Following an analysis of the problems and challenges of public hospitals in Shanghai,the paper presented the approach of Shanghai Shenkang Hospital Development Center in its problem-based reform of such hospitals.The measures include promotion of capital construction,enhanced discipline human resources,and accelerated informationization,as well as overall budget management and hospital director performance appraisal,which enhanced their service capacity and operational efficiency.

The paper described the significance of strategic planning and management for hospitals and analyzed the presence practice of such strategic planning and management in the country. It focused on the practices of 23 tertiary hospitals in Shanghai in making and implementing their development plan for the "12th Five-year Plan"; summarized their three characteristics in public benefic guidance, better operability and better services. In addition, it introduced the initial achievements made in enhancing service quality and patient satisfaction, tapping resource potentials, enhancing operation efficiency and sustainable development.

Objective To investigate the effect of antisense telomerase reverse transcriptase (TERT) on 5-hydroxytryptamine (5-HT) induced proliferation and cell cycle of pulmonary artery smooth muscle cells (PASMCs). Methods PASMCs were cultured and divided into four groups: control group (cultured in RPMI-1640 culture medium), 5-HT group (cultured in culture medium containing 5-HT), antisense oligonucleotide (ASODN) group (cultured in culture medium containing 5-HT and ASODN TERT), and sense oligonucleotide (SODN) group (cultured in culture medium containing 5-HT and SODN TERT). The apoptosis of PASMC was observed by fluorescence microscopy with Hoechst staining. Apoptosis and cell cycle was analyzed with flow cytometry. Expression of proliferated cell nuclear antigen (PCNA) was determined by immunohistochemistry staining. Results Hoechst staining showed that apoptosis in 5-HT group (161?33) was significantly higher than that in control group (63?16, P

Objective To summarize the experience in nursing children with pediatric advanced intraocular retinoblastoma treated with 23-gauge microinvasive vitrectomy. Methods Eleven infants (12 eyes) suffered from advanced intraocular (D or E) retinoblastoma and treated with 23-gauge microinvasive vitrectomy. Preoperative psychological nursing, postoperative complication nursing and follow-up nursing were performed. Results The retinal tumors was completely removed in all 12 eyes. After the follow-up of a half year, the conditions in 8 eyes were stable, and the tumors in 4 eyes recurred. Visual acuity in 4 eyes improved and that in 1 eye remained unchanged. Conclusions Microinvasive vitreous operation can effectively remove advanced intraocular retinoblastoma. Active efficient perioperative nursing plays an important role for the prevention of complications and promoting the recovery of affected eyes.

Objective To explore the role of hypoxia-inducible factor-1? (HIF-1?) in the expression of telomerase reverse transcriptase (TERT) in the pulmonary arterial smooth muscle cells (PASMCs) under anoxia.Methods HIF-1? and TERT mRNA in the PASMCs were examined by RT-PCR with the presence of HIF-1? inducers (CoCl_2,DFX),inhibitor (FAS,CBZ-LLL) and oligodeoxynucleotides,or under anoxia.HIF-1? protein in the PASMCs was determined by Western blotting.Results Expressions of HIF-1? and TERT mRNA significantly up-regulated under anoxia (0.59?0.07,0.60?0.06) compared with that in control group ( 0.11? 0.02,0.1?0.01,P0.05).Antisense oligodeoxynucleotides invalidated CoCl_2-induced increase in TERT mRNA levels (0.45?0.04) compared with CoCl_2 group (0.95?0.08,P

Objective To analyze the clinical characteristics of severe retinopathy of prematurity (ROP) in extremely low birth weight infants (ELBWI),and to evaluate the management model of ROP screening of ELBWI and the clinical effects and treatment timing of photocoagulation with intravitreous injection of vascular endothelial growth factor inhibitor (Avastin).Methods Forty-five cases of ELBWI (birth weight ＜ 1000 g) survived finally in our neonatal intensive care unit from July 1,2004 to June 30,2011 were reviewed.ROP screening was regularly performed in 4 ～ 6 weeks postpartum with binocular indirect funduscope by ophthalmologists.Newborns with severe ROP were treated with laser photocoagulation in the fundus.Some newborns that developed aggressive posterior ROP(APROP) were treated with combined intravitreous injection of Avastin and photocoagulation.Results Thirteen of 45 cases (28.89％) had not developed to ROP finally.Six cases (13.33％) developed to stage 1 ～ 2 ROP and then spontaneous recovery during the follow-up period.Twenty-six newborns (57.78％) developed to severe aggressive posterior ROP (APROP) and need to be treated with photocoagulation.All 3 APROP infants (6.67％) were received intravitreous Avastin injection prior to photocoagulation.The visual acuity of all 45 patients (100％) in this study was preserved.Conclusion ELBWI have a higher morbidity of severe ROP.Timely screening and intervention are effective to prevent disease progression.Intravitreous Avastin injection prior to photocoagulation may be necessary to preserve the visual acuity of infants with APROP.Respiratory management is the key for post-operation care.

