Objective To perform the research on the domestic hospital marketing. Methods Through deep discussion,data analysis and marketing survey,we conducted a research on the market positioning and marketing strategies for Shanghai Ruijin-Harvard Heart Center which is a Sino-foreign joint venture. Results The demand is much bigger than the current supply in the market for cardiovascular diseases.The establishment of the center meets the demands of the market. Conclusion The center will focus on the adult patients in Shanghai and Yangtze Delta,and combine the external,internal and interactive marketing strategies.It may provide some useful experience for the Chinese hospital management,especially for hospital marketing.

Abstract?AlM:To study the thickness changes of retinal nerve fiber layer ( RNFL) in Parkinson's disease ( PD) .?METHODS:Fifteen eyes of 15 PD patients in early stage and 18 eyes of 18 controls were chosen to take RNFL examination by optical coherence tomography ( OCT ) . Circular scans were taken around the optic nerve head (diameter = 3. 46mm) to record the features of RNFL. Scanning areas included eight quadrants of the temporal, superior, nasal, inferior, inferior-temporal, superior-temporal, inferior-nasal and superior-nasal quadrant. RNFL thickness was comparatively analyzed in eight quadrants and the average level in two groups.?RESULTS: RNFL thickness in two groups in temporal, superior, nasal , inferior, temporal- inferior, temporal-superior, nasal-inferior, nasal-superior were: ( control/PD) 83. 2 ± 17. 5μm/68. 7 ± 13. 5μm, 132. 7 ± 17. 4μm/128. 1 ± 25. 3μm, 83. 7 ± 22. 3μm/76. 5 ± 17. 8μm, 141. 5 ± 15. 3μm/128. 6± 13. 2μm, 117. 9 ± 24. 5μm/103. 3 ± 14. 1μm, 120. 8 ± 21. 2μm /102. 6 ± 23. 7μm, 110. 2 ± 27. 7μm/96. 6 ± 15. 0μm, 109. 6 ± 20. 6μm/101. 2 ± 20. 9μm. The average RNFL thickness in controls was 109. 9 ± 8. 5μm while it showed 102. 3 ± 11. 9μm in PD group. RNFL thickness in inferior, temporal, inferior-temporal, superior-temporal and the average RNFL thickness were statistically different in two groups ( t= 2. 595, 2. 700, 2. 153, 2. 330, 2. 131;P= 0. 014, 0. 011,0. 040,0. 026,0. 041).?CONCLUSlON: RNFL thickness in inferior, temporal, inferior temporal, superior temporal and the average RNFL thickness are significantly thinner in mild PD than those in the controls.

Objective To establish a biotin-streptavidin ELISA method to measure CTGF,and evaluate the clinical value of CTGF for the diagnosis of liver fibrosis in chronic hepatitis B (CHB) patients.Methods Biotinylated anti-CTGF polyclonal antibody and monoclonal antibodies were prepared for the establishment of this biotin-streptavidin ELISA method.Two hundreds and sixty-four CHB patients were subjected into non-or mild liver fibrosis group (S0-S1,108 cases) and severe liver fibrosis group (S2-S4,156 cases),according to the liver biopsy pathological diagnosis.The CTGF assay's diagnostic capacity for CHB was assessed by comparing the area under ROC (AUC) with that of a panel of hepatic fibrosis markers ( HA,PC Ⅲ,C Ⅳ,LN and APRI).Analysis of variance and rank sum test were performed to carry out comparisons between multiple groups.Student's t-test and Mann-Whitney U test were performed for the pairwise comparison between multiple samples.Spearman rank correlation test was performed to analyze the correlation between different hepatic fibrosis stages.Results The minimum detectable dose and detection rang of the ELISA was 0.2 μg/L and 0-64 μg/L respectively.The intra-assay and inter-assay CV at high and low level were 4.5％,9.8％ and 10.1％,12.8％ respectively.Serum CTGF concentrations in S0-S1 group and S2-S4 group were 6.7(3.1 - 10.1 ) μg/L and 16.1 ( 11.8 -27.2) μg/L,with a statistically significant difference (U =1 217,P ＜0.001 ).There was a significant correlation between the levels of serum CTGF and fibrosis stages ( r =0.689,P ＜ 0.001 ),AUC of CTGF was 0.841 (95％ CI:0.762 - 0.920) in distinguishing mild fibrosis from significant fibrosis.When the cut-off value of CTGF was 10.3 μg/L,the sensitivity and specification was 70.5％ and 82.4％ respectively.The sensitivity of parallel combination test of CTGF and APRI was 96.1％,which was higher than that of HA (75.6％),PC Ⅲ (70.5％ ),C Ⅳ(63.6％),LN(79.5％ ),APRI(86.3％ ).The specificity of the combination test was 65.5％,which was lower than of above liver fibrosis markers [HA ( 72.5％ ),PC Ⅲ ( 76.5％ ),C Ⅳ ( 78.4％ )].The specificity of serial combination test of CTGF and PC Ⅲ was 95.9％,which was higher than that of HA,PC Ⅲ,CⅣ,LN(64.7％ ),APRI(66.1％ ),however,the sensitivity of the combination test was 67.7％,which was lower than that of above HA,PC Ⅲ,and APRI.Conclusions The biotin-streptavidin ELISA method measuring serum CTGF has a high minimu detectable dose sensitivity,and specificity.Serum CTGF level is significantly correlated with fibrosis stage,and CTGF maybe a valuable marker for liver fibrosis assessment.The paralledl combination of CTGF and APRI could be used as screening for significant liver fibrosis markers.The serial combination of CTGF and PC Ⅲ may be considered as a confirmatory diagnostic marker for liver fibrosis.

