can improve the behavioral and psychological symptoms and cognitive function of AD patients,while low frequency (1Hz) rTMS does not have obvious effects.

Translational medicine has been on the rise for 20 years as a new model of biomedical research,which plays a positive role in narrowing the gap between basic research and clinical medicine and in development of medical sciences.This paper traced back the milestones of translational medicine,and analyzed the hurdles for China to develop translational medicine,namely the organization system,management model and benefit sharing.On such basis,the authors recommended on the development and strategy,especially in clinical medical institutions in China.

Effect of ginsenoside total saponin (GTS) on the regulation of P450 of livers of rats after γ-ray irradiation was studied. Rats were irradiated by the ⁶⁰Coγ-ray for one-time dose of 5.5 Gy, dose rate of 117.1-119.2 cGy. The cocktail probe, qPCR and Western blot were used to detect expression of enzymatic activites, mRNA and protein of rats. Contrasted with blank group, expression of CYP1A2, 2B1, 2E1, 3A4 of irradiation group showed a up-regulated (P < 0.05). Contrasted with irradiation group, exprression of CYP1A2, 2B1, 2E1, 3A4 of GTS group showed a downward trend. GTS had negative agonistic action against expression of P450 of rats by irradiatied.
Animals ; Cytochrome P-450 Enzyme System ; genetics ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Gamma Rays ; Ginsenosides ; pharmacology ; Liver ; drug effects ; enzymology ; radiation effects ; Male ; Microsomes, Liver ; drug effects ; enzymology ; Panax ; chemistry ; Rats ; Rats, Wistar

To study the cost-effectiveness of temozolomide combined with radiotherapy in the treatment of glioblasto-ma. Methods:According to the clinical trial data, cost-effectiveness and sensitivity of the results was analyzed based on the domestic cost and consumption level. Results:Temozolomide combined with radiotherapy could prolong one month of overall survival with the additional cost of RMB 58 959. 7 yuan in each case when compared with radiotherapy alone. Conclusion:Temozolomide combined with radiotherapy has no advantage on cost-effectiveness when compared with radiotherapy alone.

Objective To explore serum Cystain C (Cys C) level in chronic heart failure (CHF) patients and its relation?ship with cardiac function and ventricular remodeling. Methods Patients with heart failure (n=75) and healthy adult (n=35) were enrolled in this study. According to the NYHA classification,CHF patients is divided into NYHA Ⅱ, NYHAⅢand NYHAⅣ;CHF patients can also be divided into 2 groups base on their level of serum Cys C:Cys C>0.95 mg/L is defined as elevated serum Cys C group, serum Cys C≤0.95 mg/L is defined as normal serum Cys C group;According to left ventricu?lar ejection fraction (LVEF), CHF patients can also be divided into 2 groups:LVEF≥0.50 is defined as ejection fraction re?served group, LVEF<0.50 is defined as the ejection fraction reduced group. Cys C, N terminal B-type natriuretic peptide (NT-proBNP), serum creatinine(Scr),UREA and Echocardiography were analyzed in all groups and their correlation was studied. Results Serum Cys C level in CHF patients was obviously higher than that in healthy controls, and it increased with NYHA heart function classification;compared with normal Cys C group,Cys C elevated group presented higher NT-proBNP level but lower eGFR and LVEF (P<0.05);compared with ejection fraction reduced group, ejection fraction reserved group demonstrated lower NT-proBNP, LVEDD, LVMI and Cys C levels (all P<0.05);Correlation analysis revealed that Cys C is correlated with age, NT-proBNP, LVEF, LVEDD, Scr and UREA (r=0.411, 0.658, 0.465, 0.310, 0.552, 0.486, P<0.01). Conclusion Serum Cys C can be used to evaluate cardiac function of heart failure, and is associated with ventricular remodeling.

Objective To investigate the protective effects and mechanisms of granulocyte-colony-stimulating factor (G-CSF)on a rabbit model of chronic myocardial ischemia.Methods Myocardial ischemia models were created by partial ligation of the left anterior descending coronary artery in Japanese white male rabbits.Rabbits were subcutaneously injected with G-CSF (G-CSF group)or saline (control group)for 6 days after myocardial ischemia.The percentage of CD34-positive cells in the peripheral blood was evaluated by flow cytometry,and CD34-positive cells homing and vWF expression in the ischemic myocardium were determined by immunohistochemistry.Results Rabbits in G-CSF group had a higher survival rate than those in control group (P <0.05).Immunohistochemistry of the ischemic myocardium showed that compared with control group,G-CSF group had increased homing of CD34-positive cells on day 7 post-surgery,and more vessels on day 28 post-surgery by anti-von Willebrand factor staining.In addition,we observed an increase in the percentage of CD34-positive cells in the peripheral blood in G-CSF group.Conclusion G-CSF produces an obvious protective effect against chronic myocardial ischemia in rabbits by increasing stem cell mobilization,homing to ischemic myocardium and accelerating neovascularization.

Objective_To evaluate the proangiogenesis of extracelluar matrix proteins SRPX2 on HUVECs.Meth-ods_pcDNA3.1-SRPX2 vector ( transfection group) and pcDNA3.1 vector ( negative group) were transfected into HEK293T cells, then divided into 3 groups including blank group.The proliferation of HUVECs ( absorbance, A450 ) was detected by CCK-8 kit.The transmembrane cell number was counted by Transwell migration and wound healing assay to evaluate the migration ability of HUVECs.A three dimensional culture system of cells was construc-ted on the Matrigel, and tube formation number of HUVECs was assessed.Results_The proliferation of HUVECs ( absorbance,A450 ) among transfection group,negative group and blank group failed to show significant difference (P>0.05).A signifiant difference was noted in the total branch point of capillary tubes among transfection group, negative group and blank group[(97 ±4)/field versus (57 ±3) and (54 ±3)/field] (P<0.05).In wound healing
assay, the distance of transfection group compared to 0, 6 and 12 h were both significantly larger than that of nega-tive group and blank group [(90 ±6), (37 ±7),(36 ±4)μm and (135 ±5),(65 ±8),(63 ±4)μm respective-ly, both( P<0.05) ] .In Tranwell assay, the number of migrating cells in the transfection group was significantly more than negative group and blank group [(549 ±10)/field vs (334 ±11) and (329 ±12)/field(P<0.05)] af-ter co-culture 16 h.Conclusions_SRPX2 may promote angiogenesis by stimulating the migration and tubing on the Matrigel of HUVECs.