By analyzing the situation that large general hospitals face at present in their development and the background of reform in the system of overall responsibility by the attending physician in the hospital, the authors offer an account of the guiding ideology for large general hospitals to adopt the system of overall responsibility by the attending physician, the specific steps taken and the initial results attained. They also discuss the impact of the system of overall responsibility by the attending physician on the hospital from the perspectives of human resources, technological innovation, managerial system, and information system. The positive significance of the system of overall responsibility by the attending physician in the management of the hospital reform is also identified.

Chemotherapy treatment plays an important role in the comprehensive treatment of malignant disease,but the chemotherapy related knowledge and the selection of an appropriate regimen for certain patient are hard to master.The establishment of computer-assisted cancer chemotherapy program and management system with a follow-up database of cancer patients can help the oncologist to master the designing skill of chemotherapy regimen and cancer-related knowledge quickly,improve the teaching qnality and the efficiency of treating malignant diseases.

Objective To investigate the functions of triple point-mutants of hypoxia-inducible factor 1α(HIF1α)in angiogenesis in bone defect region under normoxic conditions.Methods Triple point-mutations (the 402,564 and 803 amino acids)in HIF1α coding sequence (CDS)were induced.The triple mutant of HIF1α(402/564/803)was inserted into the adenovirus pAdEasy-1 system to complete viral packaging and titer measurements. The wild-type HIF1α gene and the empty adenovirus vector were packaged in the same way.For the in vitro experiment,the rabbit bone marrow mesenchymal stem cells (MSCs)were divided into four experimental groups:A,MSCs infected with viral solution containing mutant HIF1α;B,MSCs infected with viral solution containing wild-type HIF1α;C,MSCs infected with viral solution without any HIF1α;and D,MSCs without viral infection. The efficiency of infection was observed by the expression of human renilla reniformis green fluorescent protein (hrGFP).The expression levels of HIF1α mRNA and protein in infected cells in each experimental group were measured.For the in vivo experiment,the MSCs were divided into the same four groups and infected with the virus solutions from each group and cultured under normoxic conditions.At 72h after the infection,the MSCs were used as seed cells and transplanted into Apatite-wollastonite magnetic bioactive glass-ceramic (AW MGC)vector to construct artificial tissue-engineering scaffolds,and then the scaffolds were implanted into the in vivo rabbit radial bone defect model.The animals from each group were sacrificed 8 weeks after the surgery and the tissues from the implantation region were harvested for evaluation of angiogenesis.Results The 402,564 and 803 amino acids in CDS area were point mutated into alanine;three types of recombinant adenovirus were successfully constructed, packaged and characterized.The expression levels of HIF1αmRNA were significantly higher in Group A and Group B than in Group C and Group D (P <0.05 ).There was no significant difference between Group A and Group B group or between Group C and Group D (P >0.05 ).The HIF1α protein expression in Group A was significantly higher than that in the other three groups (P <0.05);however,there was no significant difference among groups B,C and D (P >0.05).There was prominent angiogenesis in bone defect region in Group A,but not in the other three groups.Conclusion ① Triple point-mutants of HIF1αefficiently expressed functional proteins under normoxic conditions.② Triple point-mutants of HIF1αeffectively promoted in vivo angiogenesis in bone defect region.

Objective To develop a new method to detect A (TA)n TAA polymorphism in the UGT1A1 gene promoter by fluo‐rescence real‐time quantitative PCR (RQ‐PCR) .Methods Genomic DNA was extracted from peripheral blood in 16 patients with Gilbert′s syndrome and 66 healthy individuals .The polymorphic A(TA)n TAA sequence in the UGT1A1 gene promoter was deter‐mined by DNA sequencing .A pair of primers and two TaqMan probes labeled with either 5′FAM or VIC reporter dye incorporated a 3′minor groove binder were designed .The A(TA)n TAA polymorphisms in the UGT1A1 gene promoter were identified by RQ‐PCR for all research subjects .The sensitivity and specificity of RQ‐PCR for detecting the A(TA)nTAA polymorphisms were veri‐fied by DNA sequencing method .Results The homozygous A(TA)7TAA polymorphism was found in the promoter region of the UGT1A1 gene in all 16 patients with Gilbert′s syndrome by using RQ‐PCR .The homozygous A(TA)6TAA polymorphism was foundin46healthysubjects,whiletheheterozygousA(TA)6TAA/A(TA)7TAApolymorphismwasfoundinother20healthysub‐jects .All A(TA)nTAA polymorphisms in the promoter region of the UGT1A1 gene identified by RQ‐PCR were consistent with that of DNA sequencing .Conclusion It is a sensitive ,specific and simple method to detect the A (TA)n TAA polymorphisms in the promoter region of the UGT1A1 gene by RQ‐PCR ,which can be promoted and applied in clinic .

In order to improve the reference service, the necessity to provide reference service for translational medicine in academic library was analyzed and the translational medicine-based reference service in Library of Qingdao University was elaborated from the aspects of its contents and ways with the existing problems and weaknesses summarized.

Objective To survey membrane inhibitor of reactive lysis(MIRL) expression in non-small cell lung careinoma(NSCLC) and to analyze the relationship between MIRL expression and clinical staging, adjuvant chemotherapy and disease-free survial. Methods The expression of MIRL in 8 adjacent tissues and 36 NSCLC sam-pies were determined by immunohistochemistry. Furthermore, the relationship between MIRL expression and clinical stage ,adjuvant chemotherapy and disease-free survival was assayed by follow-up. Results Among 36 samples of non-small-cell lung cancer,there were 10(27.8%) samples expressing MIRE. Out of 18 samples of squamous carcinoma, 4(22.2%) expressed MIRL,while 6(37.5%) expressed it in 16 samples of adenocarcinoma,there was no statistical significance between them(P>0.05). There were no expression in 2 samples of large cell carcinoma. There was no correlation between MIRL expression and disease-free survival(P>0.05). MIRL positive expression rate in patients with preoperational adjuvant chemotherapy was significantly lower than that of those without preoperational adjuvant chemotherapy(P<0.05). Conclusions There is great percentage of MIRE expression in NSCLC. Our present study suggests that the immunological inhibition of MIRL should be blocked when monoclonal antibody is used in the treat-merit of NSCLC.

