The study applied the model of authorized leadership to emergency night nursing in large general hospitals in order to explore the effect of such management. As it turned out, the evaluation of the administrators means of authorization by the three groups of research subjects averaged respectively 20 70,20 62 and 20 05, and the evaluation of the effect of authorization averaged respectively 79 80,78 39 and 83 55. The results indicate that the administrators means of authorization were basically rational and sound and the managerial abilities of those with authorized leadership were appreciated by the emergency night doctors and nurses. Thus management of emergency night nursing by those with authorized leadership may lead to improved efficiency and quality.

Objective To investigate the relationship between molecular biological markers and recombinant human endostatin targeted therapy in non-small-cell lung cancer(NSCLC).Methods 68 cases patients with non-small-cell lung cancer to meet the requirements were randomly divided into group A (n=34)and group B (n=34).Group A received docetaxel and cisplatin(DP)and gefitinib;group B received recombinant human endostatin on the base of group A.The biological markers species,such as,EGFR,KRAS,VEGF,BRCA1,EML4-ALK,ERCC1,β-tubulin and CD3 were detected by immunohistochemical.The types of population for different programs were summarized according to the expression of biological markers and progression free survival (PFS)of the two groups. Results Group B median PFS was significantly longer than that in group A;no matter low or high expression of VEGF and BRCA1,group B median PFS was significantly longer than that in group A(P<0.05);high expression of ERCC1,KRAS,EML4-ALK andβ-tubulin,group B median PFS was significantly longer than that in group A(P<0.05);low expression of EGFR and CD3,group B median PFS was significantly longer than that in group A (P<0.05 ).Conclusion No matter low or high expression of VEGF and BRCA1 ,low expression of KRAS, ERCC1,EML4-ALK and β-tubulin and high expression of EGFR and CD3 in patients with non-small cell lung cancer may be more sensitive to the treatment of DP and gefitinib combined with recombinant human endostatin.

Objective To explore the neuroprotective mechanism of mild hypothermia by studying the effect of mild hypothermia on neuronal apoptosis after transient global cerebral ischemia in rats.Methods A model of transient global cerebral ischemia was made by bilateral common carotid artery occlusion and hypotension in rats. The neuronal demage in the CA 1 section of the hippocampus after cerebral ischemia was observed by nissel body stain mothed;apoptosis was detected by in situ end-labeling of fragmented DNA using the terminal deoxynucleotidyl transferase reaction (TUNEL) and the electrical microscope.Results The hippocampal CA 1 section neurons in normothermic ischemic group were significantly deficit as compared with the false operative group in mild hypothermic ischemic group (P

Hongkong pediatric specialist training had successful experiences in the last twenty years.Hongkong hospital authority and Hongkong college of pediatricians managed pediatric specialist training together and made a series of regulations,which have strict training rotation requirements.Training hospitals all need to obtain the authentication including basic training,higher training and overseas training agencies.After 6 years strict training,the trainees have strong pediatric basic theories,procedure abilities,evidence-based practice and team work spirit.In short,the experiences of Hongkong pediatric specialist training is deserved to be learned by the standard training of pediatric resident in mainland China.

BACKGROUND: Transcranial Doppler(TCD) spectrum analysis techniques cannot measure the diameters of blood vessels and therefore and not be used to calculate the changes of brain blood flow. A formula was designed for regional cerebral blood flow loss index(rCBFLI) following arteriostenosis when arteriostenosis index formula was deduced; the former may provide a reference to assess cerebral function.OBJECTIVE: To introduce the formula of cerebral blood flow loss ratio obtained basing on TCD results.DESIGN: Retrospective controlled study based on patients with cerebral middle arteriostenosis diagnosed with TCD and healthy people.SETTING: At the departments of neurology in a university hospital and in a military medical university affiliated hospital of Chinese PLA.PARTICIPANTS: Between October 1994 and December 2000,43 patients who were confirmed of arteriostenosis with TCD at outpatient or neurological ward of the First Affiliated Hospital of Fujian Medical University were enrolled into this study,and their TCD results were compared with 908 normal controls between March 1992 and September 2000.METHODS: Stenosis index (STI) formula was deduced from TCD results of 31unilateral and 12 bilateral stenoses at middle cerebral artery(MCA) . STI = 1- [ normal average blood velocity (Vm0) ÷ average blood velocity at stenosisSince(PI1 ÷PI0) may be equal to [post-stenosis blood flow(Q1) ÷ normal blood flow(Q0)],regional cerebral blood flow loss index is concluded as:MAIN OUTCOME MEASURES: rCBFLI,relationship between STI and Vm,as well as between rCBFLI and STI.RESULTS: rCBFLI formula was used to calculate the rCBFLI of 31 patients following unilateral MCA stenosis. rCBFLI of these 31 patients was obtained by Pearson statistical analysis. STI was found to be related to the average blood velocity at stenosis with relative coefficient(Vm) of(r) =0.76( P ＜ 0. 001 )and r = 0. 83 ( P ＜ 0. 001 ) . rCBFLI was proved to be correlated with Vm and STI with r = 0. 76( P ＜ 0. 01 ) and r = 0. 81 in 55 side MCA stenoses,and the difference was of statistical significance( P ＜ 0. 001 ).CONCLUSION: rCBFLI can be used to assess the decrement of regional brain blood flow due to the stenosis of supplying artery; also,it can be used to observe the changes of brain hemodynamics if combined with STI.