Objective:To investigate and evaluate the anti-tumor activity of hydroxychloroquine ( HCQ) in vitro. Methods:CCK-8 assay was applied to detect the inhibitory effect of HCQ at different concentrations(4. 78, 9. 55, 19. 10, 38. 20,76. 40 μg?ml-1 ) on A549 cells, HepG2 cells, HT-29 cells, K562 cells, Hela cells and B16 cells. Absorbance was detected by a microplate reader, and then the inhibitory rate of the tumor cells and the IC50 was calculated. Results:Compared with those of the negative control group, the inhibitory rates of HCQ at different concentrations against the six tumor cells were all increased significantly in a dose-dependent manner (P<0. 01). The inhibitory rates of the tumor cells were all above 60% when the concentration reached 38. 20μg?ml-1. The IC50 was 26. 70(A549), 27. 47(HepG2), 5. 72(HT-29), 14. 03(K562), 20. 21(Hela) and 13. 62(B16) μg?ml-1, respectively. Conclusion:HCQ shows anti-tumor activity on several cancer cells in vitro. There may be a good application prospect for HCQ in the treatment of colorectal cancer, liver cancer, cervical cancer, melanoma and leukemia.

Objective To analyze the incidence of retinopathy of prematurity(ROP)among extreme-ly preterm infants,and to evaluate the treatment methods and effects among those with severe ROP.Methods A retrospective analysis was performed to analyze incidence of ROP in 96 cases of extremely preterm infants who were born at a gestational age of 〈28 weeks and survived beyond a postmenstrual age of at least 1 year from Apr 2006 to Oct 2013,and to analyze the treatment outcomes of photocoagulation and ranibizum-ab intravitreal injection among the infants with severe ROP.Results Fifty-six of 96 cases(58.33%)grew into ROP finally and 21 cases(21.88%)grew into severe ROP,2 cases(2.08%)grew into aggressive poste-rior ROP.Fifteen cases with severe ROP were treated with laser photocoagulation.Four cases with severe ROP were received ranibizumab intravitreal injection prior to photocoagulation.Two cases with severe ROP were only treated with ranibizumab intravitreal injection.The eyesight of 96 patients (100%)in this study were all preserved.Conclusion ROP screening should focus on extremely preterm infants because of higher incidence of ROP and severe ROP among them.The infants with severe ROP should be treated with laser photocoagulation in time.The infants in critical condition or with aggressive posterior ROP can be treated with ranibizumab injection.

Objective To investigate the methylation patterns of secreted apoptosis-related protein 2 (SARP2) gene extron 1 in patients with pancreatic adenocarcinoma and its clinical value in diagnosis and prognosis. Methods The samples were collected from 23 patients with pancreatic carcinoma, 6 with chronic pancreatitis and 7 normal controls. The extracted DNA was treated with sodium bisulfite and analyzed by PCR for methylation patterns in the CpG islands of SARP2 gene. Results The incidence of methylation in CpG islands of SARP2 gene was significant higher in pancreatic carcinoma (37.9%) than that in paracaneerous (15.2%), pancreatic (15.2%) and normal (0%) tissues (P<0.05). The methylation in some CpG sites (region 1) had specificity to pancreatic cancer. The methylation of SARP2 gene was not associated with sex, age, tumor size, stage and metastasis. But the hypermethylation of CpG was related with the tumor size and differentiation. Conclusions The distribution of CpG hypermethylation in SARP2 gene extron 1 is not equilibrium. Some CpG hypermethylation has specificity to pancreatic carcinoma, and may be served as potential targets as well as prognosis indexes for pancreatic cancer.

Objective Studies of the positioning,framework and weight of the performance of directors of third-grade public hospitals will pave the way for launching a study of the performance of these directors,and for the performance appraisal of the directors of third grade public hospitals.Methods The following methods are called into play:Meta-analysis of literature to summarize the research outcomes of the appraisal thinking and modeling for managers of public hospitals;the balance score card to design the theoretical base of public hospital performance framework;the Delphi Method to identify the functionality expected of public hospitals,and the thinking and framework for performance appraisal;in addition to experts consultancy to demonstrate via questionnaires.Results Positioning of directors performance appraisal of third-grade public hospitals comprises both desirable social effect outcomes and desirable operating status.This performance appraisal consists of such five dimensions as social satisfaction,effective management,asset operation,development sustainability,and employee recognition,totaling 12 performance objectives.Conclusion Scientific and reasonable design of the framework and weight of the perfofinance appraisal for managers of public hospitals is conducive to assuring the public interest nature for public hospitals.