Objective: This paper develops a methodology for steady and orderly expansion of the designated medical insurance drugstores. Methods:With the help of grid management ideology, the paper uses ArcGIS and its function modules to define and visualize the scope of the medical insurance drugs service with the guidance of fairness and efficiency through analyzing the basic data including population distribution, the physical distribution of drug-stores and soon. Results:In order to figure out the procedure of the methodology,the key problems were all solved, including defining and visualizing the scope of the medical insurance drugs service area,,checking and ratifying the scope that need to supplement or increase the medical insurance drugstores, making measures for the annual imple-mentation and confirming a selection principle for designated medical insurance drugstores. Conclusion:The Method-ology guided by fairness and efficiency of the medicare designated pharmacy layout planning is practical and feasible, which can probably provide a reference for increasing the designated medical insurance drugstores steadily and orderly.

Objective To develop a framework and indicators system for disability-related service data in China. Methods Using International Classification of Functioning, Disability and Health (ICF) framework and approach, the framework and indicators system were developed using content analysis, logical reasoning and expert consultation. Results A system with nine aspects, 35 dimensions and 115 indicators was established. Eleven experts with disability-related background all accepted the system, and satisfied in the importance and operability.Conclusion A data framework and indicators system with nine aspects, 35 dimensions and 115 indicators has been established for disability-related service, which can be used in further data collection.

OBJECTIVETo investigate the changes of peripheral blood marrow-derived suppressor cell level after chemotherapy induction remission by regimen consisting of vincristine, daunorubicin, L-asparaginase and prednisone (VDLP) and to analyze their relationship with immume system in B-ALL children.

METHODSThirty B-ALL children after induction remission by VDLP regimen from August 2015 to August 2016 were selected as B-ALL group and 30 normal healthy children were selected as control group. The peripheral blood in 2 groups was collected and detected by flow cytometry, then the ratios of CD30cells and CD33HLA-DRmarrow-derived suppressor cells, CD14CD33HLA-DRmarrow-derived suppressor cells and CD15CD33HLA-DRmarrow-derived suppressor cells were calculated, and their changes after induction remission by VDLP regimen and the relationship with immune system were analyzed.

RESULTSAfter treatment the ratio of CD33cells in peripheral blood of B-ALL group and control group was not significantly different (P> 0.05), moreover, the ratio of CD33cells in B-ALL group was significantly higher than that before treatment (P<0.05), while the ratios of CD33HLA-DRmarrow-derived suppressor cells, CD14CD33HLA-DRmarrow-derived suppressor cells and CD15CD33HLA-DRmarrow-derived suppressor cells in B-ALL group were significantly lower than those in control group (all P<0.05), but the ratios of these cells in B-ALL group were higher than those before treatment, and yet there was no statistical significance (P>0.05).

CONCLUSIONThe ratios of marrow-derived suppressor cells in peripheral blood of B-ALL children in complete remission after treatment with VDLP regimen are higher than those before treatment, but are significantly lower than normal value, which may be related with non-complese recovery of immune system in B-ALL children after treatment.

Objective: To conduct a knowledge survey on heart failure (HF) guidelines for HF diagnosis and treatment in physicians in China. Methods: A questionnaire including15 multiple-choice and 10 blank-filling questions was developed based on Chinese HF diagnosis and treatment guidelines 2014. The survey was conducted in physicians who registered at Chinese HF study from 88 hospitals in China and the knowledge level was presented by the correction rate of questionnaire survey. Results: A total of 2146 physicians finished the survey including 56.2％ female and 43.8％ male with the mean age of (35.6±7.6) years. The ratios of resident, attending physician, associate chief physician and chief physician were 28.2％, 43.6％, 20.3％ and 7.9％ respectively; the ratios of cardiovascular specialists, physician and general practitioners were 62.1％, 28.8％and 9.1％ respectively. Physicians from community hospital, 2nd grade hospital and 3rd grade hospital were 5.4％, 26.5％, and 68.2％ respectively. The correct answer for 15 multiple-choice questions was only 32.6％ and for 10 blank-filling questions regarding the target doses of anti-HF drugs was 42.5％. Physicians with the higher professional title had greater awareness of HF guidelines than those with the lower title, P<0.001. The compliance and command to HF guidelines were different among hospital levels, P<0.001; the command to HF prevention and treatment were different among physicians in different practice scopes, P<0.001. Conclusion: The knowledge for HF diagnosis and treatment had deficiency in physicians in China, further systemically study should be enforced.

