Japan has accumulated much mature experience in hospital management, which is worthy of being drawn upon by hospital managers in China. By means of an account of the model of ward rounds by doctors at three levels, the system of academic previews and the system of regular meetings for copying down and reading medical papers in foreign languages in Japanese hospitals and in light of the situation of domestic hospital management, the paper discusses measures for improving the system of ward rounds and scientific research management. The goal is to enhance the medical expertise levels, scientific research capabilities and foreign languages proficiency of medical workers in China so as to deliver better medical and healthcare services to the broad masses of the people.

Objective To explore the clinical features of pulmonary tuberculosis complicated with DM and related factors. Method The manifestations of 87 newly diagnosed PTB patients with type 2 DM(DM-PTB group) at two hospitals in Tianjin during October 2003 to October 2004 were compared to 88 PTB patients without DM who were randomly choosen from the same hosipital.The factors related to sputum-positive TB or cavity were explored through unconditional logistic regression model. Results DM-PTB patients showed significanly lower frequencies of cough(66.7% vs 83.0%),toxicity symptoms(37.9% vs 62.5%) and haemoptysis(16.1% vs 33.0%) than those of PTB group.Positive-sputum(63.2% vs 34.1%),cavity(56.3% vs 13.6%),wide lesions and bilateral lesions on chest radiographs was more common in DM-PTB group than in PTB one.Introversion(OR=1.582, 95%CI:1.063 ～2.355),type 2 DM(OR =2.186,95% CI:1.082 ~4.420)and cavity(OR =2.793,95% CI:1.308 ～5.964)were factors independently associated with positive-sputum TB.The factors related to cavity included diabetes(OR=14.199,95%CI:5.376~ 37.501),cough,postive sputum and lore-up lobe lesion.Conclusion This study confirmed that clinical manifestations and chest radiographs of PTB patients complicated with type 2 DM significantly departed from the typical presentation.Type 2 DM seems to have a negative effect on postive-sputum and cavity.So it should be alarmed that DM-PTB patients who tend to have untypical clinical symptom and higher rate of positive sputum become the reservoirs of infection to cause the transmission of TB.

Objective To investigate the extracellular regulated protein kinases (ERKs) pathway of hepatitis B virus(HBV) X protein(HBx) on glomerular mesangial cell(GMC) proliferation of rat and tumor necrosis factor(TNF)-? expression.Methods The HBV X gene was amplified by polymerase chain reaction(PCR),inserted into the eukaryotic expression vector PCI-neo and confirmed by restrict endonuclease digestion and sequence analysis.PCI-neo contained HBV X gene (PCI-neo-X) was transfected into cultured GMC via liposome.GMC proliferation,TNF-? and its mRNA expression were investigated in the condition of with or without U0126 in the culture media.HBx,ERK1/2 and phosphorynated-ERK1/2 (p-ERK1/2) expression in GMC were assessed by Western blot.TNF-? mRNA expression was assessed by semi-quantitative reverse transcriptase-PCR (RT-PCR).TNF-? level in supernatants was measured by enzymelinked immunosorbent assay(ELISA).GMC proliferation was assessed by methyl thiazolyl tetrazolium(MTT).Results HBx expression was found in transfected GMC,and became prominent at 36 and 48 hours after transfection whether with or without U0126 in culture media.TNF-? mRNA expression was significantly decreased in U0126 group compared with U0126-free group.TNF-? levels in supernatants in PCI-neo-X transfection without U0126 group were (189.0?18.1) ng/L at 36 hours and (172.3?24.3) ng/L at 48 hours after transfection,respectively.In contrast,TNF-? levels in supernatants with U0126 were (65.6?11.6) ng/L and (84.0?24.6) ng/L,respectively.The TNF-? le-vels in the latter groups were significantly lower than the formers (Pa

Objective To know the influence of heat preservation intervention on temperature among aged patients who had accepted abdomen surgery. Methods Divided 40 aged patients into the heat preservation group and the routine temperature group, there were 20 cases in the each group. Heat preservation intervention were used in the heat preservation group, while the routine nursing cares were used in the routine temperature group. Compared the incidence rate of shivering and the changing of temperature during the course of operation between the two groups. Results There was no significant difference in the heat preservation group about changing of temperature during the course of operation, while the difference in the routine group was significant. The incidence rate in the shivering in routine group was significant higher than that of in the beat preservation group. Conclusions It is necessary for aged patents about heat preservation during the operation, which can avoid low body temperature and promote satisfactory prognosis.

Objective To explore influence of perioperative protection from hypothermia on surgical site infection (SSI) in patients undergoing gastroenteritic operation. Methods A retrospective study was carried out in 1536 patients undergoing gastroenteritic operation in general surgery department of our hos-pital.Patients (764 cases) admitted before July 2006 were set as the control group,while those after July 2006(772 cases) were set as the observation group. The observation group received a series of measures for protection from hypothermia besides of routine perioperative nursing.The control group only adopted routine perioperative nursing.The SSI rate was compared between the two groups. Results The SSI rate of the observation group was lower than that of the control group(P < 0.01 ). Conclusions Incidence of periop-erative hypothermia in patients undergoing gastroenteritic operation can increase the SSI rate.Appropriate measures for protection from hypothermia can prevent the incidence of hypothermia as well as SSI.

Objective To investigate the effect of insulation during surgery on the prognosis of hy-potherrnic trauma patients. Methods Trauma patients (80 cases) with injury severity score (ISS) of 16～40 and anal temperature < 36℃,were selected and randomly divided into the insulation group and the control group with 40 cases in each group.Both operations went along under room temperature. The in-sulation group keep anal temperature ≥ 36 ℃,while the control group received no insulation interven-tion.The palinesthesia time,time length of hospital stay,infection of wound and fatality were observed in the two groups. Results The palinesthesia time and time length of hospital stay dramatically shortened,the infection rate of Wound and fatality reduced in the insulation group compared with that of the control group (P<0.05). Conclusions Insulation during surgery can significantly shorten the palinesthesia time and time length of hospital stay,reduce the infection rate of wound and fatality.

AIM:To analyze the effect 17?-estradiol on activated macrophages and possibility of being a target of screening drugs for endometriosis. METHODS: Using scanning electron microscope, the surface of macrophages was observed. Nitric oxide (NO) in supernatant was determined by Griess's reagent. TNF-? was measured by MTT via L929 cells. Using Fluo-3/AM, i was measured by laser scanning confocal microscopy (LSCM). RESULTS: (1) Increased size, extension of more microvilli, expression of retraction fibers and elaboration of membrane ruffles were detected in 17?-estradiol treated macrophages. (2) 17?-estradiol induced NO release from peritoneal macrophages. (3)The more TNF-? was made by macrophages under the induction of 17?-estradiol. (4)Intracellular Ca 2+ elevated 39.8% in peritoneal macrophages after 17?-estradiol (100 nmol/L) treatment. CONCLUSIONS: Macrophages were activated by 17?-estradiol at a certain concentration. Activated macrophages by 17?-estradiol may participate in endometriosis and may be a target of screening drugs for endometriosis.