This paper analyzed the economic background,contents and effects of the existing business model of the hospital.On this basis,further study and reform are made on optimal business model of the hospital.The authors recommended that appropriate regional health scale,appropriate technical service,appropriate pricing for charges,appropriate operating cost and appropriate incentive constraints be adopted.These measures will safeguard state assets,public benefit nature of the hospital,enhanced hospital power in general,and compliance in operations,making the people satisfied and healthy.

Objective To study influence of tongxinluo on blood endothelial microparticles(EM Ps) and matrix metalloprotei‐nase‐9(MMP‐9) in patients with acute myocardial infarction after percutaneous coronary intervention(PCI) .Methods One hundred and twenty‐eight hospitalized patients with acute myocardial infarction after per‐cutaneous coronary intervention were recruited from January 2012 to December 2014 ,All patients were randomly divided into tongxinluo group (n=65) and control group (con‐ventional treatment ,n=63) .Tongxinluo group was on the basis of conventional treatment group with tongxinluo capsules 2 plus ,3 times a day .We detected the EMPs and MMP‐9 of two groups preoperatively and on the 7th postoperatively day .Results Com‐pared with the conventional treatment group ,blood EMPs and MMP‐9 in tongxinluo group were lower after 7 days treatment ,the difference was statistically significant (P<0 .05) .There was a positive correlation between the EMPs and MMP‐9(P<0 .05) .Con‐clusion For patients with acute myocardial infarction after percu‐taneous coronary intervention ,tongxinluo could further inhibit in‐flammatory reaction ,make the plaque stability and improve the function of endothelial cells on the basis of conventional treatment groups .

Objective:To explore the relationships between the endothelial microparticles (EMPs)in peripheral blood and CD4+ CD25 + Foxp3+ regulatory T cells and their cytokine levels in the patients with acute coronary syndrome (ACS),and to clarify the mechanism of EMPs in the pathogenesis of ACS by affecting the Treg cell differentiation and function.Methods:Twenty-three patients with stable angina (SAP)were allocated to SAP group,and 52 patients with ACS were allocated to ACS group.Twenty individuals with normal conventional coronary angiography results were recruited as control group.The levels of EMPs and the percents of CD4+ CD25 +Foxp3+ regulatory T cells in peripheral blood of the patients in various groups were measured by flow cytometry. The expressions of Foxp3 mRNA and the plasma levels of TGF-β1 were detected with Real-Time PCR and ELISA, respectively.Correlation analysis was performed between EMPs and regulatory T cells,Foxp3 mRNA expression level and TGF-β1 level.Results:Compared with control group and SAP group,the level of EMPs in peripheral blood of the patients in ACS group was increased significantly,but the percentage of regulatory T cells,the Foxp3 mRNA expression level and the plasma TGF-β1 level were decreased markedly (P <0.01).The correlation analysis showed that there were significantly negative correlation between EMPs and regulatory T cells,Foxp3 mRNA expression level and TGF-β1 level (r = - 0.452,P = 0.001;r = - 0.466,P = 0.001;r = - 0.555,P = 0.000 ). Conclusion:EMPs may involve in the process of occurrence and development of ACS and plaque instability by regulating the differentiation and function of CD4+ CD25 + Foxp3 + regulatory T cells.

Objective To establish an assay for the detection of Streptococcus pneumoniae by real-time fluorescence quantititive polymerase chain reaction (PCR).Methods Special primers and probe for the autolysin A (lytA)gene were designed.The sensitivity and specificity of primers and probe were studied,and cut-off of cycle threshold was assayed.158 clinical specimens were confirmed by real-time fluorescence quantitative PCR and bacterial culture method.Results Primer and probe design for LytA gene could sensitively detect serotype Streptococcus pneumoniae strains of common pathogenic,and the sensitivity was 100 copies.Among 35 strains of Streptococcus pneumoniae,34 cases were detected to be positive for Streptococcus pneumoniae by real-time fluorescence quantitative PCR,while 1 case was detected to be negative;among 15 strains of non-Streptococcus pneumoniae, all were detected to be negative.Among the 158 clinical sputum specimens,34 cases with Streptococcus pneumoniae were detected by real-time fluorescence quantitative PCR,while only 10 cases with Streptococcus pneumoniae were detected by the culture method.White blood cells count and time in hospital of cases with Streptococcus pneumoniae were higher than those of cases without Streptococcus pneumoniae (P <0.05 ). Conclusion Real-time fluorescence quantitative PCR is a sensitive and specific assay for the detection of Streptococcus pneumoniae.It can be used for the diagnosis of Streptococcus pneumoniae.

Objective To evaluate the effect of intravenous administration of gadolinium-DTPA on diffusion weighted imaging (DWI)of breast lesions and apparent diffusion coefficient(ADC)values,and to evaluate the diagnostic performance of post-contrast ADC for differentiating benign from malignant lesions in breast.Methods Thirty-eight histopathologically-confirmed breast lesions were analyzed.We examined the signal to noise ratio(SNR)of normal breast tissue and lesions and evaluated the contrast to noise ratio(CNR)of each lesion.We also assessed the relation between pre-and post-contrast ADC values.Results SNRs and CNRs of DWI before and after contrast were not significantly different.The mean post-contrast ADC values for malignant lesions significantly decreased after contrast injected (mean of -1 1.6%),while ADC values in the benign lesions were not significantly different before and after contrast.Conclusion Post-contrast ADC values may be a better indicator of potential breast tumors than pre-contrast ADC values.

Objective To study the influence of walking exercise training on heart function, left heart ventricle structure and plasma brain natriuretie peptide (BNP) concentration in patients with chronic heart failure ( CHF), to explore the sense of exercise training.Methods A total of 223 CHF patients were randomly assigned to a guided rehabilitation group, a non-guided rehabilitation group and a control group.All patients were given basic medicine treatment, and the guided rehabilitation group was administered guided walking exercise training program, while the non-guided rehabilitation group was encouraged to do exercise freely but with no guidance.Blood pressure, 6 min walking distance test, plasma concentration of BNP and echocardiography were measured in all patients before and after exercise training.Results At entry to the study, there was no significant difference among the 3 groups with regard to blood pressure, 6 rain walking distance and BNP level as well as echocardiographic parameters including left ventrieular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDd).A follow-up at the 6th month after intervention, the amount of readmission patients in guided rehabilitation group were significantly less than those in non-guided rehabilitation and control groups ( P < 0.05 ).It was also revealed that the plasma concentration of BNP decreased significantly ( P < 0.01 ) ; LVEF and 6 min walking distance improved significantly ( P < 0.01 ) in the guided rehabilitation group when compared with baseline and 6-month follow-up of the non-guided rehabilitation and control groups.However, there observed no significant change with regard to LVEDd.Conclusion Walking exercise training can improve exercise endurance in CHF patients and is safety; but has no influence on left heart ventricular structure in short time.