Hospital values in hospital management plays a leading position,the hospital values is the essence of hospital management and the core is embodied the spirit of the decisive factors in the hospital.Only thorough analysis of the reasons for the distortion of values and values distorted the adverse effects can be full demonstration Hospital values is the soul of hospital management.

Idiopathic Refractory Nephrotic Syndrome (IRNS) has been an intractable problem in clinical treatment .Anti CD20 monoclonal antibody is a new type of immunosuppressive agent , which can induce the lysis and apoptosis of B cells .Significant-ly, it improves the prognosis of IRNS patients .In recent years, a number of case studies and clinical trials have been conducted on the effectiveness of anti CD20 monoclonal antibody in the treatment of children with IRNS .In this paper, the mechanism, clinical applica-tion, adverse effects and problems in the study of anti CD 20 monoclonal antibody in IRNS will be reviewed .

Since the chronic kidney disease (CKD) and end-stage renal disease (ESRD) can cause serious disease burden and consume huge amounts of health resources to human life,research on CKD received increasing attention.For the particularity of the elderly,whether the current definition,stages and renal function assessment of CKD should be distinguished from the adults has been controversial.We conducted a comprehensive review on these issues.Furthermore,the studies on the epidemiologic status,trends,and characteristics of CKD for the elderly were summarized,and possible reasons for the differences between the various studies were analyzed.

Objective To investigate the effects of pulmonary rehabilitation (PR) on the depression and exercises capacity and pulmonary function in elderly patients with stable moderate-to-severe chronic obstructive pulmonary disease. Methods 38 participants [(68.01 ± 5.27) years old; moderate 28, severe 10] were en-rolled in a 6-month PR program with exercise training. Subjects measurements were made of the Epidemiologic Studies Depression scale (CES-D), 6-minute walk test (6MWT) and pulmonary function. Result The CES-D Scores before and after PR were 23.94 ± 4.86 vs. 14.66 ± 2.47, P = 0.000; 6 MWT and the percent of the predicted FEV1 before and after PR were (353.6 ± 27.90)m vs. (276.8 ± 30.95)m, P = 0.000, 58.09 ± 8.77 vs. 58.34 ± 7.94, P > 0.05. CES-D scores and exercise capacity improved after PR. But PR contributes nothing to the improvement of pulmonary function. Conclusion Although the PR improves the depression and exercise capacity in elderly patients with stable moderate-to-severe COPD , no statistically significant correlation was ob-served between depression scores and 6MWD and the percent of the predicted FEV1.

Thin-Layer Chromatography (TLC)used for separation and quantitation of phospholipids including phosphatidyl-choline (PC), Phosphatidyl-ethanolamine (PE), platelet activating activating-factor (PAF) were studied. The experimental processes were: lipid extract from tissue sample by Bligh-dyer methods, separation of phospholipids by TLC. and quantitation of phospholipids by phosphorus quantitative method. Using this method had found that reperfusion caused membrane phospholipids degradation in rat heart in situ subjected to 5 min of ischemia and followed by 10 min of reperfusion, myocardial total phospholipid, PC, PE decreased by 38.7, 46. 2 and 42.2%. respectively. Results indicated that membrane phospholipid play an important role in the genesis of ischemic-reperfusion induced myocardial damage.

The hospital culture management is an important aspect of hospital management.The service concept and performance are different in each hospital because each hospital has its own cultural characteristics,resulting in different hospital cultures.Hospital culture is the spiritual pillar of the hospital brand.A good cultural atmosphere in the hospital will be the most important and lasting protection on the creation of hospital brand services.The key of nurturing hospital culture is to shape the hospital spirit.Hospital spirit is hospital staff′s concentrated expression of value orientation,culture status,group consciousness and the behavioral code.So it is an important task of hospital culture construction to strengthen medical ethics and build a harmonious physician-patient relationship.And this is also the new requirements for medical staff.To enhance hospital′s core competitiveness calls to develop innovative hospital culture.

Objective: To observe the efficacy of mild moxibustion combined with functional exercise in the treatment of upper-limb lymphedema after breast cancer surgery and its effect on serum vascular endothelial growth factor C (VEGF-C). Methods: Seventy-eight patients were divided into a control group and an observation group by the random number table method, with 39 cases in each group. The control group received functional exercise and the observation group received mild moxibustion plus functional exercise. The differences in circumference between the two upper limbs, the lymphatic flow of the affected upper limb, the disability of arm, shoulder and hand (DASH) score, the functional assessment of cancer therapy-breast (FACT-B) score and serum VEGF-C level between the two groups were compared before and after treatment. Efficacy was evaluated after treatment. Results: The total effective rate was significantly higher in the observation group than in the control group (P<0.05). The difference in circumference between the two upper limbs of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The lymphatic flow of the affected upper limb of the two groups increased significantly after treatment (both P<0.05), but it was significantly greater in the observation group than in the control group (P<0.05). The DASH scores of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The FACT-B scores of the two groups increased significantly after treatment (both P<0.05), but it was significantly higher in the observation group than in the control group (P<0.05). After treatment, the serum VEGF-C level increased significantly in the observation group (P<0.05), whereas the control group did not show significant change (P>0.05). The post-treatment serum VEGF-C level was significantly higher in the observation group than in the control group (P<0.05). Conclusion: The efficacy of mild moxibustion combined with functional exercise for upper-limb lymphedema after breast cancer surgery is certain, which can reduce the difference in circumference between the two upper limbs, increase the lymphatic flow of the affected upper limb, improve the limb function and the quality of life, and regulate the serum VEGF-C level.

