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

Objective To observe the changes in contrast sensitivity(CS) and color vision in patients with primary acute angle-closure glaucoma(PACG).Methods CS and color vision tests were performed in 35 patients(35 eyes) with preclinical stage of PACG,32 patients(32 eyes) with acute attack stage of PACG and 15 normal subjects(30 eyes).Then patients were followed up 1 month(31 eyes) and 3 months(28 eyes) after operation.Results The results of CS and color vision tests were abnormal in PACG patients when they were compared with those of normal people.The threshold of CS at 18.0 c/d was increased(P

Object To investigate the features of health related quality of life ( HRQOL) among elderly hypertensive patients with different body mass index (BMI) so s to provide evidence for the health promotion of hypertensive. Methods A cross-sectional survey of health status data from a population of 1281 elderly hypertensive patients from Beijing and 8 provinces of China ( Jiangsu, Anhui, Gansu, Qinghai, Fujian, Jilin, Jiangxi, and Henan) was made in the study. Analysis of variance was applied to compare the differences in HRQOL of elderly hypertensive patients in different BMI categories. Results For the elderly hypertensive patients with low body mass index, the scores of 8 dimensions and scores in physical component summary (PCS) and mental component summary( MCS) of SF-36 were the lowest;except the role-emotional(RE) dimension,the scores of other 7 dimensions,PCS and MCS were significantly different(PF,RP,BP,GH,VT,MH, P<0.01; SF,PCS,MCS, P<0.01). Comparing the scores between any two groups in PCS, the scores of patients with low body mass index were significantly lower than normal weight group (62.30 ± 22. 12 vs72.40 ±20.86, P<0.05) .overweight group (62.30 ± 22.12 vs 74.97 ± 19.20, P<0.05 ) and obese group (62.30 ± 22.12 vs 74.57 ± 19. 22, P < 0.05 ). Comparing the scores between any two groups in MCS,the scores of patients with low body mass index were significantly lower than normal weight group (68. 81 ± 20. 48 vs 74. 70 ± 20.41, P < 0. 05), overweight group (68. 81 ± 20. 48 vs 78.08 ±18.23, P<0.05) and obese group (68.81 ±20.48 vs 78. 69 ± 17.77, P<0.05); the score of normal weight group was significantly lower than the overweight group (74. 70 ±20. 41vs 78. 08 ±18.23, P<0.05). Gender Stratification showed that females with low body mass index had worse HRQOL than males. Conclusion The HRQOL of elderly hypertensive patients with low body mass index is significantly lower than normal weight patients, overweight patients and obese patients, the health promotion of elderly hypertensive patients with low body mass index should be paid more attentions, especially females with low body mass index.

Objective To create a new animal model which can preferably simulate the human's scoliosis. Methods Forty-five 4-week-old female Wistar rats were randomly divided into 3 groups. Group 1 underwent subcutaneous left scapula-to-contralateral ilium tethering procedure with a non-absorbable suture,which made the spine convex towards right side, and then removed forelimbs and tails of rats to create the bipedal rats. Tethering sutures were cut at postoperative 8th week, and the spines of rats were then observed during 2 weeks. Group 2 were the same as group 1 but in which scapula-to-ipsilateral ilium tethering procedure was performed. Group 3 were the same as group 1 except that the bipedal rats were not created. All postoperative rats were fed separately in special high cages for group 1 and group 2 or in standard cages for group 3. Operative duration, postoperative first food-taking duration, operative mortality, body weight, relative length of the spinal cord, Cobb angles in the coronal and sagittal planes, modeling mortality, the incidences of re-operation, scoliosis and vertebral rotation among the 3 groups were compared. Results There were no significant differences in the degree of scoliosis or kyphosis among the 3 groups at the time of initial tethering. At 2 weeks after tether release, the incidence of vertebral rotation was significantly higher in group 1 than group 2 (86.7% vs. 33.3%), and the degree of scoliosis or kyphosis was significantly larger in group 1 than group 3 (coronal plane: 30.2°±10.4° vs. 20.5°±7.7°; sagittal plane: 55.6°±10.0° vs. 43.8°±6.3°). There was no significant difference in postoperative first food-taking duration among the 3 groups, and no death of rats occurred in all groups during intraoperative and postoperative 6 hours, although operative duration was significantly longer in group 1 or group 2 than group 3. There were no significant differences in body weight,relative length of the spinal cord, modeling mortality, the incidences of re-operation and scoliosis among the 3 groups. Conclusion The bevel and axial loads of the vertebrae can significantly enhance the incidence of vertebral rotation and the degree of kyphoscoliosis, respectively. The scoliosis model created by scapula-to-contralateral ilium tethering procedure in bipedal rats can preferably simulate the human's scoliosis.

Objective To improve the effects of health education(HE)and satisfaction degree on HE of inpatients by executing hierarchical full-responsibility nursing. Methods Fourteen wards were randomly chosen form the hospital and divided into the control group and the experimental group, each group having 7 wards. The control group carried out routine holistic nursing model, and the experimental group carried out a new hierarchical full-responsibility nursing system. Reforming nursing scheduling and diminishing the nursing unit to assure that the patients acquired the continous and stable nursing service when they were in hospital. The effect and the degree of satisfaction of HE were compared between two groups after 6 months. Results The effects of HE in the experimental group were significantly better than those in the control group, and the degree of satisfaction on HE in the experimental group was much higher than in the control group. Conclusions The hierarchical full-responsibility nursing system can give patients systematic and normalized HE. It can significantly improve the effects and the degree of satisfaction on HE.