OBJECTIVE:To provide reference for systematic reform in national state-owned hospital.METHODS:System reforms of township hospitals in Zhangjiagang were analyzed.Then three kinds of reform modes were summarized including privatization,town-owned-town-management and sino-foreign joint venture.Reform effects were also discussed.RESULTS & CONCLUSIONS:The achievement that the reformed township hospitals have made in Zhangjiagang in improving the medical insurance and pharmaceutical management system,reforming hospital management system and operation mechanism and creating a harmonious relationship between doctor and patient can provide a reference for domestic state-owned hospital reform.

Objective To analyze the epidemic characteristics of HIV/AIDS among older adults in Chongqing,and to provide scientific evidence for developing prevention and control measures.Methods The data were collected through the national AIDS reporting information system,SPSS 17.0 was used to analyze the data.Results From 2001 to 2015,a total of 10495 cases had been reported accumulatively,and HIV/AIDS cases was accounting for 31.1％.The study was showed that the main infection people was man and the main professional was the main farmer.Moreover,the main infection was heterosexual transmission and accounting for 91.5％.Conclusion The epidemic of HIV/AIDS aged over 50 was on the rapid rise from 2001 to 2015 in Chongqing,the publicity and education should be focused on them,to improve the relevant awareness and reduce their risk behavior.

Objective To explore the prospects for applying a brain-computer interface system in the reha-bilitation of dyskinesia by testing the brain-electricity signals of spinal cord injury patients and stroke patients during motor imagery. Methods The brain-electricity signals of 5 healthy people, 4 spinal cord injury patients and 2 stroke patients were tested during motor imagery, and the results were analyzed with a computer. Results All of the 5 healthy people showed event-related synchronization and desynchronization (ERS/ERD) in the α and β bands in the motor related cortex. Three of the 4 spinal cord injury patents showed similar characteristics, and 1 showed ob-vious and stable characteristics, but the 2 stroke patients did not show meaningful characteristics. Conclusions Spinal cord injury patients have brain-electrlcity characteristics similar to those of healthy people when they are expe-riencing motor imagery, whilst in the affected hemisphere of stroke patients the brain-electricity characteristics are not similar to those of healthy people.

Objective To observe the effects of secoisolariciresinol (SECO) and its metabolites, enterolactone (ENL) and enterodiol (END), on proliferation of MCF-7 cell line and to the probable mechanism. Method Effect of SECO, END, ENL and genistein (GEN) on MCF-7 proliferation was investigated by MTT assay. Cell cycle arrest was measured by flow cytometry (FCM). Cell morphology was observed by optical microscope. The anticarcinogenic mechanism of SECO was analyzed. Results SECO had promotive effect on the cell growth at lower concentration (≤40 ?mol/L) but inhibition effect at higher concentration (100 ?mol/L). ENL and END, however, showed significant inhibition effect at all tested concentrations (10~100?mol/L). The cell cycle progression was arrested at G2/M phase and apoptosis was observed by optical microscope. Conclusion Effect of SECO on the MCF-7 cell proliferation depends on its concentration. Inhibition effect of SECO may relate to its metabolites ENL or END.

Objective To investigate the accuracy of functional magnetic resonance imaging(fMRI) and contrast-enhanced ultrasound on evaluation of the breast cancer patients after neoadjuvant chemotherapy.Methods Forty-eight patients with breast cancer who were confirmed by biopsy,undergoing 4 cycles weekly dose-concentrated programs (wPC) neoadjuvant chemotherapy,evaluated the efficacy by fMRI and contrastenhanced ultrasound.Results In pathology,complete remission was 12 cases (25.0％,12/48),non remission was 13 cases (27.1％,13/48).In contrast-enhanced ultrasound,complete remission was 20 cases (41.7％,20/48),non remission was 10 cases (20.8％,10/48).In fMRI,complete remission was 17 cases (35.4％,17/48),non remission was 11 cases (22.9％,11/48).The P values more than 0.05 showed no statistically significant among three methods,the Kappa test showed that fMRI were superior to contrastenhanced ultrasound on evaluating the efficacy of neoadjuvant chemotherapy.Conclusions fMRI and contrast-enhanced ultrasound can be used in evaluating the efficacy of neoadjuvant chemotherapy,however,the data shows fMRI is superior to contrast-enhanced ultrasound.Contrast-enhanced ultrasound must be as the supplementary method.

