To genuinely orient our service towards the needs of patients, we modified the wards in our hospital, turning previous wards housing 8 to 10 patients each into medium-sized and small ones, with each one having a separate toilet, balcony, and air conditioner, meeting the diversified needs of patients, and attracting more patients to seek service at the hospital. As a result, in 2000, as compared with 1999, the number of emergency outpatients increased by 14.4%, the number of discharged patients increased by 16.2%, the average ratio of bed usage increased by 9.0%, the turnover rate of beds increased by 6.8%, the average length of stay dropped by 7.0%, income from outpatient service increased by 43.9%, the proportion of income from the sale of pharmaceuticals in the total business income dropped by 10.5%, and the annual business income increased by 18.9%.

Objective To investigate the effects of O-GlcNAc modification on gintamine (Glu)-induced heat shock protein 70 (HSP70) expression in LPS-treated rat cardiomyocytes.Methods Primary cultures of neonatal rat cardiomyocytes were randomly divided into 6 groups:group Ⅰ control(group C);group Ⅱ Glu;group Ⅲ LPS;group Ⅳ Glu+LPS;group Ⅴ Glu+LPS+Alloxan and group Ⅵ Gln+LPS+PUGNAc.In group C double distilled water 25 μl was added.In group Ⅱ-Ⅵ the cells were exposed to the sanle concentrations of Glu (5 mmol/L)and LPS(4 μg/ml) except Alloxan (an inhibiter of O-linked β-N-acetyl glucosamine transferase/OGT) (1 mmol/L) and PUGNAc (an inhibitor of O-linked β-N-acetyl glucosaminidase/OGA)(100μmol/L).After being incubated for 6 h,cardiomyocyte viability,O-GlcNAc modification level and HSP70 expression level were measured.Results There was no significant difference in cell viability among the six groups.The levels of O-GlcNAc modification and HSP70 expression were significantly higher in group Ⅱ-Ⅵ than in group Ⅰ,were significantly higher in group Ⅳ and group Ⅵ than in group Ⅲ,were significantly lower in group Ⅴ and higher in group Ⅵ than in group Ⅳ.Conclusion O-GlcNAc modification may be involved in Glu-induced HSPT0 expression in LPS-treated cardiomyocytes.

OBJECTIVE:To provide reference for improving the data integrity management system of pharmaceutical produc-tion enterprises. METHODS:According to related reports in US Food and Drug Administration(FDA)and China Food and Drug Administration(CFDA),the source of data integrity problems was analyzed,its reasons were summarized and solutions were put forward. RESULTS&CONCLUSIONS:The reasons why there were data integrity problems in enterprises can be attributed to 3 as-pects(staff,hardware/software system and quality management),and the 3 aspects showed large gap with current standards. It is suggested that enterprises evaluate the existing system by adopting the gap analysis,establish a data integrity management project team,strengthen personnel training,upgrade hardware/software system to ensure its safety,stability and effectiveness;and opti-mize the quality management system by developing good ducument specification,special regulation system of data integrity. In addi-tion,the enterprise should establish quality culture,pay attention to industry and regulatory trends in real time to guarantee the data integrity effectively.

