Weight management is an important initiative to improve the serious situation of overweight and obesity in China,and clinical dietitians in tertiary hospitals are a key part of it.Currently,clinical dietitians in China are facing problems such as unclear role definitions and responsibilities,marginalization of work content and imbalance of resource allocation.A clear definition of responsibilities and an efficient service model are necessary for the effective implementation of weight management.On the basis of constructing the post responsibility matching model for clinical dietitians in tertiary hospitals,it explored the weight management service model for clinical dietitians,analyzed optimization pathways for their workflow,and proposed suggestions for the optimization of the post responsibilities and incentive measures,so as to provide theoretical support and practical paths for the improvement of the population's weight management system.

Weight management is an important initiative to improve the serious situation of overweight and obesity in China,and clinical dietitians in tertiary hospitals are a key part of it.Currently,clinical dietitians in China are facing problems such as unclear role definitions and responsibilities,marginalization of work content and imbalance of resource allocation.A clear definition of responsibilities and an efficient service model are necessary for the effective implementation of weight management.On the basis of constructing the post responsibility matching model for clinical dietitians in tertiary hospitals,it explored the weight management service model for clinical dietitians,analyzed optimization pathways for their workflow,and proposed suggestions for the optimization of the post responsibilities and incentive measures,so as to provide theoretical support and practical paths for the improvement of the population's weight management system.

Top-notch innovative talents are the core driving force for the development of public hospitals.At present,there are prominent problems such as the institutional isomorphism,attach importance to the introduction of external talents and despise the cultivation of internal talents,and the poor flow of talent.It is urgent to reshape the governance mechanism of top-notch innovative talents in public hospitals from the perspective of new quality productivity.Combined with the basic characteristics of hospital new quality workers,it analyzes the training,introduction,use and reasonable flow mechanism of top-notch innovative talents,and puts forward the governance strategy of top-notch innovative talents in public hospitals from the perspectives of talent revival,incentive measures,knowledge renewal and informatization,to provide a strong basic guarantee for the high-quality and sustainable development of public hospitals.

ObjectiveTo explore the molecular mechanism of Sanhuang Xiexintang （SHXXT） in protecting stress gastric ulcer （SGU） in rats through network pharmacology， molecular docking， and animal experiments. MethodThe active ingredients and corresponding targets in SHXXT were collected and screened from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， Traditional Chinese Medicine Information Database （TCMID）， Bioinformation Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine （BATMAN-TCM）， and Swiss Target Prediction database. SGU-related targets were screened from the Online Mendelian Inheritance in Man （OMIM）， Therapeutic Target Database （TTD）， GeneCards database， and PharmGKB database. Herbal-ingredient-target （H-C-T） network was constructed by using Cytoscape 3.9.1 software. Protein-protein interaction （PPI） of drug and disease intersection targets was analyzed by using the Protein Interaction Platform （STRING） database. Gene ontology （GO） enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway analysis were conducted through the Database for Annotation Visualization and Integrated Discovery （DAVID）. The active ingredients and key targets were validated using AutodockVina 1.2.2 molecular docking software， and the experimental results were further validated through animal experiments. ResultThe 55 active ingredients were screened， and 255 potential target genes for SHXXT treatment of SGU were predicted. The PPI analysis showed that protein kinase B （Akt）， phosphatase and tensin homolog deleted on chromosome ten （PTEN）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and cyclooxygenase-2 （COX-2） are the core targets of SHXXT for protecting SGU. GO and KEGG analyses showed that SHXXT may affect the development of SGU by regulating various biological processes such as the phosphoinositide 3-kinase （PI3K）/Akt signaling pathway and inflammatory processes. The molecular docking results showed that both the active ingredients and key targets had good binding ability. Animal experiments showed that compared with the blank group， the ulcer index （UI） of the model group was significantly increased （P<0.01）， and the serum levels of TNF-α and IL-1β significantly increased （P<0.01）. The phosphorylation level of PTEN in gastric mucosal tissue was significantly down-regulated （P<0.05）. The phosphorylation levels of PI3K， Akt， and nuclear factor kappa-B （NF-κB） were significantly up-regulated （P<0.05）. Compared with the model group， the UI of the treatment group was significantly reduced （P<0.01）， and the serum levels of TNF-α and IL-1β were significantly reduced （P<0.01）. The phosphorylation level of PTEN in gastric mucosal tissue was significantly up-regulated （P<0.01）， and the phosphorylation levels of PI3K， Akt， and NF-κB were significantly downregulated （P<0.01）. ConclusionThe application of network pharmacology prediction， molecular docking simulation， and animal experimental validation confirms that SHXXT regulates the PI3K/Akt/NF-κB signaling pathway to regulate the inflammatory response of rats and thus protects the gastric mucosa of SGU rats.

Top-notch innovative talents are the core driving force for the development of public hospitals.At present,there are prominent problems such as the institutional isomorphism,attach importance to the introduction of external talents and despise the cultivation of internal talents,and the poor flow of talent.It is urgent to reshape the governance mechanism of top-notch innovative talents in public hospitals from the perspective of new quality productivity.Combined with the basic characteristics of hospital new quality workers,it analyzes the training,introduction,use and reasonable flow mechanism of top-notch innovative talents,and puts forward the governance strategy of top-notch innovative talents in public hospitals from the perspectives of talent revival,incentive measures,knowledge renewal and informatization,to provide a strong basic guarantee for the high-quality and sustainable development of public hospitals.

