Objective To investigate the expression and clinical significance of survivin and PTEN in bladder transitional cell carcinoma(TCC).Methods The expression of survivin and PTEN was studied by S-P immunohistochemisty in 10 cases of normal urinary bladder tissues and 62 cases of the bladder TCC. Results All the normal urinary bladder tissues showed positive staining pattern of PTEN protein, negative staining pattern of survivin protein, positive rate of PTEN in 62 cases of the bladder TCC is 46.8%,the difference of positive rate between grade Ⅰ and grade Ⅲ was significant(P＜0.05),the difference of positive rate between Tis～T_1 and T_2～T_4 showed a trend of decreasing, but there was no statistically significant difference(P＞0.05);positive rate of survivin in 62 cases of the bladder TCC is 56.5%,the difference of positive rate between grade Ⅰ and grade Ⅲ was significant(P＜0.05),the difference of positive rate between Tis～T_1 and T_2～T_4 was significant too(P＜0.05).The expression of PTEN protein and survivin protein was reversely correlated(P＜0.05).Conclusion The abnormal expression of PTEN protein and survivin protein play an important role in the occurrence and progress of the bladder TCC.It can be regarded as a useful diagnostic marker in the bladder TCC.

Objective To establish an animal model to investigate the effects of prolonged vaginal distension on the leak-point pressure(LPP) and urethral anatomy.Methods Eighteen virgin female rats were randomly divided into control group(6 rats) and experimental group(12 rats).In the experimental group,the rats were underwent vaginal distension for 4 h. The rats in the control group were not received vaginal distension.The greatest bladder volume and LPP were measured,and sneeze test was performed for all rats in two groups 4 weeks after distension.All the rats were killed after the test and the bladder and urethra were harvested for histological study.Results The greatest bladder volume and LPP were significantly decreased than those of control group.Stress urinary incontinence(SUI) was occurred in 45.5% rats of the experiment group,but none in control group.Histological studies showed that the urethral striated and smooth muscle became thin,but the collagenic tissue was increased.There was no change in control group.Conclusion Prolonged vaginal distension can cause SUI and it is a desirable animal model for studying the mechanism and treatment of SUI.

Objective To analysis the risk factors and drug resistance of multidrug-resistant pseudomonas aeruginosa(MDRP) infection and to provide the basis for clinical anti-infective therapy .Methods Predisposing factors and drug resistance to clinical commonly used antibacterial drugs of MDRP which were separated from September 2010 to December 2011 were adopted for retro-spective analysis .Results A total of 235 hospital MDRP infection were collected ,97 multidrug resistant strains were concluded ,the separation rate was 41 .2% .The separation rate of ICU and neurosurgery were higher ,account for 35 .54% and 22 .31% respective-ly .The main resource of specimen is respiratory tract ,about 75 .21% .The resistance of MDRP was very serious .The resistant rate of Amikacin was the lowest ,account for 37 .11% ,followed by piperacillin/tazobactam ,ceftazidime ,account for 47 .4% and 48 .45%respectively .The resistant rate of other antimicrobial agents were greater than 50% .Advanced age ,serious underlying diseases ,long hospital stay ,long-term repeated application of broad-spectrum antimicrobial drugs ,admission to ICU ,invasive treatment operations were the risk factors for MDRP resistance .Conclusion The resistance is very serious ,in order to reduce the generation and spread of drug-resistant strains ,the hospital infection control ,drug resistance monitoring ,rational use of antimicrobial drugs and prevention of cross-infections should be strengthened .

During the 14th Five-Year Plan period, China′s public hospitals are facing important development opportunities as well as many difficulties and challenges. Using PEST model, this study analyzed the macro-environmental factors of the development of public hospitals in China from four aspects: political environment, economic environment, social environment and technological environment. The authors proposed relevant countermeasures and suggestions to promote the high-quality development of public hospitals, including implementing functional positioning and promoting differentiated and synergistic development, strengthening operation management and enhancing the capacity for high-quality development, and building smart hospitals and stimulating new efficiency in service management.

Objective To determine the dose-response relationship of ropivacaine for paravertebral nerve block in treating acute severe herpetic neuralgia.Methods One hundred patients with herpetic neuralgia,with the course of disease ≤ 1 month,of numeric rating scale score ≥ 7 points,scheduled for elective paravertebral nerve block with ropivacaine under ultrasound guidance,were divided into 5 groups n=20 each) using a random number table method:5 different concentrations of ropivacaine groups R1.5 groups).The herpes zoster-affected thoracic spinal nerves were identified,and the mixture 5 ml was injected into the paravertebral space corresponding to the spinal nerves.The mixture solution contained ropivacaine with the concentrations of 0.075 0％ (group R1),0.112 5％ (group R2),0.150 0％ (group R3),0.187 5％ (group R4) and 0.225 0％ (group R5),compound betamethasone 1 ml,and mecobalamin injection 1 ml diluted to 20 ml with normal saline.Effective block was defined as numeric rating scale score≤ 1 point at 10 min after paravertebral nerve block with ropivacaine.The median effective concentration (EC50),95％ effective concentration (EC9s) and 95％ confidence interval of ropivacaine for paravertebral nerve block in treating acute severe shingles neuralgia were calculated by Probit analysis.Results The EC50 and EC95 (95％ confidence interval) of ropivacaine for paravertebral nerve block in treating acute severe shingles neuralgia were 0.150 0％ (0.097 0％-0.216 0％) and 0.216 0％ (0.175 0％-0.541 0％),respectively.Conclusion The EC50and EC95 of ropivacaine for paravertebral nerve block in treating acute severe herpetic neuralgia are 0.150 0％ and 0.216 0％,respectively.