Currently,there are a few problems existed in managing the research outlay of hospital including mistiness of the managing boundary,disfluency of the guarantee chain,weakness of the cost-benefit consciousness,irrationality of resource configuring,lack of supervision mechanism,etc.These problems could be resolved by strengthening the inner management of the outlay,carding the management mechanism,broadening the channel of outlay,concerning about the cost accounting,optimizing the resource configuring and founding the performance evaluation mechanism.To offer a powerful guarantee for the material effect of scientific research and to promote the continuous development of scientific research healthily,we should explore the new way of strengthening the management of the scientific research outlay incessantly.

Purpose:To investigate the therapeutic effect a nd toxicity of combination chemotherapy with navelbine (NVB) and epirubicin (E- ADM) in treating metastatic breast cancer. Methods:37 patients with metastatic breast cancer were treated with combination chemotherapy of vinorelbine 25 mg/m2 d 1.8, E-ADM 60 mg/m2 d 1, 21 days for a cycle, a total of 2-4 cycles, made tracks for 6-37 months. Results:Among 27 patients with 37 metastatis, CR was 37.84%(14/ 37), PR 16.22%(6/37), SD 37.83%(14/37), SD≥6 months,21.62%(8/37), PD8.11%(3/37) , ORR(CR+PR) 54.05%, (CR+PR+SD≥6 months) 75.68%, and TTP was 6-9 months. Th e peak value of the efficiency to the lymph metastasis above the clavicle was 90 .9%. The toxicity was leukopenia,losing hair,milieu phlebitis. 74.07% of cases was in Grade Ⅲ and Grade Ⅳ leukopenia , 11.11% of cases was phlebitis. Conclusions:The combination chemotherapy with navelbine(NVB) an d epirubicin (E-ADM) in treating metastatic breast canser is effective and has acceptable tolerance.

Objective To investigate the myocardial protection effect of dexmedetomidine hydrochloride during off-pump coronary artery bypass graft surgery. Methods Forty patients undergoing off-pump coronary artery bypass grafting were randomly divided into two groups:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine hydrochlo-ride was given at a loading dose of 0. 5 μg?kg-1 to patients in group D, and then infused continuously at a rate of 0.5 μg?kg-1?h-1.The same amount of saline was given to patients in group C. After loading dosing,general anesthesia was per-formed with TCI technique.Trans-esophagus Doppler monitoring was conducted to monitor the blood volume and heart function, and close monitoring of fluid infusion to maintain stable circulation.Invasive blood pressure and heart rate were recorded every 5 min. Blood samples were taken for detection of cTnI,CK-MB,TNF-αand IL-6 contents at the following time points:after induction ( t0 ) ,before operation ( t1 ) ,after operation ( t2 ) ,12 h postoperation ( t3 ) and 24 h postoperation ( t4 ) . Results The blood pressure and heart rate decreased significantly at t0 and t1 in group D compared with group C,and there were no significant differ-ences in the two indexes at other time points between the two groups.Blood CK-MB,cTnI and inflammation factors TNF-α,IL-6 were much higher at t2,t3,t4 than at t0 and t1 in both groups(P<0.05).They were significantly decreased at t2,t3,t4 in group D relative to group C (P<0.05).Vessel active medicines were less given after the operation in group D (P<0.05). Conclusion Dexmedetomidine hydrochloride can mitigate the inflammation responses caused by off-pump coronary artery bypass grafting,re-duce the myocardial injury and improve the cardiac function of the patients.