Objective To compare the sensitivity and specificity of mucin 7(Muc7) mRNA test with urine cytology in detection bladder cancer.Methods In 86 patients suspected with bladder cancer,RT-PCR for Muc7 mRNA and urine cytology were conducted in the same urine samples.Fif-ty-two patients with bladder transitional cell carcinoma were confirmed histologically.The sensitivity and specificity of Muc7 mRNA and urine cytology were analyzed.Results The overall sensitivity,specificity and false positive of Mue7 mRNA test were 84.6%,85.2% and 14.7% respectively.Those of urine cytology were 34.6%,91.2% and 8.8% respectively.There were no significant differences between urine cytology and Muc7 mRNA test in the specificity and false positive; however,Muc7 mRNA had significantly higher sensitivity than urine cytology in detection of bladder cancer.Conclusion The sensitivity of Muc7 mRNA test is superior to urine cytology in detection of bladder cancer.

Objective To investigate the relationship between serum levels of PCT and neutrophil CD64 contents with the effect of hormone therapy and complications in the patients with primary nephrotic syndrome.Methods Sixty-five patients with primary nephrotic syndrome in our hospital from September 2015 to September 2016 were selected as the research subjects,all cases were treated with hormonal therapy,the serum levels of PCT and neutrophil CD64 were detected and their relationship with the curative effect and complications of nephrotic syndrome was analyzed.Results According to the PCT and neutrophil CD64 median levels,the cases were divided into the high level group and low level group,the results found that serum creatinine,serum protein,urine protein and pathological types had no statistical difference between the high level group and low level group.The hormone sensitivity had 15 cases in the patients with high PCT level,which was significantly lower than 21 cases in the patients with low PCT level;the hormone sensitivity had 14 cases in the patients with high neutrophil CD64 level,acute renal failure,infection and thrombus in the patients with high PCT level had 8,10,6 cases,which were significantly lower than those in the patients with low PCT level;acute renal failure,infection and thrombus in the patients with high neutrophil CD64 level had 7,11,6 cases,which were significantly higher than those in the patients with low neutrophil CD64 level (P<0.05).Conclusion The levels of serum PCT and neutrophil CD64 are significantly correlated with the therapeutic effect and clinical prognosis in the patients with nephrotic syndrome.

Objective To investigate the expression of human epididymal protein 4 (HE4) in chronic kidney disease (CKD) and its clinical value.Methods From April 2014 to December 2015,Serum samples of 92 non-cancer patients diagnosed as CKD and 84 healthy controls were collected in Nantong University Hospital.HE4,BUN,Scr,Cys C and β2MG were detected.The difference of HE4 expression in different stages of CKD and the correlation of HE4 with Urea,Scr,Cys C and β2MG were analysized,respectively.ROC curve was used to evaluate the auxiliary diagnostic value of HE4,BUN,Scr,Cys C and β2MG.Results The serum HE4 expression in patients with impaired renal function was 388.2 (130.1～1 659.5)mIu/ L,(F=16.237,P=0.001).Which was significantly higher than that in the control group [38.1 (32.77 ～ 48.17)mIu/L].The serum HE4 expression was increased by the stage of renal damage and the difference was existed among different groups (P＜0.05).HE4 expression was positive related with Cys C and β2MG.The AUC of HE4,BUN,Scr,Cys C and β2MG were 0.878,0.785,0.816,0.874 and 0.819,respectively.Conlusion It needs to consider the exsits of impaired renal function when the HE4 was detected.The HE4 might be a novel early diagnostic indication for CKD.

Objective Currently,the sit-to-stand process is not well evaluated.The aim of the study is to evaluate quantitatively the reliability of posturographic parameters in the sit-to-stand process.Methods Seventy-four healthy participants were enrolled and required to finish 20-second sitting,standing and the sit-to-stand process.The computer calculated the posturographic parameters automatically.The test was repeated twice to assess the reliability at an interval of six days.Results During sitting and standing position,the intraclass correlation coefficients (ICCs) of all the parameters were above 0.50,indicating a good or fair reliability.During the standing stance and sitting phase of the sit-to-stand process,the ICCs of all the parameters were above 0.40 and 0.60 respectively,showing a good or fair reliability.Conclusions Sit-to-stand posturographic parameters are a new way to assess the position control ability among the healthy participants with a good reliability.Further study should be conducted among patients to result in better functional and effectiveness evaluation.

ObjectiveTo investigate personal reflections of head nurses on 360-degree performance assessment system. Method Twenty-three head nurses being involved in 360-degree performance assessment received semi-structured interviews and the data were analyzed with content analysis.ResultThe head nurses were positive about the assessment system,believing that the assessment system was helpful for detecting the weak links of daily work and thinking that the assessment indexes varied in weights with different clinical disciplines.ConclusionsThe 360-degree performance assessment was beneficial for ability promotion of head nurses and continuous improvement of nursing quality.Hospital administrators should continuously improve and promote 360-degree performance assessment system.