In this paper,we focus on how to planning and implementing CRM system in hospital,and address this topic in three main sections.Firstly, The comprehending and urgent need of hospital leaders and managers about CRM are the most important.Secondly,before implementing CRM,the status of information management in hospital and characteristic of relationship between customers(or patients) and hospital should be sufficiently understood.Thirdly,which kind of CRM,and how much investment what you need should be analyzed.A general principle is put forward,that is "clear aim,macro planning,(uniform) disposal and stepping into implementing".

We examined diseases occurring farmed Whitmania pigra(L.) in Hebei province in the aspect of situation of disease,clinical symptoms and pathological changes.In addition,the molecular identification were conducted to representative strain,the 16S rRNA gene was sequenced and compared with that of related strains,molecular phylogenetic tree was constructed.The results showed that the disease was infected by Aeromonas hydrophila.Pure cultures of 10 strains have the same serotype.Selected representative strain was proved to be the corresponding primitive causal agent of the disease by artificial infection experiment to healthy Whitmania pigra(L.).Antibiotic sensitivity of the isolates to used thirty-seven antimicrobial agents showed that the tested strains were high sensitive to cefotaxime et al.,were sensitive to streptomycin et al.,were resistant to oxacillin et al.

Background The measurement of the extraocular muscle is critical for the diagnosis of extraocular muscle diseases,but conventional medical imaging techniques present some shortcomings because of the contact pattern.The anterior segment optical coherence tomography (OCT) is thought to be an in vivo noninvasive optical diagnostic imaging method.Objective This clinical study attempted to seek an available approach to the evaluation of the anatomic structure of human horizontal rectus insertion with Visante OCT.Methods One hundred and fourteen eyes of 58 subjects were included in this study and were divided into the low refractive power group (≤-3.00 D) with 43 eyes,moderate refractive power group(＞-3.00 D-≤-6.00 D) with 49 eyes and high refractive power group(＞-6.00 D) with 22 eyes.The horizontal rectus insertion distance to the scleral spur and its thickness were measured by Visante OCT.The correlation of the refractive power with the rectus insertion distance or thickness was analyzed.Written informed consent was obtained from each subject before medial assessment.Results The average distance from the scleral spur to the lateral and medial rectus insertion were (5.23±0.50)mm and (3.81±0.46)mm respectively.The average thickness of the lateral and medial rectus insertions were (0.39±0.06)mm and (0.39±0.06)mm respectively,showing no significant differences in comparison with those of ultrasound biomicroscopy (P=0.338,P=0.759).The lateral and medial rectus insertion distances were (5.25±0.45)mm and (3.74±0.53)mm in the low refractive power the group,(5.22±0.60)mm and (3.81±0.42)mm in the moderate group and (5.20±0.35)mm and (3.90±0.42)mm in the high refractive power group,presenting inconsiderable difference among these three groups(lateral rectus: χ2=0.054,P=0.974;medial rectus: F=0.508,P=0.604).The thickness of the lateral and medial rectus insertions were (0.41±0.06)mm and (0.40±0.06)mm in the low refractive power group,(0.40±0.07)mm and (0.37±0.07)mm in the moderate refractive power group,(0.36±0.05)mm and (0.39±0.05)mm in the high refractive power group with a significant difference among lateral rectus (F=4.922,P=0.009) but not medial rectus (F=2.152,P=0.125).The lateral rectus insertions thickness in the high refractive power group was thinner than that in low refractive power group (P＜0.05).A positive correlation was found between refractive power and the thickness of lateral or medial rectus insertions (r=0.284,P＜0.01).Conclusion Visante OCT is a uscful way in measuring the distance and thickness of the extraocular muscles.Lateral rectus insertions thickness tends to be thinner with the worsening of myopia,which is obvious in high myopia.

Objective: To investigate the effect of carboxymethylchitosan on autocrine growth factor and morphology of fibroblasts cultured in vitro, so as to discuss the possible mechanism by which carboxymethylchitosan alleviates overheating and prevents adhesion in wound healing. Methods: Fibroblasts were cultured in vitro. Fibroblasts of passage 4-6 were treated with different concentrations of carboxymethylchitosan (0.01,0.1,1.0 and 10 mg/ml) for 4 days or with 0.1 mg/ml carboxymethylchitosan for 1, 2, 3, 4, 5, and 6 days. The levels of autocrine transforming growth factor-β1 (TGF-β 1) and epidermal growth factor (EGF) of fibroblasts were determined by ELISA and radioimmunoassay. The fibroblastic morphology was detected by transmission electron microscopy (TEM) and microscope after fibroblasts were treated with different strategies. Results: Carboxymethylchitosan (≥ 0.1 mg/ml) inhibited autocrine TGF-β1 of fibroblast in a time- and concentration dependent manner (P< 0.05). However, Carboxymethylchitosan had no obvious influence on the secretion of EGF(P>0.05). Carboxymethylchitosan (≥ 0.1 mg/ml) also inhibited the proliferation of fibroblasts and caused their ultrastructural changes. Conclusion: Carboxymethylchitosan (≥0.1 mg/ml) can inhibit fibroblasts proliferation and reduce tissue adhesion, possibly through altering fibroblast ultrastructure and selectively inhibiting secretion of TGF-β1.