Objective To find an ideal animal model of acute respiratory distress syndrome (ARDS) through investigating the characteristics of three two-hit animal models of ARDS.Methods Forty-eight SD rats were randomly divided into 4 groups: Control group [2.5 mL/kg normal saline (NS) i.v.given at 0 min and 30 min];OA+OA group [0.5 mL/kg oleic acid (OA) i.v.given at 0 min and 30 min];LPS+LPS group [2.5 mg/kg lipopolysaccharide (LPS) i.v.given at 0 min and 30 min];and OA+LPS group [0.5 mL/kg OA i.v.given at 0 min and 2.5 mg/kg LPS,i.v.given at 30 min].The samples were collected at 5 h after the second drug injection.White blood cells count (WBC),polymorphonuclear leukocyte ratio (PMN%),total protein concentration,tumor necrosis factor α (TNF-α) level in bronchoalveolar lavage fluid (BALF),arterial blood gas analysis and lung wet-dry weight ratio (W/D) were measured,respectively.Pathological changes in the lung tissues were observed and histological scores were evaluated.Results Compared with those in the control group,PaCO2,WBC,PMN%,total protein concentration and TNF-α levels in BALF were significantly increased,while PaO2 was dramatically decreased (P<0.01) in the OA+OA,LPS+LPS and OA+LPS groups.The levels of protein concentration in BALF and lung W/D ratio in the OA+LPS group were significantly higher than these in the LPS+LPS group (P<0.05 for all),but had no statistically significant difference compared with these in the OA+OA group.The levels of WBC,PMN% and TNF-α in BALF in the OA+LPS group were significantly higher than those in the OA+OA group (P<0.05),but not significantly different from those in the LPS+LPS group.The most typical pathological changes and the highest pathological scores were found in the OA+LPS group.Conclusions All the three different methods including OA+OA,LPS+LPS,and OA+LPS can be used to establish “two-hit” animal models of acute respiratory distress syndrome.The “two-hit” animal model of acute respiratory distress syndrome induced by OA+LPS is more closer to clinical ARDS and is useful for studies on the pathophysiology of ARDS,and is an ideal “two-hit” animal model of ARDS.

Objective To investigate the clinical efficacy of integrated Chinese and western medicine for the treatment of anovulatory dysfunctional uterine bleeding. Methods A total of 108 anovulatory dysfunctional uterine bleeding patients were evenly randomized into treatment group and control group. Both groups were given basic conventional treatment, estrogen-progestogen sequential therapy for 3 menstrual cycles for dysfunctional uterine bleeding patients at puberty and child-bearing period, and Marvelon for patients at menopause transition period after excluding uterine tumor by diagnostic curettage. Additionally, the treatment group was given Chinese herbal decoction of Radix Rehmanniae Preparata, Semen Cuscutae, Fructus Corni, Placenta Hominis, Herba Ecliptae, Fructus Schisandrae Chinensis, Rhizoma Alismatis, raw Rhizoma Dioscoreae, Rhizoma Atractylodis Macrocephalae, Rhizoma Cyperi, Radix Codonopsis, Radix Astragali, Radix Angelicae Sinensis, Radix Paeoniae Alba, Pericarpium Citri Reticulatae, and charred Herba Schizonepetae. Therapeutic effect, bleeding-arresting time, and recurrence rate during 3-month follow-up were observed in the two groups. Results ( 1) The treatment group had a total effective rate of 100.0%, higher than 94.4%in the control group, the difference being significant (P<0.05). (2) Bleeding-arresting time was (45.50 ± 13.0) hours in the treatment group and was (58.0 ± 15.0) hours in the control group, and the difference was statistically significant (P<0.05). (3) During the 3-month follow-up, the treatment group had the recurrence rate of 16.7% ( 9 cases) , lower than 29.6% ( 16 cases) in the control group, and the difference was statistically significant ( P<0.05). Conclusion Integrated Chinese and western medicine has certain effect for the treatment of anovulatory dysfunctional uterine bleeding, showing good prospects for extensive application in gynecological clinic.

Objective:To preliminarily compile the words list of personality in southern China, and structurally analyse the words with natural personality traits.Methods:A semi-structured questionnaire was used to obtain 603 valid questionnaires in six provinces in southern China, and the lexical collation, consolidation, deletion, lexicographic analysis and structural analysis were conducted.Results:(1)After three rounds of collation and merging of 8 022 natural words describing personality traits, a personality trait word list containing 136 words was obtained.(2)Econometric analysis of words according to positivity, neutrality and negativity, showed that all negative words involving moral evaluations (ruthless, vicious, evil, cunning, narrow-minded and so on) were used to describe others, while negative words describing oneself were mainly non-virtuous words (capricious, stubborn, impatient, impetuous, pessimistic and so on). (3) The proportion of desirability and virtue dimensions in the words list was highest(23.20%, 16.80%); and the proportion of desirability and extroversion in total words frequency was highest(24.39%, 19.96%).Conclusion:A personality word list containing 136 personality traits in southern China is compiled from primary sources; and a 7-factor personality structure was latent in the word list.Subjects are richer in describing the content of the vocabulary of agreeable, virtuous, pioneering, and persevering personality traits, while agreeable and extroverted personality traits are most easily perceived in interpersonal interactions.