The paper reviewed basic concepts of corporate governance.Based on these concepts,the authors proposed the general strategy and practices for introducing corporate governance structure at the hospital,and stated key characteristics of such a structural reform,thus making worthwhile attempts to this direction.

Objective To evaluate the efficacy of ambroxol on community acquired pneumonia (CAP) in elderly patients.Methods Totally 120 patients with CAP were selected and divided into 3 groups:low-dose group (patients received ambroxol 15 mg intravenously,3 times per day,n=40),conventional-dose group (patients received ambroxol 30 mg intravenously,3 times per day,n=40)and control group (patients received routine treatment including antibiotic therapy and oxygen inhalation,n=40).All patients were treated for 7 days.The levels of white blood cell (WBC),high sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were determined dynamically during the treatment.Results The markedly efficient rate,efficient rate and inefficient rate were 62.5％ (25/40),15.0％ (6/40) and 22.5％ (9/40) in low-dose group,82.5％ (33/40),15.0％ (6/40) and 2.5％ (1/40) in conventional-dose group,40％ (16/40),15.0％ (6/40) and 45.0％ (18/40) in control group,respectively.The total efficient rates were 77.5％,97.5％ and 55.0％ in low dose,conventional dose and control groups,respectively.The markedly efficient rate was higher in lowdose,conventional-dose groups than in control group (x2 =15.29,P＜0.05).There was a significant difference in markedly efficient rate between low dose and conventional-dose groups (x2 =4.01,P＜ 0.05).The total efficient rate was higher in low-dose,conventional-dose groups than in control group (x2 20.22,P＜0.05).There was a significant difference in total efficient rate between low dose and conventional-dose groups (x2=7.31,P＜0.05).Compared with before treatment,the levels of WBC,hs CRP and PCT were decreased in 3 groups after treatment (all P＜0.05).The levels of WBC,hsCRP and PCT were decreased more remarkably in low dose,conventional-dose groups than in control group (all P＜0.05).There was a significant difference in the decrease of WBC,hs-CRP and PCT levels between low-dose and conventional-dose groups (all P＜0.05).Conclusions Conventional dose ambroxol treatment (30 mg,iv,3 times/d) is an efficient therapy for community acquired pneumonia in elderly patients.

Necrotizing pneumonia is a severe complication of community-acquired pneumonia in children, with no clear deif-nition currently, characterized by parenchymal injury, necrosis and cavity formation. Streptococcus pneumonia is the most common pathogen;however a positive microbiology is not always obtainable. The clinical manifestation of necrotizing pneumonia is more seri-ous than ordinary pneumonia, and complications are common. Chest CT scan is helpful to early detection and diagnosis. Antibio-tics remain the mainstay of treatment, and the prognosis is relatively well.

TCM hospital preparation, which is only used inside its own orgnations, is an important part of clinical medicine in TCM. In recent years, the lack of a corresponding constitution of legal safeguard seriously hampered the prosperities of TCM hospital preparations. It's a high time to settle a targeted legal safeguard constitution of TCM preparations developed by the hospital. The author takes hospital of TCM preparation as the research object, starting from the current situation and problems of development of hospital of TCM to dig out the reasons. It has great significance to ensure the status of TCM preparation developed by the hospital at first, to combine with other measures. and to put forward about the establishment of comprehensive legal safeguard mechanism for the development TCM hospital preparation.

Accidents, Occupational ; Adult ; Female ; Humans ; Male ; Middle Aged ; Nitrites ; poisoning

Objective To detect neuroendocrinal factor,and explore whether neurohormonal activation exists in children with conge-nital heart disease(CHD).Methods Concentrations of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),angiotensionⅡ(AngⅡ),aldosterone(ALD),endothelin-1(ET-1),and norepinephrine(NE)were determined in 100 children with CHD and were assayed at 24 hours,1 month,3 months and 6 months after interventional therapy in 70 cases with CHD.Results Children with CHD heart disease had elevated levels of ANP(25.6?7.5) pmol/L,BNP(15.7?7.4) pmol/L,ET-1(1.12?0.31) pmol/L(all P=0.0001),(AngⅡ)(90.3?11.5) ng/L,NE(1.07?0.08) nmol/L and ALD(246.1?42.3) pmol/L(all P=0.001).There was a highly significant stepwise increase in ANP,BNP,ET-1,AngⅡ,ALD and NE according to New York Heart Association class,with even asymptomatic patients having evidence of significant neurohormonal activation.The neurohormonal function gradually returned to normal after interven-(tional) therapy.Conclusions Neurohormonal activation in children CHD bears the hallmarks of chronic heart failure,relating to symptom severity and ventricular dysfunction.

Objective: To investigate the changes in apoptosis of mouse mammary cancer cells (MA-891) after transfection with IL-23 gene in vitro and in vivo and explore the anti-tumor mechanism of IL-23. Methods: IL-23 gene was transferred into two packing cell lines (ectotrophic ψ2 and amphotrophic PA317) in sequence by a retrovirus vector (LXSN), and the positive cellular clones that can produce retroviruses carrying IL-23 gene were screened by G418. The retroviruses were used to transduce the mIL-23 gene into mouse mammary cancer cells (MA-891). After being screened by G418, IL-23/MA-891 cells expressing IL-23 protein were obtained. The expression of IL-23 protein in IL-23/ MA-891 cells was detected by ELISA method. The proliferations of MA-891, LXSN/MA-891 and IL-23/MA-891 cells were detected by MTT assay in vitro. Mice were subcutaneously inoculated with IL-23/MA-891, LXSN/MA-891 and the parental MA-891 cells and the solid tumor formation was observed in vivo. The apoptosis of tumor cells from mice injected with different MA-891 cells was detected by TUNEL and flow cytometry analysis. The expressions of Fas and survivin were determined by RT-PCR and Western blotting in vivo. Results: IL-23 gene was successfully transfected into MA-891 cells. The stable IL-23/ MA-891 cells with over-expression of IL-23 was obtained. Transfection with IL-23 gene had significant effects on the proliferation and apoptosis of MA-891 cells in vitro (P > 0.05). But the tumor growth in mice was greatly inhibited and apoptosis ratio of tumor tissues was significantly increased in the IL-23 gene-transfected group compared with the control group (P <0.01). The expression of Fas on the surface of cells was up-regulated and the expression of survivin was significantly decreased (P <0.01). Conclusion: Transfection with IL-23 gene has no significant effects on the apoptosis of MA-891 cells in vitro. But IL-23 exerts its anti-tumor effect by up-regulating the expression of Fas and down-regulating the expression of survivin in vivo.

Heart ; growth & development ; Humans ; MicroRNAs