Objective To study the species and drug resistance of Mycobacterium isolated from patients with spu-tum smear positive for acid-fast bacillus in Wuj iang city,and provide reference for the prevention and control of tu-berculosis. Methods Sputum specimens with positive smear were cultured,isolated bacteria were identified and performed drug susceptibility testing,drug resistance among different species of strains and between patients with initial and repeated treatment were compared.Results A total of 1 03 Mycobacterium isolates were included in the study,13 of which were nontuberculous Mycobacterium,drug resistance rate was 100.00% ,multidrug resistance (MDR)rate was 84.62% ;90 isolates were Mycobacteriumtuberculosis,81(90.00% )of which were Mycobacteri-umhominis. Drug resistance rate of Mycobacteriumtuberculosiswas 35.56% ,MDR rate was 14.44% . Of 70 ini-tially treated tuberculosis patients with positive sputum smear,14(20.00% )were resistant to drugs,MDR rate was 4.28% (3/70);Of 20 repeatedly treated tuberculosis patients with positive sputum smear,18(90.00% )were resist-ant to drugs,MDR rate was 50.00% (10/20).Conclusion Mycobacteriumtuberculosisis the major isolated strain from patients with positive sputum smear. Drug resistance and MDR rates of nontuberculous Mycobacterium are very high. Drug resistance and MDR rates of Mycobacteriumtuberculosisin repeatedly treated patients are higher than initially treated patients.

The spinal dural arteriovenous fistula is a common vascular malformation with unclear etiology and unspecific clinical presentations.An early diagnosis is important for the treatment,therefore the authors reviewed and comprehanded the pathology,diagnosis and treatment of this AVM.

Objective To investigate the characters of morphology,immunology and cytogenetics of adult acute leukemia (AL) in different ages. Methods 172 cases of newly diagnosed adult AL were divided into two groups:the non-aged group (age＜60 years) and the aged group ( age≥60 years). Morphology,immunology and cytogenetics between the two groups were compared. Results The incidence of M3 in aged AL was significantly lower than that in non-aged AL[6.0 %(3/50) vs 18.9 %(23/122),P ＜0.05]. The incidence of hypo-or extremely hypo-cellular AL in aged AL was significantly higher than that in non-aged AL[14.0 %(7/50) vs 4.1 %(5/122),P ＜0.05],but the incidence of hyper-or extremely hyper-cellular was significantly lower than that in non-aged AL[52.0 %(26/50) vs 73.8 %(90/122),P ＜0.05]. Among aged acute myeloid leukemia (AML),the incidence of lymphoid antigen positive AML (Ly+AML) was significantly higher than that in non-aged AML[63.4 %(26/41) vs 41.3 %(38/92),P ＜0.05]. The incidence of adverse karyotypes in aged AML was significantly higher than that in non-aged AML[33.3 %(11/33) vs 14.1 %(10/71),P ＜0.05].Conclusion Age is an important prognostic factor in AL. Generally,aged AL has poorer prognosis than nonaged AL.

Objective To investigate the protective effect of total flavones of Artemisia capillaris Thunb.on acute hepat-ic injury in rats. Methods Rats were randomly divided into blank control group,model control group, Yinzhihuang group,and groups of total flavones of Artemisia capillaris Thunb.(low,medium and high dose) in terms of 7-day different treatments.All rats except those in the blank control group were administrated with D-galactosamine hydrochloride ( 500 mg?g-1 , ip ) once at the sixth day.Then,concentrations of ALT and AST were detected 48 h later,and the liver samples were collected from each group for pathological examination. Results The serum ALT and AST in high-dose group of total flavones of Artemisia capillaris Thunb. was [(189.2±112.9) and (231.7±149.9) U?L-1],respectively,significantly lower than those in model control group ALT [(391.9±181.3) U?L-1] and AST [(403.9±133.8) U?L-1].Fragmented necrosis,fatty degeneration,inflammatory cells infil-tration and acidophilic degeneration of hepatic cells were improved to varying degrees in groups of total flavones of Artemisia capil-laris Thunb.compared with model control group.Fragmented necrosis of liver cells and steatosis occurred in 20 and 19 rats,respec-tively,in the model control group,while those appeared in 1 and 2 rats,respectively,in high-dose group of total flavones of Artemi-sia capillaris Thunb.. Conclusion Total flavones of Artemisia capillaris Thunb. are effective in protecting D-galactosamine hydrochloride-induced acute hepatic injury in rats.