OBJECTIVETo investigate the effect of premature rupture of the membrane (PROM) on neonatal complications in premature infants.

METHODSThe registration information of 7684 preterm infants with gestational age <37 weeks were collected from the cooperative units in the task group between January 1, 2014 to December 31, 2014. Specially trained personnel from each cooperative units filled in the unified form in a standardized format to record the gender, gestational age, birth weight, PROM, placental abruption, antenatal corticosteroid, Apgar score, amniotic fluid pollution, and complications of the infants. The data were analyzed comparatively between the cases with PROM and those without (control).

RESULTSThe preterm mortality rate was significantly lower but the incidences of ICH, NEC, ROP and BPD were significantly higher in PROM group than in the control group (P<0.05). The 95% confidence interval of the OR value was <1 for mortality, and was >1 for ICH, NEC, ROP and BPD. After adjustment for gestational age, birth weight, gender, mode of delivery, placental abruption, placenta previa, prenatal hormones, gestational diabetes mellitus (GDM), gestational period hypertension and 5-min Apgar score <7, the incidences of NEC, ROP and BPD were significantly different between the two groups (P<0.05) with 95% confidence interval of OR value >1, but the mortality rate and incidence of ICH were not significantly different between the two groups (P>0.05).

CONCLUSIONPROM is a risk factor for NEC, ROP and BPD in preterm infants, and adequate intervention of PROM can reduce the incidences of such complications as NEC, ROP and BPD in the infants.

Apgar Score ; Birth Weight ; Female ; Fetal Membranes, Premature Rupture ; pathology ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; Infant, Premature ; Pregnancy ; Risk Factors

Objective To evaluate the antibacterial activities of severalβ-lactam/β-lactam inhibitor combinations in vitro.Methods All the clinical isolates were Enterobacteriaceae collected from hospitals and the susceptibility tests were performed using agar dilution method recom-mended by CLSI.The minimum inhibitory concentration ( MIC ) results were interpreted according to the breakpoints of CLSI (2014) guideline.The data was analyzed by software SPSS17.0.Results A total of 2166 Enterobacteriaceae were collected and were performed MIC tests.Based on the MIC results, the MIC50 and MIC90 of piperacillin to Escherichia coli were 256 , 512 μg · mL-1 , while piperacillin/tazobactam were 2 , 8μg· mL-1 , respectively.The sensitive rates of piperacillin/tazobactam to ESBLs -producing Escherichia coli and Klebsiella pneumoniae were 93.7% and 86.1%, cefoperazone/tazobactam were 91.5% and 82.5%, while cefoperazone /sulbactam were 74.4% and 58.39%. Among ESBLs -non -producing Escherichia coli and Klebsiella pneumoniae, there is not much difference between using β-lactam/β-lactam inhibitor combinations and β-lactams alone.β-lactam antibiotics have higher sensitive rates to Proteus vulgaris than Proteus mirabilis, butβ-lactam/β-lactam inhibitor combinations have no difference against them.The sensitive rate of mezlocillin/sulbactam to Morganella spp.was 97.4%, significantly higher than mezlocillin alone with sensitive rate 76.3%.The MIC90 of cefotaxime/tazobactam and ceftriaxone/tazobactam were lower than using cefotaxime and ceftriaxone alone.Conclusion β-lactam/β-lactam inhibitor combinations have greater antimicrobial activity to Enterobacteriaceae than β-lactams alone, especially for ESBLs-producing Escherichia coli and Klebsiella pneumoniae.Among them, piperacillin/tazobactam has the greatest antimicrobial activity.

OBJECTIVETo explore the association between parental genetic polymorphism of methylenetetrahydrofolate reductase (MTHFR) 677C/T and occurrence of nonsyndromic cleft lip with or without cleft palate (NSCL/P) in offspring in Shandong Province.

METHODSMTHFR genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Parents of 89 NSCL/P patients treated at Qilu Hospital from August, 2006 to August, 2008 and those of 64 healthy children were recruited in this case-control study.

