Hospital humanism management is an important idea of modern hospital management.The core of hospital humanism manage is the people-centered principle,which is to explore the resources of humanism and culture within hospitals,and promote to realize the target of hospital and the individual smoothly. This article put great emphasis on the positive effects and the exiting problems of the hospital humanism management in current situation.

Objective To research the characteristics of early esophageal cancer's endoscopy and its clini-cal diagnosis. Methods Retrospective analyze the clinical symptoms and endoscopy performance of the 24 cases of early esophageal cancer which were confirmed by opemtion. Results Unaided eye observing of 24 cases of early e-acphageal cancer:diameter of pathological changes within 1.0 cm,there are four cases of the surface rough,turbidity,vascular fuzzy texture, congestive mucosa, small pieces of rotten to the core, around the realm of clear, easy bleeding by touch of three cases. Mucosa focal irregular plaquelike erosion or superficial helcosis of five cases Mucosa mild uplift,smooth surface or erosion, with slightly different colors of 10 cases ( including one case of pelypoid change) Mucosa fo-cal wormhole-like change, a slight hollow, moss-covered, rubeosis or bleeding lesions after water rinse, irregular and clear borders of two cases, pathology report: one case of small cell carcinoma,one case of adenocarcinoma (cardia),High-level intraepithelial neoplasia transformation nine cases, one case of poorly differentiated adenocarcinoma, 12 ca-ses of squamous cell carcinoma. Conculsion Endoscopic early esophageal cancer for the mainfeatures of the mucous membrane color changes, mucosal thickening, transparency and mucosal vascular network st ructure changes, and mu-cosal rough, nodules, plaques, erosion and uplift superficial, shallow depression and other patterns chang, GeneraUe-sions were confined or isolated like chang, irregular, and the mucous membrane around the borderclear. Clinicalofte misdiagnosed, missed diagnosis, early diagnosis to have significant value.

MicroRNA (miRNA) is a class of endogenous,single-stranded non-coding small RNA that contains 21 to 23 nucleotides and is widely distributed in eucaryon,miRNA plays an important regulatory role in cell proliferation,apoptosis,growth and development through the regulation of gene translation after transcription and expression,miRNA has a close relationship with pathogenesis and development of hepatocellular carcinoma.And in this process,part of miRNA acts as oncogenes or tumor suppressor genes.A number of miRNA,such as miR-30d,miR-221,miR-222 and miR-101,had been found to express abnormally in hepatoeellular carcinoma.Here we summarize the related progress in research of miRNA and hepatocellular carcinoma.

Objective To study the changes in parameters of blood flow and frequency-spectrum appearance in superior mesenteric artery (SMA)and inferior mesenteric artery(IMA) in the patients with ulcerative colitis(UC). Methods The parameters of blood flow and frequency-spectrum of SMA and IMA in 16 cases of patients with UC were observed before and after treatment, and 10 healthy volunteers served as control. Results The parameters of blood flow of IMA in patients with left half colon UC (9 cases) and all colon UC (7 cases) significantly changed after treatment(P

Objective To investigate the expression of adenosine receptor (ADOR) subtypes (A2A and A2B subtypes) in the mucosal dendritic cells (DCs) from patients with Crohn's disease and their pathogenic roles.Methods Mucosal DCs (mDCs) were isolated from resected intestine of patients with or without Crohn's disease.Some of the mDCs were cultured in vitro and others were used to extract RNA.The expression of ador-a2a and ador-a2b were detected by real-time qPCR.mDCs in culture were treated with selective ADOR-A2A and ADOR-A2B agonists (CGS 21680 and BAY 60-6583) and then the concentration of IL-1,IL-6 and IL-12 in the medium were measured by ELISA.The binding affinities of ADOR-A2A and ADOR-A2B to adenosine were determined by 3H-adenosine in combination with selective ADOR-A2A and A2B antagonists (SCH58261 and MRS1706).Na(i)ve CD4+ cells were collected from human umbilical cord blood and co-cultured with mDCs treated by different ADOR agonists to observe T cell responses.The production of cytokines in culture was measured by ELISA.The polarization of CD4+ cells was analyzed by intracellular cytokine staining and FACs analysis.Peripheral blood mononuclear cells (PBMCs) were treated with IL-4 and GMCSF to induce the expression of monocyte-derived DCs (Mo-DCs).Mo-DCs were treated with different toll-like receptor ligands to investigate their effects on the expression of ador-a2a and adora2b.Moreover,Mo-DCs were treated with LPS and BAY 60-6583 individually or in the combination to stimulate CD4+ cells.Then the production of cytokines and the polarization of CD4+ cells were evaluated.Results Compared with patients without Crohn's disease,patients with Crohn's disease showed no change in the expression of ador-a2a but a significantly increased expression of ador-a2b in mCDs (CD-mDCs),enabling to bind more adenosines.Activated ADOR-A2B signaling pathway induced CD-mDCs to secret more proinflammatory cytokines and to promote polarization of CD4+ cells toward Th1 and Th17 cells.Toll-like receptor ligands,pam3csk4 and LPS could intensively augment the expression of ador-a2b in Mo-DCs.The pathogenicity of Mo-DCs was strengthened upon a combined stimulation with BAY 60-6583 and LPS.Conclusion The significantly increased expression of ador-a2b in mDCs might be involved in the pathogenesis of Crohn's disease by promoting mDCs to secret more pro-inflammatory cytokines and enhancing the polarization of CD4+ cells.Moreover,the expression of ador-a2b in DCs could be regulated by certain toll like receptors.

