Objective To establish a BALB/c mouse model of total hysterectomy and to investigate and analyze its characteristics and formation mechanism. Methods The control group was fed conventionally without any treatment. The mice in the model group were anesthetized and performed hysterectomy. The animals in the sham-operated group had abdominal cavity opened and only exposing the uterus. The changes of body weight were observed dynamically,and at the end of the fourth weeks. The concentration of serum estradiol was determined and histological structure of the ovaries was examined. Results The general status of all the mice after operation was good without obvious inflammation, and the incision healed completely. There was no significant difference in the body weight before operation among the mice, whereas the weight of model group mice was higher than the control group and sham-operation group at the end of the second,third and forth weeks(P< 0.05). The estradiol contents of the model group was significantly lower than that in control group and sham operation group(P< 0.01). The histological structure of ovaries in the control group and sham-operation group was normal,however the model group showed differences,such as irregular shape of the ovaries,changed number of mature follicles, loosely distributed granulosa cells, and apoptosis. Conclusions The mouse model of total hysterectomy established in our study can well simulate the clinical manifestations of ovarian dysfunction after operation, and is an ideal model for the study of complications after ovariectomy and screening of drugs.

Objective:To analyze the internal conditions and external environment of high-quality development of high-level public hospitals and establish a high-quality development strategy model, for reference of public hospitals to formulate and implement high-quality development strategies.Methods:The case hospital was a pilot in high-quality development of high-level public hospitals. SWOT method was used to analyze the influencing factors, AHP analytic hierarchy process was used to compare the importance of each influencing factor, and then the four-quadrant coordinate system method was used to establish a high-quality development strategy model.Results:The total strength(S), the total weaknesses(W), the total opportunity(O), and the total threat(T)were 0.095, 0.063, 0.065 and 0.024 respectively, reflecting that the strength of internal conditions was greater than the weaknesses, and the opportunities of external environment were greater than the threats. In the four-quadrants, the growth strategy model had the largest triangle area(0.003), and the strategic quadrilateral center of gravity was located in the opportunity area of the growth strategy.Conclusions:High-level public hospitals as represented by the case hospital had entered a period of important strategic opportunities, which the external opportunities were greater than its own strength. These hospitals were recommended to fully leverage the external opportunities, adopt a positive growth oriented(SO)strategy, formulate a development strategy with their own characteristics, promote the interaction of internal conditions and external environment to form new momentum, hence achieving high-quality development.

The five core indicators(the case mix index, the proportion of level-4 surgery, the proportion of technical service income in medical income, the proportion of personnel expenditure in business expenditure, and the proportion of fixed part in personnel salary) and target values determined by the pilot goal of high-quality development of high-level public hospitals jointly built by National Health Commission and Provincial Government had become the core indicators for evaluating the quality and efficiency of public hospital development. The authors proposed the optimization and improvement measures for the five core indicators one by one from the internal reform and innovation in hospitals, as well as the synergetic development and governance of " insurance-medical-medicine linkage", combined with the current situation of a pilot hospital. The authors also proposed the starting points and driving force for promoting the high-quality development of public hospitals through the synergetic development and governance of " insurance-medical-medicine linkage", including implementing government investment responsibilities, streamlining the price evaluation of medical services, deepening the reform of medical insurance payment, accelerating the expansion of drug and consumable procurement, and promoting the application of advanced technologies and products, in order to provide reference for the in-depth promotion of high-quality development of public hospitals.

OBJECTIVETo observe the effect and safety of acupoint catgut embedding for prediabetes.

METHODSEighty-six patients with prediabetes were randomly assigned into an observation group and a control group, 43 cases in each one. Diabetes health education was applied in the two groups. Catgut embedding was used at bilateral Pishu (BL 20), Weiwanxiashu (EX-B 3), Ganshu (BL 18), Shenshu (BL 23), and Zusanli (ST 36) in the observation group, once every 15 days for 6 times. The type and number of postoperative reactions of the last time had been recorded since the second embedding, and the situation of the last postoperative reactions was observed 15 days after treatment. Total cholesterol (TC), triglyceride (TG), fasting plasma glucose (FPG), 2 hours postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), empty stomach insulin (Ins) and TCM syndrome score were tested before and after treatment as well as 6 months after treatment. The clinical efficacy was evaluated.

