OBJECTIVE:To explore the problems and improvement measures in the process of operation and management of B2C pharmaceutical E-commerce enterprise,and to promote their development. METHODS:The performance evaluation index sys-tem was built preliminarily,including 5 first-level indexes and 28 second-level indexes. Questionnaires survey was conducted among 16 experts by Delphi method,and the weight of every index was calculated by experts according to importance,familiarity and reference. The company performance was analyzed and judged objectively by fuzzy comprehensive evaluation method. The re-sults of Y enterprise performance evaluation were empirically analyzed. RESULTS & CONCLUSIONS:The performance evaluation index system has been built,including 5 first-level indexes,24 second-level indexes. Average expert authority degree of two rounds survey is 0.76(>0.70),showing survey result is credible. The performance of the company in the finance and popularization have more influence to the performance of B2C pharmaceutical E-commerce enterprise. The performance of Y company is outstanding in profit growth,site stability and security,suppliers development and maintain and other aspects;however,it is not good enough of performance in employee satisfaction,customer professional services,logistics and distribution quality and other aspects. It is sug-gested to establish logistics by B2C pharmaceutical E-commerce enterprise themselves,carry out whole-course monitoring to im-prove the quality of logistics and distribution;increase product and pharmaceutical knowledge training input and introduce talent with the background of medical education so as to strengthen professional service;survey the satisfactory degree of staff to working environment,working group,working content and other aspects,and adjust enterprise system or communicate with staff in order to improve satisfactory degree.

Objective:This study aimed to investigate the expressions of EZH2 and Ki-67 in the salivary adenoid cystic carcino-ma (SACC) of humans and their correlation. Methods:A total of 42 cases of SACC tumor tissues and 5 cases of normal tissues were considered to determine the expressions of EZH2 and Ki-67 by immunohistochemistry. The relationship and correlation of such expres-sions with the clinicopathological characteristics were also analyzed. Results:The expression of EZH2 was notably higher in SACC than in normal tissues (P<0.05). EZH2 expression was detected in 66.67%(28/42) of the tumor tissues. This expression was correlated with pathological grade and clinical stage. By contrast, EZH2 expression did not correlate with gender, age, and localization. EZH2 was not expressed in normal tissues. The incidence of EZH2 expression in the Ki-67 positive group was 75.76%(25/33) and the incidence in the Ki-67 negative group was 33.33%(3/9). The difference between the two groups was statistically significant (P<0.05). Conclu-sion:The increased expression of EZH2 in SACC was related to tumor proliferation. EZH2 may participate in tumor cell proliferation via cell cycle management.

Antidepressive Agents ; therapeutic use ; Depression ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Electroacupuncture ; Humans ; Integrative Medicine ; Phytotherapy

The research of induced phripotent stem(ips)cells is a hotspot in the area of life sciences at present.Currently,the research of ips cells has focused on cells'induction methods,source and differentiation.At the same time,the research of ips cells'application has also made some achievements.With the extensive research of application,ips cells will have an inestimable effect on the future of biomedical development.This article will give an reviews the latest application and future research trends of ips cells.

When the body is attacked by trauma and infection,the serum C-reactive protein( CRP) con-centration which is produced by the liver will increase.CRP participates in the body′s humoral immunity through regulating the phagocytic cells to clear the pathogenic bacteria and necrotic tissue.The occurrence and develop-ment of malignant tumor is associated with complex inflammatory response pathway.Serum CRP concentration will change with the progress and remission of tumor.CRP is associated with differentiation of benign and malignant, the early diagnosis,the pathological stage,the lymph node metastasis,the organizational characteristics,the prog-nosis,and the treatment of malignant tumor.It is expected to be a clinical screening indicator of malignant tumor.

Objective To investigate the advantages of susceptibility-weighted imaging (SWI) over conventional T2*-weighted spoiled phase gradient-echo imaging (T2* WI) in detecting brain hemorrhage in patients with mild traumatic brain injury (MTBI) and its relationship to outcome after MTBI.Methods Clinical information,T2* WI and SWI of 57 patients with MTBI were collected.Bleeding cases and number of cerebral micro-cerebral bleeds (MCBs) detected using T2* WI and SWI were compared statistically.Correlation analysis between SWI and clinical outcome was performed.Results Hemorrhage in 43 patients (75％) with MCBs amounting to 237 was detected using SWI,while hemorrhage in 32 patients (56％) with MCBs amounting to 123 was found using T2* WI (P＜0.01).Thirty-five patients experienced short-term unconsciousness,including 22 being detected with post cerebral traumatic syndrome (PCTS) at follow-up.Twenty-two patients experienced no coma,among which 10 developed PCTS at follow-up.Based on the SWI,patients who experienced coma showed higher incidence of hemorrhage compared with patients who did not (86％ vs 59％,P＜0.05),and patients with hemorrhagic focus was associated with higher probability of PCTS compared with patients without (65％ vs 29％,P＜0.05).Conclusions SWI is more sensitive than conventional T2* WI in detecting cerebral MCBs.MCBs are related to the late prognosis of MTBI patients,but SWI can supply certain valuable and objective information.

