Study of the strategic objectives chosen by hospitals from the perspective of stakeholders is now under the spotlight of researchers at large. To identify whether there exist differences in strategic objectives among various groups in the hospital and probe into the causes, the author called into play the competing values framework as the analysis tool. An evidenced-based study on public hospitals in Hangzhou identified marked differences on choices of strategic objectives among various internal stakeholders in the hospital For example, hospital administrators tend to focus on internal control, while medical doctors tend to focus on interactions between the hospital and the external environment. On this basis, further studies are proposed.

Adoption of the board of directors system in a public hospital is conducive to straightening out its internal management system and enables its head to more effectively exercise his power of supervision while giving full play to his functions. In addition, when major issues are concerned, decision-making is more democratic and scientific, reducing disputes over trifles. The board of directors system may after all be accepted as an effective form of management.

Objective To investigate the repeated dose toxicity of doxorubicin liposome injection and doxorubicin injection in rats. Methods Ninety SD rats ( body weight 180-220 g, male:female=1:1 ) were divided into 3 groups (30 rats in each group), and were administered intravenously with physiological saline, doxorubicin liposome injection (1 mg·kg-1 ) and doxorubicin injection ( 1 mg·kg-1 ) , respectively, once every three days for thirteen times. The body weight, blood biochemistry, hematology, organ coefficient and histopathology were analyzed for the overall toxicity assessment. Results The rats administered with doxorubicin liposome injection (1 mg/kg) showed hair loss and skin ulcer, significantly reduced growth of body weight, increased levels of urea nitrogen ( BUN ) , alanine aminotransferase ( ALT ) , blood platelet ( PLT ) , and kidney and heart coefficients, decreased thymus and testicular coefficients, myofibrillar rupture and lysis, and partial loss of cell nuclei, hyaline casts in the renal convoluted tubules, interstitial edema and loss of spermatogenic cells in the testicular tubules. Compared with the doxorubicin liposome injection group, similar abnormal changes were also observed in the doxorubicin injection group, but the hair loss and skin ulcer were milder and the heart and kidney toxicities were severer. Conclusions Compared with doxorubicin injection, the doxorubicin liposome injection causes milder heart and kidney toxicity but more serious skin toxicity.

The health care alliance in county was the vertical integration of medical service system,which was conductive to improve the overall efficiency of the county medical service,achieve tiered health care system,optimize regional health resources and enhance the capacity of primary health care services.It took Tianchang County,Anhui as a case study.It investigated and analyzed how the local took measures to carry out the health care alliance reform in organization structure,interest distribution,health human resources construction,information construction,division and coordination mechanism,medical service pattern,etc.,so as to provide references for implementing county medical alliance reform in other regions.

Objective To investigate the distribution of Malassezia species in lesional and non-lesion-al sites of patients with pityriasis versicolor(PV),species-variation in different anatomic sites and in lesions with different pigmentation,and the relationship between various Malassezia species and severity and age of PV patients.Methods A total of629skin specimens taken by sterile adhesive tape from the lesions and non-lesional skin were inoculated on media containing rapeseed oil in113patients with PV.Isolated colonies were identified to species based on physiological and morphological characteristics.Results The isolation rates of Malassezia spp.were not significantly different from both lesions and corresponding non-lesional skin.Among non-lesional sites,the isolation rate was significantly higher in forehead and trunk than that in upper and lower extremities.Five species were identified out of565strains obtained from the patients,including M.sympodialis(44.78%),M.furfur(32.94%),M.globosa(11.68%),M.obtusa(5.84%)and M.restricta(4.76%).Two dif-ferent species were isolated simultaneously from27sites.There was no obvious difference in species distribu-tion patterns between lesions and non-lesional sites.M.restricta was isolated from forehead exclusively.Species-variation was closely linked to lesions with different pigmentation and the age of patients,not to the severity of disease.Conclusion There is neither statistical difference of Malassezia isolation rate and species distribution between lesions and non-lesional skin,nor correlation between disease severity and species-varia-tion.The anatomic sites,the diversity of pigmentation pattern and the age of patients seem to be associated with different Malassezia species.

