Delicacy management is an important issue to the hospital logistics mode innovation,which is the only way to realize a scientific hospital logistics management.This article proposes the practical ways to push on the hospital logistics delicacy management from many respects,such as working regulation,consumption measurement,contract supervision,cost accounting,structure control and convergence supporting.

In the face of both market competition and health logistic support,whether military hospitals can adapt their operation and management strategies to balance the relationship of battlefield and market place,is the lifeline of their survival and development.The study summarized significance of strategic management of the hospitals in view of characteristics of such hospitals,and introduced explorations made at the hospital in their strategic management.

Objective To investigate the effects of triptolide on proliferation,apoptosis and the changes of Ski,Smad3,Smad7 and collagen type I(ColI) in cultured rat mesangial cells induced by transforming growth factor (TGF)-β1.Methods Cultured HBZY-1 rat mesangial cells were divided into 5 groups:(1)normal control group; (2)TGF-β1 group (10 μg/L); (3)-(5)triptolide (0.4,2,10 μg/L)+TGF-β1 (10 μg/L) groups.The cell proliferation was detected by MTT.Apoptosis of mesangial cells was detected by TUNEL assay.The expressions of Ski,Smad3,Smad7 mRNA were examined by real-time quantitative PCR.The expressions of Ski,Smad3,Smad7 and ColI protein were detected by Western blotting.The localizations of Ski and Smad3 protein were detected by laser confocal fluorescence microscope.Results Compared with the normal control,TGF-β1 (10 μg/L) significantly stimulated mesangial cells proliferation,while decreased apoptosis.The mRNA and protein expressions of Ski,Smad7,Smad3 and ColI protein expression in TGF-β1 group were increased (P ＞0.05).In comparison with TGF-β1 group,triptolide could significantly inhibit TGF-β1-induced mesangial cells proliferation in dose-dependent manner,and promote the apoptosis of mesangial cells.In TGF-β1 group,mRNA and protein expresscons of Ski and Smad7 were increased (P＜0.05),Smad3 mRNA and protein were decreased (P ＞0.05),and ColI protein was decreased (P＜0.01).In comparison with TGF-β1 group,fluorescence intensity of Ski,Smad3 proteins was significantly increased in cytoplasm,while decreased in nucleus.Conclusions Triptolide can inhibit TGF-β1-induced mesangial cells proliferation through regulating the expressions of Ski,Smad7 mRNA and protein,inhibiting Ski.Smad7 translocation to the nucleus,and down-regulating Smad3 mRNA and protein expression.Triptolide can promote apoptosis of mesangial cells.

Objective To investigate the predictive value of plasma gelsolin in the prognosis of patients with ST-sgement elevation myocardial infarction ( STEMI ) and undergone primary percutaneous coronary intervention ( PCI ) .Methods The study included 206 patients with STEMI and undergone primary PCI, 148 patients with stable angina pectoris and received elective PCI and 80 healthy volunteer as the health population (NP) control.Blood samples were taken at admission on day 1, 3, 5, 7 and 9 to determine the plasma gelsolin level .Patients′baseline clinical characteristics , blood biochemistry tests results , details of operation and their cardiovascular risk factors were recorded .Major adverse cardiovascular events (MACE) within one year were recorded.Results (1) Compared to the stable angina group and the NP group, the level of plasma gelsolin of STEMI patients were obviously decreased at various time points ( all P<0.05 ) .There were no statistical differences between the stable angina group and the NP group .( 2 ) Patients with STEMI were catagorized into MACE group (n=78) and non-MACE group (n=128) according their follow up record in 1 year.The level of plasma gelsolin in patients with MACE were lower than the non-MACE group ( P <0.05 ) with the minimum value detected on day 7.Among patients complicated with MACE (n=78), they were further devided into the deceased group (n=18) and the survival group (n=60).Plasma gelsolin levels were lower in the deceased group with satistical differences found on day 5, 7 and 9.(3) Single factor Logistic regression analysis showed that the level of plasma gelsolin on day 7 was independent risk factor of MACE within one year ( P =0.014 ) .( 4 ) Setting the cutoff value of plasma gelsolin on day 7 as 21.7 mg/L,the sensitivity and speciticity for the MACE in STEMI patients treated with primary PCI within one year were 82.1%and 81.4%respectively , with the area under the receiver operator characteristic curve ( ROC ) was 0.854 ( 95% confidence interval 0.732 -0.961 , P <0.01 ) . Conclusions Plasma gelsolin levels are correlated with the severity of STEMI lesions and plasma gelsolin can be used as predicting factor of prognosis .