Objective To investigate the effect of exogenous interleukin-10 (IL-10) on liver regeneration in rats with biliary obstruction.Methods Male Wistar rats were divided randomly into either a sham operation (SO) group,obstructive jaundice (OJ) group,or IL-10 treated group.Rats in OJ and IL-10 treated groups underwent ligation and division of the common bile duct,while only the SO group had division of the common bile duct.Rats in the IL-10 treated group received daily intraperitoneal injection of IL-10 at a dose of 4 μg/kg after the operation.Quantitative fluorescence real-time PCR was performed to detect hepatic TGF-β1 mRNA expression.Immunohistochemistry for hepatic proliferating cell nuclear antigen (PCNA) labeling index was used to evaluate and epitope of IL-10.The serum levels of total bilirubin (T Bil),direct bilirubin (D Bil),alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also measured.Results Hepatic TGF-β1 mRNA,PCNA labeling index and serum levels of ALT and AST in OJ group rats were significantly higher than SO group rats at days 3 and 7 after the operation (P＜0.05).Compared to the OJ group,the IL-10 group had significantly lower hepatic TGF-β1 mRNA and serum levels of ALT and AST.Conversely the IL10 group's hepatic PCNA labeling index was significantly increased as compared with those in OJ group 7 days after operation (P＜0.05).Conclusion Exogenous IL-10 could enhance liver regeneration and alleviate hepatic dysfunction by down-regulating hepatic TGF-β1 expression in rats with biliary obstruction.

Objective To investigate the reflectance confocal microscopy (RCM) features of mycosis fungoides (MF).Methods Four male and two female patients with MF,who were aged 7-73 years with a clinical course of 1-5 years,were collected from June 2011 to May 2012 in the department of dermatology.Of the six patients,two were in patch stage,three in plaque stage,and one in tumor stage.All the cases were confirmed by histopathological,immunohistochemical and relevant examinations.For each patient,three lesions were selected and investigated using RCM,and one of the three lesions was subjected to histopathological examination.Results RCM features of MF included hyperkeratosis,disarray of honeycomb of stratum spinosum,reduced refractivity of dermal papillary rings,roundish or round scattered hyperrefractive cells in the epidermis,infiltration of a small quantity of inflammatory cells in the papillary dermis.Occasionally,some round to oval hyporefractive cells aggregated to form vesicle-like structures.These RCM features correlated well with histopathologic findings.Conclusion Combined with clinical manifestations,RCM may serve as a noninvasive auxiliary tool for the diagnosis of MF.

Effects of mannan-oligosaccharide (MOS) on the growth of Lactobacillus were investigated by pure culture of three swine originated Lactobacillus strains or co-culture with swine pathogenic E. coli. The pure culture results revealed that OD values and lactic acid concentration of three Lactobacillus strains in the MOS supplemented cultures were higher than those of the control group without MOS supplementation, a lower pH was observed for MOS supplement compared with that of the control group. The co-culture results showed that MOS were utilized by both Lactobacillus strains and swine pathogenic E. coli strain. But Lac-tobacillus grew faster than the latter. A significant increase in lactic acid concentration (P

Objective To establish the decision tree model of Yang deficiency syndrome and clinical conventional indexes in type 2 diabetes mellitus patients.Methods Syndrome decision and clinical indexes collection from 249 type 2 diabetes mellitus patient were observed and analyzed.Tree structure model were built to summarize the correspondence between Yang deficiency syndrome and clinical conventional indexes based on T test,nonparametric analysis,and Spearman correlation analysis.Results The Yang deficiency syndrome accounted for 31.33％ of 249 type 2 diabetes mellitus patients.The accuracy identification rate of tree structure model of Yang deficiency syndrome with four core index,such as LPa、FT3、TSH、FINS was 84.74％,the sensitivity and specificity were 74.36％ and 89.47％.Conclusion Decision tree model can identify Yang deficiency syndrome of type 2 diabetes mellitus patients clearly and more intuitive.Decision tree model can provide the chance of syndrome objective.