By means of literature review,the authors initiated the behavior expression system of hospitals' social responsibilities,which is further refined and revised with questionnaires and Delphi method.13 expressions of such behavior expressions were determined,namely “providing quality of care to patients”,“undertaking rescue assignment for emergencies”,and “fulfilling government-assigned tasks”.All of the 13 expressions were supported by 75％ of the experts during the second round of experts consultation.

Objective To explore the diagnosis and management of functional pancreatic endocrine tumor.Methods Clinical data of 19 cases of functional pancreatic endocrine tumor were retrospectively analyzed.Results 15 cases of insulinoma,2 cases of gastrinoma and 2 cases of glucagonoma were qualitatively diagnosed.The positive rate of preoperative diagosis for type B ultrasonic inspection,CT,MRI,EUS,selective portovenous sampling and intraoperative type B ultrasonic inspection was 15.8％ (3/19),67.5％ (10/16),71.4％ (5/7),87.5％ (7/8),100％(2/2) and 85.7％(6/7) respectively.Of the total 19 cases,7 cases underwent open surgery,11 cases unde rwent laparoscopic surgery,and one case didn't undergo any surgery as liver metastasis had occurred when glucagonoma was diagnosed.The operation methods included tumor enucleation (n=13),distal pancreatic resection (n=3),distal pancreatic resection plus splenectomy (n=1),and pancreatic head resection with duodenum preserved (n=1).Conclusions The measurement of serum insulin,gastrin and glucagon is the main basis for qualitative diagonosis of pancreatic endocrine tumor.Two stage spinal CT thin scanning is the main method for tumor location.Intraoperative type B ultrasonic inspection is the supplement to preoperative location.Tumor enucleation is the main choice of treatment.

Objective To explore the expression of tumor necrosis factor (TNF) mRNA, TNF and TNFR in the gallbladder mucosa which developed from hyperplasia, dysplasia to carcinoma, and to further discuss the relationship between TNF and pathogenesis of gallbladder carcinoma.Methods In situ hybridization and immunohistochemistry were used to determine TNF mRNA, TNF protein and TNFR protein expression in hyperplasia, dysplasia and carcinoma of gallbladder. Results ①No one of 20 cases of gallbladder hyperplasia was found to express TNF mRNA, while 4 of 20 (20%) cases of dysplasia and 18 of 20 (90%) cases of carcinoma were found to express TNF mRNA (P

Objective To explore the safety and efficacy of hepatic resection with selective hepatic vascular exclusion(SHVE). Methods SHVE was used in 246 consecutive patients undergoing major or complex liver resection in our center. Preoperative demographic and clinical data,details of the surgical procedure, pathologic diagnosis, postoperative course and complications were collected and analy zed. Results From January 2000 to July 2007, liver resections were performed IJnder SHVE in 246 patients; total SHVE, right partial SHVE and left partial SHVE in 145, 54 and 47 patients, respectively. SHVE was converted to total hepatic vascular exclusion(THVE)in 3 patients to repair the wall of inferior vena cava(IVC). Hemodynamic tolerance to SHVE was excellent, only with a slight increase in systemic and pulmonary vascular resistance during clamping.There were no deaths. and the morbidity was 24.8%.The mean leyth of hospital stay was 9.6 days(range 8-18) .Conclusion Our study showed that SHVE is a safe and effective procedurei and it is applicable to liver tumors near but not invade the inferior vena cava.

Objective To study the expression of skin aspartic protease (SASPase) in lesions of cutaneous lupus erythematosus (CLE) and its role in the pathogenesis of CLE.Methods Skin samples were resected from the lesions and normal skin of 9 patients with CLE,including 3 cases of subacute cutaneous lupus erythematosus (SCLE),4 cases of discoid lupus erythematosus (DLE) and 2 cases of acute cutaneous lupus erythematosus (ACLE).Keratinocytes were isolated from the tissue samples and cultured in serum-free medium.Total proteins were extracted from the keratinocytes and separated by two-dimensional gel electrophoresis.ImageMaster 2D analysis software was used to assess differentially expressed proteins in keratinocytes between the lesional and normal skin,which were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS).The expression levels of SASPase were further determined by Western blot.The data were analyzed statistically by Student's t test.Results Keratinocytes were isolated from the tissue samples and successfully cultured in vitro.Two-dimensional electrophoresis profiles of proteins from the keratinocytes were obtained with high resolution and reproducibility,and the average matching protein spots were about 1200 with the matching rate higher than 80％.As Western blot showed,the relative expression level of SASPase was 0.463 ± 0.018 in keratinocytes from the lesional skin,and 0.145 ± 0.011 in those from the normal skin (P ＜ 0.05).The Western blot results were consistent with those of two-dimensional electrophoresis.Conclusion The initiation and progression of CLE seem to be associated with the abnormal activation and overexpression of SASPase.