The paper tells how the authors' hospital managed under the circumstances of fierce competition in the medical market to integrate the idea of a marketing chain with medical service, construct a quality and efficient marketing chain for medical service, constantly readjust each part and element of the “chain management” of technical items and service manner, and realize multi layer and multi dimensional network management. The hospital also established a “chain management” framework characterized by “compliance with market laws, customers highest and delivery of quality service”. Setting on itself such high demands as “highest speed, best quality, lowest cost and optimal service”, the hospital did its best to create a strong marketing chain for medical service products, thus providing theoretical basis and practical reform experience for the marketing of medical service products.

The heterogeneity is one of the main points in study on the mast cells. In the present paper, the heterogeneity of skin connective mast cells (CTMC) in comparison with that of gastrointestinal mucosal mast cells (MMC) with both toluidine blue staining and immunostaining was studied. The results showed that the CTMC fixed with formaldehyde could be demonstrated with routine toluidine blue staining, whereas the MMC could be demonstrated only with lower pH and prolonged staining duration. In immunostaining almost all of the CTMC showed serotoninimmunoreactivity, and only 10% of the CTMC showed substance P-immunoreactivity; while approximate 35% of the MMC showed serotonin-immunoreacivity and no substance P-immunoreactivity was found. The results indicate that the mast cell heterogeneity may be found in toluidine blue staining as well as in immunostaining.

Objective To find out the hygienic status of rural drinking water in Jianhe County of Guizhou Province.Methods Forty-eight source water and tap water samples from small centralized water supply stations in 12 townships of Jianhe County in dry season and wet period were tested from 2009-2011.The water samples were examined in accordance with the relevant provision of Standard Examination Methods for Drinking Water (B/T5750-2006).The contents included:①sensory indicators:standard color,turbidity,smell and taste and visible objects; ②general chemical indicators:pH,iron,manganese,chloride,sulfate,total dissolved solids,total hardness,oxygen consumption and ammonia; ③toxicological indicators:fluoride,arsenic and nitrate; ④microbial indicators:total number of colonies,with a total population of Escherichia coli and heat-resistant Escherichia coli Outcome evaluation was carried out in accordance with the Drinking Water Health Standards (B/T 5.749-2006).Results A total of 192 rural water samples were collected in 2009-2011,and 18 samples were qualified,accounting for 9.38％.The differences of water passing rate between groups of years were statistically significant (x2 =14.74,P＜ 0.01).Rural drinking water quality in dry season (18.75％,18/96) was better than that in wet season (0.00％,0/96; x2 =19.76,P ＜ 0.01).Passing rate of source water quality (16.67％,16/96) was higher than that of tap water(2.08％,2/96; x2 =11.95,P ＜ 0.01).Sensory indicators and toxicological indicators of 192 water samples were qualified.General chemical indicators:in addition to four water samples with pH exceeded the standard(two copies in 2009 and two copies in 2010),other test indicators were qualified.Microbiological indicators:passing rates of the total number of colonies,Escherichia coli group and heat-resistant Escherichia coli group were 77.08％ (148/192),9.90％ (19/192) and 20.31％ (39/192),respectively.Passing rate of microbes was 18.75％ (18/96) in dry season and 0.00％ (0/96) in wet period,and microbes passing rate was significantly higher in dry season than that of the wet period(x2 =19.76,P ＜ 0.01).Passing rate of microbes was 16.67％(16/96) in source water and 2.08％(2/96) in tap water,and passing rate of the source water was significantly higher than that of the tap water(x2 =11.95,P ＜ 0.01).Conclusions The hygienic status of rural drinking water in rural areas of Jianhe County of Guizhou Province is poor.Microbial pollution is the main reason.

Objective To observe the effect of Du-moxibustion on cognitive impairment after stroke. Methods 60 patients with cognitive impairment after stroke were randomly divided into control group (n=30) and treatment group (n=30). They were treated with conventional medical treatment and rehabilitation training, the treatment group received Du-moxibustion treatment in addition with once a day, 6 days per week for 8 weeks. They were evaluated with modified Barthel Index (MBI) and Montreal Cognitive Assessment (MoCA) before and after treatment. Results The scores of MBI and MoCA increased after treatment (P<0.05) in both groups and the scores were higher in the treatment group than in the control group (P<0.05). Conclusion Du-moxibustion can further improve the cognitive function and activities of daily living in stroke patients.

Pancreatic cancer is one of the most lethal human malignant tumors, and its incidence is rising. Now, its treatment includes surgical resection,chemo - radiotherapy and supplementary treatment. The prognosis of pan-creatic cancer is still dismal. And its one-year survival is low. This article talks about the effect of clinical treatment on quality of life in patients with pancreatic cancer.

