Synergy is key to the formation of a community of interests and responsibilities for a healthcare alliance.This paper analyzed the management synergy dilemma and countermeasures of the alliance, in such terms as its model selection, function orientation and governance;its two-way referral, drug interchange and homogeneity of medical quality;its human resource two-way flow, equipment resource sharing and information platforms unification;as well as its medical insurance policy, financial subsidy and personnel system.On such basis, countermeasures were proposed based on trust.

Objective To predict the B cell line epitopes of human cytomegalovirus glycoprotein (gB)by analyzing its structure and physicochemical properties using bioinformatics approaches .Methods Based on the sequence of the HCMV gB,the probable B cell epitopes are predicted using two online prediction programs and DNAstar software .Meanwhile,the tertiary structure of gB was constructed by homologous modeling with the assistance of SWISS -MODEL server to rule out im-possible B cell epitopes .Results and Conclusion The B cell line epitopes of gB are predicted , which provides a theoreti-cal basis for further verification of gB immunodominant epitopes and screening the source plasma with high HCMV IgG titer .

Objective To know the effects of living with the elderly on nursing students' willingness engaging in aged nursing and attitude towards the elderly so as to provide references for nurturing professionals for caring for the aged.Methods 231 nursing students were surveyed.The questionnaire included four parts,general information,life experience with the elderly,willingness engaging in aged nursing,attitude towards the elderly and cognition of aging.Results 45.9 percent of the nursing students were willing to engage in aged nursing.Living with elderly and relationship with the elderly affected their willingness.Conclusions Creating more opportunities for nursing students in touch with the elderly can help nursing students to have a good impression of the elderly and stimulate them to choose aged nursing.

Objective To know the nursing students' willingness engaging in geriatric nursing and analyze affecting factors so as to provide references for nurturing professionals for caring for the aged.Methods 231 nursing students were surveyed.The questionnaire included general information,life experience with the elderly,willingness engaging in geriatric nursing,attitude towards the elderly and cognition of aging.The investigation results underwent analysis.Results Single factor analysis showed that whether ever living with the elderly (x2=6.027),time living with the elderly and relationship with the elderly (x2=4.928) influeced the nursing students' willingness engaging in geriatric nursing.Multiple correspondence analysis indicated that nursing students living with elderly more than one year and having good relationship with the elderly had positive willingness.Conclusions Geriatric nursing curriculum should be optimized and more opportunities should be created for nursing students to be in touch with the elderly.At the same time,we must pay attention to occupation guide and moral education about how to respect and care for the elderly.

This paper retrospectively analyzed the quality control methods of Fructus Forsythiae, summarized the corresponding achievements and problems on its quality control. It can provide some available envidences for the quality control of Fructus Forsythiae and its preparations.

Promotion of outstanding people to head nurses is key to hospital nursing management.In view of the current shortcomings in the analysis of appraisal data and the interpretation of appraisal results,the analysis of means(ANOM)method is introduced to the process of hospital human resource management.The proposed method aims to solve the problem when the score differences between interviewers are great and the score differences between candidates are small.An example for head nurses' promotion appraisal in a hospital is offered to demonstrate that statistical tools can provide the decision support for hospital personnel selection.Finally,the application differences between ANOM and analysis of variance(ANOVA) in human resources appraisal are compared.

Objective To develop an effective process for isolating and purifying haptoglobin ( Hp) from Cohn fractionⅣby a new ion exchange chromatography and to preliminarily identify and analyze the product of each purification step . Methods The fraction was first diluted and impurities were adsorbed with Rivanol .Then, the supernatant was treated with 50%ammonium sulfate.Finally, the precipitate was redissolved , and Hp was purified further with Q Sepharose Fast Flow chromatography .Native-PAGE was used to measure the activity of the haptoglobin-bound hemoglobin , while SDS-PAGE analysis and immunoblot were used for identification of the target protein .Results After pretreatment , some of the impuri-ties were removed from the Cohn fraction Ⅳ, and the target protein was enriched .In our case, the target protein was Hp and Hp2-2 was the main phenotype in the human plasma fraction Ⅳ.Target protein band and high purity were identified by SDS-PAGE.Immunoblot analysis further proved that this method could successfully isolate the target protein Hp , and the activity of 2.8 U/ml was measured by Native-PAGE method.Conclusion Haptoglobin is successfully isolated from human Cohn fractionⅣwith this method.The purification process is simple and suitable for scale-up production with a good prospect.

Objectives To investigate the prevalence of childhood asthma in 2000～2010,to find the changes of childhood asthma in distribution characteristics,precipitating factors,diagnosis and treatment status,and to provide scientific data for the improvement of the prevention and management of asthma in children in Kunming city,China.Methods Children were selected by random cluster sampling.Standardized preliminary questionnaire was used for screening out possible patients in the two surveys of 2000 and 2010.Diagnosis of asthma was confirmed by diagnostic criteria in suspected asthmatic children.Asthmatic children were further asked for past diagnosis and treatment with the questionnaire of asthma in children.Double entry and validation were adopted for all data and analysis was carried out using Epi-Info software.Results Compared with 2000,the total asthma incidence rate increased significantly from 0.88％ to 1.40％ (x 2=12.52,P＜0.05),the coincidence rate of final diagnosis and previous diagnosis increased from 22.8％ to 51.3％ (x2 =19.23,P ＜0.05) and the proportion of acute exacerbation of asthma reduced from 40.2％ to 19.3％ (x 2 =12.54,P＜0.05) in 2010.Compared with 2000,Antibiotics use rate reduced from 97.8％ to 80.0％ (x 2=14.28,P ＜0.05) and the proportion of inhaled corticosteroid increased from 12.0％ to 64.0％ (x 2=60.53,P＜0.05).Conclusion Compared with 10 years ago,the total asthma incidence of childhood asthma aged 0 ～ 14 year old in Kunming city was significantly increased.The coincidence rate of final diagnosis and previous diagnosis increased and the proportion of acute exacerbation of asthma reduced.Antibiotics use rate reduced and the proportion of inhaled corticosteroid increased.The treatment and management of asthma in children awaits improvement as well,especially in reducing the rate of missed diagnosis in children with asthma and regulating the use of corticosteroids and bronchodilators inhaling treatment and reduces the use of the proportion of antibiotics.

