Effective leadership is crucial for health organizations' performance and numerous western universities thus offer leadership courses or modules to their students.However,such education practice has not started in China.In order to optimize knowledge and skills of health service management practitioners,to content with requirements of health service organizations,to cope with dynamic organization environment,to implement health reform successfully and to realized sustainable development of health organizations,it is necessary to provide leadership course for students of health service management at Chinese universities.

Objective To investigate the features and risk factors associated with lymph node metastasis in colorectal neuroendocrine neoplasm.Methods Clinical and pathological data of 99 patients with colorectal neuroendocrine neoplasm treated between January 2009 to January 2015 were analyzed retrospectively.Comparisons of categorical data and univariate analysis of risk factors of lymph node metastasis were conducted.Results Of the 99 patients,the rate of regional lymph node metastasis was 30.3％ (30/99)with 56.7％ limited to para-intestinal lymph nodes in 17 cases,26.7％ limited to mesenteric lymph nodes in 8 cases,and 16.7％ limited to mesenteric root central lymph nodes in 5 cases.No metastasis exceeding central lymph nodes was observed.Multivariate regression analysis revealed that tumor size,invasion of lymphatic vessel and pathological grading were independent risk factors for lymph node metastasis in colorectal neuroendocrine neoplasm (P ＜ 0.05).Conclusions Colorectal neuroendocrine neoplasm with larger tumor size,invasion of lymphatic vessel or higher grade (G2,G3) has high risk of regional lymph node metastasis.

Cirrhotic portal hypertension is associated with both increased intrahepatic vascular resistance and hyperdynamic circulation.These two pathogical changes of portal hypertension can be contributed to the unusually high or unusually low levels of vasodilator in liver and splanchnic organs.Vascular hyporesponsiveness due to reactive oxygen species is also a key factor which accounts for portal hemodynamic abnormalities.Transcription factor nuclear factor E2-related factor 2 (Nrf2),known by its role in anti-oxygenation,can initiate and enhance transcription of antioxidant response element (ARE) when exposure to oxidative stress occures.Related influence on expression of nitric oxide,carbon monoxide and their coenzymes has also been demonstrated for decades.The potential clinical significance will be unfolded if changes of Nrf2 expression,as well as the way modulating Nrf2,are found in cirrhotic portal hypertension.

Objective To study the relationship among hydrops fetalis(over 28 gestational weeks),Mirror syndrome and preeclampsia(PE). Methods Clinical data of 13 cases of hydrops fetalis were analyzed and relative publications were reviewed. Results Eight out of the 13 cases were diagnosed as PE,and 5 were Mirror syndrome.Serious maternal complications occurred in all cases with either Mirror syndrome or PE. ConclusionsFetaland placental hydrops was closely related with maternal symptoms.Clinicians should be aware of this condition and detect Mirror syndrome in time so as to prevent its progress to PE.However,the pathogenic mechanism remains to be fully elucidated.More attention should be paid to both mothers and the hydrops fetalis.

The relationship between PGE2 and sIL-2R and ca rcinoma of large intestine and the development of its immunological study is de scribed briefly.

Humans ; Myocardial Infarction ; complications ; therapy ; Myocardial Reperfusion Injury ; etiology ; therapy

Female ; Fetal Growth Retardation ; genetics ; physiopathology ; Humans ; Insulin Resistance ; physiology ; Insulin-Secreting Cells ; physiology ; Metabolic Syndrome ; embryology ; etiology ; Pregnancy

10.3969/j.issn.2095-4344.2013.25.005

Objective To evaluate the value of lung ultrasound score (LUS) on assessing the severity and extubation opportunity in postoperative patients of general surgery, and to investigate the correlation between LUS and oxygenation index (PaO2/FiO2), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), stay length in ICU and stay length in hospital. Methods A prospective double- blind cohort study was conducted. Eighty- nine postoperative patients of general surgery with successful extubation were selected, and the patients were divided into 2 groups:group A ( admission ICU to extubation time less than 48 h, 52 cases) and group B(admission ICU to extubation time more than 48 h, 37 cases). Before extubation, the PaO2/FiO2 was recorded according the blood gas analysis, and APACHE Ⅱ, SOFA and LUS were examined, and the staying time in ICU and staying time in hospital were recorded. The correlation was analyzed. Results The LUS, APACHE Ⅱ, SOFA, staying time in ICU and staying time in hospital in group A were significantly lower than those in group B: (3.98 ± 2.31) scores vs. (13.41 ± 2.82) scores, (7.52 ± 1.96) scores vs. (14.92 ± 3.07) scores, (4.50 ± 2.24) scores vs. (9.70 ± 3.64) scores, (1.77 ± 1.41) d vs. (8.49 ± 4.35) d and (8.49 ± 2.28) d vs. (15.63 ± 6.10) d, and the PaO2/FiO2 was significantly higher than that in group B:(441.57 ± 45.31) mmHg (1 mmHg=0.133 kPa) vs. (305.78 ± 90.72) mmHg, and there were statistical differences (P<0.01). The LUS had negative correlation with the PaO2/FiO2 (r=-0.882, P<0.01), and it had positive correlation with APACHEⅡ, SOFA, staying time in ICU and staying time in hospital (r=0.711, 0.590, 0.930 and 0.709;P<0.01). Conclusions The LUS is simple and easily available. It can evaluate the changes of pulmonary ventilation, and also evaluate its degree of severity and prognosis. It is helpful in the prediction of the extubation time, staying time in ICU and staying time in hospital in patients with general surgery.

OBJECTIVE:To establish a HPLC method for determining the concentration of dexketoprofen in rabbit’s pla_ sma.METHODS:Dexketoprofen was extracted from samples with ether.HPLC was performed on C 18 column with methyl al?cohol-50mmol/L sodium dihydrogen phosphate as mobile phase.Detection wavelength was260nm.RESULTS:The linear range was0.05～25?g/ml.Recovery was99.92%～100.54%.Within-day and between-day RSDs were0.56%～2.94%and0.6%～2.89%respectively.CONCLUSION:This method is simple,accurate and good in repetitiveness.Satisfactory results have been obtained in determining plasma concentrations of dexketoprofen in6rabbits after taking dexketoprofen-?-cy?clodextrin inclusion microspheres.