The author explained in the first place what was meant by the modernization of hospitals. In his view, modernization of a hospital includes modernization of its buildings and modernization of its science and technology. The former refers to the modernization of a hospital's main buildings and supporting facilities and modernization of its environment, the style of which should be in line with the main buildings. These manifest as having functional, ecological, humane, intelligent and artistic features. The latter refers to the degree of bit and modernization seen in the ideas and quality of the managers. Then the author gave an account of how the hospital he works with put the above ideas into practice during the second phase of its construction.

Taking the 8-year management practice of Sanjiu Brain Hospital of Guangdong since its founding as a case, the paper gives an account of how the hospital managed to grow by leaps and bounds. The steps taken include: guiding decision-making with innovations in thought and blazing new trails in such aspects as growth strategies, leadership structure, system of operation, quality control, nursing management, service skills, marketing management, hospital culture, and logistics management. The paper argues that innovation is the soul and driving force of hospital management and reform and that daring to and knowing how to make innovations are indispensable to enhancing the core competitiveness of the hospital and promoting its fast and sustainable growth.

Carotid atherosclerosis is a major cause of ischemie stroke. Understanding the compositions of carotid plaque arid preventing plaque rupture are of importance to reduce the risk of ischemic stroke. Magnetic resornance imaging (MRI) is noninvasive, highly reproducible, does not involve exposure to ionizing radiation. It is one of the most potential imaging tools for carotid atherosclerotic plaques. This article reviews the application of MRI in the imaging of carotid atherosclerotic plaques.

ObjectiveTo study the relationship between Borna disease virus (BDV) and the human viral encephalitis.MethodsThe P24 fragment of BDV RNA in peripheral blood mononuclear cells (PBMC) from 59 patients with viral encephalitis diagnosed clinically, and 112 healthy donors were examined by fluorescence quantitative nested reverse transcriptase polymerase chain reaction (FQ-nRT-PCR).ResultsThere were 3 positive of BDV P24 fragment in 59 patients with viral encephalitis, and no positive in blood donors. The positive rate of BDV p24 in PBMC in viral encephalitis (5.08%) was higher significantly than that in blood donors (P

Objective To investigate the appropriate surgical procedure for unilateral papillary thyroid microcarcinoma (PTMC).Methods Clinical data of 323 patients with unilateral PTMC in Cancer Hospital of Chinese Academy of Medical Sciences from 1999-2007 were retrospectively studied.Survival outcomes and prognostic factors were analyzed.Results After a median follow-up of 102 (range,12-188) months,the 10-year overall and disease-specific survival was 95.3％ and 98.9％.The 10-year recurrence-free survival was 85.5％.The 10-year cumulative recurrence rate of residue glands was 6.5％.Capsular invasion,pT stage and clinical stage were significant predictive factors for recurrence of residue glands (all P ＜ 0.05).Cox regression multivariate analysis showed that pT stage (HR 2.153,95％ CI 1.231-3.767,P =0.007) was independent predictive factor.Of the 311 patients treated with non-total thyroidectomy,the 10-year cumulative recurrence rate of residue glands was 6.8％ Conclusions Unilateral PTMC has a good prognosis and hemithyroidectomy (lobectomy and isthmusectomy) is an appropriate surgical pattern.Extrathyroidal extension is a significant predictor for recurrence.

BACKGROUND:In terms of the histocompatibility, immune rejection and scar formation after repair, acel ular nerve al ograft is closer to autologous nerve cel s. At present, hyaluronic acid has been applied for autologous peripheral nerve repair;however, research on the nerve al ograft is rarely reported.
OBJECTIVE:To explore the effect of hyaluronic acid on the anastomotic scar in acel ular nerve al ograft repair of rat sciatic nerve defect.
METHODS:Thirty-six Sprague-Dawley rats were randomly divided into three groups (n=12 per group). The rat model of nerve defect of 10 mm was established by cutting the sciatic nerve of the left hind leg and then given nerve al ograft combined with the injection of hyaluronic acid at anastomosis (experimental group), only nerve al ograft (control group) and autologous nerve graft (nerve autograft group), respectively. Afterwards, the healing of the proximal anastomosis was observed and scar components were assessed.
RESULTS AND CONCLUSION:Gross observations showed that the rat skin and muscle fascia had no significant differences in healing among groups, while the surrounding tissue adhesion in the experimental group was milder than that in the control group (P<0.05). Masson staining found that col agen deposition in the epinerium could be observed in each group. In the experimental group, a smal amount of col agen fibers arranged orderly in the epineurium;in the control group numerous col agen fibers accumulated and arranged irregularly;in the nerve autograft group, sparse epineurial col agen fibers appeared in an order arrangement. The gray value of col agen type I in the experimental group was higher than that in the control group (P<0.05), while the gray value of col agen type III was lower than that in the control group (P<0.05). No significant differences were found in the sum gray values of col agen type I and III among groups (P>0.05). These findings indicate that in the peripheral nerve repair, hyaluronic acid abrogates the scar formation by increasing the deposition of col agen type III and reducing the deposition of col agen type I.