RESULTSAfter treatment, the levels of TC, TG, FPG, 2hPG, HbA1c of the observation group were lower than those before treatment and those of the control group (all<0.05). The Ins changed little after treatment and was not significantly different from that of the control group (both>0.05). All the above indices had no significant difference at follow-up compared with those before treatment (all>0.05). After treatment, the TCM syndrome score in the observation group was lower than that before treatment and that in the control group (both<0.05). The TCM syndrome score at follow-up was better than that before treatment in the observation group (<0.05). The total effective rate of the observation group was 76.7% (33/43) after treatment, which was superior to 30.2% (13/43) of the control group (<0.05). The rates at follow-up was 37.2% (16/43) in the observation group and was 25.6% (11/43) in the control group (>0.05). 18 postoperative reactions occurred 168 times totally after embedding, which could be divided into 5 categories, including 75 times (44.6%) of dietary inhibition, 41 times (24.4%) of abnormal feeling, 23 times (13.7%) of local discomfort, 21 times (12.5%) of general malaise, and 8 times (4.8%) of other symptoms. The postoperative peak responses were after the second and third operations.

CONCLUSIONS3-month catgut embedding can improve some of the indices of prediabetes, but long-term healthy living habits need to be kept. There exist various postoperative reactions after embedding without blocking the treatment.

OBJECTIVE: To study the impact of aconitine and Shuang-huang-lian injection on the expression of myocardial ryanodine receptor (RyR2) and to discuss the anti-arrhythmic mechanisms of Shuanghuanglian against aconitine poisoning.
 METHODS: A total of 52 SD rats were randomly divided into 3 groups: aconitine group (group A, n=20), Shuang-huang-lian group (group B, n=20) and control group (group C, n=12). Aconitine at a dose of 0.3 mg/kg was firstly administrated to the rats of group A and group B through gavage. 30 minutes later, normal saline was delivered to rats in group A through intraperitoneal injection, while rats in group B received Shuang-huang-lian at a dose of 100 mg/kg through intraperitoneal injection. Group C accepted twice administration of normal saline by gavage and intraperitoneal injection. The disposals for each group were implemented for 10 consecutive days. The rats' electrocardiograms (ECG) were recorded on day 1, 3, 6 and 10. Immunofluorescent staining technique and real-time quantitative PCR technique was used to detect the protein and mRNA expression of myocardial RyR2.
 RESULTS: The arrhythmia scores of group B at different time were lower than group A and the difference was statistically significant (P<0.05 or P<0.01). The protein and mRNA expression of RyR2 in group A was slightly increased on the first day compared to group B and group C, with no statistical significance (P>0.05). On day 3, 6 and 10, the expression of RyR2 protein and mRNA in group A was dramatically increased compared to group B and group C (P<0.01). 
 CONCLUSION Shuang-huang-lian injection can effectively prevent the arrhythmia caused by aconitine, which is related to suppressing the aconitine-induced RyR2 expression.
Aconitine ; Animals ; Anti-Arrhythmia Agents ; Drugs, Chinese Herbal ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Ryanodine Receptor Calcium Release Channel

Objective: To explore the direct⁃on⁃target micro⁃droplet growth assay (DOT⁃MGA) for rapid detection of the susceptibility of tigecycline and polymyxin. Methods: A total of 67 strains of Klebsiella pneumoniae were collected for DOT⁃MGA. 6 μl droplets with or without tigecycline or polymyxin (The final drug concentration is 2 μg/ml) were added in triplicate into the wells of the MALDI plate with four incubation time points (3 h ,4 h ,6 h , and 8 h) . The results were classified as susceptible (score < 1. 7) and non⁃susceptible (score≥1 . 7) according to the Bruker Biotype software Results: After incubation for 4 h , the growth efficiency, specificity and positive predictive value of tigecycline and polymyxin were both 100. 00% . The classification consistency rate was 98. 15% and 96. 15% , the sensitivity was 96. 30% and 92. 31% , and the negative predictive value was 96. 45% and 92. 86% , respectively. Conclusion DOT⁃MGA can provide rapid and reliable drug susceptibility diagnosis of tigecycline and polymyxin ,which is of great significance for the clinical anti⁃infective treatment.