Background Fungal keratitis has a high incidence in China and its clinical treatment is very difficult,and its etiology diagnosis and appraisal is the premise to improve the prognosis of disease.With the changes of regional environment and climate in recent years,whether the spectrum of fungal keratitis change in South China is remarkable.Objective The purpose of this study was to investigate recent pathogenic distribution of fungal keratitis in South China area.Methods The consecutive fungal culture resuhs of 3 350 purulent keratitis at Zhongshan Ophthalmic Center from January 2009 to December 2014 were retrospectively reviewed.The positive rate of fungal culture,genus or species distribution,seasonal distribution and different term distribution were analyzed.Results The culture-positive rate was 31.34％ in this study (1 050/3 350),and the average culture-positive number was 175 strains per year.In the positive fungus,the highest positive rate was Fusarium SP (32.10％,337/1 050),and followed by Aspergillus SP (25.71％,270/1 050),Heminthosporium SP (14.29 ％,150/1 050) and Mucor SP (9.14％,96/1 050).The fungal culture-positive rate was 36.05％ (367/1 018) in 2009 to 2010,32.45％ (324/1 014) in 2011 to 2012,and 26.86％ (354/1 318) in 2013 to 2014,respectively,with a significant difference among the three periods (x2 =22.37,P＜0.01),showing a decreasing tendency of incidence.Two hundreds and sixtyone strains were isolated from January to March (31.15 ％,261/838),182 strains from April to June (25.53 ％,182/713),237 strains from July to September (30.00％,237/790),370 strains from October to December (36.67％,370/1 009),showing a statistically significant difference among them (x2 =25.19,P ＜ 0.01).The number of infectious strains was most during October to December and fewest during April to June.Conclusions The leading pathogenic fungi of fungal keratitis is Fusarium SP and followed by Aspergillus SP,Helminthosporium SP,Mucor SP in turn.Fungal keratitis is usually prevalent from October to December,and its incidence is still rising in Chinese mainland recently.However,the increasing tendency in South China has been prevented in recent six years.

Fractalkine has been recognized as the first member of the fourth chemokine family recently and its receptor, CX3CR1, was identified afterwards. This pair of ligand/receptor play important roles in the migration and adhesion of peripheral leukocyte through different ways. They are also likely to be related to the embryogenesis and regeneration of several organs and may possess some functions in the central nervous system.

Non-alcoholic fatty liver disease (NAFLD) is an important type in chronic liver diseases. Its incidence is growing. It is regarded as the liver manifestation of metabolic syndrome, which is closely correlated with the onset of cardiocerehrovascular diseases. The prevention of stroke in patients with NAFLD is very important. Statius are the most important type of medications. They decrease cholesterol synthesis, upregulate low-density lipoprotein (LDL) receptor in the liver and lower the levels of low-density lipoprotein cholesterol (LDL-C) in circulation through inhibiting hydroxy-methyl-glutaryl coenzyme A (HMG-CoA) reductase, and thus effectively reduce the risks of stroke. Besides, the pleiotropy of statins and their effects on cholesterol-related cell signaling pathway may relieve or prevent the progression of NAFLD. There is greater controversy about whether statins can be used in patients with chronic liver diseases because they have some adverse reactions on liver, The evidence available has demonstrated that statins can he used safely in patients with NAFLD, and usually liver enzymes have no need to be monitored. Too much attention on the liver toxicity of statins may result in inappropriate drug withdrawal, and brings about the increased risk of cardiovascular events. So further evaluation is needed for the efficacy and safety of statins in patients with NAFLD.

[Objective]To evaluate a simple,safty and effective therapeutic option to treate subaxial cervical fracture-dislocation with locked-facet.[Method]With the patients being awake and supervized under X-ray fluoroscopy,the authors used the early and continued closed skull traction-reduction to treate 16 cases of traumatic subaxial cervical fracture-dislocation with locked-facet.Before the beginning of the treatment,all the patients were taken for X-ray plain films and MRI/CT examinations as well as American Spinal Injury Association(ASIA) neurological function grade.The dynamic ASIA neurological function scale and X-ray fluoroscopy examnations were asked during the skull traction–reduction procedures.The average interval from the traumatic events to begin to skull traction–reduction was 31 hours(6-52 hours).The authors would continue the skull traction to maintain the anatomy position as soon as they succeeded in reducing the dislocation with locked-facet,forthmore they would take the anterior operation or combinations with anterior and posterior operations during the best condition.[Result]The MRI scans showed that there were 8 disc hernations and 5 disc disruptions at the dislocation levels before traction–reduction procedures.The ASIA scale were 7 grade C,5 grade D and 4 grade E,respectively.All the 16 cases succeeded in reduction as well as no neurological deterioration occurred.The postreduction MRI scans showed that 2 disc herations had converted to nearly normal disc position and another 4 disc hernations remained unchanged.Accordingly,2 disc disruption remained unchanged and another case had converted to disc hernation.The average traction weight was 19 kg(10~32 kg) and average traction time was 53 minutes(30~135 minutes).[Conclusion]Under the intensive dynamic ASIA neurological function grade and X-Ray fluoroscopy examnations,with the patients being awake and co-operation,the early and continued closed skull traction-reduction and then performing elective anterior or anterior-posterior surgery depending on the patient's overall and local status to treate subaxial cervical fracture-dislocation with locked-facet is safe and effective.

