The service behavior of medical staff is influenced by the organizational environment and management mode of the hospital. That is to say, the organization and management determine the standardization and sustainability of a hospital's humanistic services, and organizational driving force is also an important factor for the staff to innovate their services. Organization and management of a hospital' s humanistic services is composed of three factors: service operation management, service elements management and service performance management. These factors ensure a hospital's humanistic services to achieve whole-staff-participation, sustainability and standardization.

Background and purpose:Nowadays, the golden standard of diagnosis for malignant hydrothorax or ascites is exfoliocytology examination, but the missed diagnosis rate is too high. Other methods including immunologic test, telomerase activation test, conjugation of chromosome analysis with cytological examination test, and RT-PCR test. But none of them was widely used due to high cost or high false positive rate. Immunomagnetic beads (IMB) technique is a popular method all over the world in recent years. It was mainly used in isolating and purifying cells, but it was rarely used to detect cancer cells in patients with hydrothorax or ascites so far. Our aim was to fi nd an effi cient way to detect the cancer cells in patients with cancer related hydrothorax or ascites and to improve the corresponding diagnosis rate. Methods:In the experiments, both the traditional exfoliocytology examination method and IMB technique were used to detect the cancer cells in the hydrothorax or the ascites for comparison. Results:Using IMB technique and exfoliocytology method, the positive rates in 30 patients with cancers were 63.3% (19/30) and 23.3% (7/30), respectively, and the false positive rates in 30 patients without cancers were 3.3% (1/30) and 0.0% (0/30), respectively. It could be observed that the positive rate using IMB technique was much higher than that using exfoliocytology method (P0.05). Conclusions:The present study demonstrated that IMB technique is an accurate, sensitive, fast and economic method in detecting the cancer cells in patients with cancer related hydrothorax or ascites, especially for diagnosis and therapy in the early clinical stage. Due to the high effi ciency, IMB technique could be used after exfoliocytology examination to improve the diagnosis rate..

Objective To investigate the expression of doublecortin-like kinase 1 (DCLK1) in colorectal cancer and colorectal adenomas,and it's role in the development and progression of colorectal carcinoma,and explore the relationship of the DCLK1 expression and prognosis in colorectal cancer patients with diabetes medical history.Methods Expression of DCLK1 in 70 cases of colorectal cancers,70 cases of para-carcinoma tissues,and 35 cases of tubulovillous adenomas were detected by immunohistochemical method.Results (1) The DCLK1 high expression rate in colorectal cancers was 41.4％ (29/70),and 45.7％ (16/35) in tubular villous adenomas,both significantly higher than the para-carcinoma tissues (4.3％;3/70) (P ＜0.01).(2) DCLK1 high positive expression had statistical significance with pathological grading (P ＜ 0.01),infiltration depth (P ＜ 0.05),lymph node metastasis (P＜ 0.05),vascular invasion (P ＜0.05),and distant metastasis (P ＜0.01).(3) There was no obvious correlation between the Diabetes medical history,expression of DCLK1,and prognosis of patients.Conclusions DCLK1 has high positive expression in colorectal carcinomas,and may have certain significance for the early clinical diagnosis and prognostic judgment of colorectal cancers.The expression of DCLK1 and prognosis of colorectal cancers has no obvious correlation with diabetes medical history.

By using intrathecal administration of antisense oligodeoxynucleotide (AS-ODN) against preprodynorphin mRNA in rats, we observed that this treatment could block both the formalin-induced behavioral nociceptive responses and the increased expression of dynorphin A (1-8) in the dorsal horn, with the increased expression of c-Fos protein being unchanged. For we have reported that intrathecal administration of AS-ODN against c-fos mRNA blocks the nociceptive responses and both the increased Fos protein and dynorphin A (1-8), the results of the present study suggest that: (1) Nociceptively induced spinal expression of dyorphin and Fos protein is involved in the transmission of nociceptive information at the spinal level and the expression of Fos protein is the up-stream event. (2) dynorphin may act as a pronociceptive, not an antinociceptive, factor in the modulation of the spinal hyperalgesic state.

