In light of the idea of realizing management by capital, the authors expound the theoretical basis of implementing the integration of the capital of funds and the capital of knowledge and give an account of their hospital's experience in this aspect. By introducing capital and talented personnel, viz. by liquidating remnant assets through the capital of knowledge and by seeking benefits through capital integration, the hospital has succeeded in inventing a new way of utilizing talented personnel resources and stimulating talented personnel to greater efforts, thus enhancing the speed of its accumulation of capital and laying a solid foundation for sustainable development.

In light of their hospital's practice in adopting new operational ideas and management models for the past three years, the authors expound the content of the new operational ideas, the necessity of applying these new ideas to hospital management, and the four basic principles that must be followed in constructing new management models. They also discuss some key issues involved in the process of the hospital's construction of new management models.

Objective To evaluate the clinical performance of CLINITEK Atlas urine dry chemistry analyzer and its supplementary strips,which could be used for other hospitals as reference.Methods Five hundred and one samples of random fresh urine were collected and analyzed by CLINITEK Atlas urine dry chemistry analyzer.10 parameters were reported for each sample,including SG,pH,BLD,LEU,PRO,GLU,KET,UBG,BIL and NIT.According to the medicals standard of the People's Republic of China,General Technical Requirements for Urine Analyzer(YY/T 0475-2004),General Technical Requirements for Chemical Reagent Strips for Urinalysis(YY/T 0478-2004)and physical,Chemical and Microscopic Examination of Urine(WS/T 229-2002),the precision,accuracy,carryover,stability,sensitivity and consistency of each parameter were evaluated.The agreement was assessed between the results for BLD and LEU obtained from CLINITEK Atlas analyzer and phase contrast microscope,and calculated the sensitivity and specificity of CLINITEK Atlas analyzer for BLD and LEU using phase contrast microscope as the gold standard.SG and pH test was performed among 200 specimens by CLINITEK Atlas analyzer,and then compared with the results obtained from MASTER-SUR-NM specific gravity refractometer and pH precision test strips respectively.In addition to SG and pH,the other eight parameters were compared with the results obtained from CLINITEK 500 urine analyzer,and Kappa value and consistency were calculated.Results The accuracy,precision,sensitivity,carryover and stability of 10 parameters could meet all the requirement of standards.SG and pH had good correlation with urine specific gravity refractometer (r =0.9838,P ＜0.001)and pH meter (r =0.8884,P ＜0.001),respectively.Compared with phase contrast microscope,BLD and LEU had coincidence rates of 90.4％ and 90.8％,respectively; Sensitivities were 90.7％ (301/332) and 83.3％ (200/240) ; Specificities were 89.9％ (152/169) and 97.1％ (255/261).Compared with CLINITEK 500,all the parameters,except for SG and pH,had good coincidence rates of ＞ 87.6％.Conclusion The performance of CLINITEK Atlas urine dry chemistry analyzer can meet the clinical requirements of all standards.

Objective To understand and analyze the situation of orthopedic nursing manpower resources in grade- Ⅲ general hospital in Shanghai and provide empirical evidence for appropriate allocation and exploitation of nursing manpower resources. Methods Data were collected by questionnaire and then underwent analysis. Results In 2009,the number of authorized beds was 1866,the actual number of open beds was 2007.The number of nurses was 595 (2 male).The ratio of ward bed and nurse were 1:0.319 and 1:0.296, calculated by the authorized beds and authorized beds, respectively.The average age of head nurses was (37.53±6.11 ) years old, average working life span was (17.87 ± 6.16) years; college degree or above accounted for 95.56%; middle professional titles accounted for 62.22%. College degree or above accounted for 75.13% in nurses, junior professional titles accounted for 92.1%; age group is mostly concentrated in the 20 to 29 years of age, accounted for 67.06%; working life span concentrated within 10 years, accounted foi 73.11%. The education level mainly is primary school in the care workers (carer), accounted for 45.83%; concentrated in the 40 to 49 years of age, accounted for 60.42%; working life span concentrated in more than 6 years, accounted for 55.21%. Conclusions There are shortage of orthopedic nursing manpower resources, unreasonable allocated structure, lack of male nurses in grade- Ⅲ general hospital in Shanghai. The management of the care workers should be standardized.

