Persistent pulmonary hvpertension of newborn(PPHN) is a life-threatening condition which occurs at a rate of 2/1 000-6/1 000.The etiology of PPHN is still unknown and its treatment remains a major challenge for neonatologist.Impaired pulmonary artery relaxation,reduced blood vessel density and pulmonary vascular remodeling are the main pathological changes in PPHN.The general managements include mechanical ventilation,sedation,surfactant and hemodynamic support.Inhaled nitric oxide is the main vasorelaxant used in the treatment of PPHN.Several other vasorelaxants have been studied such as phosphodiesterase inhibitors,prostacyclin,endothelin-1 inhibitors.Even with the introduction of several new therapeutic modalities there has been no significant change in survival rate.

Objective:To analyze the probability of breast cancer with skin involvement and discuss the extent of removal of skin.Methods:Skin of the tumor surface was examined by series section in 40 cases of breast cancer.Results:Of the 40 patients,except 1 Paget disease,none of the rest was confirmed with skin involvement.The rate of skin involvement was 2.5%.Conclusion:If there are no abnormal clinical manifestation in skin,the extent of removal of skin shall not be enlarged and subcutaneous mastectomy with skin preservation can be accepted for early stage breast cancer.

AIM: To establish a method for determining isofraxidin and formononetin in Aidi Freezing Dried Powder for Injection(Radix et Rhizoma Ginseng,Radix Astragali,Radix et Rhizoma seu Caulis Acanthopanacis senticosi,etc.) by HPLC. METHODS: Chromatographic assay was performed on Hypersil C_(18) column(200 mm?4.6 mm,5 ?m).The mobile phase consisted of acetonitrile(A) and water(B).Gradient program was adopted as follows:0-15 min:16% A,15-45 min:40% A.The flow rate was 1.0 mL/min and the detection wavelength was 344 nm and 254 nm. RESULTS: Isofraxidin had a good linearity(r=(0.999 7)) in the range of 36.80-184.0 ?g/mL.The average recovery was 97.2%,and RSD=2.1%(n=9).Formononetin had a good linearity(r=0.999 7) in the range of 36.40-182.0 ?g/mL.The average recovery was 98.8%,and RSD=2.1%(n=9). CONCLUSION: The above method is simple,sensitive and accurate.It can be used for quality control of Aidi Freezing Dried Powder for Injection.

Mother-to-child transmission (MTCT)is an important way of hepatitis B virus (HBV)transmission.Blocking the HBV MTCT has a great significance for the prevention and treatment of hepatitis B.This article reviews the current blocking strategies implemented in the antepar-tum,peripartum,and postpartum stages,and summarizes the controversies existing in the blocking strategies in different stages.The significance of HBV occult infection and germ cell transmission in the HBV MTCT is analyzed.The results indicate that the current strategies for the prevention of hepatitis B MTCT need further improvement.Attentions should be focused on HBV occult infection and germ cell transmission.

Objective:To pursue a scientific approach for medical equipment purchase, set up a standard purchase model, and try to transform the extensive and empirical way in purchase management into a scientific way.Methods: Analyze and test the data using linear regression method on yearly revenue, equipment value, yearly volume of work and yearly maintenance and repairs fee for 25 kinds of equipment in one hospital.Results: Assuming other parameters do not change, for each additional 10,000 yuan in equipment value, the revenue of the hospital increases by 14,858 yuan; for each additional 10,000 times in the volume of work, the revenue increases by 2,214,407 yuan; for each additional 10,000 yuan in maintenance, the revenue decreases by 132,683 yuan.Conclusion: Based on the scientific approach on equipment purchase management, we should improve the efficiency of medical equipment usage, scientifically mange the maintenance and repairs of equipment, in order to provide more accurate information and data for equipment purchase in hospital and make the purchase management more scientific, objective and rational.