Objective To isolate and indentify fetal hepatic progenitor/stem cells, and study the feasibility and effectiveness of their transplantation on acute liver injury in nude mice. Methods The primitive cells isolated from 13.5dpc pregnant mouse fetal hver by way of enzyme digesting were cultured in vitro and liver specific markers as AFP, CK19, Albumin, c-Met, were identified by immunofluorescence and RT-PCR on colonies. 4 × 105 cells were transplanted into nude mice with carbon tetrachloride induced acute liver injury. Hapatic functions were measured pre- and -post transplantation on days 1,2,4, 7. Meanwhile, hepatic pathology was studied. Results Compared to control group the hepatic functions gradually recovered in transplant group, on days 1,2,4 after fetal hepatic stem cell transplantation. The hepatic pathology significantly improved in stem cells transplantation group. Conclution Fetal hepatic progenitor/stem cell were successfully yielded by enzyme digest. Stem cells transplantation improved the hepatic function and pathology in acute hapatic injury model of nude mice.

Objective To investigate human pulpal response to mineral trioxide aggregate (MTA) and calcium hydroxide (CH) as pulp capping agents. Methods This study was conducted on 90 intact first and second premolars of human maxillary and mandibular teeth of 30 volunteers. The patients were randomly assigned into three groups with 10 in each group. Under local anesthesia, the teeth were exposed and capped either with MTA, or CH. After 30, 60, and 90 days, 10 teeth of each group were extracted and prepared for histologic ob-servation. The data were analyzed with Wilcoxon rank sum test and paired t-tests (α = 0.05). Results MTA had a higher success rate and resulted in less pulpal inflammatory response and more predictable hard dentin bridge formation than CH (P < 0.05). Conclusion MTA appears to be a suitable replacement for CH in direct pulp capping.

ObjectiveTo explore the relationship of blood volume changes and postoperative delirium in elderly patients undergoing surgery for hip fracture.Methods One hundred and fifty elderly patients who underwent surgery for hip fracture were enrolled in the study.Delirium was diagnosed by Confusion Assessment Method(CAM).Preoperative,intraoperative and postoperative data were collected,and the correlation of postoperative delirium and blood volume changes were analyzed by logistic regression analysis.ResultsA total of 59 patients(28 males and 31 females)had delirium after surgery and the occurrence rate of postoperative delirium was 39.3％ (59/150).The average age in delirium group was significantly older than that in the control group[ (77.71 ±6.63)years old vs(73.79 ±5.42) years old,t =-3.958,P ＜0.001 ].The average hemoglobin concentration and hematocrit in delirium group were both less than that in control group whether before surgery or at 7 days after surgery( before surgery:average hemoglobin concentration:[ ( 117.80 ± 16.59)g/L vs( 123.92 ±14.61 ) g/L,t =2.378,P =0.019; hematocrit:(0.355 ± 0.154) vs(0.372 ± 0.210),t =2.291,P =0.023 ;7days after surgery:average hemoglobin concentration:(98.15 ± 11.51 ) g/L vs ( 102.33 ± 9.88 ) g/L,t =2.369,P =0.019; hematocrit:(0.296 ± 0.040 ) vs (0.306 ± 0.030),t =-3.958,P ＜ 0.001 ].There was no significant difference on gender,fracture type,surgical approach,operative time,blood loss and hemoglobin concentration at 1,3 days after surgery between the two groups( P ＞0.05 ).Logistic regression analysis showed that age ( OR 3.280 ),education ( OR 0.389 ),and hemoglobin concentration at 7 days after operration ( OR 1.097) were significantly related to the occurrence of postoperative delirium ( P ＜ 0.05 ).Conclusion Our findings suggest that the risk for postoperative delirium is the result of more than one factor.Older age,continued postoperative low hemoglobin concentration and low degree of education present high risk of delirium in patients underwent surgery for hip fractures.