Starting from the brand new angle of exploring the interaction between the knowledge capital and the financial capital of the hospital, the paper presents the theoretical basis and practical significance of the interaction between the knowledge capital and the financial capital of the hospital. Moreover, by establishing tentative models of hospital capital operation and by making theoretical analyses into the interactive and incremental relationship between knowledge capital and financial capital by means of mathematical analysis and deduction, the paper further demonstrates that the interactive integration of the knowledge capital and the financial capital of the hospital is an important condition which ensures that the operation of the hospital will maintain a high momentum and its comprehensive competitiveness will continue to be in a power position.

Objective To characterize the association between the mean CT value on a scout view and the dependent mA selection method, and to evaluate the clinical value of a mA selection method based on scout view mean CT value in obtaining individualized scan protocol and consistent image quality for patient population on 64-row MSCT CT coronary angiography (CTCA).Methods One hundred patients (group A) underwent CCTA consecutively using standard protocol with a fixed mA.The mean CT value of a fixed ROI (region of interest) from the scout AP view and the CTCA image noise (standard deviation on the root of ascending aorta) were measured.The correlation between CT values and noise was studied establish a formula and a list to determine the required mA for obtaining a consistent CTCA image noise based on the measured SV CT value.Another 100 patients (group B) were scanned using the same parameters as group A except the mA and the CT value was also measured.The mA was determined by the list established previously.The CTCA image quality (IQ) as well as the image noise (IN) and the effective dose (ED) from the two groups were statistically analyzed using t-test.The CT findings for the 32 patients in the group B were also compared with the selective coronary angiography (SCA) results.The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CCTA for detection of significant stenosis were obtained.Results The formula between the required mA and the CT value was : XmA=FmA×[(K1×CTscout + C1)/INa]2.The CCTA images in B group had statistically higher IN (27.66±2.57,22.22±4.17,t=11.33, P=0.000), but no statistical difference between IQ scores for the two groups (3.29±0.66,3.37±0.67,t=0.009, P=0.990), and ED[(8.72±2.51) versus (12.53±0.90) mSv]was 30% lower for the B group (P<0.01).For the 32 patients in the B group who had SCA, the CCTA sensitivity, specificity, positive predictive value, negative predictive value, and stenosis detection accuracy were 94.92% (56/59), 92.13% (82/89) ,88.89% (56/63) ,96.47% (82/85) and 93.24% (138/148) wspectively for stenosis greater than 50%.Conclusion The mA selection method based on the SV CT value for CCTA in 64-row MSCT provides individualized protocol to obtain consistent image quality and to optimize dose delivery to patients.

Purpose To assess the clinical and pathological features of small gastrointestinal stromal tumours (sGIST).Methods To reevaluated the clinical,histological and immunohistochemical parameters of 21 sGISTs.The standard immunohistochemical panel antibodies were studied on the tumor sections.All data were compared with clinical sGIST.Results There were a total of 7 females and 14 males of sGISTs.The median age was 63 years old.The tumors were predominantly located in the stomach showing a spindle cell morphology and the tumor sizes ranged from 0.5 cm to 1.5 cm.9 sGISTs combined with malignant tumors,which were gastric cancer have been incidentally detected during surgery.As the lesions were small in size,with infrequent bleeding,necrosis,mucosal invasion,ulceration and less mitotic index,sGISTs reoccurred less compared with clinical sGIST.p53,Ki-67 labeling index and microvascular density (MVD) in sGIST were significantly lower than clinical sGIST (P ＜ 0.05).Conclusion sGIST may occure with digestive tract cancer synchronously.p53,Ki-67 labeling index and MVD were lower than clinical GIST,which means better prognosis.

Objective:To investigate the effect of PTS on the related pathophysiological changes and serum IL-6 level at different time points after the middle cerebral artery occlusion (MCAO) in rat’s brain.Methods:The model of focal cerebral ischemia of rat was established by the suture-occluded method.The effect of PTS on the behavioral disturbance,the pathological change of ischemia tissue and the level of serum IL-6 at different time points(3d,7d,28d) after MCAO and cerebral ischemia in rats were studied.ResultsAfter MCAO,different degrees of motion disturbances were observed in all rats.The infarct spot can be observed in all groups except the normal.The nerve cell necrosis can be found in all rats after 24 hour of MCAO.The result showed that PTS could improve the degree of motion disturbance,reduce the infarct spot obviously;after MCAO,the serum IL-6 were increased obviously but could be reduced by PTS.Conclusion:PTS can protect the neurons,reduce and eliminate the infiammatory reaction of cerebral ischemia cascade reaction effectively,which may relate to its inhibiting effect on cell factors such as IL-6 production after cerebral ischemia.

