Through demonstrating the satisfaction evaluation system of Singapore hospitals,the article analyzed the differences between the satisfaction evaluation system of Singapore and the system made by Shanghai Municipal Commission of Health and Family Planning.It was concluded that the humanized evaluation methods should be highlighted,the conformity of establishment of evaluation system and policy be focused on,staff incentive mechanism be focused on and perfected,and patients' expectation indicator and perceived quality be considered as strategic tools to improve the healthcare system performance.

Objective To study the effect of endurance training on the cardiac Akt/mTOR signaling pathway in aged mice.Methods Male 2-month.old SAMP8 mice were randomly divided into young control group(YC)(n=12),endurance training group(E)(n=12)and aged control group(AC)(n=12).The group YC was executed at three-month old;and the group AC was executed at six-month old.The group E underwent a 3-month endurance training program (three times per week,40min once a day).After completion of the training program,the ratio of hean mass to body mass(heart mass/body mass)was measured,cardiac tissue of each group was observed using the HE stain,and the mRNA expressions of Akt,mTOR,p70S6K and eIF-4E in mouse heart of each group were analyzed using the real-time PCR.Results The heart weight and the heart weight/body weight ratio significantly increased in group E comparing with that in group AC(P<0.05)without any pathological change.The mRNA expressions of Akt,mTOR, p70S6K and eIF-4E in group AC decreased more significantly than that in group YC(P<0.05).The expression of targets in group E increased more significantly than that in group AC(P<0.05),however,there was no significance difference between group E and group YC.Conclusion Endurance training can elevate the cardiac Akt/mTOR signaling pathway expression,produce exercise-induced cardiac hypertrophy for aged mice.

Objective To detect the apoptosis and the intensity of proliferation in different types of renal pathology in children with lupus nephritis (LN), analyzed the relationship between apoptosis and proliferation in LN. Methods Twenty - seven children (aged 7-16 years old, 21 type IV and 6 type V ) with biopsy- proven LN and nine as controls were included in the study. Apoptosis was detected by in situ nick- end labeling techniques (TUNEL) in renal biopsy samples. Immunohistochemistry was employed to detect the proliferating cells identified by proliferating cell nuclear antigen (PCNA) and detect the expressions of proteins of apoptosis associated gene PDCD5 and Caspase - 3 in these patients. Results 1. Compared to type V LN, the patients with type IV LN had more apoptolic cells,more PCNA positive cells and higher ratios of PCNA/apoptosis (P/A) in glomeruli. 2. There were no difference in expression of PDCD5 in glomeruli in type IV LN compared with those in type V LN. Numbers of apoptotic cells were observed in glomeruli. The expression of Caspase- 3 in type IV LN increased in glomeruli compared with that in type V LN. Conclusions The up- regulation of mechanism of apoptosis in type IV LN was less than that of type V LN. Caspase- 3 participated in the apoptosis of glomeruli of LN, but PDCD5 did not play a role during apoptosis of glomeruli of LN or the effect of PDCD5 promoting apoptosis was depressed.

Objective To develop fluorescence quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) for detection and quantitation of transforming growth factor ?1 (TGF-?1) mRNA in peripheral blood mononuclear cell (PBMC) of patients with chronic hepatic disease.Methods The TGF-?1 recombined plasmid was constructed by conventional molecular biological techniques,and strand-specific cRNA standard was synthesized by T7 RNA polymerase in vitro transcription.The cRNA standard and a TaqMan-MGB probe were used for quantitation of the TGF-?1 mRNA,and the assay was evaluated.Moreover,the plasma TGF-?1 was detected by ELISA.Results Sequence analysis indicated that the recombined plasmid contains the specific 102bp fragment of TGF-?1. The FQ-RT-PCR could detect as low as 6.81 copies of standard cRNA,the linear range was from 6.81 to 6.81?10~9 copies,and the coefficient variation was 1.28%-2.27% and 2.56%-2.61% respectively in intra and inter-assay.The levels of TGF-?1 mRNA in PBMC and plasma TGF-?1 of patients with chronic hepatic disease were significantly higher than that of healthy controls(P

OBJECTIVE:To provide reference for prescriptions audit before payment in hospital pharmacy. METHODS:The management measures of prescriptions audit and intervention before payment in our hospital were introduced. 1 200 outpatient pre-scriptions within 1 year before and after management were subjected to a statistical analysis. The effects of prescriptions audit be-fore payment were evaluated through analyzing and comparing qualification rate of prescription and unqualified prescriptions. RE-SULTS:Our hospital adopted a series of measure to realize prescriptions audit and intervention before payment by clinical pharma-cists,such as using information audit system,formulating audit standard,educating pharmacists,establishing audit job system, prescriptions review and feedback system,setting up communication system,etc. Of the total audited 189 665 prescriptions, 14 581(7.69%)failed to audit and 606 prescriptions hadn’t been revised after 1 year management,with effective intervention rate of 95.84%. Compared with before management,the prescription qualification rate increased from 88.83% to 98.67% after manage-ment(P<0.01). The quantity of overdose,inconformity with medical insurance,overload and other conditions reduced to 0. CON-CLUSIONS:It is feasible for pharmacists to audit and intervent prescriptions before payment in hospital pharmacy to improve pre-scription qualification and promote rational drug use in the clinic.