Objective To explore the clinical characteristics in twin premature infants in order to provide some guidance for clinical work in future.Methods The clinical data of 593 premature infants hospitalized in Department of Pediatrics,the Affiliated Hospital of Kunming Medical University were collected from June 2010 to June 2012,in terms of gestational age,birth weight and neonatal complications.A retrospective analysis was performed for the data.The premature infants were divided into 2 groups:study group of 131 twin premature infants and control group of 462 singleton premature infants.The 131 twin premature infants in study group were divided into large double group(n =64) and small double group(n =67) according to delivery time.The clinical data of premature infants in each group were statistically analyzed.Results The gestational age of study group was (34.23 ± 1.90) weeks,which in control group was (33.91 ± 1.82) weeks,and there was no significant difference between the 2 groups(t =1.689,P =0.092).The birth weight in study group [(1 921.64 ± 414.05)g] had statistically significant difference compared with control group [(2 164.98 ± 495.85) g] (t =-5.209,P =0.000).The study group of incidence of premature rupture of membranes was 16.79％ (22/131 cases)and which in the control group was 32.68％ (151/462 cases),and there was statistically significant difference between the 2 groups (x2 =12.472,P =0.000) ;the incidence of neonatal asphyxia of study group was 9.92％ (13/131 cases) and that of the control group was 17.10％ (79/462 cases),there was statistically significant difference between the 2 groups (x2 =4.010,P =0.045) ; the incidence of respiratory distress syndrome in study group was 6.87％ (9/131 cases) and that in the control group was 3.03 ％ (14/462 cases),the difference was statistically significant between the 2 groups (x2 =4.037,P =0.045) ; the incidence of apnea in study group was 4.58％ (6/131 cases) and that in the control group was 0.65％ (3/462 cases),the difference was statistically significant between the 2 groups(x2 =8.085,P =0.004) ; the incidence of meconium aspiration syndrome of study group was 0 and that of the control group was 3.90％ (18/462 cases),there was statistically significant difference (P =0.018) ;the incidence of neonatal hypoglycemia of study group was 27.48％ (36/131 cases) and that of the control group was 16.67％ (77/462 cases),the difference was statistically significant between the 2 groups (x2 =7.738,P =0.005) ;the incidence of sepsis of study group [16.79％ (22/131 cases)] was significantly higher than that of the control group [8.44％ (39/462 cases)],and the difference was statistically significant between the 2 groups (x2 =7.715,P =0.005) ;the incidence of extrauterine growth retardation of study group was 6.10％ (8/131 cases) and that of the control group was 2.38％ (11/462 cases),the difference was statistically significant between the both groups (x2 =4.568,P =0.033).In the study group,the incidence of neonatal sepsis in big double group was 29.68％ (19/64 cases),and that in small double was 14.93％ (10/67 cases),there was statistically significant difference between the 2 groups(x2 =4.138,P =0.042).The other complications between the big double group and small double group had no significant difference.Conclusions The incidence rates of acute respiratory distress syndrome,apnea,neonatal hypoglycemia,sepsis and extrauterine growth retardation of twin premature infants are higher than the singleton premature infants in the neonatal period.But the incidence rate of meconium aspiration syndrome is a higher in singleton premature infants.

Objective To investigate the clinicopathologic features and prognostic significance of BRCA1 and Ki-67 expression in breast cancer.Methods The expression levels of BRCA1 and Ki-67 were assayed by immunohistochemistry in 194 cases of breast cancer tissues.The correlations of BRCA1 and Ki-67 expression with patients' clinicopathologic features were also analysed.Results Low expression of BRCA1 was detected in the lymph node metastasis group,ER/PR negative group,and HER-2 positive group in 194 patients with breast cancer (P ＜ 0.05),as well as in the triple negative breast cancer (TNBC) group compared to non-TNBC group (P ＜0.05).High expression of Ki-67 was detected in patients with higher histological grade,negative ER/PR,and positive HER-2 (P ＜ 0.05).Furthermore,negative correlation was found between the expression of BRCA1 and Ki-67 (P ＜ 0.05).The combination of low expression of BRCAl and high expression of Ki-67 was mostly found in the patients with postmenopausal,lower histological grade,lymph node metastasis,negative ER/PR and positive HER-2 (P ＜ 0.05).However,there was no significant difference between TNBC and non-TNBC.Conclusion Joint detection of BRCA1 and Ki-67 might play an important role in predicting clinical outcomes of breast cancer,especially BRCA1 may be one of prognostic factors in TNBC.