Objective To analyze the present situation of technical efficiency in TCM hospitals throughout the country, discuss the influencing factors causing inefficiency and propose corresponding suggestions. Methods The technical efficiency in 60 TCM hospitals in the country was analyzed using the stochastic frontier cost model for panel data and the influencing factors causing inefficiency were discussed using the multiple stepwise regression method. Results The average technical inefficiency was 22.59% and inefficiency showed an upward trend as the areas shifted from the eastern through the middle to the western regions. Five factors, including the utility rate of beds and the proportion of health technicians among the entire hospital staff, were statistically significant so far as the effect on the increase of the overall cost was concerned. Conclusion The stochastic frontier cost model for panel data is the best method for evaluating the technical efficiency in TCM hospitals. On the basis of the above analysis, suggestions for strengthening scientific management, improving the utility rate of resources and reducing unnecessary waste are put forward.

Objectives To evaluate the effectiveness of ARB in antihypertensive therapy and judge whether it can also protect cardiovascular. Methods A randomized double-blinded placebo-controlled study was used to survey over ten thousand patients in ARB clinical practices. The primary endpoint was stroke, acute myocardial infarction, heart failure, deadly cardiovascular diseases, total mortal. The results were given comprehensive analysis and statistical processing. Results In LIFE study, ARB was more effective than ?-blockers and ARB had the role of protecting the cardiovascular besides lowering the blood pressure. But the VALUE study showed that ARB was not more effective than Besylate. Conclusion There is no obvious distinction between ARB and the other drugs in reducing the blood pressure.

Objective To study pathological feature of sacroiliitis of spondyloarthropathies (SpA) in different stages,and improve the threshold of early diagnosis of SpA.Method Samples of sacroiliac joints (SIJ) of 8 patients with ankylosing spondylitis (AS) and 5 patients with undifferential spondyloarthropathies (uSpA) were taken when SIJ steroid injection was performed.The pathological feature was studied.Results Synovitis,including lining cell hyperplasia and inflammatory cell infiltration in looseconnective tissue,local cartilage degeneration,fibrosis and inflammatory cell infiltration in subchondral bony plate and marrow cave were found in 6 (86%,6/7) samples in patients with normal/suspectable SIJ CT scan.In the CT Ⅱ and Ⅲ degree sacroiliitis,marked degeneration and fibrosis of cartilage,inflammatory cell infiltration,pannus formation and subchondral bony plate destruction were increasingly prominent.In the advanced sacroiliitis (CT Ⅳ degree),destruction and calcification of cartilage and subchondral bony plate were the major feature.Eosinopil (EO) was increased in the infiltration cells of synovium and subchrodral bony plate in 3 samples.Conclusion Synovitis,including hyperplasia of lining cell and the infiltration of inflammatory cell in loose connective tissue,and local cartilage degeneration and inflammatory cell infiltration,and destruction of subchondral bony plate are the early changes identified in sacroiliitis.Pathological examination can improve the threshold of early diagnosis of sacroiliitis in case it cannot be confirmed with CT scan.

Objective:To study the teeth of the ancients in Xia Dynasty,the first dynasty in Chinese history about 4 000 years ago,and acquaint ourselves with their incidences of periodontal disease,and the evolution of oral diseases.Methods:The teeth and jaws excavated in Erlitoou,Henan Province and Youyao,Shanxi Province were observed with clinical methods.The specimens totaled 56 individuals(male 38,and female 18),including 894 teeth,and 86 dental arches.The objects were all permanent teeth.The major observation items were periodontal disease.The prevalence of periodontal disease of the people in Chinese Xia Dynasty were outlined.Results:The prevalence rate of periodontal disease was 19.80% in the 894 teeth,while prevalence rate was about 42.86% among the individuals.The premortal tooth lossrate was 7.45% in the observed teeth.Conclusion:Periodontal disease is an aging-related disease without sex difference and commonly seen in the mandible,which is quite similar to the situation at present.The periodontal disease was the main reason for tooth loss in people of Xia Dynasty.

To study the pharmacokinetics of 5 FU after splenic artery(IA) and auricular vein(IV) infusion, portal vein blood was collected for measurement to appraise the clinical value of treatment with this anti tumor drug via different routes on malignant hepatic neoplasms. 5 FU in portal vein blood was measured with high performance liquid chromatography. The results showed that the concentration of 5 FU in IA group was higher than that in the IV group. The peak concentration of 5 FU in the IA group was higher than that in the IV group by 64%. The area under the curve (AUC) of 5 FU in the IA group was larger than that in the IV group by 42%. It suggested that higher concentration of anti tumor drug in the portal vein could be obtained via splenic artery infusion, and it is valuable for the treatment of malignant hepatic neoplasms.

Objective We reported 16 eosinophilic fasciitis (EF) patients with eosinophilic fasciitis and performed a systematic review of the literature to improve the disease awareness.Methods The clinical course of 16 patients with eosinophilic fasciitis at the Peking Union Medical College Hospital were described,inclu-ding demographic data,clinical manifest-ations,laboratory tests,pathology and treatment.Results The mean age at diagnosis was (47±8) years,with 13 female and 3 male patients.Three cases had exertion or strenuous sports before the onset of EF.Positive ANA was noted in 6 of 12,positive RF was noted in 3 of 10,hyper-gammaglobulinemia was noted in 6 of 7,elevated IgG was noted in 8 of 13,peripheral blood eosinophilia was noted in 10 of 16,while thrombocytopenia was found in one patient.Conclusion Based on this and other reported cases in the literature,EF may be a kind of autoimmune disease.Genetic influence and environ-mental factors are involved in the development of this disease.Systemic involvement is rare.In general,corticosteroids and immunosuppressive are effective in EF.

