critical incidents are significant for the management of hospitals,and it may even be critical to the survival and development of the hospital.This article introduces a series of practices adopted by the First People's Hospital of Changzhou conducted in cases of crisis,and discusses the strategies and measures in hospital crisis management.

There are three kinds mainly of the present government worldwide management of public hospital management system and public service system.This paper compares the management system of public hospitals of the United States of America,Britain,Singapore and other countries,discussion of foreign public hospital public welfare system arrangement.With a view to put forward effective suggestions for the reform of public hospitals in China and public hospital regression public.

The compensation mechanism reform is the key and difficult point of the public hospital reform.Although current health care reform has been carried out including strengthening public welfare of public hospitals and adjusting the compensation mechanism,the effect is not very obvious.How to conduct the compensation mechanism reform orderly and smoothly has become an important topic.I have analyzed the historical evolution,the status and problems of the hospital compensation mechanism.On the basis I have made views and suggestions about the current drive and the path optimization for the compensation mechanism reform.

This paper dicusses the significance of drug clinical trials,and summarises the experiences in policy making,personnel trainning,supervising and management in drug clinical trials at the First People's Hospital of Changzhou,which may provide reference for drug clinical trials in China.

Objective To improve the clinical use of donor kidneys having abnormal blood vessels.Methods The kidneys with abnormal blood vessels were transplanted after vessel reconstruction was made. Various techniques were used for different types of abnormal arteries and veins.Results Of 78 donor kidneys with abnormal arteries (23 kidneys also have abnormal veins) been transplanted, 77 grafts excreted urine immediately and the recipients' blood creatinine level were normal was weeks after transplantation. During a period of one-year follow-up, no vascular complication was observed. One kidney was resected because of uncontrolled bleeding secondary to poor venous return. Conclusion Donor kidneys with vascular abnormalities can function well after proper reconstruction.

Objective To improve life quality of renal transplant patients by exploring erectile function in men with renal failure before and after kidney transplantation.Methods The International Index of Erectile Dysfunction (IIEF) was employed to evaluate erectile dysfunction (ED) of 50 patients with chronic renal failure before and after kidney transplantation, and sex hormones were determined.Results The prevalence of ED was 84 % before kidney transplantation and it decreased to 54 % in patients with normal renal function after transplantation ( P

Objective Discoidin domain receptor 2 is a kind of receptor tyrosine kinases, which was found to be over-expressed in synovial fibroblasts in rheumatoid arthritis (RA). The present study was to construct and express wild type (FLDDR2), Fc chimera (FcDDR2) and truncated form of mouse discoidin domain receptor 2 (ttDDR2) for further study. Methods Full-length, truncated form of mouse DDR2 were amplified by RT-PCR. A chimera form of mouse DDR2 was constructed by replacing part of the extracellular domain with Fc fragment of human immunoglobulin G1 (IgG1). Eukaryotic expression vectors of the different forms of mouse DDR2 were constructed by subcloning the PCR products into pcDNA3.1(+) or pMKIT-Neo. Then COS-7 cells were transient transfected with the eukaryotic expression vectors of full-length (FLDDR2), truncated (ttDDR2) and chimeric form of mouse DDR2 (FcDDR2). Successful transfection and expression was confirmed by Western blot(WB) and Immunoprecipitation (IP)/WB. With or without stimulation with soluble type I collagen for 3h, phosphorylation level of transfected cells were detected by IP/WB. Eukaryotic expression vectors of full-length, truncated form and chimeric forms of mouse DDR2 were successfully constructed and confirmed by sequencing. After transient transfection, the expression of these three forms in the respectively transfected cells was observed by Western blot. Results The result of IP/WB suggested that the chimeric form of mouse DDR2(FcDDR2) could be properly expressed in the COS-7 cells. Under the condition of collagen, decreased tyrosine phosphorylation of FLDDR2 was detected in the COS-7 cells that were cotransfected with ttDDR2 and FLDDR2, comparing with that in COS-7 cells transected with only FLDDR2. There was no obvious difference in phosphorylation level between FcDDR2 without collagen stimulation and FLDDR2 with the collagen stimulation. Conclusion Three different forms of mouse DDR2 were successfully constructed. FcDDR2 could be an activator for its auto-phosphorylation. And ttDDR2 could be a partially negative competitor.