Objective: To investigate the relationship between MALT1 mRNA expression in extranodal B cell lymphoma and the pathogenesis of MALToma and DLBCL, and to explore the effect of MALT1 mRNA expression on the clinicopatho-serve the expression of Bcl-2 and Ki-67 in 106 samples of extranodal B cell lymphoma.The mRNA of MALT1 was detected by RT-PCR.Clinicopathological data were reviewed.Follow-up and statistical analysis were performed.Results: Expression of MALT1 mRNA was statistically different between the cases with lymph node metastasis and those without lymph node mestastasis, and between staging Ⅰ-Ⅱ cases and stage Ⅲ-Ⅳ cases, The expression of MALT1 mRNA in cases with posi-tive expression of MALToma, DLBCL, and Bcl-2 was higher than in those without expression of the three indices (P<0.05).However, no significant difference was found in MALT1 mRNA expression between cases with Ki-67≥30% and those with Ki-67<30% (P>0.05).MALT1 mRNA-positive cases showed a worse survival status than MALT1 mRNA-negative cases (P<0.05).Conclusion: Expression of MALT1 gene is different between MALToma and DLBCL.Inhibition of apoptosis by Bcl-2 overexpression caused by activation of NF-κB may lead to the pathogenesis of MALToma and DLBCL.The expression of MALT1 mRNA is associated with the types of lymphoma, involvement of lymph node, stage of lymphoma, and patient sur-vival.The expression of MALT1 gene may be associated with poor prognosis of MALToma and DLBCL.

Objective:To understand the current situation and influencing factors of successful aging in widowed elderly.Methods:From May to October 2019, 225 widowed elderly people were investigated by questionnaire in 7 communities and 5 villages in Shandong Province. The Successful Aging Scale of the Flood was used to assess their successful aging status. The general data sheet, Physical Activity Scale for the Elderly (PASE), Multidimensional Scale of Perceived Social Support(MSPSS), Connor-Davidson Resilience Scale (CD-RISC) and Mini Mental State Examination(MMSE) were used to measure its influencing factors.Results:The successful aging score of the widowed elderly was 46.22 ± 9.49. The results of multiple linear regression analysis showed that the influencing factors of the successful aging of the widowed elderly were: social activity participation, household registration, consciously successful aging status, psychological resilience, MMSE—attention and computing power, perceived social support—other people, leisure physical activity, which can explain a total of 70.7% of the regression equation.Conclusions:The successful aging status of widowed old people is at a low level, and its influencing factors have both common factors and specific characteristics compared with those with spouses. In particular, more attention should be paid to "participation in social activities", and the widowed old people should be actively encouraged to participate and improve their successful aging.

Objective: To study Duraphat fluoride varnish on the remineralization of demineralized permanent enamel by carbonated beverages. Methods: 30 permanent premolar teeth from 12 to 25 years old young people were collected from orthodontic extraction. Enamel blocks were prepared from each tooth and randomly divided into group A (Coco cola), B(deionized water), C(Coco cola + Duraphat), D(Coco cola + 2％ NaF) and E(Coco cola + artificial saliva) (n = 15), the specinens were respectively treated for 7 d. The enamel surface were observed by scanning electron microscope(SEM). The Ca2 + and P3 + content(weight percentage) were detected by energy spectrum analyzer. Results: The surface of permanent enamel of group A showed a characteristic honeycomb-like appearance, that of group B were smooth. Group C showed irregular large globule deposits on the surface, group D showed some globule structures on the surface, group E showed a little deposits on the surface. Ca2 + and P3 + content of group A was lower than that of group B, in group C was higher than in group E(P＜ 0. 05). Ca2 + content in group D was higher than that in group E(P＜ 0. 05). Conclusion: Duraphat fluoride varnish can promote the remineralization of demineralized permanent enamel by carbonated beverage.