Hospitals, obliged to resort to marketing as a result of changing external environment, ought to take the concept of patient-centered marketing as the core of their marketing activities. They can better meet the needs of patients by making their marketing plans more effective through market subdivision and target market selection. The features of medical service determine the role of credit in the evaluation of medical service. Differentiation, two major methods of which are service quality and brand creation, is a means of avoiding price war, over-competition and vicious competition while positioning refers to patients' understanding and the goal of a hospital's differentiation.

Objective:To investigate the feasibility of adipose tissue-derived stem cells(ADSCs) as the seeding cells of skin engineering for skin defect repair. Methods :Adipose tissues were isolated from a SD rat groin, the fat was cut and incubated in a collagenase solution, and then the ADSCs were cultivated in culture medium. The amplified cells in vitro were inoculated in collagen gel to form tissue engineered skin. Fifteen SD rats were randomly divided into three groups: experimental group was treated with ADSCs collagen tissue engineered active skin substitute, and single collagen and blank were served as two control groups. The materials were grafted onto total skin defect wounds on the back of rats in the corresponding group respectively. The effect of wound repair was observed histologically. Results:The time of wound healing in the ADSCs and collagen experimental group, the single collagen control group and the blank control group were (14.3?1.7) days,(16.9?2.5)days,and (21.2?4.2)days respectively, and showed significant differences(P

Objective To know the situation of the water environment in the Eling Lake Area and provide the theoretical basis for protecting the biosystem of this area. Methods The water samples were collected from the sites 0.5 meters below the water surface of input and output water area, the water area near the east and west bank of the Eling Lake, the center of the lake, and also from the sites 0.5 meters above the bottom of the lake .The water sampling was carried out in August 2005, October 2005 and May 2006. Country standard method was used to determine the physical and chemical characteristics of water samples. The sampling, determination and evaluation in the investigation were according to related standard regulations. Results The water temperature was 5.6 ℃, pH value was 8.49, the total amount of Ca2+ and Mg2+, suspended matter, chlorides, sulfate, DO, COD, BOD5, Cu2+ and Zn2+ were 95.4 mg/L, 87.0 mg/L, 45.0 mg/L, 80.0 mg/L, 7.1mg/L, 11.0 mg/L, 2.0 mg/L, 0.002 mg/L and 0.009 mg/L respectively. Conclusion All of the physical and chemical characteristics of the water samples meet the water quality criterion of the class ruled by GB 3838-2002, and the water can be used as source water.

Objective To assess the methods and points of transvaginal ultrasound - guided partly microwave ablation (MWA) on polycystic ovary syndrome(PCOS). Methods 22 patients with PCOS underwent transvaginal ultrasound - guided MWA with 18G PTC needle on part of ovarian interstitium. Results The one - shot achievement of earlier period ratio was 20% with 5 cases. The other 17 cases underwent injecting 400ml normal saline or pressure on inferior belly. Then the one - shot achievement ratio was 81.2% . The average puncture time was respectively 3.8 and 1.7. Conclusion Transvaginal ultrasound -guided puncture on polycystic ovary appears realtime and safe with little complications. Also it can improve the puncture achievement ratio by better means.

Objective:It is important to make sure hyperbaric oxygen chamber safe and stable for its generalized and high risk.Methods: The gas path, control system and operation of hyperbaric oxygen chamber should be maintained timing based on quality management and clinical using requirement.Results: Medical engineering technicians and clinical use of personnel to cooperate with each other, from the regular inspection, personnel management and preventive maintenance to make sure the safety use of hyperbaric oxygen chamber.Conclusion: Making relative system and emergence plan, strengthening train to users and strict management can make its used safe.

OBJECTIVE:To investigate the long-term toxicity of repeated intramuscular injection of Escherichia coli O157∶H7 polysaccharide-conjugated vaccine(O157) in rats so as to provide safety evidence for clinical trials.METHODS:A total of 48 SD rats were randomly assigned to receive either 0.5 mL vaccine(containing 25 ?g polysaccharides) (immunization group,n=24) or phosphate buffered solution (PBS,control group,n=24) with the same volume for 3 times at a dose interval of two weeks.Sacrifice of 6 rats in each group were scheduled at 2 weeks after first immunization,and at 1,3,and 5 weeks after the third immunization,respectively for observation and determination of hematological and biochemical parameters,histopathology,specific antibody,myeloid tissue,the tissues in injection sites,etc.RESULTS:Compared with control group,immunization group showed no significant pathological change except the dynamic regular change of some hematological parameters induced by the immunization,and no immunologic system damage was observed.CONCLUSION:Repeated intramuscular injection with O157 vaccine in rats wouldn't cause overt toxicity and local irritation.

AIM: To demonstrate the susceptibility of cell apoptosis varies during the progress of cell malig- nant transformation from human being in vitro. METHODS: A SV40T - transfected human bronchial epithelial im- mortalized cell line (called M) was selected in this work, which has acquired some characteristics of malignant trans- formation at the later passage. The alterations of apoptosis and bcl- 2, P53 genes between early and later passage of M cells were investigated by means of TDT labeling in situ, chromosome FISH, RNA and protein testing, etc. RE- SULTS: Incidence of apoptosis induced by cis - platin was significantly lower in later than in early passages of M. Levels of bcl - 2 mRNA and protein in later passages were higher than early passages of M, and overxpression of bcl -2 was accumulated following the development of cellular malignancy. P53 protein level was as high in early as in later passages. CONCLUSION: Overexpression of bcl - 2 decreases the cellular sensitivity to apoptotic inductors plays an important role during progress of carcinogenesis in human bronchial epithelial cancers. The inactivation of P53 protein in the SV40 - T transfected M cell line may be one of reasons of bcl - 2 overexpression, but not associated with the accumulation of bcl - 2 expressed level during cell transformation.