Objective To report the preliminary results of Less Invasive Stabilization System (LISS) applied in treatment of proximal tibial fractures. Methods 22 patients with acute fractures of proximal tibia were treated with LISS plates from November, 2003 to June, 2004. There were 6 females and 16 males, with a mean age of 41.8 years (ranging from 22 to 69 years). According to AO classification, 7 cases were type 41- A, and 15 cases were type 41- C (9 combined with other fractures). 5 of these were open fractures (3 cases of Gustilo- Anderson type Ⅲ A and 2 cases of type Ⅲ B). Results All fractures were eventually healed. There were 2 cases of superficial infection. No deep infection, failure of fixation or malalignment was found in this group. However, 1 case showed displacement of articular surface 6 months postoperatively. The range of motion was from 2? to 98.6? . The mean time of radiographic healing was 14.5 weeks (ranging from 11 to 17 weeks) and the mean time of full weight bearing was 15.2 weeks (ranging from 12 to 18 weeks). By Johner - Wruhs' evaluation, 13 cases were rated as excellent, 7 as good, 2 as fair 1 year postoperatively. Conclusions LISS is a safe and effective fixation device for proximal tibial fractures, especially for those caused by high- energy injuries. The benefits of this system include less intervention of blood supply, less soft tissue complications and a high union ratio of fractures.

Objective To evaluate minimally invasive plate osteosynthesis (MIPO) technique in the treatment of humeral shaft fractures using locking compression plate (LCP). Methods Between February 2004 and January 2005, 17 consecutive patients with 17 humeral shaft fractures were treated with LCP by MIPO technique. There were 12 men and 5 women with a mean age of 48 years (range, 18 to 75). According to AO classification, three fractures were type12-A, 10 type 12-B, and four type 12-C. Results The mean duration of follow-up was 19. 1 months (range 14 to 25) . Union occurred in all patients with a mean healing time of 11. 3 weeks (range 9 to 14) . With regard to ROM of the shoulder, the mean flexion was 174 degrees (range, 135 to 180 ), the mean extension was 38 degrees (range, 20 to 40), and the mean abduction was 87 degree (range, 70 to 90). For the elbow, the mean flexion was 133 degree (range, 115 to 135), the mean extension was -1 degree(range, - 10 to 0). Using the patient-rated functional questionnaire, the mean DASH (disabilities of the arm, shoulder and hand) score of 11 points (range, 6 to 44) at the latest follow-up indicated a mild to moderate impairment. There were three postoperative complications. One superficial infection occurred in a Custilo type MB open fracture and was uneventfully healed with conservative managements. One patient experienced transient radial nerve palsy which showed complete remission within 3 months. The third one demonstrated a dysfunction of shoulder and elbow. There were no cases of secondary malalignment or late hardware failure in this cohort. Conclusions Internal fixation using LCP in MIPO can attain a stable fixation, a high union rate as well as a low complication rate. The neurovascular structures may be at less risk of iatrogenic injuries through the anterior approach. It may be considered a reliable and efficient method for humeral shaft fractures, especially for comminuted ones and those with poor bone quality.

Objective To evaluate the indications and clinical results of less invasive stabilizing system (LISS) in the treatment of complex fractures around the knee. Methods Screws in this system can be inserted through the aiming handle and can be locked into the plate-holes. Between Dec. 2003 and Jun. 2004, 41 cases(29 males, 12 females) of complex fractures around knee were treated with LISS. The mean age of the patients was 40.6 years (range 24 to 67 years). The proximal tibia was involved in 28 cases and distal femur in 13. In all 41 cases, there are 22 (53.7%) polytrauma, 6 (14.6%) delayed fractures and 1 revision surgery. All fresh fractures were operated in a minimal invasive way (only articualr surfaces need open reduction), fractures in metaphyseal area and tibial shaft were reduced indirectly and stabilized with minimal invasive percutaneous plate osteosynthesis(MIPPO). The delayed and revisional fractures were reduced with limited approach and stabilized with MIPPO. Results The mean operation time was 87.2 min. The follow-up averaged 16 months(range 13 to 21 months). 3 patients with bone deficit in distal femur underwent a bone graft which unioned eventually, the other patients had a mean healing time of 15.1 weeks(11 to 23 weeks) and a mean weight bearing time of 16.8 weeks (12 to 25 weeks). One pulling device broken and one screw lost in the tibial medullary cavity occured intraoperatively. Postoperatively, one loss of reduction occurred, no deep infection, loosening, breakage or failure of implants was noted. According to Rasmussen criteria of fracture reduction, excellent in 31 (75.6%) cases, good in 10 (24.4%). One year postoperatively, the mean ROM of the knees was 2.4? to 95.6?, the mean HSS knee score was 88.4 points(58 to 98 points)with 27 excellent, 10 good, 3 fair and 1 poor according to HSS scoring system. Conclusion LISS, with a novel operating concept and technique different to traditional methods, is an effective and alternative way for complex juxtaarticular fractures around the knee, especially for those difficult to deal with in traditional way. As a novel product further clinical studies are required to verify its effectiveness.

Objective To summarize the clinical and pathological features of exaggerated placental site (EPS),explore its pathogenesis regularity,diagnosis and treatment strategies.Methods The clinical data related to 34 patients with EPS were analyzed retrospectively.Results In 34 patients,11 patients performed full-term cesarean section,2 patients performed normal vaginal delivery,the other 21 patients had abortion.Thirty-one patients had pregnancy history.Fifteen patients performed hysterectomy,13 patients performed dilatation and curettage,6 patients performed exploratory hysteroscopy and lesions resection.All the patients survived after treatment.Conclusions The patients can not be diagnosed in the antepartum and intrapartum,but can be diagnosed relying on the pathological diagnosis.When it is ineffective to stop bleeding after delivery or abortion by conventional treatment,we should consider the possibility of EPS.Timely perform hysterectomy is theeffective method to stop bleeding,can save the life of patients.If bleeding is not much,curettage or exploratory hysteroscopy can get a significant effective treatment and avoid hysterectomy.