Objective To study the clinical efficacy of autologous peripheral blood stem cell transplantation for the treatment myocardial infarction,in the same period of coronary artery bypass grafting (CABG).Methods From January 2012 to January 2015,76 patients with myocardial infarction were selected.Patients were divided into transplantation group (n =46) and control group (n =30) on the basis of whether being treated by autologous peripheral blood stem cell transplantation.After myocardial infarction patients were taken to the hospital with the therapy of conventional drug,5 days before CABG,transplantation group was given the autologous peripheral blood stem cell mobilization and expansion,24 hours before CABG,taking autologous peripheral blood stem cell collection.76 patients took CABG with non-cardiopulmonary by pass,transplantation group was given autologous peripheral blood stem cell via transplantation vessels and subepicardial,while the control group was not given the injection of autologous peripheral blood stem cell.The LV morphology,wall motion score index (WMSI) and index of cardiac function before and after the operation in both groups were evaluated by echocardiography.Results Six months after CABG,there was a significant decrease in Left ventricular end-diastolic diameter and wall motion score index,Left ventricular ejection fraction was increased.The indexes of cardiac function in the transplantation group were better than the control group.Conclusion Autologous peripheral blood stem cell transplantation for the treatment myocardial infarction can improve the heart function,and has obvious recent clinical curative effect in the same period of CABG.

Objective To integrate urine strip chemistry analysis with urine sedimental analysis and set up the criteria for urine microscopy review following automated urine analysis.Methods A total of 1 714 urine samples were collected from Peking Union Medical College Hospital from November 2008 to October 2010.Out of 1 714 samples, 1 300 samples were used for the establishment of review criteria, and 214 samples were used for criteria verification.The other 200 samples from healthy donors were used to set up the normal reference range of fully automated urine sedimental analyzer UF-1000i.RBC,WBC,PRO and CAST in all the samples were measured by Siemens Bayer Clinitek 500 urine strip chemistry analyzer, Sysmex UF-1000i urine sedimental analyzer and microscopic examination.Based on the different laboratory automation in urine analysis, four microscopic review protocols were defined: (1) Protocol 1: based on chemistry results only, microscopy review was performed when any of WBC, RBC and PRO was positive; (2) Protocol 2: based on fully automated sedimental analyzer only,microscopy review was performed when any of WBC, RBC and CAST was over the upper limit of the reference range; (3) Protocol 3: All the results of urine chemistry analyzer and sedimental analyzer were integrated.If two WBC results were different between two systems (in one system WBC was positive or over the upper limit of the reference range but in another system WBC was negative or within the reference range), and any of RBC, PRO/CAST was positive or over the upper limit, microscopic review was performed; (4) Protocol 4: if any of WBC, RBC, PRO/CAST was different between two systems, microscopic review was performed.Review criteria were performed with Sysmex Laboman UriAccess 3.0 software.Results The reference ranges of UF-1000i parameters were RBC 0-7.5/μl (male), 0-15.9/μl (female); WBC 0-11.6/μl (male), 0-12.7/μl (female); Epithelial cell were 0-6.5/μl (male), 0-21.4/μl (female); CAST 0-1.3/μl.The results of microscopic examination revealed that positive samples were 47.46% (617/1 300) and negative samples were 52.54% (683/1 300). Among positive samples, majority showed the presence of RBC (60.13%,371/617), followed by CAST (8.43%,52/617).The false negative rates of four protocols were 8.38% (109/1 300), 4.69% (61/1 300), 0.62% (8/1 300) and 0.54% (7/1 300), respectively.The review rates were 47.85% (622/1 300), 59.38% (772/1 300), 72.85% (947/1 300) and 52.23% (679/1 300), respectively.Although there were false negative cases in protocol 4, all the patients had normal serum creatine level.In those 214 patients for verification, the false negative rate using protocol 4 was zero, the review rates were 53.74% (115/214).Conclusions Protocol 4 shows lest false negative rate and lower review rate.Importantly, there was no patients with serious renal function abnormality missed using protocol 4.Therefore, protocol 4 is an ideal criteria for microscopy review following automated urine analysis.