Objective To find out about the effect of the trustee policy on the quality of medical workers' material life so as to further improve the trustee reform. Methods An investigation was made via questionnaires on the annual income, consumption structure and housing area of 320 medical workers in hospitals that had adopted trusteeship. Results After the adoption of trusteeship in 2002, the quality of all the medical workers' material life was improved, but there was a signiticant difference among the doctors, nurses and medico-technicians (P

Objective To understand and master the system for assessing the strategies, management and effect of special medical services marketing. Methods Survey sheets on customer satisfaction towards special medical services and survey sheets on the effect of special medical services on the caliber of medical personnel were fandomly distributed to the patients and medical staff in a particular hospital and special topic interviews and statistical analyses of special topic survey data were conducted. Results The satisfaction rate of customers receiving special medical services was 98.9%, and special medical services had a positive effect on the improvement of the quality of medical services, economic benefits and the caliber of the medical personnel. Conclusion Correct orientation is the marketing strategy guiding special medical services. Market-based orientation, marketing-based medical services and resources-based guidance are of important practical values to special medical services while high quality, high caliber and high benefits are the major indexes for assessing special medical services.

Objective To observe the effect of neoadjuvant chemotherapy combined with tumor cells reduction and postoperative intraperitoneal perfusion chemotherapy on the efficacy and quality of life of ovarian cancer.Methods From October 2010 to October 2013 at the Department of gynecology,Taizhou Municipal Hospital,65 cases of ovarian cancer patients for the treatment of stage Ⅲ and Ⅳ were randomly divided into intervention group (n =32) and control group (n =33).Patients in the intervention group received neoadjuvant chemotherapy after tumor cell reduction cytoreductive surgery and received postoperative intraperitoneal hyperthermic perfusion chemotherapy and conventional surgery after chemotherapy.Patients in the control group received conventional tumor cell cytoreductive surgery plus postoperative chemotherapy.Surgical status,the effectiveness of treatment,and adverse reactions were compared between two groups.Moreover,survival quality score,relapse rate,and mortality differences were compared between two groups.Results For the intervention group,operation status and effective treatment were better than the control group.The proportion of adverse reactions had no significant difference between two groups.Survival quality had no statistically significant difference between before treatment and after receiving treatment.Quality of life in the intervention group was better than that of the control group.Relapse rate,and mortality rate in the intervention group was lower than the control group.Conclusions Accepted neoadjuvant chemotherapy combined with tumor cytoreductive surgery and surgery after intraperitoneal hyperthermic perfusion chemotherapy can improve the effectiveness of treatment of ovarian cancers,and improve the quality of life,with better short-term effect.

Objective:To compare the mRNA expression of IRG1in PBMCs from patients with TB, individual with latent infection and healthy controls, and investigate its diagnostic value for Mycobacterium tuberculosis infection.Methods: The mRNA expression of IRG1 from PBMCs stimulated with Mtb-specific antigens was quantitatively detected by quantitative real-time PCR ( qPCR).Receiver-operating-characteristic ( ROC) curves were used to determine the cutoff points yielding the highest specificity and sensitivity,and discriminative ability was evaluated by the area under the ROC curve.Results: The mRNA expression of IRG1 in healthy controls was significantly lower than that in patients with tuberculosis and LTBI ( P<0.05 ).The AUC for using IRG1 mRNA levels (>0.01536 ) to identify Mycobacterium tuberculosis infection was 0.91, with 76.47% sensitivity, 96.30% specificity, LR 20.65,and 85.2% of cases correctly classified.Conclusion: IRG1 may be used as a biomarker for diagnosing Mycobacterium tuberculosis infection.

Objective To investigate the effect of bronchodilators on dyspnea and pulmonary function in patients with chronic obstruction pulmonary disease (COPD) at different degrees.Methods 50 patients with COPD from January 2014 to January 2015 in pneumology department of Tongchuan City People's Hospital were selected.According to the standard of Global initiative for chronic obstructive lung disease (GOLD), the patients were divided into mild degree of 14 cases, moderate degree of 18 cases and severe degree of 18 case.The changes of Borg score of dyspnea, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and inspiratory capacity (IC) after received tiotropium bromide inhalation in each group.Results FEV1, FVC, PEF and IC values significant improved in mild, moderate and severe degree groups after received tiotropium bromide inhalation and the values of improvement rate changed significantly with degrees of disease ( P <0.05 ).The improvement rates of FEV1, FVC and IC were highest in patients at severe degree, improvement rate of PEF was highest in patients at mild degree (P<0.05).After received tiotropium bromide inhalation, the Borg score improved significantly compared with that of pre-treatment in mild, moderate and severe degree groups (P<0.05), the improvement rate of Borg score was highest in severe degree group(P<0.05).There were significantly positive correlations between Borg score and FEV1(r=0.372),FVC(r=0.296),PEF(r=0.284),IC(r=0.704)(all P<0.05).Conclusion Bronchodilator could significantly improve dyspnea and lung function in patients with COPD, and the improvement rate of FEV1, FVC and IC is highest in patients with COPD at server degree, PEF is highest at mild degree and Borg score is highest at server degree, which need the comprehensive analysis of each indicators for reversibility of airflow obstruction.

