The strategic cost management of the hospital means setting the cost management of the hospital in the realm of strategic management and analyzing the hospital and its cost behavior and structure from a strategic level so as to create advantages in competition, attain the goal of adapting the hospital to the continuously changing environment and facilitating stralegic management. Strategic cost management is characterized by a protracted, overaU, extensional and innovative nature and methods for it include value chain analysis, strategic positioning analysis, cost agent analysis and many others. Clarifying the goals of strategic cost management, selecting different strategies according to strategic cost information, perfecting the cost management of the hospital and enhancing cost awareness, and giving play to the functional role of economic management personnel are some of the prerequisites for the hospital to implement strategic cost management.

Objective:To construct adenovirus containing murine MHC class II transactivator (CIITA) mutant gene and to observe expression of this gene mediated by adenovirus as well as function of the expression product in vitro.Methods:The type IV CIITAcDNA gene was cloned from peritoneal macrophage of BALB/c mouse by conventional way of molecular biology, and then it was cloned into expression vector pIRES. CIITA mutant gene was constructed by the way of overlap extension by PCR (OE-PCR), and then it was also cloned into expression vector pIRES. By using of pAdEasy-1 system we acquired the deficient recombination adenovirus Ad-CIITAm, containing CIITA mutant gene, which had the ability of infection and the no-loaded control adenovirus Ad-GFP.Then the two adenoviruses strains were processed for a great deal amplification,purification and titer determining. The Ad-CIITAm and Ad-GFP were infected into HeLa cells and Raji cells.Inducible or constitutive expression of HLA-DR molecule and the following changes were observed by the use of flow cytometry.Results:The murine CIITA gene was cloned successfully and the recombinantant adenovirus Ad-CIITAm containing murine CIITA mutant gene was also constructed successfully. It was proved by flow cytometry that expression of HLA-DR molecules on the surface of HeLa cells and Raji cells infected by Ad-CIITAm were all decreased remarkably in comparison with those of control cells infected by Ad-GFP.Conclusion:This experiment proves that expressed murine CIITA mutant mediated by adenovirus could inhibit the expression of MHC II molecules efficiently.

The paper first analyzes the intrinsic need for cultural integration in hospital regrouping and sums up its content, including the integration of values, management ideas, institutional cultures and institutional frameworks. It then introduces some methods of cultural integration in hospital regrouping, such as running in on the basis of respecting human nature, resolving conflicts on the basis of being mutually tolerant, and merging completely on the basis of optimizing means of integration. The paper points out that success or failure of cultural integration in hospital regrouping depends on the thinking of the leaders. For this reason, it is imperative to enhance integration awareness and improve integration capability.

ObjectiveTo study infection status of voluntary blood donors and epidemic trends of related infectious diseases in Bengbu area.MethodsBlood infection markers(ALT, HBsAg,Anti-HCV,TP and Anti-HIV) of 130 118 voluntary blood donors were detected.Voluntary blood donors were divided into college students group,reservation group and street group.Then, the positive rates of blood infection markers of three groups were compared.ResultsAccounting for 4.41％ ,5 748 voluntary donors of 130 118 volunteers were unqualified.The positive infection rates of students group, reservation group and street group were 2.42％, 4.08％ and 4.85％.The statistical differences of ALT and anti-HCV among these groups were significant (x2 = 35.07,12.31,12.45,116.49, all P ＜0.01),and no statistical significance was found in ALT difference among these groups(x2 = 3.82,0.59, all P ＞0.05).ConclusionThe infection rates of these blood donation related diseases of voluntary donors in bengbu aera showed increasing tendency, and that of college students in bengbu area was relatively lower.

An introduction to the background of theSettlement by disease scoringpolicy in Yinchuan,concept and principles of the policy,and the medical insurance payment practice according to this policy.The authors compared the year-end settlement of medical insurance of a tertiary hospital in Yinchuan before the policy came into practice,expense growth per visit for inpatients of medical insurance,ratio of reimbursement,and ratio of complete out-of-pocket payment.These data were analyzed regarding the merits of such a policy and problems incurred,along with recommendations.

