Taking the 8-year management practice of Sanjiu Brain Hospital of Guangdong since its founding as a case, the paper gives an account of how the hospital managed to grow by leaps and bounds. The steps taken include: guiding decision-making with innovations in thought and blazing new trails in such aspects as growth strategies, leadership structure, system of operation, quality control, nursing management, service skills, marketing management, hospital culture, and logistics management. The paper argues that innovation is the soul and driving force of hospital management and reform and that daring to and knowing how to make innovations are indispensable to enhancing the core competitiveness of the hospital and promoting its fast and sustainable growth.

Aiming at the confused situation of Stephania tetrandra and its adulterants in the production,supply and sale market,the author had overviewed information on Stephania tetrandra and its adulterants in source,character identification,microscopic identification,physical and chemical identification at home and abroad in recent years,so thus for scientific identify of species,distinguishing between the families and genera and correcting medication for clinical use.

Hypoxia-inducible factor-1 (HIF-1) is a key transciptional regulator of cellular and systemic oxygen homeostasis,composed of the two subunits,HIF-1α and HIF-1β.HIF-1α is an inducible subunit regulated by hypoxia,which is posttranslationally modified by various ways,including ubiquitination,phosphorylation,hydroxylation,acetylation and glycation,accordingly affecting its protein's stability,nuclear translocation and regulation of its target genes.Small ubiquitin-related modifier (SUMO) is an micromolecule protein participating in posttranslational modifications of proteins dynamicly in eukaryotic organism,which is similar in structure to ubiquitin.SUMOylation and deSUMOylation are involved in multiple regulations of biologic processes,such as signal transduction,transcriptional regulation,cell cycle processes and biological rhythm.SUMOylation is related to HIF-1α stability and transcription activity in hypoxia,providing a newthread to study self-regulation mechanism of HIF-1α for us.

Objective Telomerase reverse transcriptase (TERT) participates in pathologic processes of many ischemic damages.It also plays an important role in ischemic brain damage.There are a lot of activation mechanisms of TERT after cerebral ischemia.At present,the hypoxia-inducible factor-1 has been more clearly studied.The protective effect of TERT in ischemic brain damage may be associated with anti-apoptosis,promoting cell survival,promoting angiogenesis,and protecting mitochondria.

Objective Objective To investigate the clinical application of high-dose-rate(HDR)endobronchial brachytherapy for the treatment of primary lung cancer with atelectasis. Methods A total of 142 cases of lung cancer with atelectasis treated with HDR endobronchial brachytherapy and 71 cases(contr01)treated with extemal irradiation only at onr center of cancer were comparatively studied.1n the treatment group,with the aid of bmnchoscope,brachytherapy was applied 2 or 3 times at the dose of 8 Gy each time to a tissue depth of 1 to 1.5 cm.Cases in the contmlgroup,treated with external irradiation,received 60-70 Gy in total.Results Complete recruitment of atelectasis was observed in 80.28%cases of the treatment group and 64.79%in the control,T11ere Was significant difference between the two groups.Survival rates after 1,2 and 3 years in cases with complete remission of atelectasis in treatment group were 60.68%,44.44%and 23.93%,but 36.00%,28.00%and 16.00%in cases with no remission of atelectasis.Significant difference of one-year survival Was found between the two groups(P

Objective　To study the indication, contraindication and short-term clinical effects of stereotactic radiotherapy (X-knife) in lung cancer. Methods　A total of 56 cases (Treatment group) of lung cancer were treated with X-knife composing of the modern 3-D treatment planning system and the stereotactic body frame, and SL-75 accelerator. And another 53 cases only treated with routine external radiation served as the control. In treatment group, 42 cases received 50 Gy radiation, at 2 Gy per day, 5 d per week in the upper mediastinum, hilus of lung, below the primary focus first and then underwent X-knife for the primary focuses, and other 14 recurrent and metastatic cases received irradiation of 8-12 Gy per day, 5 d by X-knife alone. Results　The actually reexamination rate for 1, 3, 6, and 12 months after X-knife treatment in 78 focuses from 56 cases was 79.5% (62/78), 89.8% (70/78), 87.2% (68/78) and 78.2% (61/78) respectively. The focuses reappeared in 3 months after the treatment and the growth rates of focus in 3, 6, and 12 month after the treatment were 2.6% (2/78), 5.1% and 9% (7/78) respectively. There were 2 focuses received a second treatment with X-knife because no change after the first one. Both the 1-and 2-year survival rates of 36 cases of the primary lung cancer in the treatment group were higher than that of control group (89.1%, 53.9% and 77.4%, 39.6%). Conclusion　The stereotactic radiotherapy is of applicable and prospective in the treatment of lung cancer. The indications include: ①As a boost dose in case when primary focus is less than 5 cm after the first external radiotherapy may reduce the exposure of lung tissue to x-ray and the occurrence of radiation pneumonia; ②Treatment for the recurrence after radiotherapy and operation; ③Radical treatment for the metastatic focus less than 5 cm. Attention must be paid to when multiple treatment is carried on the volume of the focus, the Karnofsky scores and the general condition when stereotactic radiotherapy combined with X-knife for lung cancer.

