Polycentric governance theory of public goods provides a new approach for the goal of Basic medical care and health service for all.From the perspective of the public goods property of basic medical care and health service,the paper analyzed the predicament brought one-center supply mode,and designed the basic medical care and health service polycentric supply mode on the basis on the polycentric governance theory.On the basis,it proposed the polycentric supply synergetic development strategies.

[Objective]To evaluate the efficacy and safety of Tanreqing injection in the treatment of viral pneumonia.[Methods]CNKI database, VIP database and CBM database were searched by keywords, and the obtained references were screened for clinical trials on the introduction of Tanreqing in therapy of viral pneumonia. The clinical trial results of efficacy were meta-analyzed. [Results]7 clinical trials were included, involving 604 patients, the result of Chi-Square testing was 2.21(P=0.09, I2=0%), so a fixed effect model was chosen and the results showed that Tanreqing injection showed a better clinical thera-py than control group[odd ratio (OR):5.45, 95% confidence interval (CI): (2.89, 10.27), Z=5.25, P<0.00001]. No serious adverse effects were reported. [Conclusion]Tanreqing was more effective and safer in the treatment of viral pneumonia according to our results. However, higher quality clinical studies are needed as most trials included in this review are of lower quality.

Information integration of heterogeneous systems needs implementing to meet the communication requirements of all subsystems of Hospital Information System (HIS). The solution is to introduce Health Level Seven (HL7), an international medical information exchange standard. With extensible Markup Language (XML) as the message-encoding manner, HL7 version 3 follows the object-oriented methodology. Based on the message system of HL7 version 3, this paper introduces an XML-based message processing technology and then testifies its feasibility.

By means of correlative analysis of critical care air transportation management between China Air Force and United State Air Force,five areas of importance are discussed in this paper,such as the management model of strategies for air transportation,critical care team personnel composition,professional training mechanism,normalization and standardi-zation of operation process,and intensive application of new technology and equipment.

OBJECTIVE To evaluate the application of antibiotics and its trend for reference to clinical utilization.METHODS The data about antibiotics used from 2005 to 2007 were collected and analyzed.RESULTS The consumption of antibiotics was fallen year by year.The rate of utilization was 67%.The rate of drug combination was 45% and the rate of antibiotic resistance test was 20%.CONCLUSIONS There are still a lot of problems in antibiotics usage of our hospital.It is necessary to strengthen the guidance and supervision.

Objective To investigate the characteristics of pharmacodynamics of rocuronium in elderly patients. Methods Ninety-four ASA Ⅰ - Ⅱ patients aged between 32-97 yr were divided into 4 age groups : groupⅠ 32-59 yr(n=28);group Ⅱ 60-69 yr (n = 29);group Ⅲ 70-89 yr (n=27);group Ⅳ 90-97 yr (n=10).The patients were premedieated with intramuscular phenobarbital 0.lg and atropine 0.5 mg. Anesthesia was induced with midazolam, propofol and fentanyl. Tracheal intubation was facilitated with rocuronium 0.6 mg?kg-1.The patients were mechanically ventilated and PET CO2 was maintained between 35-45 mm Hg. Anesthesia was maintained with isoflurane 1 MAC and intermittent iv boluses of fentanyl. Rocuronium was continuously infused during operation to maintain T1 at 10%-20% control.Neuromuscular (N-M) function was monitored using TOF response measured by accelerography.(1) Onset time (time from end of rocuronium injection to 100% block of T4 ),(2) maximal effect (time from end of injection to 100% block of T1 ),(3) clinical duration (time from end of injection to 10% recovery of T1 ) ,(4) intubating condition,(5) the amount of rocuronium consumed every 30 min and (6) recovery time (time from termination of rocuronium infusion to recovery of T1 to 25% control)Results (1) The onset time and the time of maximal effect were significantly longer in group Ⅰ than those in other three groups.(2) The time of maximal effect in group Ⅳ was significantly shorter than that in group Ⅱ and Ⅲ (3)The recovery time in group Ⅰ and Ⅱ was significantly shorter than that in group Ⅲ and Ⅳ.(4) The amount of rocuronium consumed per 30 min was decreasing with increasing duration of infusion and age. Conclusion The duration of action of rocuronium is longer and less amount of rocuronium is needed when it is given to elderly patients.

OBJECTIVETo explore the distribution features of Chinese medical constitutions in different ages population, thus providing scientific evidence of constitution process theory.

METHODSRecruited were 21 948 cases from a survey of Chinese medical constitutions and health conditions in 9 provinces or municipalities across China (including Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi, and Henan) from Dec 2005 to Jan 2007. The body constitution type of individual was diagnosed using discriminant analysis on the basis of Chinese medical constitution questionnaire. By using correspondence analysis, the correlation between the general population, genders, ages, and Chinese medical constitution types was studied.

RESULTSConstitutions of yin-deficiency type, wetness-heat type, qi-depression type, and special diathesis type often occurred in the population ranging 15 -24 years old. Gentleness type mostly occurred in the population ranging 25 -44 years old. During this time period, phlegm-wetness type and wetness-heat type were liable to occur in males, while blood-stasis type was liable to occur in females. Qi-deficiency type and yang-deficiency type were most often seen in those older than 45 years. Phlegm-wetness type and blood-stasis type body constitution were also liable to occur in those older than 45 years.

CONCLUSIONSThe distribution features were different in different Chinese medical constitutions. Different constitution types exist in different genders. Different constitution types exist different ages population.