Aim To investigate effects of chlorzoxazone on survival and apoptosis of HepG2 cells.Methods The necrosis of HepG2 cells was evaluated by measurement of LDH release.The effects of chlorzoxazone on survival of HepG2 cells were assayed by MTT dyereduction.The effects of chlorzoxazone on cell apoptosis was analyzed by TUNEL method.The ultrastructure of HepG2 cells was observed by transmission electron microscope.Results Chlorzoxazone at concentrations of 100～500 ?mol?L-1 inhibited survival ratios of HepG2 cells in a dose-dependent manner significantly.Typical apoptotic changes were observed in HepG2 cells under the fluorescence microscope and transmission electron microscope.Apoptosis of HepG2 cells was induced after treatment of chlorzoxazone at concentrations from 100 ?mol?L-1 to 500 ?mol?L-1 for 48h,which showed obvious concentration-effect relationship.The apoptotic ratios of HepG2 cells were also increased when chlorzoxazone(100,200,300 and 500 ?mol?L-1) was treated for 24,48 and 72 h,which showed obvious time-effect relationship.Conclusion Chlorzoxazone inhibited HepG2 cells survival and induced cell apoptosis.

Objective To detect the change of exoression level of plasma microRNA‐21(miR‐21) and TGF‐β1 in cardiac remode‐lin affer acute myocardial infarction(AMI) of the pateins .Methods 200 pateints with AMI and 100 normal controls(age ,sex matched) were enrolled .Blood samples were obtained from the normal controls and patients with AMI on the 3 days ,7 days and 14 days .Real‐time PCR was developed to detect the expression of miR‐21 and TGF‐β1 in plasma .Results The expression of miR‐21 was significantly up‐regulation in the 3 days ,7 days and 14 days in MI group than that cntrol group ,0 .74 ± 0 .21 vs .2 .62 ± 0 .23 , vs .3 .67 ± 0 .25 ,vs .4 .13 ± 0 .27 up‐regulation in the 3 days ,7 days and 14 days in MI group than that cntrol group ,0 .98 ± 0 .18 vs .2 .35 ± 0 .24 ,vs .3 .67 ± 0 .25 ,vs .4 .13 ± 0 .27 ,P<0 .05 ,respectively .The expression of miR‐21 and TGF‐β1 were up‐regulation with the change of cardiac function .Positive relationship between miRNA‐21 expression and LVDd (r=0 .757 ,P<0 .05);Positive relationship between TGF‐β1 mRNA expression and LVDd(r=0 .701 ,P<0 .05) .Conclusion The expression of miR‐21 and TGF‐β1 were up‐regulation in cardiac remodelin affer AMI of the pateins ,which involved in regulation in cardiac remodelin affer AMI .

With quickening the population aging , the incidence of the Alzheimer′s disease is increasing year by year .Only using drugs was limited and many studies have confirmed that non-drug therapy can retard the progress of disease and promote the quality of patients′life.In this article, we describe the rehabilitation nursing advances in non-drug therapy to Alzheimer′s disease patients .We hope to supply the referential data for clinical treatment.

OBJECTIVETo investigate the cardiac effect of QT interval prolongation in the treatment of acute promyelocytic leukemia (APL) with arsenic trioxide (As(2)O(3)), and the relationship between QT and serum arsenic concentration.