Objective To grasp the development of private hospitals of traditional Chinese medicine (TCM) from a macro level;To provide reference for stakeholders by analyzing the underlying database of TCM private hospitals. Methods By analyzing the TCM database of hospital health agency annual statement from“National Health Statistical Investigation System”, current status of TCM private hospitals were analyzed from the aspects of organization, personnel, beds, number of service, and patient burden. The developing level of TCM was reflected by comparison with public hospitals. Results By the end of 2013, there were 938 TCM private hospitals, accounting for about 26.13% of TCM hospitals. Average annual growth rate of beds, health technicians, outpatient visits, and discharged patients exceeded 10%, while the hospital degree, bed utilization ratio, physician burden, and average length of stay for discharge patients were only 70%of TCM public hospitals. Conclusion TCM private hospitals have achieved rapid development in the number of these indicators, but the service efficiency, scale and level are still far behind TCM public hospitals.

Objective To investigate the distribution and antimicrobial resistance of clinically isolated pathogens from geriatrics department of a hospital in 2013,so as to provide reference for clinical antimicrobial use.Methods Distribution and antimicrobial resistance of pathogens isolated from patients in a geriatrics department between Janu-ary and December 2013 were analyzed statistically.Results Of 1 896 pathogenic strains,1 289(67.99%)were gram-negative bacteria,439 (26.00%)were gram-positive bacteria,and 114(6.01%)were fungi;the top 4 isolated pathogens were Klebsiella pneumoniae ,Pseudomonas aeruginosa ,Acinetobacter baumannii ,and Escherichia coli .Extended-spec-trumβ-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae accounted for 53.26% and 31.10% of Escherichia coli and Klebsiella pneumoniae respectively;Of Staphylococcus aureus and Staphylococcus epidermidis strains,methicillin-resistant isolates (MRSA and MRSE)accounted for 22.47% and 80.00%,respectively,of Enterococ-cus strains,vancomycin-resistant isolates (VRE)was 3.10%,Klebsiella pneumoniae and Enterobacteriaceae were highly sensitive to imipenem,meropenem and ertapenem.Resistant rate of Acinetobacter baumannii to imipenem and meropenem was 79.48% and 80.35% respectively,Pseudomonas aeruginosa had the lowest resistant rate to amikacin (10.70%). Gram-positive bacteria were highly sensitive to vancomycin and linezolid.Conclusion The major pathogens isolated from the elderly patients are gram-negative bacteria,and antimicrobial resistance is serious,surveillance of antimicrobial resist-ance is important for rational use of antimicrobial agents and control of pathogen resistance.

The Human Milk Banking Association of North America(HMBANA) is a professional association for supporters of non-profit donor human milk banking.HMBANA develops guidelines for donor human milk banking practices.The construction of China's human milk bank has just begun in few areas in 2013.To further promote the development and implementation of donor human milk banking in our country,this review introduce the guideline for establishment and operation of a donor human milk bank which drafted by HMBANA in 2013.The guideline can provide the basis for the development of human milk bank in our country.

Objective To study the relationship between polymorphic (CAG)n repeats of androgen receptor(AR) gene and occurrence of prostate cancer (PC). Methods (CAG)n repeats of both malignant cells and adjacent nonmalignant cells from 34 paraffin embedded PCs, and that of peripheral blood cells from 2 PC patients were assessed using dsDNA cycle sequencing. Results The number of (CAG)n repeats in malignant cells was equal to that in adjacent nonmalignant cells from the same paraffin embedded PC; the mean of (CAG)n repeats in the 36 PC patients was 20.06 which was significantly smaller than that of normal men ( P 0.05). Conclusions Shortening of (CAG)n repeats within AR gene may be associated with the occurrence of PC.

The public ethics consciousness,with medical ethics included,fundamentally depends on the gradual improvement in the self-identity of human as objective itself.However,the improvement of humanistic consciousness is a long and painful process.Former recognition of historical culture,including the humanistic ideal in traditional Chinese ethical thoughts and systemic rational thoughts in modern western society,mainly employs transcendental test of abstract anthroposophy as its cultural premise,superficially enhancing certain individuals and their thoughts,motives,and objectives to historical ontology,but actually resulting in the absence of human individuals in realistic history.The self-conscious improvement of human-oriented public ethics can only be realized by the subjective humanistic consciousness which undergoes the regression from axiology,epistemology,to existence theory,making human realize that they themselves are the utmost purpose of all values and significances.