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.

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.

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 determine the influencing factors of post-stroke depression by machine learning.Methods Stroke patients' medical records (688 cases eligible) were extracted from record system,including age,gender,pulse manifestation,complexion,tongue quality,fur,Chinese medicine intervention,body mass index (BMI),blood pressure,blood glucose,blood triglyceride,blood total cholesterol,smoking history,drinking history,depression family history,stroke lesion site in imaging,as well as the final depression judgment.Single rule algorithm (1R) was adopted to learn.The risk factors influencing post-stroke patients' depression in extracted information were determined.Then the cases collected were divided into the training dataset (500 cases) and the test dataset (188cases).Optimal discriminant results were obtained by random forest model.Results Single rule algorithm showed that the most important influencing factor of post-stroke depression was stroke lesion site.By computer speculation,stroke lesions in the frontal and temporal lobes were most prone to post-stroke depression.Basal ganglia,brain stem,cerebellum,medulla oblongata and occipital lobe lesions were less likely to cause depression.The accurate classification rate could amount to 88.95％ (612/688 cases).Random forest model determination was made in the former 500cases in the training dataset.The total correct rate of determining depression was 98.2％.The total correct rate of determination in 188 cases of the test dataset was 99.47％.Six hundred and eighty-eight patients' data were learnt by random forest model.The total correct rate was 98.84％.The importance measure results showed that top 3 important indexes of post-stroke depression were lesion site,Chinese medicine intervention and depression family history.Conclusion Patients with lesions in the frontal & temporal lobes and depression family history were most prone to post-stroke depression.

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 detect the expression and correlation of serum Hepcidin,IL-6,sTfR,BMP6 diversity and explore the role of serum Hepcidin in prostate cancer with bone metastasis.Methods From January 2012 to March 2012,serum Hepcidin,IL-6,sTfR,BMP6 diversity were tested by ELISA in 25 prostate cancer patients with bone metastasis,30 prostate cancer patients without bone metastasis and 30 patients with BPH were used as the control group.The mean patient's age was 67 years (range from 55 to 75 years).In prostate cancers with bone metastasis group,the mean PSA base line was 138.0 μg/L (ranged from 20.0-1500 μg/L),the prostate cancers without bone metastasis group,mean PSA was 10.2 μg/L(ranged from 3.5-28.2 μg/L),and in BPH group,the mean PSA was 3.7 μg/L (ranged from 0.3-14.2 μg/L).Venous blood samples were taken in fasting mornings,then stored 3 ml in EDTA anticoagulant vacuum tube and centrifuged at4 ℃ for 10 min,the isolated serum were then preserved in-80 ℃ refrigerator.The competitive in-phase enzyme-linked immunoassay (ELISA) was used to detect serum Hepcidin,IL-6 and sTfR and BMP6 levels.Results Serum Hepcidin expressions in three groups were 67.7 ± 40.6 μg/L,37.5 ± 15.3 μg/L and 34.3 ± 10.7 μg/L,respectively.For prostate cancers with bone metastasis group,serum Hepcidin expression were higher than control group (P ＜ 0.05),and associated with IL-6(22.5 ±22.1 μg/L),sTfR (5.7 ± 2.6 μg/L),BMP6 (429.3 ± 188.4 μg/L),correlation coefficients were 0.972,-0.987,0.971 (P ＜ 0.05).Conclusions Increased serum Hepcidin level might be a sensitive index for diagnosis and prognosis of prostate cancers with bone metastasis.