RESULTSFrequencies of T and C alleles in mothers of patients and healthy children were 65.73% and 46.09%, and 34.27% and 53.91%, respectively (Chi-square=13.663, P<0.01). Offspring whose mothers had T alleles were 2.243 times more likely to develop NSCL/P (95%CI: 1.408-3.572). Frequencies of T and C alleles in fathers of patients and healthy children were 62.92% and 55.47%, and 37.08% and 44.53%, respectively (Chi-square=2.222, P>0.05). The chance for parents of the patient and control groups to bear an affected fetus carrying homozygous mutations were 43% and 29%, respectively (P>0.05).

CONCLUSIONIn Shandong Province, maternal genotype for the MTHFR 677C/T polymorphism has a significant impact on the occurrence of NSCL/P in their offspring, whilst paternal genotype for this polymorphism may not be a risk factor for NSCL/P in their offspring.

Alleles ; Case-Control Studies ; Child ; Cleft Lip ; genetics ; Cleft Palate ; genetics ; Female ; Genotype ; Homozygote ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Polymorphism, Genetic

Objective To construct the head nurses performance evaluation system in order to measure their performance fairly and equitably and to enhance their responsibility,crisis and sense of competition.Methods Many methods were used such as the balanced scorecard four elements were used to construct the basic framework of the performance evaluation system and Delphi method was used to determine the various index,analytic hierarchy process was used to identify the index of value at all levels.Results Two wheels consultation were used and the enthusiasm of experts was high with the coefficient was 88％ and authoritative coefficient was 0.76.Four primary indexes of performance evaluation system were consisted,such as finance,client,interior process,learn and study. It included sixteen secondary indexes,such as nursing service projects,nursing equipments,patients and families,nurses,doctors,and so on.Conclusions Performance evaluation system construction of head nurses based on the Delphi method can measure their performance fairly and equitably and it is worth to applyingin nursing.

To systematically summarize the evidence on the effectiveness of measures regarding tobacco control in China. Papers on several databases published between 1990 and 2009were systematically searched. Methods in American Guide to Community Preventive Services were used to evaluate the quality and strength of evidence on the effectiveness of tobacco control programs.Overall, 282 studies were included in this paper, but only 75 (26.41%) studies had acceptable execution quality. Items as pharmaceutical therapy and behavior intervention in the smoking population that would show sufficient evidence on the effectiveness of the programs. In general population, multi-component intervention programs appeared to be effective. However, the effectiveness regarding items as clinical consultation, therapy with traditional Chinese medicine,education programs alone, non-smoking related laws and regulations etc. were of insufficient evidence. The overall execution quality of intervention studies on tobacco control in China was considered to be poor and few of them would show the evidence on the effectiveness of the programs. Only few studies on non-smoking related laws and regulations touched upon the positive effectiveness on this issue. We suggested that the execution and evaluation on non-smoking related laws and regulations be strengthened.

The aim of the present study is to investigate the expression of a novel estrogen receptor, G protein-coupled receptor 30 (GPR30) and its correlation with matrix metalloproteinases-9 (MMP-9) in epithelial ovarian cancer (EOC). Ovary tissues were obtained from 39 female patients, including 30 cases of EOC and 9 cases of benign ovarian tumor. Four normal ovary tissues were used as control. Immunohistochemical staining was used to detect the expressions of GPR30 and MMP-9. Chi square test, Fisher's exact test and Spearman's rank correlation analysis were used for statistical analysis. The results showed that GPR30 overexpression rate in EOC cases was significantly higher than those in benign ovarian tumor and normal ovary cases. Whereas MMP-9 overexpression rate in EOC cases was significantly higher than that in normal ovary cases, without any difference to that in benign ovarian tumor cases. To demonstrate the relationship between GPR30 and clinicopathological variables of EOC, we further analyzed the pathology type, FIGO stage and age of patients sampled in our study. The analysis showed there were significant differences of GPR30 overexpression rate among various pathology types and different FIGO stages (P<0.05), and no significant difference of both GPR30 and MMP-9 among three age groups (P>0.05). Moreover, GPR30 expression was positively correlated with MMP-9 (r(s)=1.000, P=0.002). These results suggest that GPR30 may be involved in the invasion and metastasis of EOC, being a potential index of EOC early diagnosis and malignancy grade prediction.
Adult ; Aged ; Biomarkers ; metabolism ; Cystadenocarcinoma, Serous ; metabolism ; Female ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; Neoplasms, Glandular and Epithelial ; metabolism ; Ovarian Neoplasms ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, G-Protein-Coupled ; metabolism ; Young Adult