Objective To investigate the clinical efficacy,operative essentials and indications of hybrid spinal fusion surgery for cervical spondylotic myelopathy.Methods From August 2008 to December 2011,thirty-eight patients with cervical spondylotic myelopathy underwent hybrid spinal fusion surgery in our hospital.There were 27 males and 11 females,aged from 33 to 70 years (average,51 years).A total of 86 segments were treated (fusion 48 vs.non-fusion 38).Twenty-eight patients underwent a two-level surgery,and ten patients received a three-level surgery.The Japanese Orthopaedic Association (JOA) score and Visual analogue scale (VAS) were used to evaluate pre-and post-operative neurological function and pain,respectively.The pre-and post-operative range of motion of the cervical spine was measured according to Xrays.Moreover,the surgical complications were recorded and analyzed.Results Thirty-seven patients were followed up for 15 to 55 months (average,29.1 months).The improvement of neurological function was obtained in 36 patients.The JOA score was improved from preoperative 10.5±1.57 to 14.3±1.97 at final follow-up,with an improvement rate of 58.46％,and the results were excellent in 16 cases,fair in 20 cases and poor in 1 case.The VAS was improved from preoperative 7.3±1.04 to 3.2±1.41 at final follow-up.The Cobb angle changed from preoperative 25°±3.21°to 20°±2.56°at final follow-up.After operation,the neurological function was not restored in 1 case; hoarseness and bucking occurred in 2 cases; sore throat occurred in 22 cases; anterior displacement of prosthesis (PCM) occurred in 3 cases.Other patients had no complications,such as displacement,loosening and heterotopic ossification.Conclusion In hybrid spinal fusion surgery,the lesions segments are decompressed fully,the severely degenerative segments are fused,and the motion of the non-fusion segments is reserved.As a result,not only the stability of the cervical spine is achieved,but also an obvious improvement of symptoms and a satisfactory short-term efficacy can be obtained.Therefore,this method is an alternative procedure for cervical spondylosis myelopathy.

Objective:To study the anti-inflammatory effect of immune milk. Method:Twenty four strains of pathogenic bacteria (including 12 strains of pathogenic E.coli, 8 strains of Salmonella, 3 strains of Shigella and 1 strain of Yersinia enterocolitica) originated from human intestinal tract were selected as antigens, and dairy cows were immunized. Results:Vaccination could not increase the concentration of IgG in the immune milk, but significantly highten the specificity of milk antibodies. The antibody titers against 24 pathogenic bacteria in immune milk was 128, 64 folds of control regular milk. Conclusion:Feeding of immune milk could inhibit edema of rat footpad induced by carrageenin and formaldehyde and the formation of acestoma of mice caused by cotton embedded hypophloedally. Meanwhile, the PGE2 level in inflammatory footpad of rat fed with immune milk was remarkably lower than that of rat fed with regular milk. These results indicate that immune milk has anti-inflammatory property.

The successful establishment of animal models of cardiac arrest-cardiopulmonary resuscitation (CA-CPR) undoubtedly provided an important basis for exploring the method of cardiopulmonary resuscitation (CPR) and advanced cardiovascular life support (ACLS). However, pathophysiology varied with the etiology of cardiac arrest (CA). Therefore, preparation of similar animal models according to etiology was the basis for pathophysiological changes research. Compared with other animals, the rabbits had both the advantages of large and small animals, so they became common research object for the CA-CPR model. This paper reviewed the common methods of animal models of CA-CPR in rabbits. In this review, the methods, criteria, advantages, disadvantages and precautions of each model were analyzed, which would provide useful reference for CPR researchers.

Salvianolic acid A (Sal A) is one of the most effective compounds isolated from the root of Salvia miltiorrhiza. Up to now, several studies regarding the pharmacokinetic profiles of Sal A have been reported, however there is no such study reported in monkeys, the species which is more similar to human. The aim of this study is to develop a LC-MS method for the determination of Sal A in monkey plasma and apply it to the pharmacokinetic studies of monkeys. After single intravenous administration of Sal A, the plasma concentration-time curves were observed and the main pharmacokinetic parameters were calculated. The plasma concentration at 2 min (C2 (min)) values were (28.343 ± 6.426), (45.679 ± 12.301) and (113.293 ± 24.360) mg x L(-1) for Rhesus monkeys treated with Sal A at 2.5, 5 and 10 mg x kg(-1). The area under the concentration-time curve (AUC(0-∞)) values were (3.316 ± 0.871), (5.754 ± 2.150) and (13.761 ± 2.825) μg x L(-1) x h, respectively. Furthermore, this method was improved and applied to the simultaneous determination of Sal A, Sal B and Sal C, which provided useful information for preclinical studies and clinical trials of Sal A, Sal B and Sal C.
Administration, Intravenous ; Animals ; Caffeic Acids ; pharmacokinetics ; Chromatography, Liquid ; Drugs, Chinese Herbal ; pharmacokinetics ; Lactates ; pharmacokinetics ; Macaca mulatta ; Mass Spectrometry ; Plant Roots ; chemistry ; Salvia miltiorrhiza ; chemistry