Objective To explore the risk factors of Qi deficiency syndrome of type 2 diabetes mellitus and to provide evidence for prevention and cure diabetes mellitus with TCM.Methods On the basisof the epidemiological survey,147 cases of Type 2 diabetes mellitus were collected and divided into Qi deficiency syndrome group and non-Qi deficiency syndrome group.The relationships between risk factors and Qi deficiency syndrome were analyzed by unconditional univariate and multivariate Logistic regression.Results Two hours postprandial blood sugar[2PPBS (β value is-0.764,OR (95％CI) is 0.466 (0.236 ～ 0.919)],apolipoprotein-B [APo-B (β value is-1.005,OR (95％CI)is 0.366 (0.140～0.959)],urine glucose [β value is-1.300,OR(95％CI)is 0.273 (0.127～0.584)] were inverse correlation with Qi deficiency syndrome of type 2 diabetes mellitus.Conclusion Qi deficiency syndrome of type 2 diabetes mellitus was inverse correlation with 2PPBS、APo-B and urine glucose.

AIM: To observe the tear film changes after phacoemulsification combined with intraocular lens implantation in age - related cataract patients and to compare the therapeutic effect of hydroxyl-glucoside and sodium hyaluronate on the postoperative dry eye.
METHODS:A total of 49 patients ( 70 eyes ) with age-related cataract suffering from dry eye after phacoemulsification combined with IOL implantation were divided into treatment group 1 ( group A, 23 eyes with conventional therapy and hydroxyl - glucoside at 7d postoperatively) , treatment group 2 ( group B, 22 eyes with conventional therapy and sodium hyaluronate at 7d postoperatively) and control group ( group C, 25 eyes with conventional therapy only ) . Questionnaire score of dry eye symptoms, SchirmerⅠtest ( SⅠt) , tearfilm break up time ( BUT ) and corneal fluoresce in staining ( CFS ) were measured at 2d preoperatively and 7, 14, 30, 90d postoperatively.
RESULTS: No statistical differences existed among the three groups of preoperative 2d ( P > 0. 05 ). At 2d preoperatively and 90d postoperatively, the results of questionnaire score of dry eye symptoms, SⅠt, BUT, and CFS displayed no statistical differences in the patients of three groups (P>0. 05). While there was statistical significance among preoperatively and 7, 14, 30d postoperatively of the three groups (P<0. 05). At 14, 30d postoperatively, the questionnaire score of dry eye symptoms, SⅠt, BUT, CFS in group A and B were better than in group C, which displayed statistical differences ( P<0. 05). At 30d postoperatively the questionnaire score of dry eye symptoms , SⅠt, BUT in group B were better than in group A, which displayed statistical differences ( P<0. 05).
CONCLUSION: At the early stage after phacoemulsification combined with IOL implantation, the tear film stability is decreased, which may promote eyesymptoms. Management with hydroxyl-glucoside or sodium hyaluronate plays a role in relief of the structure and stability of the tear film and improves dry eye symptoms, while sodium hyaluronate eye drops is more effective.

Objective To report and analyze the renal function improvement in a case with ad-vanced bilateral renal cell carcinoma after targeted therapy. Methods The patient was a 60-year-old man who complained of lower back pain for 1 month. Ultrasound and CT scan detected bilateral renal masses, left lesion was 11.0 cm×9.4 cm×8.5 cm, and the right one was 3.5 cm×4.3 cm×4.1 cm. X-ray examination showed metastatic lesions in liver and lower right lung. GFR was 20.39 ml/min of left kidney, 25.40 ml/min of right kidney. The renal biopsy confirmed renal clear cell carcinoma. Sorafenib was administrated 400 mg twice or once daily for 12 weeks. Results After the targeted therapy, the decreased bilateral kidney tumor sizes were identified by CT scan. There was liquid nec-rosis in the tumor, and no new metastatic lesion detected. The kidney function was improved as well. The total GFR increased to 71.38 ml/min. Left kidney GFR increased to 31.57 ml/min, right kidney GFR increased to 39.81 ml/min, respectively. Conclusion Targeted therapy could improve renal function in advanced renal cell carcinoma cases by controlling tumor development.