Objective: To prepare and evaluate the effectiveness of chitosan-carboxymethylcellulose membrane in preventing postoperative intestinal adhesion. Methods: Chitosan-carboxymethylcellulose membrane was prepared with 1:1 ratio of chitosan and carboxymethylcellulose. Glutaraldehyde and ammonium aluminium sulfate were used for cross-linkage, glycerin for enhancing plasticity; and then the product was dried. The membrane was observed with scanning electron microscopy (SEM) and its tensile strength and breaking elongation were measured. Forty-eight SD rats with ileum injury were randomly divided into A, B and C groups (n=16). During operation, the injury in group A was treated with chitosan-carboxymethylcellulose membrane, in group B with chitosan membrane, and in group C without treatment (control group). The adhesion was observed on the 14th postoperative day. Results: The tensile strength of chitosan-carboxymethylcellulose membrane was 20 MPa and the breaking elongation was 65%. SEM showed that the morphology of the membrane had crossed fibroid structures and irregular pores. The severity of adhesion in group A and B was significantly lower than that in group C (P<0.01). Milder inflammatory changes and less fibrous proliferation were found in group A and B compared with those in group C. Epithelia rehabilitated better in group A than in group B, and the proliferation of fibroblast was not significant under electron microscope. In group C, epithelia rehabilitated slowly and fibroblasts excreted collagen actively. Conclusion: Chitosan-carboxymethylcellulose membrane is feasible for suturing during operation and is effective in reducing intestinal adhesion and it is superior to chitosan membrane.

Amyloid beta-Peptides ; analysis ; Animals ; Frontal Lobe ; drug effects ; physiology ; Hippocampus ; drug effects ; physiology ; Learning ; drug effects ; Memory ; drug effects ; Rats ; Rats, Wistar ; Sodium Azide ; pharmacology ; Space Perception

Chromosome Disorders ; Chromosomes, Human, Pair 13 ; Humans ; Infant ; Male ; Trisomy ; Trisomy 13 Syndrome

Case report form (CRF) is a key document for data collection in clinical trials. A well-designed CRF is required for database construction, data accuracy, data query/cleaning, CRF completion and statistical analysis. A well-defined process or SOP should be in place for CRF design. Data collection should fully meet the demand of study protocol. The layout of CRF should be clear with well-structured fields and standard coding for fields.
Clinical Trials as Topic ; standards ; Data Collection ; standards ; Documentation ; standards ; Research Design ; standards

Objective: To explore the effect of KangXin oral solution on brain mitochondrial DNA(mtDNA) deletion mutation in aged Balb/c mice.Methods: The Balb/c mice were divided into the young group(6weeks),middle-aged group(6months) and aged group(14 months),each group has 10 mice.Brain mtDNA were obtained and polymerase chain reaction(PCR) technique was used to examine the fragment deletion of brain mtDNA,thus,to confi rm there was deletion of mtDNA in aged mice,s brain.The aged Balb/c mice were divided into two groups: the aged blank control group being given 0.9% normal sodium,KangXin oral solution group.After being treated for four months,the brain mtDNA were obtained and polymerase chain reaction(PCR) technique was used to amplify wild-type and deletion from of mtDNA.Gel imaging meter was used to detect optical density,then,to compare the optical density ratios of deletion from mtDNA/ wide type mtDNA in two groups.Results: There were 304bp mtDNA deletion in brain mitochondrial of aged Balb/c mice,but same mtDNA deletions were not detected in brain mitochondrial of young and middle-aged mice.Compared with aged blank control group,the mtDNA deletion of aged Balb/c mice in KangXin oral solution group decreased obviously(P〈0.001).Conclusion: mtDNA deletion mutation accumulates with the increase of age.KangXin oral solution can inhibit mtDNA deletion of aged mice.

AIM: To investigate clinical effects of local resection of eyelid tumors and pathological examination or frozen section examination as well as the stage I recovery.
METHODS: For all 92 cases 92 eyes of eyelid tumor patients who underwent local resection, reconstruction in stage Ⅰ and routine pathological examination ( 37 cases of suspected malignant tumors using frozen section examination. If it was malignant, excision by Moths surgery) . Using free palate mucosa autograft in stage I or reconstruction by Hughes surgery combined with eye flaps repaired eyelid defects.
RESULTS: The postoperative pathological diagnosis:52 cases were benign tumors, and 40 cases malignant tumors. All cases of eye flaps and hard palate mucosa grafts were survived. Followed up for more than 6mo, no tumor were recurred. The appearance and function of eyelid were satisfactory.
CONCLUSION: In this group of cases, nearly half of eyelid tumors are malignant tumors. It should be treated and operated as early as possible. For suspected malignant tumors, we use frozen section examination to confirm its properties in order to excision cleanly in stageⅠ, reducing the recurrence and metastasis. According to the eyelid defect after resection, we could do repair operation in stage Ⅰ. The inner larger defect is repaired by using hard palate mucosa transplantation or Hughes surgery. The outer layer of the eyelid defect is repaired by using eye flap glide, the free flap, the kite flap, the simple suture, etc. It should be careful when using the hard palate mucosa transplantation in the upper eyelid defect.