Objective To design and prepare a new prosthesis of chest wall by selecting and integrating the appropriate biodegradable materials,and to evaluate the efficiency and safety of the prepared prosthesis in order to explore the feasibility of reconstruction of an extensive chest wall defect.Methods Three types of chest wall prostheses,polydioxanone(PDO)mesh,chitin fiber reinforced polycaprolactone(CFRP)plate and CFRP strip,were designed and prepared to fulfill the function of chest wall.A canine model of the chest wall resection and reconstruction was reproduced to evaluate these porstheses.15 adult mongrel dogs were subjected to extensive resection of anterior-lateral chest wall and reconstruction with chest wall prosthesis.Chest wall stability,the degradative process of the prosthetic materials and regeneration of the chest wall tissue postoperatively were recorded dynamically by macroscopic inspection and histopathologic examinations,so as to provide valuable scientific data for improving chest wall prosthesis.Results The implanted PDO mesh was well integrated with autogenous connective tissue 8 weeks after operation,degraded gradually and reabsorbed completely within 24 weeks.It provided adequate support to the chest wall and achieved satisfy cosmetic and functional repair.CFRP plate was the best in chest wall stabilization among the three groups,and paradoxical respiratory movement was efficiently relieved with CFRP rib,and it had a better biological compatibility.There was no obvious morphological change in the CFRP material after it was implanted for 24 weeks.Conclusion The synthetic prostheses developed here showed excellent biocompatibility,and they fulfilled the function in providing chest wall stabilization.Each prosthesis has its respective favorable properties in chest wall reconstruction,and all of them are valuable in clinic application in the management of complicated chest wall defects.

Fractalkine has been recognized as the first member of the fourth chemokine family recently and its receptor, CX3CR1, was identified afterwards. This pair of ligand/receptor play important roles in the migration and adhesion of peripheral leukocyte through different ways. They are also likely to be related to the embryogenesis and regeneration of several organs and may possess some functions in the central nervous system.

Objective To investigate the methylation status of E-cadherin(E-cad)and its protein expression in human small bowel adenocarcinomas(SBAC),and the association of these findings with clinico-pathological characteristics.Methods E-cad gene hypermethylation and its protein expression in 36 patients with primary SBAC and the paired adjacent tissues were tested by methylation-specific PCR(MSP)assay and immunohistochemistry(IHC)respectively.Data associated with clinico-pathological characteristics was analyzed.Results The hypermethylation frequency of E-cad was 38.9% in cancerous tissues and 8.3% in adjacent tissues(P＜0.01).The positive rate of E-cad expression was 41.7% in cancerous tissues and 97.2% in adjacent tissues(P＜0.01).Twelve out of 21 cases without protein expression revealed methylated(P＜0.01).Methylation status was closely related to E-cad protein expression in SBAC.The hypermethylation of E-cad gene and the expression Of E-cad protein were significantly correlated with the depth of invasion,the differentiation and lymph node metastasis(P＜0.05),but were not correlated with other clinico-pathologic parameters such as age,sex,tumor size or location(P＞0.05).Conclusions The hypermethylation of E-cad gene can down regulate the protein expression,which closely related to the depth of invasion,the differentiation and lymph node metastasis.