METHODSBlood serum arsenic concentrations of thirty APL patients were determined at 2 hours, 4 hours, 8 hours, and 24 hours after As(2)O(3) injection using atomic fluorophotometry. Cardiac functions were measured simultaneously using a 12-lead body-surface electrocardiogram (ECG). Q-T intervals were manually measured, and then corrected using Bazett's formula (QTc). QT dispersion (QTd) was also calculated. In order to assess the effects of arsenic on the symptoms of anemia, twenty-four anemia patients were divided into two groups on the basis hemoglobin concentration: Group 1 (Hb > or = 90 g/L), and Group 2 (60 g/L < or = Hb < 90 g/L). QTc and QTd of these patients were also manually measured.

RESULTSAll QT intervals of APL patients treated with As(2)O(3) injection were prolonged [32.2 ms (27, 41 ms); P < 0.05], but the changes of QTd were not prominent [3 ms (-8, 7 ms), P > 0.05]. There was a delay of 2 hours in maximum QTc following peaks in serum arsenic concentration. Changes in QTc and QTd of the two anemic groups were not prominent.

CONCLUSIONSAs(2)O(3) can prolong QTc intervals in APL patients, but the effects are delayed compared to peak serum arsenic concentrations. As(2)O(3) has no prolongation effect on QTd. Mild and moderate anemia do not effect QTc and QTd.

Arsenicals ; pharmacology ; therapeutic use ; Electrocardiography ; drug effects ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; Oxides ; pharmacology ; therapeutic use

Objective: To study the effects p-phenylenediamine (PPD) on lung function and health-related quality of life of occupational exposed workers. Methods: This study was based on data from a company that produce hair dye containing PPD in China. Workers who exposed to PPD were selected as the study group, and workers un-exposed to PPD were selected as the control group. Questionnaires on health-related quality of life of workers using the 36-item Short Form Health Survey (SF-36) . Occupational health examination assessment results were tested in Taizhou Cancer Hospital. The lung function test includes forced vital capacity (FVC) , forced expiratory volume in one second (FEV_1.0) , and ratio of FEV_1.0 to FVC (FEV_1.0/FVC) . Results: The difference in systolic blood pressure between the PPD exposed group and the control group was statistically significant (P<0.05) . FVC, FEV_1.0, and FEV_1.0/FVC of the lung function indexes in the exposed group were lower than those in the control group (P<0.05) . In the health-related quality of life, body pain (P=0.002) , general health (P=0.029) , vitality (P=0.038) , and mental health (P=0.003) were lower in the exposed group than in the control group. Conclusion Occupational exposed to PPD may induce hazard to the workers’lung function and may cause detrimental effect on workers’ health-related quality of life.

Objective: To study the effect of p-phenylenediamine (PPD) on liver and kidney function in occupational exposed workers. Methods: Workers in a hair dye production enterprise which used p-phenylenediamine as a raw material for production were selected as the main research population. Then we conducted a questionnaire survey on the basic conditions of workers and conducted occupational health checkups on general health status, liver and kidney function. Occupational health examination assessment results were tested in Taizhou Cancer Hospital. All data was built using EpiData 3.1 software, and statistical analysis was performed using software SPSS 20.0. Results: The liver function indicators including direct bilirubin, prealbumin, total protein, and white protein, globulin, aspartate aminotransferase, glutamyl transpeptidase, and total bilirubin in the workers exposed to high concentration of PPD were at high normal values, and these indicators were significantly different from low PPD concentration group (P<0.05) . The serum creatinine and serum uric acid in the renal function index were significantly higher in workers exposed to PPD than in workers exposed to low concentrations and in the control group (P<0.05) . Conclusion Occupational exposed to PPD may have a hazard to the workers’ liver and kidney function. Long-term occupational exposure to PPD may lead to increased cumulative exposure of workers, which may cause potential chronic liver and kidney damage in occupationally exposed populations.