Objective To observe the effects of vaporized perfluorocarbon (PFC) combined with exogenous pulmonary surfactant (PS) inhalation on rabbit models of acute lung injury (ALI).Methods Thirty-two New Zealand rabbits were randomly divided into four groups: ALI group, combination treatment group, PFC group, and PS group (each groupn = 8 rabbits). The rabbit model of ALI was induced by the whole lung normal saline lavage. After modeling, in the combined group, 3 mL/kg vaporized perfluorooctyl bromide/dipalmitoylphosphatidylcholine (PFOB/DPPC) emulsion was inhaled, the rabbits in PFC and PS groups were treated with vaporized PFOB emulsion and vaporized DPPC emulsion 3 mL/kg inhalation respectively, and in the ALI group was given the same amount of vaporized normal saline inhalation. In each group, before modeling for 30 minutes (basic value), after modeling for 1 hour and after treatment at 0 minute, 30 minutes, 2 hours, 4 hours, the respiratory rate (RR), oxygenation index (OI), dynamic lung compliance (Cdyn) were observed, and the lung coefficient (LI) and lung permeability index (LPI) were calculated; the levels of serum tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA); the lung tissue was collected and the lung pathological changes were observed under macroscopic and microscopic observation.Results Aftermodeling, the levels of OI, Cdyn were quickly lowered, RR became significantly elevated, and there were obvious edema, hemorrhage and exudation in lung tissue of ALI group. The levels of OI were significantly increased in combined group and PFC group compared with the level in ALI group after treatment at 0 minute initially [mmHg (1 mmHg = 0.133 kPa): 231.0±16.7, 221.4±19.0 vs. 189.5±21.0, both P < 0.05], while the level of OI in PS group was increased significantly until 4 hours after treatment, being higher than that in ALI group (mmHg: 297.0±20.7 vs. 243.3±36.7,P < 0.05); RR was decreased significantly in combined treatment group at 30 minutes after treatment compared with that in ALI group (bpm: 151.1±13.3 vs. 178.5±32.0,P < 0.05), while the RR in PFC group and PS group were not increased significantly until 4 hours after treatment being higher than that in ALI group (bpm: 129.3±14.3, 133.1±13.9 vs. 157.5±32.5, bothP < 0.05). Compared to ALI group, the three treatment groups resulted in significant improvement in Cdyn right at 0 minute (mL/cmH2O: 1.64±0.10, 1.45±0.10, 1.43±0.09 vs. 0.57±0.05, allP < 0.05), their LPI, LI and inflammatory cytokines were significantly decreased [LPI (×10-5): 4.21±0.42, 4.76±0.55, 4.87±0.49 vs. 5.56±0.52, LI: 8.04±0.58, 8.90±0.88, 9.22±0.71 vs. 10.85±0.73, TNF-α (ng/L): 50.05±4.91, 56.18±5.54, 63.60±5.96 vs. 73.60±5.27, IL-1β (ng/L): 34.27±4.55, 40.29±5.03, 48.13±6.38 vs. 54.71±4.26, allP<0.05], and pulmonary edema, congestion and inflammatory cell infiltration were obviously ameliorated (pathological scores: 3.74±0.58, 4.50±0.75, 5.29±0.72 vs. 6.13±0.72, P < 0.05). Cdyn levels were increased significantly in combined treatment group at 0 minute, 30 minutes, 4 hours after treatment compared with thosein PFC and PS group, but there were no significant differences between PFC and PS group. Levels of LI, LPI, inflammatory factors and pathological scores were decreased significantly in combined treatment group compared with those in PFC and PS group, the degrees of improvement of inflammatory factors and pathological scores in PFC group were more obvious than those in PS group (allP < 0.05).Conclusions PFOB combined with DPPC inhalation can provide greater oxygen delivery, reduce the pro-inflammatory cytokines, supplement PS and influence its distribution on the surface of lung, which might lead to a marked and sustained improvement in oxygenation, pulmonary function and amelioration of lung edema and inflammatory reaction in saline lavage induced lung injury of rabbits.