Objective To construct the wt-p53's eukaryotic expression vector pE6/p53/GFP that was controlled by the radiation induced promoter and research its functions.Methods Radiation response element E6 was synthesized by gene synthesis.The wt-p53 cDNA sequence was prepared from pcDNA3.1(+)/p53 plasmid by PCR.IRES2-EGFP report gene segment was prepared from double cistron expression vector IRES2-EGFP by enzyme digestion.After sequenced and identified,the recombinant plasmid was transformed into H1299(p53-/-)cell with Lipofectamine 2000,and the cell lines in stable expression was screened by G418.In the H1299(p53-/-)cell transfected with the recombinant plasmid or without,wt-p53 mRNA expression was analyzed by RT-PCR,the p53 expression by Western blot when exposed to 4 Gy 8 MV X ray for 0,3,8,12,24,36 h or when exposed to 0,1,2,4,8 Gy 8 MV X ray for 12 h.The cell cycle of H1299(p53-/-)cell transfected stably with the recombinant vector was analyzed by flow cytometry after exposed to 4 Gy 8 MV X ray.Results The recombinant pE6-p53/GFP plasmid had been constructed correctly and the expression of p53 gene in the transfected H1299 cell lines had been determined.After 4 Gy X ray radiation,the expression of wt-p53 protein had a significant rise.The transfected H1299 cell lines stopped in G1 stage after radiation and their cloning efficiency decreased notably.Conclusion We had constructed successfully the recombinant pE6/p53/GFP plasmid that was regulated by radiation induced response element E6.This provides experimental data for radiation-gene therapy of non-small lung cancer.

Nutritional risk screening is the priority for nutrition support after stroke.The advance in nutritional risk screening after stroke was reviewed in order to provide assistant information for post-stroke nutrition support and nursing care.

Objective To analyze the efficacy,dose and complications of total body irradiation(TBI) for patients to receive hematopoietic stem cell transplantation(HSCT) in the treatment of leukemia and malignant lymphoma.Methods From May 2002 to February 2007,78 cases with leukemia or malignant lymphoma received the TBI before HSCT in our department.All the patients were irradiated with linear accelerator in 2 consecutive days at a total dose of 7 to 11 Gy,dose rate of 4.5 to 5.0 cGy/min,once per day.Among them,55 cases received traditional high-dose chemotherapy before radiotherapy,and the other 23 cases got TBI first followed by high-dose chemotherapy.Results All the cases used TBI prior to transplantation was successful,and no serious complication such as radiation pneumonitis was observed.Conclusion Our TBI regime is a safe and effective pretreatment for HSCT.TBI used before the large doses of the chemotherapy is recommended because it is proved to be effective,without affecting the survival rate,and of lesser TBI reaction and of lesser preparation work for irradiation to radiotherapist.More attention should be paid when the linear accelerator is employed for TBI.

Objective To investigate the chemical constituents of Wedelia trilobata.Methods The chemical constituents were separated by chromatography and their structures were determined by physico-chemical constants and spectral analyses.Results Eleven compounds were isolated and identified as grandiflorenic acid(1),1?-acetoxy-6?,9?-dihydroxy-4,10?-dimethyl-5?H,7?H,8?H-endesm-3-en-8,12-olide(2),1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide(3),16?-hydroxy-ent-kauran-19-oic acid(4),(3R,4R,6R)-3,4-dihydroxy-1-menthene(5),trilobolide-6-O-isobutyrate(6),1?-acetoxy-4?,9?-dihydroxy-6?-isobutyroxyprostatolide(7),16?,17-dihydroxy-ent-kauran-19-oic acid(8),daucosterol(9),protocatechualdehyde(10),and caffeic acid(11).Conclusion All the compounds are isolated from W.trilobata for the first time except compounds 6 and 7.Compounds 2 and 3 are new sesquiterpene lactones,named as trilobolide A and 1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide,respectively.