Objective To investigate the chemical constituents of Wedelia trilobata.Methods The chemical constituents were separated by chromatography and their structures were determined by physico-chemical constants and spectral analyses.Results Eleven compounds were isolated and identified as grandiflorenic acid(1),1?-acetoxy-6?,9?-dihydroxy-4,10?-dimethyl-5?H,7?H,8?H-endesm-3-en-8,12-olide(2),1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide(3),16?-hydroxy-ent-kauran-19-oic acid(4),(3R,4R,6R)-3,4-dihydroxy-1-menthene(5),trilobolide-6-O-isobutyrate(6),1?-acetoxy-4?,9?-dihydroxy-6?-isobutyroxyprostatolide(7),16?,17-dihydroxy-ent-kauran-19-oic acid(8),daucosterol(9),protocatechualdehyde(10),and caffeic acid(11).Conclusion All the compounds are isolated from W.trilobata for the first time except compounds 6 and 7.Compounds 2 and 3 are new sesquiterpene lactones,named as trilobolide A and 1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide,respectively.

Objective:To explore the efficacy and safety of amisulpiride at low dosage combined with clozapine in the treatment of refractory schizophrenia. Methods:Totally 160 patients with refractory schizophrenia were chosen from the psychiatric department of 4 hospitals during January to September in 2014 and randomly divided into the observation group and the control group with 80 cases in each. The patients were treated with clozapine plus amisupiride or clozapine plus placebo for 12 weeks. The positive and negative syn-drome scale ( PANSS) and treatment emergent side effect scale ( TESS) was used to respectively evaluate the efficacy and the adverse effects. Results:At the weekend of the 4th, 8th and 12th week after the treatment, the clinical efficacy in the observation group was sig-nificantly better than that in the control group (all P<0. 05). The total and every factors scores of PANSS after the treatment were sig-nificantly lower than those before the treatment in both groups ( P<0. 01), and the decrease in the observation group was more signifi-cant than that in the control group (P<0. 05 or P<0. 01). There was no significant difference in the incidence of adverse effects be-tween the two groups (P>0. 05). Conclusion:Amisulpiride at low dosage combined with clozapine can significantly improve the effi-cacy in the treatment of refractory schizophrenia without added adverse effects.

Objective To investigate the reference intervals of mean corpuscular volume (MCV) ,mean corpuscular hemoglo‐bin(MCH) and mean corpuscular hemoglobin concentration (MCHC) examined by the MindrayBC‐6800 hematological analyzer to establish the reference intervals suitable for our laboratory .Methods According to the method recommended by the NCCLS C28‐A3 ,600 healthy adult individuals were selected as the reference individuals .MCV ,MCH and MCHC levels were determined by the MindrayBC‐6800 hematological analyzer for constructing the reference intervals ;other 150 healthy persons undergoing the physical examination were selected and their MCH ,MCV and MCHC detection results were collected for verifying the established reference intervals .Results The detection results of MCV ,MCH and MCHC in healthy adults showed a normal distribution ,MCV had sta‐tistical difference among different age periods (P<0 .05);the reference intervals :82 .278 -94 .242 fL for young adults ,83 .032-94 .608 fL for the middle‐aged persons and 83 .137-96 .343 fL for the elderly .MCH had statistical differences between different se‐xes and among different age periods ;the reference intervals :27 .785-32 .415 pg for male young adults ,28 .324-32 .456 pg for male middle‐aged persons and 28 .274-32 .966 pg for male elderly ;27 .367-31 .973 pg for female young adults ,27 .445-32 .215 pg for female middle‐aged persons and 27 .532 -32 .468 pg for female elderly .MCHC had statistical difference between different sexes (P<0 .05) ;the reference intervals :328 .611-352 .810 g/L for male and 323 .771-348 .750 g/L for female .In 150 individuals un‐dergoing the physical examination ,the proportion of individuals locating at the outside of reference interval was less than 10 .0% , therefore the newly established intervals were suitable for this laboratory .Conclusion The sex difference or/and age differences of MCV ,MCH and MCHC exist among adult populations .So the reference intervals are respectively established according to the prac‐tical situation ,which are suitable for this laboratory by verification .

Objective To explore the therapeutic value of modified endoscopic submucosal dissection with ligation (ESD-L) for small tumors originated from gastric muscularis propria.Methods Total of 60 patients with tumors originated from gastric muscularis propria,which was confirmed by endoscopic ultrasonography and smaller than 12 mm and were recruited to the present study.The conventional ESD technique was used to dissect the tumor to the depth of muscularis propria.Then the bottom of the tumor and the beneath muscularis propria were ligated fully with a nylon loop.Further dissection was applied till the whole tumor was isolated.Results All 60 lesions were dissected completely with perforation occurred in 10 cases,which were managed successfully with metal hemoclip.Pathologic diagnosis was obtained in all lesions,and no recurrence was found during the follow-up.Conclusion Modified technique of ESD-L is effective for complete resection of small tumors originated from gastric muscularis propria,which can also decrease the risk of stomach perforation.