A mouse model for acute hepatitis B virus (HBV) infection was established by using the hydrodynamical injection of mouse tail vein, in which the immunocompetent BALB/c mice were hydrodynamically injected with a competent replication plasmid pAAV-HBV1.2 having 1.2 fold over-length of HBV DNA. On day 1, 2, 4, 6 and 8 after injection, the levels of HBsAg, HBeAg and HBV DNA in blood serum were detected by using ELISA and fluorogenic quantitative PCR assay (FQ-PCR). And on day 8. HBsAg and HBeAg in liver tissue were assayed by immunohistochemical staining. It was found that HBsAg in blood serum could be detected on day 1 after infection in 14 of 16 mice (85.7%) injected with pAVV-HBV1.2 by using ELISA assay and the peak levels of HBsAg and HBeAg were attained during the first day after injection and then it dropped down gradually up to day 8 following injection. The titer of HBV DNA in blood serum attained its peak on day 2 and maintained a high level later on. On day 8 after injection, its titer was 1.9×10~4 copies/mL. The percentage of HBcAg-positive hepatocytes and HBsAg-positive hepatocytes in liver tissues were 5% and 2% respectively. Thus, by using the hydrodynamic injection with the competent replication plasmid, a mouse model for acute HBV infection is successively developed.

Objective To investigate the feature of Th1 cytokines induced by Mtb-specific antigen in patients with refractory pulmonary tuberculosis.Methods 28 patients with refractory pulmonary tuberculosis,67 patients with first-treated pulmonary tuberculosis,and 25 healthy controls with positive T.spot (LTBI group) were enrolled.IFN-γ,IL-2 and TNF-α in supernatants from PBMCs stimulated with ESAT-6 and CFP-10 were analyzed with Bender Flowcytomix on flow cytometry.Results The levels of the three cytokines were utmost high in patients with first-treated pulmonary tuberculosis.The lowest level of IFN-γ and IL-2 were induced in patients with refractory pulmonary tuberculosis,and were significantly lower than the LTBI group(Mann-Whitney U ＝ 105.5,162.5,P ＜ 0.01).Conclusions The immunotherapy with IFN-γ and IL-2 may play a role in treatment for refractory pulmonary tuberculosis but not for most of first-treated pulmonary tuberculosis.

Objective To discover T cell reactive peptides of mycobacterium tuberculosis antigen Rv2608 for treatment or adjuvant treatment for tuberculosis.Methods The T cell epitopes of Rv2608 were predicted by bioinformatics.The long-chain peptides were screened with strong affinity with HLA-A0201,HLA-A1101,and HLA-A2402.The physical and chemical characters of the peptides were predicted.The stable and hydrophilic peptides for chemical synthesis were selected.The T cell reactivity of the peptides in patients with active tuberculosis was detected by ELISPOT.The results were compared with the clinical diagnosis kits TSPOT.TB.Results Four peptides of Rv2608 were predicted and screened,and they could be active T cells of patients with active TB.Rv2608p3 was the most efficient to prime the T cell response.Conclusions Software prediction was consistent with the result of ELISPOT.Rv2608p3 might be the candidate for therapeutic vaccine for tuberculosis.

Objective To investigate the clinical significance of narrow-band imaging (NBI) system in the diagnosis and treatment of Peutz-Jeghers syndrome (PJS) in children. Methods To retrospectively summarize the clinical data of 15 cases diagnosed with PJS, and compare with 70 cases diagnosed with juvenile polyp. And all of the polyps were further diagnosed with pathological examination and the histological type should be analyzed.The polyps of 15 children with PJS were diagnosed with the white light imaging (WLI) and the NBI system, respectively. The pit patterns of various polyps was observed with NBI. We made a comparison between the sensitivity and speciifcity of NBI and WLI in diagnosis of adenomatous polyps. Result 76 lesions in 15 cases were detected by the WLI and NBI system,including adenomatous polyps (12) and harmatoma (64) which were further diagnosed by pathological examinations.By using the NBI system,69.7% (53/76)PJS polyps (pit patterns)were diagnosed as typeⅠand 27.6%(21/76) PJS polyps were diagnosed as typeⅡorⅢ.By using the NBI system,the sensitivity and speciifcity for diagnosing PJS polyps were 83.3%(10/12)and 98.4%(63/64),which were obviously higher than those by using the WLI system (P<0.05). Conclusion Observation of pit patterns of polyps by the NBI system can help predict the pathological changes of PJS polyps.By using the NBI system,the sensitivity and speciifcity of the diagnosis of adenomatous polyps are higher than those by using the WLI system.It has guiding signiifcance to choose the method to remove a polyp.

Objective To explore the early-term efficacy of porous titanium trabecular metal acetabular (TTM) compo-nents produced by E-beam technology in total hip arthroplasty(THA). Methods From May 2012 to JUN 2013, nineteen primary THA patients (20 hips) were devided into observation group of porous TTM acetabular prosthesis produced by E-beam technology and control group of Pinnacle acetabular prosthesis. TTM group had nine patients (10 hips), including 7 males and 2 females, with the mean age of 61.0 years. Pinnacle group had ten patients (10 hips), including 6 males and 4 females, with the mean age of 58.6 years. The patients were followed up at the 6,12,24 weeks after operation. X-rays were taken at the follow-ups. Acetabular compo-nent stability and osseointegration were assessed through radiograph. Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Osteoarthritis index were recorded before and after operation to evaluate clinical effects of surgery. Results In TTM group, the Harris score improved from 48.2 ± 5.5 preoperatively to 89.5 ± 4.0 postoperatively, SF-36 scores from 329.1 ± 86.7 to 763.8 ± 15.1, and WOMAC index from 18.8 ± 11.0 to 1.3 ± 0.9. No cases suffered aseptic loosening and migration. After 24 weeks, There was no significant difference regarding Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Os-teoarthritis index between two groups. In TTM group, two hips had a radiolucent line postoperatively, which occurred in 2 and 3 zone. The lines were disappeared 24 weeks later. Conclusion In THA, the initial stability of TTM produced by E-beam tech-nology was fine, which can facilitate bone ingrowth in early stage. However, the long-term follow-up effect still needs to be con-firmed.