Objective:To understand general hospital medical staff status quo and characteristics of blood -borne occupational exposure , analysis its ethics factor , to make the prevention countermeasures of blood -borne oc-cupational exposure to provide scientific basis .Methods:From January 2013 to December floor all the medical staff of blood -borne occupational exposure cases were retrospectively analyzed .Results:A total of 101 medical staff blood-borne occupational exposure , which is given priority to with the nurse , accounted for 60 .40%;More con-centrated in under 30 employees, accounted for 70.29%;Occupational exposure personnel distribution in the ma-jority with surgical department (42.57%), followed by the physician (36.63%);Wards (60.40%), the operat-ing room (15.84%) and therapy (11.88%) are the sites of occupational exposure often happen;Sharp injury in the composition of the ratio of 87.12%, in the first place, in which a proportion (23.76%), pull out the needle (18.81%) and blood (15.84%), surgical suture (14.85%) and transfusion injection (13.86%) as the sharp injury of frequent occurrence of occupational exposure;Exposure is given priority to with hepatitis b ( 61 .38%) . Conclusion:Medical staff blood-borne occupational exposure risk is high , the hospital infection control personnel must pay attention to occupational exposure of the whole education , strengthen the administration of the occupation-al exposure of ethics , reduce the risk of occupational exposure and injury .

Objective:To analyze the genetic test results and ultrasonographic markers of 41 fetuses with short femurs and their relationship.Methods:This study retrospectively analyzed 41 fetuses who were diagnosed with short femurs by ultrasound during 19-37 gestational weeks and underwent prenatal genetic examination at the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2019. According to the results of genetic examination, these cases were divided into three groups after excluding three cases of variants of unknown significance: genetically normal group, chromosome variation (including chromosomal aneuploidy and pathogenic or likely pathogenic copy number variations) group, and gene mutation (including pathogenic or likely pathogenic gene mutations) group. According to the head circumference (HC), abdominal circumference (AC) and femur length (FL), Z FL, FL/HC, FL/AC, ΔZ H-F and ΔZ H+A-2F for each fetus were calculated. One-way ANOVA and LSD- t test were used for statistical analysis. Results:(1) Among the 41 fetuses with short femurs, there were 28 in the genetically normal group, five in the chromosome variation group, three with chromosome variations of unknown significance and five in the gene mutation group. (2) In the genetically normal, chromosome variation and gene mutation groups, Z FL values were -2.78±0.77, -4.36±0.69 and -4.69±0.70; FL/HC ratios were 0.178±0.011, 0.170±0.010 and 0.131±0.022; FL/AC ratios were 0.197±0.013, 0.186±0.011 and 0.151±0.017; ΔZ H-F values were 2.49±1.09, 3.53±1.28 and 8.17±1.30; ΔZ H+A-2F values were 4.44±2.00, 6.78±2.20 and 14.28±1.26, respectively. The differences in Z FL values between the genetically normal group and the chromosome variation group as well as the gene mutation group were statistically significant (both P<0.05); so were the differences in FL/HC, FL/AC and ΔZ H-F values between the gene mutation group and the genetically normal group as well as the chromosome variation group (all P<0.05) and in any pairwise comparison of ΔZ H+A-2F among the three groups (all P<0.05). Conclusions:The genetic etiology of fetal short femurs is mainly related to chromosomal variations (including chromosomal aneuploidy and pathogenic or likely pathogenic copy number variations) and gene mutation. In fetuses with chromosome variation and gene mutation, the degree of the femoral development delay relative to the development of HC and AC is worse than that in the normal genetic results group.

Objective To study the histopathological characteristics and the correlations between the cortical tissues from ictal discharge (ID) area and interictal epileptiform discharge (IED) area in epilepsy patients due to focal cortical dysplasia (FCD), in order to further discuss the mechanism of epileptogenicity. Methods Twenty-two subjects who underwent epilepsy surgeries consecutively in our institute since April 2005 to August 2006. All patients underwent intracranial electrode implantations and long-term video-EEG monitoring before the resective surgeries and the postoperative pathologies proved to be FCD. According the long-term EEG monitoring results, the cortex with intense IED and the cortex with ID onset were resected separatively in the operation for further histopathologic studies. Twenty cases were collected. Based on the Palimini' s pathologic subtype classification for FCD as well as quantificational scoring for immunocytochemistry for the calcium-binding protein parvalbumin (PV) which we designed by ourself, the specimens of IED and ID were studied and compared. Results The resected specimens from 20 cases were examed. ID specimens showed more severe abnormalities in the laminar cortical architecture, alterations in the morphology of neurons and in the appearance of abnormal balloon cells. With the PV quantificational scoring, we found significant difference between IED (6.4±2.1) and ID (4.4±1.8) from FCD Ⅱ specimens (P=0.042). No difference was found between ID subtypes (F=2.734, P=0.093 ). Conclusions ID cortical area showed more severe abnormalities in histopathologic changes than lED area. Our results suggested that the ID area of FCD had more severe damage in inhibitory synaptic circuits and neural networks, which meant it was more epileptogenic than IED. No difference was identified between each ID subtype in term of epileptogenicity, which meant all of them should be resected during the surgery.