In order to reform the medical talent evaluation system, establish evaluation systems of physician competency, and implement physician resources management systems according to work position, and the compensa-tion system which reflects the value of medical services, The basic principles and standards of different physician tiers and grades are created in Shenzhen based on literature review, expert consultation and the methods from the American Centers for Medicare and Medicaid Services ( CMS) . Some results have achieved, including medical competency as-sessment of a certain number of physicians in the pilot project ( the coincidence rate of special hospitals is higher than general hospitals, respectively 78. 9% and 44. 8% ), comprehensive personnel systems reforms in public hospi-tals, and the trial selection of medical talents. The paper also provides some implications:The cognition of all sectors of society and physician themselves should be improved, Transitional policies for position recruitment and performance pay needs further improvement. Meanwhile, the grade evaluation system of non-physicians must also be given greater attention.

We explored the status of Bartonella infection in rodents and the sequence characteristics of Bartonella in Fujian Province.Rodents in Fujian Province were captured by the night trapping method during 2014-2016.Information of the captured rodents on capturing dates and geographic locations,species,gender and ages were recorded.Heart blood samples were collected,from which the fragments of ghA gene and16S-23S rRNA gene of Bartonella were amplified by polymerase chain reaction (PCR).The PCR products were sequenced and the phylogenetic tree was constructed for homology analysis by biological analysis software.Data on infection rate were analyzed with Chi-square or Fisher exact test to indicate statistical significance.Results showed that 5 917 cages were laid and 381 rodents were captured,density of rodent was 6.44％.The overall Bartonella infection rate in rodents was 12.34 ％,while infection rate in domesticated rodents was 10.61％,with 11.30 ％ in Rattus norvebicus and 10.00％ in R.flavipectus.And the infection rate in wide rodents was 13.86％,with a rate of 22.86％ in Rattus losea and 18.00％ in R.fulvescens,respectively.The infection rate was higher in wild rodents than in domesticated rodents,however,no significant difference was found.The Western Fujian and Northern Fujian region had the higher infection rates of 20.00％ and 25.33％,and no infection was found in Southern Fujian region.The statistical analysis result revealed that a significant difference in infection rate among different region and habitats,but no significant difference in infection rate between male and female rodents,or among different ages.The BLAST results revealed the species to be B.tribocorum,B.elizabethae and B.grahamii.In conclusion,Bartonella infection is found in the rodents in Fujian Province and more attention should be paid on its impact on public health in the province.

Objective To investigate and analyze the clinical application of washed red blood cells in Quzhou in 2014-2015 years,and to provide evidence for the rational and effective use of washed red blood cells in clinical practice.Methods the amount of washed red blood cells,the distribution of diseases and the serological detection before transfusion were analyzed retrospectively in 8 hospitals of grade two and over in Quzhou during the past 2014-2015 years.Results the amount of washed red blood cells in 2015 increased by 39.07％ compared with 2014,an increase of 24.4 times the amount of red blood cells increase,increase mainly in 3 hospitals;Diseases of the blood system,malignant tumors and chronic kidney disease is the main diagnosis of transfusion cases,accounted for 63.49％,19.05％,12.70％.There were different standards for the development of serological testing items before transfusion Conclusion the advantages of washed red blood ceils gradually recognized by clinicians,but also don't rely on experience,hospitals should pay attention to the comprehensive evaluation of clinical blood transfusion and standardize the serological detection of blood transfusion department,which is the key to improve the cost performance of this component.

Objective To discuss the effect of quick freezer equipment and quick freezing time on the preparation of cryoprecipitate.Methods The cryoprecipitate,already prepared,was placed into the MBF21 freezer and minus 30℃ SANYO refrigerator for 30-minute and 50-minute storage.The activity of coagulation factor VⅧ,and the content of fibrinogen in different equipment were detected by automatic coagulation analyzer,in order to make sure whether it met the quality requirements.Results The content of fibrinogen in the cryoprecipitates from both of the equipment after 30-minute storage met the requirement,with the qualification rate of 100％.As to the activity determination of coagulation FⅧ,low temperature refrigerator showed a qualification rate of 62.5％,which was significantly lower than that of quick freezer with a qualification rate of 97.5％ (P＜0.01).The cryoprecipitates from both of the equipment after 50-minute storage,with part of fibrin precipitation,had a qualification rate of fibrinogen content lower than 50％ (P＞0.05).The qualification rate of quick freezer and low temperature refrigerator was 35％ and 12.5％,respectively,with significant difference.Conclusion Quick freezer can make the cryoprecipitate quick-frozen,which can ensure the quality.The coagulation factor VⅧ is unstable,whose activity decreased with the increase of temperature.We should try our best to shorten the time off the cold chain.

AIM: To investigate the multidrug resistance(MDR),reversal activity of 2-[4-(2-pyridin-2-yl-vinyl) henyl]-4,5-bis-(4-N,N-diethylaminophenyl)-1(H)-imidazole(FG020318) in a retinoblastoma subline SO-Rb50/VCR,which is resistant to vincristine.METHODS: The procedure of stepwise increase in drug concentrations was used to obtain SO-Rb50/VCR,which was resistant to 200 ?g/L vincristine. The chemosensitivity of this drug resistant cell line with and without FG020318 or cyclosporine A(CSA) were detected by MTT assay and the function of p-glycoprotein(P-gp) was examined by rhodamine 123 accumulation detected with flow cytometry(FCM).RESULTS: FG020318(2.5 ?mol/L) significantly reduced IC50 and increased the rhodamine accumulation in a concentration-dependent manner. It was much stronger than the positive control CSA in reversal of MDR.CONCLUSION: A new tumor MDR modulator FG020318 partly reverses MDR in SO-Rb50/VCR.It may be a promising new drug to tackling MDR.