Objective To investigate the regulation effect of hepatocyte nuclear factor (HNF) 1α on the gene expression profile and the signal pathways in HuH7 cells.Methods The expression of HNF1α was increased or decreased in HuH7 cells by Lenti-virus carrying HNF1α or shHNF1α.The expression profile of the cells after treated was examined by microarray technology.The difference expressed gene regulated by HNF1α were screened and the pathway was analyzed with DAVID software and related analysis system.The regulation effect of HNF1α on transforming growth factor (TGF)β signal pathway was detected by reporter gene test and the regulation role of HNF1α on related genes of TGFβ signal pathway was determined by real-time polymerase chain reaction (PCR) and Western blotting assay.Results The expression of HNF1α in HuH7 cells was significantly up-regulated by Lenti-virus carrying HNF1α gene (Lenti-HNF1α) and which was down regulated by Lenti-virus with shHNF1α gene (LentishHNF1 α).Expression profile analysis revealed that 339 genes were positively up regulated two times by HNF1α and 325 genes were negatively down regulated two times.Signal pathway analysis revealed that HNF1α regulated drug metabolism,biosynthesis of unsaturated fatty acids and glycolysis/gluconeogenesis metabolism signal pathways.Moreover,it also involved in the regulation of TGFβ、nuclear factor (NF)-κB and p53 tumor-related signal pathways.Furthermore,Luciferase reportor gene experiment indicated that up-regulated HNF1α could inhibit the activation of TGFβ signal pathway.And the results of real-time PCR and Western blotting verified that up-regulated HNF1α could inhibit TGFβ signal pathway related gene c-myc and TGFβ1 and then inhibited the activation of TGFβ signal pathway.Conclusion HNF1α broadly affects the gene expression profile and the tumor genesis and development related signal pathways in HuH7 cells,furthermore,HNF1α can inhibit the activation of TGFβ signal pathway.

Objective To treat hydrosalpinx by using interventional embolization of fallopian tube or laparoscopic salpingectomy before the performance of auxiliary reproductive technology,i.e.in vitro fertilization and embryo transplant (IVF-ET),and to compare the clinical effect,technical advantages and disadvamages between the two methods.Methods A total of 170 patients with tubal infertility who had received IVF-ET were selected,the clinical data were retrospectively analyzed.The patients were divided into three groups:(1) interventional embolization group (n=65),using interventional embolization for hydrosalpinx;(2) laparoscopic salpingectomy group (n=55),adopting laparoscopic salpingectomy for hydrosalpinx;and (3) control group (n=50):for these patients bilateral proximal fallopian tube obstruction was performed,and IVF-ET was directly carried out if the patient had no hydrosalpinx.Results No statistically significant differences in the used dosage of gonadotropin (Gn),E2 level on HCG-injection day,the number of follicles on HCG-injection day,the number of retrieved oocytes,the fertilization rate,cleavage rate,clinical pregnancy rate,abortion rate,and ectopic pregnancy rate existed between each other among the three groups (P＞0.05).The technical success rate in both interventional embolization group and laparoscopic salpingectomy group was 100％.No severe complications occurred.The interventional embolization procedure had some advantages,it could be completed at clinic room,the operation time was short,no anesthesia was needed,the medical cost was low,etc.Conclusion Interventional embolization of fallopian tube and laparoscopic resection are equally effective in treating hydrosalpinx before IVF-ET is conducted.Both methods can improve pregnancy outcome,but interventional embolization method is more simple,safe,economical and effective,which deserves to be the preferred method of treatment.

Objective Establishing an employee satisfaction indicator system for tertiary hospitals in Beijing.Methods Evaluation indicators are built on theory research,and questionnaires are designed for survey.Such methods as principal component factor analysis,and verification factor analysis are called into play to test the construct validity and establish in the end the employee satisfaction indicators system.Results Such indicators comprise five grade-1 dimension and 34 grade-Ⅱ dimension,such as hospital management satisfaction indicator.Conclusion This self-designed scale ideally mirrors the employee satisfaction of tertiary hospitals in Beijing,proving the indicators to be objective and reasonable.

Objective To explore the clinical feature, gene mutations and treatment of isolated hypogonadotropic hypogonadism (IHH). Methods The clinical data from a case of IHH and his families were retrospectively analyzed. The related literatures were reviewed. Results The propositus was a 7-year-old boy with a small penis and testes, whose younger brother was 5-year-old with a small penis and cryptorchidism. In both boys testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) levels were low. The GnRH provocation test was not reactive. Their parents denied the consanguineous marriage. Illumina sequencing revealed that both of the brothers had homozygous mutation of GnRHR gene in C.806C>T, and their parents were heterozygous mutations in C.806C>T gene. After confirmation of the diagnosis, human choronic gonadotropin (hCG) treatment was given. The levels of testosterone and dihydrotestosterone were significantly increased after 6 weeks. Conclusion The combination of clinical phenotype, biochemical analysis, and gene detection is helpful for early diagnosis of IHH.

[Summary] Microcephalic or Majewski's osteodysplastic primordial dwarfism type Ⅱ ( MOPD Ⅱ) is an extremely rare genetic disease mainly caused by pericentrin ( PCNT) gene mutations. This paper reported one 13-year-old boy, who was admitted because of the slow growth for more than 13 years and deepened skin color over six months. He was diagnosed as MOPD Ⅱ associated with a combination of growth hormone deficiency, type 2 diabetes, hypertension, acanthosis nigricans, multiple café-au-lait spots. On magnetic resonance imaging of brain, no vascular malformations such as aneurysms were shown. There were novel compound heterozygous mutations of PCNT gene in the patient, with the nonsense mutations of c. 502C > T ( p. Gln168 * heterozygous variation) and c. 3103C > T (p. Arg1035* heterozygous variation). His father carried a nonsense mutation c. 3103C > T ( p. Arg1035 *heterozygous variation ) and his mother had a nonsense mutation c. 502C > T ( p. Gln168 * heterozygous variation). After treatment with metformin for three months, his blood glucose returned to normal, and acanthosis nigricans was improved. It seems critical to evaluate the abnormal condition of blood vessels regularly for MOPD Ⅱpatients with PCNT gene mutations.