Myelin of the adult mammalian central nervous system(CNS)has been attributed to affect nerve structural plasticity and suppress regeneration of nerve fibers.Nogo-A is possibly the best characterized of a variety of neurite growth inhibitors in CNS myelin.Neutralizing its activity results in improved axon regrowth and functional recovery in experimental spinal cord injury(SCI)models of animals.Nogo-A and its receptors,especially Nogo-66 receptor(NgR),p75 neurotrophin receptor(p75NTR),and LINGO-1 increasingly become the hot spot in the study of SCI repair,and have become the major targets for therapeutic intervention to promote axon regeneration after SCI.Inhibition of Nogo-A and its receptors NgR/p75NTR/LINGO-1 may be promote the regeneration of axon and maximize functional recovery after SCI.

Aim To develop a rapid and inexpensive method for purification of human albumin, a method of immunomagnetic microspheres (IMMS) based on enzyme-linked immunosorbent assay (ELISA)for the purification of human albumin from human serum. Methods Polystyrene magnetic microspheres with carboxyl groups as carriers were prepared, and then the carboxyl groups on the surface of the microspheres were activated by ethylcarbodiimide (EDC). Finally rabbit anti-human serum albumin (HSA) antibodies were covalently bound to it and the complex can specifically capture HSA. After the procedure of capturing HSA, through taking rabbit anti-human albumin protein antibodies as a capture antibody, and goat anti-human albumin protein antibodies as a detection antibody, an ELISA on IMMS was developed, which can determine the recovery yield of HSA from the human serum. Results The result of the experiment was that the recovery of human albumin with IMMS was (86 ± 4) % , and IMMS were reused for two other purifying cycles, the results of which were (69.0 ± 0.6) % and (40.8 ± 0.8) % , and the purity of the product was about 90%. Conclusion The results above prove that the immunomagnetic purifiying strategy was shown to be efficient and offers an new thought for a large scale production of highpurity HSA.

Objective To clone and express the immunodominant domain of the chlamydial proteaselike activity factor(CPAF) from Chlamydophila psittaci(Cps) and evaluated the diagnosing value of the recombinant protein in Cps infection.Methods The immunodominant region epitope of CPAF (CPAFm,A196-A450)from Cps was chosen according to bioinformatics analysis and references.The specific primer was designed and the gene was amplified by PCR and then ligated into a pGEX6p-2 vector.Recombinant protein was induced to express by IPTG and analyzed by SDS-PAGE and Western blot.Indirect EL1SA method of serological diagnosis was established with the reorganization protein as coating antigen.One hundred and eighty sera samples from ducks with respiratory tract infection symptoms were detected with the established indirect ELISA and a commercial ELISA-kit to assess the value of the recombinant protein in serodiagnosis.The results were further identified with Western blot.Results Prokaryotic expression vector pGEX6p-2/CPAFm was constructed and a 54x103 fusion protein was attained.The indirect ELISA method was established with reorganization protein for envelope antigen.Using the indirect ELISA to detect Cps lgG positive and negative reference sera,the sensitivity and specificity were both 100％ (20/20).And the recombinant protein has no cross reaction with either Chlamydophila pneumoniae or Chlamydophila trachomatis.The concordance rate between the indirect ELISA and Western blot to 180 ducks sera samples was 100％,while the concordance rate of the commercial ELISA kit was 77.5％-95.0％.Conclusion The prepared recombinant protein of the CPAF immunodominant region epitope gene from Gps can highly benefit on developing new indirect ELISA as methods to detect specific anti-Cps antibodies.

Objective To evaluate the systolic function of left ventricle in myocardial infarction(MI)patients with ventricular aneurysm and the changing law of blood flow in ventricle with regional abnormality of wall movement by vector flow mapping (VFM).Methods Tirty-one MI patients with ventricular aneurysm and 35 healthy participants were enrolled in this study.The characteristic of vector and streamline,and the changing of the velocity gradient in left ventricular outflow tract (LVOT), and the average flow quantity through aneurysm neck were detected in the isovolumic contraction period, the rapid ejection period and the slow ejection period by VFM.Results The distinction between aneurysm and control group was mainly the persistance of vortex in aneurysm.The size of vortex in aneurysm was highly correlated with that measured by 2-D ultrasound(P ＜0.01).The percentage of vortex duration to cardiac cycle in patients group was significantly greater than that in control group(P ＜0.01).In the early systolic contraction the velocity gradient in LVOT in patients with ventricular aneurysm was smaller than that of control group(P ＜0.05).The average flow through aneurysm neck was notablely decreased compared with control group(P ＜0.01).Conclusions VFM can reveal the hemodynamics of left ventricle with aneurysm directly as well as quantitively measure the regional velocity and flow quantity.VFM can evaluate the systolic function of left ventricle exactly.