OBJECTIVE: To prepare gynecological Jiekang lotion and to establish its quality standard. METHODS: The Caffeotannic acid in Flos Lonicerae, the Berberine in Cortex Phellodendri and the Ammothamnine in Radix Sophorae Flavescentis were identified by TLC; HPLC was adopted to determine the content of Osthole with Hypersil DOS C18 as chromatograpic column. The mobile phase consisted of acetonitrile-water (54∶46) with a flow rate of 1.1mL? min-1. The detection wavelength was set at 321nm. RESULTS: Both the chief components in Jiekang lotion and the corresponding reference substances showed the identical discrimination reactions. The linear range of Osthole was 13～130?g?mL-1. CONCLUSION: The method is sensitive in qualitative reaction, specific in TLC identification, accurate in HPLC quantitation and recurrent. The established standard is applicable for the quality control of Jeikang lotion.

Objective To investigate the common chromosome abnormalities in the patients with multiple myeloma and the relationships of cytogenetic abnormalities and clinical features. Methods The interphase fluorescence in situ hybridization (I-FISH) analysis method was designed to detect RB1-/13q14-and 14q32 rearrangements in 49 MM patients. The statistic value of its effect on clinical features were determined. Results FISH disclosed 14q32 translocations in 26 of the 40 (53.1%) patients. 25 out of the 49 (51.02 %) cases were found with deletion of chromosome 13q14 included del(RB1) in 9 (18.4 %) and del(13q14.3) in 18 (36.7 %). 13q14 deletion and 14q32 translocation were simultaneously observed in 18 (36.7 %) cases. Spearman correlation analysis were found associated of 14q32 rearrangement with the percentage of plasma cells in bone marrow (r=0.316, P=0.27). Conclusion The frequency of 13q14 deletion and 14q32 gene translocation in multiple myeloma are high. There is a significant correlation between the presence of 14q32 translocations and chromosome 13 abnormalities in MM patients. The percentage of 14q32 translocation in plasma cells was increased significantly. The 14q32 translocation is an independent prognostic factor.

Objective To investigate the effects of simvastatin (SV) on the proliferation,differentiation and apoptosis of human promyelocytic leukemia cell line NB4.Methods NB4 cells were incubated with SV at different concentration with or without all-trans retinoic acid (ATRA),and NB4 cells without any treatment were taken as normal control.Cells of different groups were collected at 24 h,48 h and 72 h after incubation for further detection.Morphological changes by Wright stain were performed.MTT method was used to assay the growth inhibition rate and flow cytometry was used to detect the surface CD11b expression levels,the early stage apoptosis ratio and cell necrosis ratio.Results Treated with 15 μ mol/L SV,10 μ mol/L SV and 5 μ mol/L SV respectively,with the NB4 cells growth,the cell inhibition rates gradually increased (F =7.15,P =0.000),as well as CD11b expression levels (F =3.41,P =0.014) and AnnexinVexpression levels (F =43.38,P =0.000).Furthermore the NB4 cells treated with 15 μ mol/L SV exhibited the most significant changes with cell inhibition rate of 0.96±0.02,CD11b expression level increased to (62.41±6.37) ％ and AnnexinV expression level increased to (87.38±2.94) ％ after 72 h incubation.Combination of 15 μmol/L SV with 0.5 μmol/L ATRA displayed obvious interaction for increasing CD11b expression levels (F =4.093,P =0.025),while no significant interaction for cell inhibition rates and Annexin V expression levels were observed.After 72 h incubation,the CD11b expression levels (89.46±9.13) ％ in NB4 cells treated with 15 μ mol/L SV in combination with 0.5 μ mol/L ATRA were significantly higher than those treated with ATRA (71.27±7.27) ％ and SV (62.41±6.37) ％ (t =2.71,P =0.054; t =4.37,P =0.017)' solely.Conclusion Simvastatin in vitro inhibits NB4 cell proliferation,promotes cell apoptosis,and synergistically induces cell differentiation with ATRA dose-dependently in vitro,which indicates that SV may have the effect of synergistic anti-promyelocytic potency with ATRA.