Objective To study the effects of He-Ne laser irradiation on histological changes and the expression of proliferating cell nuclear antigen ( PCNA ) and B-cell lymphoma/leukemia-2 ( Bcl-2 ) in the gastric mucosa of rats with chronic atrophic gastritis (CAG) so as to elucidate the relationship of He-Ne laser irradiation with precancerous lesions and apoptosis in the gastric mucosa. Methods The rats were divided into a normal group,a model group and a laser group.A model of CAG was established by gastric perfusion with a mixture of sodium salicylate and alcohol combined with irregular fasting and forced exercise.A He-Ne laser was used to irradiate the rats at 3.36 J/cm2 for 7 min daily for 20 d.Histopathological changes including the severity of inflammation in the gastric mucosa and the morphology and structure of the parietal cells were observed with a light microscope,and the expression of PCNA and Bcl-2 was detected with immunohistochemical methods. Results The pathologic morphological changes in the gastric mucosa of the model group were atrophy of the glands of the gastric mucosa and notable inflammatory infiltration.But in the laser group inflamed cells decreased,and the morphology,structure and volume of the cells all recovered close to normal.The immunohistochemistry results showed that during the atrophy of the gastric mucosa the expression of PCNA and Bcl-2 was elevated,and it was significantly higher in the model group than in the normal group.After irradiation the expression of PCNA and Bcl-2 was significantly lower. Conclusions There was hyper-proliferation in the gastric mucosa of the CAG model rats,with high expression of apoptosis suppressor PCNA and Bcl-2 proteins.Laser irradiation can reduce the expression of PCNA and Bcl-2,enhance cell proliferation and induce apoptosis,preventing the development of cancer.Laser irradiation has a good adjuvant therapeutic effect for all the pathological changes observed.

With the understanding of the development and pro-gress of the cancer,the research of targeted cancer drug devel-opment reaches into a new era.p53 is an important tumor sup-pressor gene,the protein coded by p53 plays a critical role in tumor suppression mainly by inducing cell cycle regulation, DNA repair and apoptosis.Nowadays,p53 becomes a relatively attractive target for anti-cancer drug development and there are some drugs targeting p53,moreover,APR-246 which targets mutant p53 is in Phase II clinical trial.In addition,it facilitates drugs discovery programmes in the challenging area of protein-protein interactions and mutant protein conformational change. The review discusses the research progress of drugs which target p53 and elucidates the characteristics and mechanisms of these compounds.

A Raman spectrum fitting method based on Voigt function was proposed. The method can be used to fit the profile of Raman spectrum produced by unknown components in sample based on Voigt functions. In the experiment, pure methanol was added by various volume fraction ( 2. 5% -80. 0%) into three base-gasoline with different compositions. It can be applied to fit the background Raman spectrum produced by basic-gasoline comprised of unknown compositions. The remained spectrum, after deducting the fitted spectrum from the mixture spectrum, was considered as the contribution attributed only to methanol. And then a linear calibration model was built based on 4 training samples to predict the concentration of methanol. The root mean square error of prediction (RMSEP) was 1. 86% (V/V) and the correlation coefficient (R2) was 0. 987. Results show that it is an effective method to solve the problem of strong spectral overlap in mixture, and it has the advantages of high generalization and few training samples.

Objective To investigate the synergism and attenuation effects of Pini Pollen on cyclophosphamide chemotherapy in model mice.Methods The models of mouse were induced with S180 tumor and cyclophosphamide.The tumor inhibiting rates, hematology, Liver function, giant cell phagocytosis, hemolysin level and indexes of thymus and spleen were determined to evaluate the synergism and attenuation effects of Pini Pollen(150,300,600 mg/kg) on cyclophosphamide chemotherapy.Results Compared with cyclophosphamide chemotherapy group,the tumor inhibiting rates,white blood cell number,giant cell phagocytosis, hemolysin level and indexes of thymus and spleen were increased, at the same time liver function damage were alleviated significantly in cyclophosphamide plus Pini Pollen groups.Conclusions Pini Pollen has a remarkable synergism and attenuation effects on cyclophosphamide chemotherapy through its immune adjustment functions.

Objective To investigate the therapeutic mechanism of umbilical cord mesenchymal stem cell(UC-MSCs)trans-plantation for the graves disease(GD)mice .Methods Thirty two mice were divided into 3 groups as following :normal control group (G0) ,GD control group (G1) ,UC-MSCs group(G2) .Enzyme linked immunosorbent assay(ELISA)was used to measure the level of TSAb in blood serum and the expression of FT4 was measured by chemiluminescence .Thyroid sections were stained with hema-toxylin and eosin(HE)for histological examination .Splenocytes were stained with multicolor immunofluorescence and detected by flow cytometry to analyze the percentages of CD1dhiCD5+CD19+ regulatory B cells(Bregs) .Expressions of IL-10 and TGF-βmR-NA in spleen organization were measured by Real-time PCR .Results At 26 weeks ,the level of TSAb in blood serum in G2 was more significantly decreased than in G1(P<0 .05) ,and the level of CD19+ B in spleen in G2 was also more significantly decreased than in G1(P<0 .05) ,however ,the percentage of CD1dhiCD5+CD19+ Bregs splenocytes and the levels of IL-10 and TGF-βmRNA in spleen organization were more significantly increased than in G1(P<0 .05) .The concentration differences of TSAb in serum was negatively correlated with the percentage differences of CD1dhi CD5+ CD19+ Bregs ,however ,positively correlated with the expres-sion differences of IL-10 and TGF-βmRNA in spleen before and after transplantation .Conclusion Activation of Bregs may be one of the mechanisms of UC-MSCs therapeutic effect on GD mice .