LDM, a product of the combination of contemporary information network technology and the tradi tional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problerms, including quality control of LDM, delegation of responsibility in IDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new contemplation and exploration for hospital managers.

LDM, a product of the combination of contemporary information network technology and the traditional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problems, including quality control of LDM, delegation of responsibility in LDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new conternplation and exploration for hospital managers.

Branding has become a core competitiveness for hospitals.They are faced with the question of how to build and maintain their brand,how to apply PDCA cycle in the management of hospital branding strategy,how to keep up the branding with constant analysis,evaluation and adjustment,for the purpose of sustained development.

In the past 20 years, emergency medicine in China has witnessed rapid development and emergency care has contributed considerably to safeguarding people's life and health. The emergency departments in most hospitals have completed the transition from being dependent to being supportive and some hospitals have set up autonomous emergency departments. The functions and business scope of emergency care have gradually been clarified. However, some problems remain to be solved in such aspects of emergency care as training, management, scientific research, and professional promotion.

Based on an analysis of the current condition of emergency department facilities in domestic urban hospitals and lessons drawn during the SARS outbreak,the paper argues that due attention ought to be paid to the spread of infectious diseases resulting from the inherent drawbacks in the construction of emergency departments.It presents constructive suggestions on ways in which construction of and medical procedures in emergency departments could meet the requirements for infectious disease prevention and treatment.

Objective To identify shortcomings in the current evaluation index system of medical quality. Methods The documentary analysis focused on the existing index system comprises the Hospital Management and Quality Evaluation Standards (2007) by China Hospital Association, Hospital Management Evaluation Guidelines (2005) by the Ministry of Health, and Implementation Rules of Hospital Management Evaluation Standards for Beijing (2007). JCI Accreditation Standards for Hospitals (edition 2) (2003), and New Hospital Accreditation Standards for Taiwan (2005, 2006) were referred to in the study. Results The shortcomings found include the weak operability of indexes, and the deficiency of evaluation indexes from the point of hospital visiting process by patients. Conclusion In view of the hospital visiting process of patients, add more indexes for patients' hospital visiting process,and quantize and highlight the operability of indexes, with summary and optimization of experiences in time by steps.

Objective To construct a luciferase reporter vector containing the 3′untranslated region (3′UTR) of nuclear factor I-C (nuclear factor I-C, Nfic), and apply dual luciferase reporter gene system to determine the association between microRNA-20a (miR-20a) and its potential target gene Nfic. Methods The potential complementary binding sites of miR-20a and Nfic were predicted by Targetscan. The 3′UTR of Nfic fragment amplified by PCR was cloned into luciferase reporter vector MIR- Report Luciferase. The luciferase reporters containing 3′ UTR of Nfic and miR- 20 mimics (experimental group) or NC mimics (control group) were co-transfected into 293-AD cells. Cells were collected, and then dual-luciferase reporter assay was performed to detect the luciferase activity of the two groups of cells, consequently the relationship between miR-20a and Nfic was identified. The miR-20a mimics and NC mimics were transfected into marrow stromal cell line ST2 respectively. The total cell lysates were collected, and the expression level of NFIC was detected by Western blotting assay. Results Results of double enzyme digestion and DNA sequencing showed that sequence of luciferase reporter vector was correct. miR-20a specificity bounded to Nfic 3′UTR and inhibited the luciferase activity of the reporter construct (P<0.05). Western blotting assay showed that the NFIC protein level was obviously down-regulated in ST2 cells after the transfection of miR-20a mimics compared with that of control. Conclusion The luciferase reporter vector containing the 3′UTR of Nfic is constructed successfully, which confirms that miR-20a can direct effect on Nfic3′UTR and repress its luciferase activity.

Objective To probe into the reliability and validity of the questionnaire on clinical pathways and patients' satisfaction.Methods Investigating the hospital patients' satisfaction with the questionnaire designed by the former Ministry of Health and analyzing the internal consistency and constructive validity through statistical methods.Results Cronbach' s α coefficient of the adjusted questionnaire was 0.947 and those of the each subscale were 0.563,0.968 and 0.820.The split-half reliability of the questionnaire was 0.869.The number of factors is 3 as same as the designed assuming structure,and the cumulative contribution rate of 3 factors was 74.178％.The factor loading of each item was above 0.4,each item of a common factor with a higher load factor.Conclusion Although there are differences from hospital to hospital,this questionnaire is applicable to investigating patients' satisfaction of the clinical pathway management mode in view of the statistical and clinical practice.

Objective To investigate the effect of 1, 25-dihydroxy-vitamin D3 (1, 25 (OH)2D3) on adipocyte differen-tiation and the underlying mechanism. Methods The mesenchymal stem cell line C3H10T1/2 was randomly divided into 6 groups including control group, differentiation group and 4 different doses of 1, 25(OH)2D3 groups. The control group was treated with vehicle. The differentiation group was supplemented with adipocyte differentiation reagent. And the 1,25(OH)2D3 groups were treated with adipocyte differentiation reagents and 10-9, 10-8, 10-7 and 10-6 mol/L of 25(OH)2D3. After culturing for 5 days, the cells were stained with oil red O, and the expression levels of adipocyte-specific transcription factors and Wnt/β-catenin signaling pathway related genes were examined by RT-PCR or Western blot methods. Results 1,25(OH)2D3 sig-nificantly reduced the number of differentiated adipocytes and blocked the mRNA levels of adipocyte specific transcription factor PPARγ(peroxisome proliferator-activated receptor gamma), C/EBPα(CCAAT enhancer binding proteinα) and adipo-cyte characterization factor aP2 (fatty acid binding protein 4). These were paralleled by the decreased mRNA expression of Wnt/β-catenin signaling pathway inhibitor sFRP1 (Secreted frizzled-related protein 1) and the increased level ofβ-catenin protein. Conclusion 1, 25(OH)2D3 inhibits adipocyte differentiation, which may be related to the activation of Wnt/β-catenin signaling.

Objective To study the influence of Compound Salvia injection combined with cefoperazone sulbactam sodium on renal function and renal interstitial fibrosis in elderly patients with chronic pyelonephritis (CPN).Methods From April 2013 to July 2014, 126 cases of CPN were divided into observation group ( n =63 ) and control group ( n =63 ) according to the order of admission to hospital.All patients were given cefoperazone sulbactam sodium, and patients in observation group were added Compound Salvia injection.The clinical efficacy of treatment were evaluated between two groups, renal function and TGF-β1 were observed and compared before and after treatment in two groups.Results After treatment, HE staining of nephridial tissue showed renal interstitial fibrosis in observation group obvious improved more.The overall response rate of observation patients (90.48%) was significantly higher (74.60%) than control group, and the relapse rate of observation group (1.59%) was significantly lower than control group (14.29%), and there were statistically significant differences (P<0.05).After treatment, urinary albumin (11.4 ±3.1) mg/L, BUN (5.7 ±0.5) mmol/L, and Scr (103.2 ±10.4)μmol/L of observation group were significantly lower than control group, respectively (P<0.05).After treatment, TGF-β1 level (103.4 ±32.5) ng/L of observation group was significantly lower than control group (202.4 ±35.2) ng/L(P<0.05).There was no significant difference in adverse reactions between two groups.Conclusions Compound Salvia injection combined with cefoperazone sulbactam sodium has good efficacy.can significantly improve renal function, delay renal interstitial fibrosis in treatment of elderly patients with chronic pyelonephritis.