Objective:This study aims to investigate the effects of Zhibao Sanbian Pills on learning and memory ability and explore its mechanism.Methods:Cognitive decline and memory impairment in mice was induced by scopolamine. Morris water maze test, platform jumping test and dark avoidance test were used to evaluate the learning and memory ability of mice. TCMSP, TCMID database and literature search were used to search the chemical components of Zhibao Sanbian Pills. The potential active components were screened through ADMETlab 2.0. The targets were predicted by Swiss Target Prediction. GO function and KEGG pathway enrichment analysis were conducted through the Metascape database, and a PPI network was constructed for MCODE module analysis.Results:Compared with the model group, the latency of water maze test in the high-dose group of Zhibao Sanbian Pills was shortened ( P<0.05), and the time of platform quadrant and the number of crossing increased ( P<0.05). 863 active components and 401 potential targets of Zhibao Sanbian Pills were collected. The enrichment analysis of MCODE, GO and KEGG pathways found that the action pathways of Zhibao Sanbian Pills to improve cognitive impairment involve neuroactive ligand receptor pathway, calcium signal pathway, Rap1 signal pathway, PI3K-Akt signal pathway, MAPK signal transduction pathway, 5-hydroxytryptamine receptor pathway, etc. Conclusion:Zhibao Sanbian Pills have the potential to improve the learning and memory ability of mice, which may be realized through MAPK signaling pathway and other neural related signaling pathways.

ObjectiveTo explore the distribution mechanism of network modules in the combined treatment of liver cancer with Jiuwei Zhengxiao granules （JWZX） based on the analysis framework of module pharmacology. MethodThe cell experiment and the animal experiment were carried out to investigate the in vitro anti-liver cancer efficacy of JWZX of different concentrations and the effect on the survival time of H22 ascites tumor mice. By virtue of the analysis strategy of modular pharmacology，the distribution characteristics of nine Chinese drugs in the liver cancer disease network modules were investigated based on the constructed liver cancer disease network and module division by MCODE. In this study，the average degree （AD） of the nodes in the modules was used as an index to screen the main modules of the disease，and the intervention of the sovereign drugs，minister drugs，and assistant drugs on the main modules was explored. Finally，the Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis was performed on the drug-acted modules by Metascape. ResultAs revealed by the cell experiment，JWZX could significantly inhibit the proliferation of H22 cells. The animal experiment demonstrated that the medium- and high-dose JWZX could significantly prolong the survival time of mice with H22 ascites tumor （P<0.05，P<0.01）. The distribution of targets of JWZX in the liver cancer disease network modules showed that JWZX interfered with tumor necrosis factor （TNF），epidermal growth factor receptor （EGFR），vascular endothelial growth factor A （VEGFA），transcription factor （JUN），tumor protein p53 （TP53），and other 26 targets and 8 modules. The sovereign drug Ginkgo Semen mainly intervened in modules 3 and 8，and the minister drugs such as Centipeda Herba jointly intervened in modules 1，3，5，8，10，and 12. Centipeda Herba and Phyllanthi Fructus intervened in module 7 and module 19 individually. Artemisiae Annuae Herba and other assistant drugs jointly intervened in modules 3，5，10，and 12. KEGG pathway enrichment analysis found that 135 pathways were enriched in 8 modules，and the pathway functions involved 12 categories including cancer，signal transduction，immune system，endocrine system，and amino acid metabolism. The functions of the four major modules involved cancer，signal transduction，and immune system. According to the results of literature verification，the key links of JWZX on the liver cancer disease network and the core mechanism were presumedly related to the inhibition of phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） and hypoxia-inducible factor-1 （HIF-1） signaling pathways，reduction of the immunosuppressive effect in the tumor microenvironment，and improvement of the anti-tumor immune response. ConclusionJWZX possesses pharmacological activity against liver cancer，and the therapeutic efficacy was achieved through the multiple targets，multiple modules，and multiple functions of drugs alone or in combination to intervene in the disease. The present study reduced the complexity of drug-disease target network analysis with module analysis strategy and explored the network module distribution mechanism of JWZX in the treatment of liver cancer，which provides a new idea for interpreting the complex mechanism of prescription compatibility.

Objective To analyze the deployment of medical linear accelerators at 26 hospitals in China, and suggest on the deployment of such accelerators. Methods From June 2017 to November 2018, a total of 26 hospitals were surveyed by stratified random sampling. Descriptive analysis of the deployment and staffing of medical linear accelerators at 26 hospitals, and the deployment appropriateness of the medical linear accelerator was evaluated using the TOPSIS method. Results The number of medical linear accelerators in different types of hospitals was significantly different. The proportion of imported equipment at tertiary hospitals was 80% (12/15) and the proportion of imported equipment at secondary hospitals was 9% (1/11). The professional staff was deployed basically reasonable, and there was a shortage of physicists at some hospitals. The suitability of medical linear accelerators at tertiary hospitals was better than that of secondary hospitals, 80% (12/15) of tertiary hospitals received " good" and above ratings, while 91% (10/11) of the secondary hospitals received " general" and below ratings. Conclusions Hospitals should carry out the allocation of large-scale medical equipment based on their own situations and requirements. Efforts should be paid on training of professional technicians for radiotherapy. It is important to strengthen the management of planning, access and supervision of medical equipment.

This paper introduced the measures to construct the hierarchical medical system in Yichang city. The authors identified problems found and proposed the city to take the following countermeasures. Such steps included service capacity building at primary level, motivating primary medical workers, attracting patients to primary care, and improving policies of hierarchical medical system.

Hierarchical medical system empowers the current healthcare reform on the medical supply side in China, a key to resolving the contradictions in the healthcare sector. This study analyzed the necessity and obstacles for such a system with synergy between hospitals, insurance and pharmacy, putting forward suggestions for building a scientific and rational hierarchical system.