OBJECTIVE： To discuss the severe liver function damage induced by antituberculostics.METHODS： The severe liver function damage induced by antituberculotis was analyzed in 50 patients admitted into this hospital from January 1995 to January 2000.RESULTS： Sever liver function damage was related to the following factors:(1)history of liver diseases;(2)aged patient and malnutritional patient;(3)chronic alcoholism;(4)combined use of isoniazid,rifampin with other drugs;(5)hepatic dysfunction before treatment.CONCLUSION： The abovementioned factors should be under consideration in choice of antituberculotics.

Adult ; Aged ; Arthritis, Rheumatoid ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

Objective To visualize blood flow changes in verruca vulgaris noninvasively with laser speckle contrast analysis (LSCA), and to evaluate the relationship of size and location of warts with efficacy of laser treatment. Methods Pulsed dye laser(PDL)was used to treat 30 verruca vulgaris lesions in 17 patients. In order to evaluate therapeutic effect of PDL, LSCA was performed to observe blood flow in warts and their surrounding normal skin, and to calculate speckle flow index (SFI)values before laser treatment, and at 10 minutes as well as on 3 weeks after laser treatment. Results Before PDL treatment, SFI values were significantly higher in warts than in their surrounding normal skin (11.600 ± 1.190 vs. 5.280 ± 0.481, t = 8.169, P < 0.01). Compared with those before the treatment, SFI values in warts significantly decreased at 10 minutes(3.112 ± 0.484, t = 4.407, P < 0.01)and on week 3(7.315 ± 1.083, t = 3.294, P < 0.01)after the treatment, and were significantly higher on week 3 than at 10 minutes (t = 4.646, P < 0.01). SFI values in surrounding normal skin significantly increased at 10 minutes after the treatment compared with those before the treatment (20.260 ± 2.063 vs. 5.296 ± 0.708, t = 6.770, P < 0.01), but were significantly lower on week 3 than at 10 minutes (4.941 ± 0.616, t = 6.964, P < 0.01). No significant difference was observed between SFI values in surrounding normal skin on week 3 after the treatment and those before the treatment (t = 0.378, P = 0.707). The efficacy of laser treatment was associated wart size and location. Changes of blood flow(|ΔSFI|)were significantly higher in warts measuring less than 0.5 cm2 in size than in those equal to or more than 0.5 cm2 (t = 2.287, P < 0.05), and significantly differed among warts at different sites (F =15.71, P < 0.01). The greatest changes of blood flow in warts were observed on fingers, followed by the dorsum of feet, toes, palms and soles and periungual areas. Conclusions Blood flow in verruca vulgaris is markedly increased compared with that in normal skin. PDL can clear verruca vulgaris by solidifying and gasifying capillaries. LSCA may be used to evaluate the efficacy of laser on verruca vulgaris more quantitively by monitoring regional blood flow.

With the deepening of the lung cancer molecular biology research,small molecular targets antitumor drugs make breakthrough progress,the epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is one of the most attention drug.A series studies show that EGFR-TKI can enhance the antitumor activity of ionizing radiation.Therefore,EGFR-TKI combined with radiotherapy alone for poor-risk patients appears survival benefit,but can't ignore the lung toxicity.However,there is a big contro-versy that EGFR-TKI combined with chemoradiotherapy for locally advanced NSCLC.

Objective To investigate the relationship between genetic polymorphism of methylenetetrahydrofolate reductase (MTHFR) and the risk of childhood acute lymphocytic leukemia (ALL).Methods 45 patients with ALL and a cohort of 45 matched healthy children were included,and DNA was extracted from their peripheral blood.PCR-RFLP was used to determine the genotypes of MTHFR C677T and A1298C.The adjusted odds tatio (OR) and 95 ％ confidence interwal (CI) were calculated using unconditional logistic regression model.Results The frequency of MTHFR 677 CC,CT and TT genetypes were 31.1％ (14/45),51.1％ (23/45) and 17.7 ％ (8/45) in controls and 51.1％ (23/45),40.0 ％ (18/45) and 8.9 ％ (4/45)in ALL,respectively (x2 =7.48,P =0.04).The frequency of MTHFR 677 T allele were 69.9 ％ (31/45) in controls and 48.8 ％ (22/45) in ALL.The MTHFR 677 T allele had an decreased risk in ALL compared with CC genetype (OR =0.4,95 ％ CI 0.21-0.83).The frequency of MTHFR 1298 AA,AC and CC genetypes were 57.8 ％,40.0 ％ and 2.2 ％ in controls and 18.8 ％,44.4 ％ and 6.8 ％ in ALL,respectively (x2 =11.23,P=0.23).The frequency of MTHFR 1298 C allele were 51.1％ (23/45) in controls and 42.2 ％ (19/45) in ALL.No significant association between the MTHFR 1298 polymorphism and the risk of ALL (OR =1.3,95 ％ CI 0.21-0.83).Conclusion MTHFR 677 polymorphism could significantly decrease the risk of developing childhood ALL,whereas MTHFR 1298 don' t significantly affect the risk of ALL.