Objective To investigate the clear effect of different blood purification techniques on the serum beta2-microglobulin ( β2-MG) of chronic renal failure maintenance hemodialysis patients.Methods Forty chronic renal failure maintenance hemedialysis patients were randomly divided into four groups: hemodialysis group (HD group), high flux dialysis group (HFD group), hemodiafiltration group (H D F group), hemodialysis and absorption group (HD+AP group). The serum β2-MG levels of the four groups were determined and compared before with after the therapy. Results The difference between the serum β2-MG in HD group detected at the first day before and after the therapy was insignificant difference [( 53.49±1.15 ) mg/L vs (49.10±2.31 ) mg/L ] (P > 0.05 ). The difference between the serum β2-MG in HD group detected at the first day before and after the therapy six months later [(55.63±1.30) mg/L] was significant difference (P <0.05). The serum levels at the first day and six months later after the therapy detected in HFD group, HDF group and HD+AP group were significantly decreased compared with those of the first day before the therapy (P < 0.05 ). Furthermore,the serum β2-MG level decreased in HD+AP group was more significant than HFD group and HDF group at six months later (P <0.05). Conclusions Hemodialysis can not clear the serum β2-MG. High flux dialysis, hemodiafiltration and resin absorptive devices associated hemedialysis can clear β2-MG effectively, while resin absorptive devices associated hemodialysis has the better effection after six months.

Objective To discuss the change and significance of hepcidin expression in patients with hyperlipemia after allograft renal transplantation.Methods Allograft renal transplantation recipients were divided into hyperlipemia group (n =35),and non-hyperlipemia group (n =25).Normal control group was divided into non-hyperlipemia subgroup (n =30),and hyperlipemia group (n =25).ELISA was used to detect serum hepcidin and IL6.Relevant indexes of hematology,biochemistry,and iron metabolism were examined.Results As compared with other three groups,hyperlipemia group after allogenic kidney transplantation had increased serum hepcidin,IL-6,and serum ferritin expression (P＜0.05).Single factor analysis of each group revealed that serum hepcidin expression was correlated with serum ferritin and IL-6 (P ＜ 0.05).Correlation analysis on all specimens demonstrated that serum hepcidin was correlated with glomerular filtration rate,total cholesterol,triglycerides,serum ferritin and IL6 expression (P＜0.05).Conclusion Renal allograft transplantion recipients with hyperlipemia have higher serum hepcidin expression; There exists correlation between the expression of serum ferritin and expression of IL-6,which could reflect the hyperlipemia-induced atherosclerosis and its progress.

Objective To investigate the effect of three blood purification techniques on minerals disorder in maintenance hemodialysis patients,and provide clinical guidance for patients to choice the blood purification techniques.Methods Eighty-eight maintenance hemodialysis patients were divided into three groups according to the blood purification techniques:hemodialysis (HD) group (30 cases),hemodiafiltration (HDF) group (30 cases),and hemoperfusion (HP) group (28 cases).Serum urea nitrogen,creatinine,calcium,phosphorus,intact parathyroid hormone (iPTH),ftbroblast growth factor (FGF)-23 and so on before and after treatment were measured and compared among the groups.Results The serum phosphorus in HD group,HDF group and HP group before treatment were (1.93 ±0.44),(2.11 ±0.54) and (2.17 ±0.59)mmol/L,and after treatment were (1.01 ±0.23),(0.84 ±0.19),(0.99 ±0.27) mmol/L.There were significant differences in serum phosphorus level after treatment compared with that before treatment in the three groups (P ＜0.05).There were no significant differences in the descend rate of serum phosphorus among the three groups (P ＞0.05).There were no significant differences in clearance index of serum phosphorus among the three groups (P ＞ 0.05).The serum iPTH in HD group before treatment was (48.8 ± 42.9) pmol/L,and after treatment was (49.9 ± 42.9) pmol/L.The serum iPTH in HDF group and HP group before treatment were (64.7 ± 45.4) and (50.4 ± 45.9) pmol/L,after treatment was (46.2 ± 37.8) and (35.8 ± 36.5) pmol/L.There were significant differences in serum iPTH level after treatment compared with that before treatment (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum iPTH in HDF group and HP group (P ＞ 0.05).There was no significant difference in serum FGF-23 in HD group before and after treatment (P＞ 0.05).The serum FGF-23 in HDF group and HP group before treatment were (782.5 ± 105.8) and (879.5 ±97.2) ng/L,after treatment were (712.0 ±98.1),(823.5 ± 89.1) ng/L.There were significant differences in serum iPTH level after treatment compared with that before treatment in HDF group and HP group (P ＜ 0.05).The descend rate of serum FGF-23 in HD group,HDF group and HP group were (5.7 ±2.8)％,(12.3 ±6.2)％ and (9.1 ±4.6)％,and there was significant difference among the three groups (P ＜0.05).The clearance index of serum FGF-23 in HD group,HD F group and HP group were 0.06 ± 0.05,0.19 ± 0.11 and 0.12 ± 0.08,and there were significant differences among the three groups (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum urea among the three groups (P ＞ 0.05).Conclusions HD can only clear serum phosphorus.HDF and HP can clear serum phosphorus,iPTH and FGF-23 effectively,while HDF has better clearance effect on FGF-23.The HDF and HP blood purification can reduce minerals disorder in maintenance hemodialysis patients and has important clinical significance in improving the long-term prognosis of the patients.