Asian Continental Ancestry Group ; Body Constitution ; China ; Discriminant Analysis ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Qi ; Surveys and Questionnaires ; Yang Deficiency ; Yin Deficiency

Objective To detect the mRNA expression of mesenchymal-epithelial transition factor (MET)gene in patients with non-small cell lung cancer (NSCLC),and to investigate the relationship and clinical significance between the mRNA expression of MET gene and clinical pathological characteristics. Methods From June 201 1 to November 201 3,48 patients with pathologically confirmed NSCLC in Chinese People′s Liberation Army General Hospital were selected.All patients included in the study were not treated before surgery.The branched DNA liquid chip technology was used to detect mRNA expression of MET gene in tumor tissues.The relationship between mRNA expression of MET gene and clinical pathological characteristics was analyzed.Results The constituent ratios of low,moderate and high mRNA expression level of MET gene were 22.9%,50.0% and 27.1 % respectively,mainly for the moderate expression.The mRNA expression of MET gene was related to the pathologic type (χ2 =7.1 83,P =0.020)and TNM stage (χ2 =24.566,P =0.01 7)of the patients;but it was not related to the gender (χ2 =0.566,P =0.754),age (χ2 =1 .857,P =0.395),smoking history (χ2 =4.959,P =0.084),degrees of differentiation (χ2 =5.749,P =0.067), lymph node metastasis (χ2 =1 .631 ,P =0.442)and distant metastasis (χ2 =4.261 ,P =0.1 1 9).Conclusion mRNA expression of MET gene is more likely to present moderate and higher level in NSCLC patients.MET gene can also be used as a biomarker for judging tumor pathological type.

Objective To investigate the functional and structural changes of connectivity of default mode network (DMN) in relapsing-remitting multiple sclerosis (RRMS) by functional MRI (fMRI) and diffusion tensor imaging (DTI) and to study the relationship between them.Methods Twenty-seven RRMS patients(clinically diagnosed as RRMS)and 27 healthy volunteers (matched to the patients in age and gender) were selected to participate in this study.All the subjects underwent 3.0 T MR scanning.Softwares such as DPARSF,MICA,TrackVis were used for data post-processing.Medial prefrontal cortex (mPFC) and posterior cingulate cortex(PCC) of DMN were chosen as ROIs,and functional and structural changes of DMN and the relationship between them were analyzed.Values of r reflecting the functional connectivity and fractional anisotropy(FA) of two groups were obtained.Then statistical analysis was performed by using student t test and Pearson correlation analysis.Results The DMN space pattern of the RRMS patients was mostly identical to that of controls,but with specific difference in the connectivity strength with respect to that of controls.Particularly,the patient group showed increased DMN connectivity in the mPFC,but decreased connectivity in the inferior parietal lobule (IPL) and PCC.Compared with controls,the r value (0.695 ±0.151 vs.0.796±0.085),FA value(0.261 ±0.012 vs.0.285 ±0.017) between mPFC and PCC in RRMS patients were decreased (t =-3.020,-6.206,P ＜ 0.05).In addition,functional connectivity (r value) was found to correlate with structural connectivity(FA value) between the PCC and mPFC (r =0.704,0.735,P ＜ 0.01).The number of MS lesion,had no correlation with r value or FA value (P ＞ 0.05).Conclusions The functional connectivity and structural connectivity of DMN change in RRMS patients.The functional connectivity and structural connectivity between mPFC and PCC are both decreased in RRMS patients compared with the controls.The injury of structural connectivity may be the structural basis of the decrease of functional connectivity.

OBJECTIVETo compare two kinds of method for treating lumbar tuberculosis with psoas abscess, to provide reference for clinical reasonable select of therapy treatment.

METHODSFrom January 2010 to January 2013,42 patients with lumbar tuberculosis combined with psoas abscess with obvious surgical indications were enrolled, including 24 males and 18 females with an average age of (38.5 ± 10.2) years old ranging from 21 to 63 years old. All patients were followed up for 18 to 24 months with an average of 20.9 months. Twenty-two patients underwent posterior vertebral body lesions cleared, bone graft fusion and internal fixation and percutaneous puncture catheter drainage for treatment of psoas major abscess as group A, and twenty patients underwent one-stage extraperitoneal approach to remove abscess, posterior vertebral body lesions cleared, bone graft fusion and internal fixation as group B. The operative time, loss of blood, length of hospital stay, clinical cure rate and other clinical results for the two groups were analyzed and compared.

RESULTSThe loss of blood was (452.3 ± 137.6) ml in group A and (603.5 ± 99.6) ml in group B, there was significant statistical difference (P < 0.05). The time of operation was (193.6 ± 91.2) min in group A and (230.5 ± 56.6) min in group B, there was significant statistical difference (P < 0.05). The time of operation and the loss of blood in group A were obviously less than which in group B. In group A 20 cases were cured and 2 cases relapsed, 19 cases were cured and 1 case relapsed in group B, there was no significant statistical differences between two groups regarding cure rate with chi-square test (χ² = 0.000, P = 1.000). All patients in two groups obtained good clinical curative effect. There were no significant statistical difference between two groups regarding for length of hospital stay with t-test (P > 0.05).

CONCLUSIONLumbar spinal tuberculosis with psoas abscess is not absolute indications for anterior open operation. Compared with the combined anterior and posterior surgical procedure, the percutaneous puncture catheter drainage combined with posterior debridement, interbody fusion and internal fixation can achieve the same clinical effect but less trauma for the patients.

Adult ; Case-Control Studies ; Debridement ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Psoas Abscess ; etiology ; surgery ; Spinal Fusion ; Tuberculosis, Spinal ; complications ; surgery ; Young Adult