Adult ; Female ; Humans ; Laryngeal Neoplasms ; complications ; Neurilemmoma ; complications ; Neurofibromatosis 2 ; complications

Acupuncture Points ; Adult ; Electroacupuncture ; Female ; Head ; innervation ; Humans ; Neuritis ; therapy

BACKGROUND: Collagen type Ⅰ possesses low antigenicity and provides special functions of scaffold structure for cell migration, proliferation and secretion.OBJECTIVE: To observe the morphological change after combination of transformed human embryonic tendon cells and artificial materials with collagen type Ⅰ, so as to provide the experimental basis for constructing tissue-engineered muscle tendon in vitro.DESIGN: Randomized and controlled observation.SETTING: Department of Orthopaedics, West China Hospital, Sichuan University.MATERIALS: This experiment was carried out at the Department of Transplantation Immunology, West China University of Medical Sciences from July to September 1998. Human hair, carbon fiber and polyglycolic acid were combined with collagen and then set corresponding groups respectively. Simply hair, carbon fiber and polyglycolic acid control groups were set respectively. Artificial materials: Healthy adult hair (30 cm in length, 80 g in weight), carbon fiber knitted strip (Lanzhou carbon factory )and polyglyolic acid fasciculi (Johnson , American) were used in this experiment.METHODS: ①In the group of human hair combined with collagen,nine healthy adult hairs were chosen . Three hairs as one bundle were knitted into tendon with 0.8 cm in length and 0.4 cm in diameter and a knot was tied respectively at the two ends. ②In the carbon fiber combined with collagen group, the purchased carbon fiber knitted strip was separated and made into artificial materials with the same diameter and length as those of human hair tendon. Two ends of the artificial materials were packed with 5/0 silk thread. ③In the polyglycolic acid combined with collagen group, three polyglycolic acid fasciculi were weaved into bundle with the same diameter and length as those of human tendon,and two ends were packed with 5/0 silk thread. ④The process of knitting scaffold materials was the same in control groups as in the corresponding experimental groups. ⑤ Five pieces were prepared in each scaffold material. After sterilized by 60Co, the scaffold materials were put in collagen type Ⅰ solution for 0.5 hour, then taken out and dried at roomtemperature for use in the experimental groups. ⑥transformed human embryonic tendon cell, density for 3×106/mm3, was used for combined culture in each group, and cell number and morphology were observed at different time points after culture under an inverted microscope and scanning electron microscope.MAIN OUTCOME MEASURES: ① Observation of cell growth and adherence under an inverted microscope ② Observation of cell morphology and material adherence under scanning electron microscope RESULTS: ① Observation of cell growth and adherenceunder an inverted microscope :In each experimental group, at two hours after culture, cells gathered around the materials, and some cells adhered to materials presented round; At three days after culture, the number of cells adhered to materials began to increase, morphology changed from round to oval, and the co-existence of round and oval cells was seen;While in each control group, at two and three hours after culture, few cells adhered to the three materials. On day five after culture, in each experimental group, cell morphology turned into fusiform, the number of cells increased further and a great many fusiform cells grew among carbon fiber materials; while in the control group, most cells presented round and ellipse, and the number of cells was less as compared with the corresponding experimental group. ② Cell morphology and material adherence under scanning electron microscope: On day 5 after in vitro culture, most tendon cells on the surface of materials presented spindle-shape in each experimental group. Apophysis stretched out from the tendon cells, grew along longitudinal axon of the materials. Silk and piece-like substance appeared among the apophysis and weaved each other. While there were fewer cells adhered in control group than in corresponding experimental group, cells also presented fusiform or round, but no silk or piece-like substance was found, also no apophysis appeared.CONCLUSION: Human hair, carbon fiber and polyglycolic acid combined with collagen type Ⅰ will facilitate cell adherence. Cells increase around the materials and co-existence of round and oval cells could be seen, and cells turned into fusiform, suggesting that exogenous collagen facilitate the cells to adhere onto the materials and proliferate.