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 investigate the clinical value of serum apolipoprotein A-1 (Apo A-1) detection in HBV-related liver cancer.Methods Totally 362 cases of patients with chronic HBV infection were enrolled from January 2010 to December 2014 in our hospital,including 88 cases of chronic hepatitis B,94 cases of HBV-related liver cirhosis,18 cases of HBV-related liver cancer (without cirrhosis) and 162 cases of liver cirrhosis merged cancer.At the same time,45 cases of healthy people were selected for normal control.The serum Apo A-1,AFP and other laboratory markers were detected,and the test results were statistically analyzed.Results The difference of Serum Apo A-1 and AFP levels in all groups was statistically significant (F =29.86,x2 =112.53,P =0.000).As the disease progressed,the serum levels of Apo A-1 gradually decreased (P ＜ 0.05).But the difference of Apo A-1 level between normal control and HBV-related liver cancer group (without cirrhosis),chronic hepatitis B and liver cirrhosis merged cancer group,liver cirrhosis and liver cirrhosis merged cancer group was not statistically significant (all P ＞ 0.05).The liver cancer patients with Child-Pugh score A,B,C had different serum Apo A-1 levels (all P ＜ 0.05);The serum Apo A-1 level of liver cancer patients with Child-Pugh score A was significantly higher than that of liver cirrhosis (t =-3.02,P =0.003),but the differences of serum Apo A-1 levels between liver cancer and liver cirrhosis patients with Child-Pugh score B and C were not statistically significant (t =0.52,1.19,P =0.610,0.240).The serum Apo A-1 levels of liver cancer patients with TNM stage Ⅰ and Ⅱ were significantly higher than those with TNM stage Ⅲ and Ⅳ (t =3.85,P ＜ 0.001).Conclusion The serum Apo A-1 levels of HBV-related liver cancer patients are related with cirrhosis,Child-Pugh score and TNM stage,and the liver reserve function,the body's stress response and many other factors may contribute to the expression of serum Apo A-1.

Objective To evaluate HBeAg quantification in predicting the efficacy of pegylated interferon (PegIFN) α treatment for patients with HBeAg-positive chronic hepatitis B (CHB).Methods A total of 216 HBeAg-positive CHB patients admitted in Ningbo No.2 Hospital during March 2009 and December 2011 were enrolled in the study.All patients were given subcutaneous injection of PegIFNα-2a or PegIFNα-2b weekly for 48 weeks and followed up for 24 weeks after discontinuation.Patients were divided into HBeAg seroconversion group and non-seroconversion group at the end of the follow-up.Receiver operating characteristic (ROC) curves were used to evaluate HBeAg levels at baseline and 12,24 weeks of treatment in predicting HBeAg seroconversion.Results HBeAg seroconversion was observed in 31.48％ (68/216) patients at the end of follow-up,and there was no significant difference in seroconversion rate between patients treated with PegIFNα-2a and those with PegIFNα-2b (32.00％ vs.29.27％,P ＞ 0.05).There was significant difference in baseline HBeAg levels between patients with HBeAg seroconversion and those without HBeAg seroconversion (Z =-3.834,P ＜ 0.05).HBeAg seroconversion patients had a tendency of rapidly decreasing HBeAg level,but there was no significant difference in decreasing rate between seroconversion and non-seroconversion patients (F =3.321,P ＞ 0.05).ROC curves showed that HBeAg level at 24-week was the best indicator for predicting HBeAg seroconversion with area under curve of 0.861.Conclusion Serum HBeAg level at 24-week of treatment may be used to predict the HBeAg seroconversion in HBeAg-positive CHB patients treated with PegIFNα.

Objective To investigate the efficacy of polyethylene glycol (PEG)-interferon α (PEG-IFNα) in treating HBeAg-positive chronic hepatitis B (CHB) and explore the relationship between hepatitis B virus (HBV) genotypes and the effect of interferon α (IFNα) therapy.Methods A total of 199 CHB patients with known genotypes were given subcutaneous injection of PEG-IFNα-2a or PEG-IFNαt-2b once a week for 48 weeks,with another 24 weeks follow up.The seroconversion of HBeAg influenced by HBV genotypes were analyzed after discontinuation of treatment.Results In local area,genotype C was the major genotype[64.32％ (128/199)].Except serum ALT and AST level,the differences in gender,age,liver inflammation,degree of liver fibrosis,HBeAg level and HBV DNA level between genotype B and C were not statistically significant(all P ＞0.05).The seroconversion rate of HBeAg in patients with genotype B at early stage of therapy (3 months) was significantly higher than that of patients with genotype C [26.76％ (19/71) vs 10.16％ (13/128),x2 =9.330,P =0.002].While at the end of follow-up,seroconversion rate of HBeAg in patients with genotype B (followed up for 6 months) was higher than that of patients with genotype C [39.44％ (28/71) vs 30.47％ (39/128)],but the difference was not statistically significant(x2 =1.645,P =0.200).By univariate analysis based on log-rank test,the time of HBeAg seroconversion in patients with genotype B was much earlier than that of genotype C [(13.99 ± 0.67) months vs (15.47 ± 0.41)months],but the difference was not statistically significant (P =0.150).Conclusions The seroconversion rate of HBeAg in patients with genotype B treated with PEG-IFNα was significantly higher than that of genotype C in early stage of therapy (3 months),while similar at the end of therapy.

Objective To explore and analyze perioperative psychological care and its effect in craniotomy patients under sober state.Methods 10 patients with cerebral tumor of functional zone undergoing craniotomy under conscious state were given pertinent psychological nursing and psychological counsehng,besides,perioperative comprehensive nursing wag given in order to reach the aim of effective psychological nursing.Results The perioperative behavioral control of patients wag better,they could cooperate with the operation as requested and reached the anticipated aim.All patients rehabilitated at discharge.Conclusions Effective psychological care plays a very important role to ensure the success of sober craniotomy and rehabilitation of patients.

Objective To explore the effect of hepatitis B virus(HBV) on the expression of apolipoprotein A1 (ApoA1) and its regulatory mechanism.Methods RT-PCR and Western blot were used to measure the expression of ApoA1 in HepG2 and HepG2.2.15 cells,serum ApoA1 and high density lipoprotein cholesterol(HDL-C) levels in patients with HBV infection and in healthy individuals were measured by biochemical analyzer,statistical difference was analyzed by SPSS13.0,HepG2 cells was co-transfected with ApoA1 promoter containing the luciferase gene and HBV infectious clone pHBV1.3,luciferase activity was measured,expression of ApoA1 in HepG2 cells was measured by RT-PCR and Western blot after transfected with pHBV1.3.Results Expression of ApoA1 mRNA and protein was lower in HepG2.2.15 cells than in HepG2 cells,serum ApoA1 and HDL-C levels were much lower in HBV patients as compared to healthy individuals( P＜0.05 ),HBV represses ApoA1 gene promoter activity,ApoA1 mRNA and protein expression in HepG2 cells.Conclusion HBV can inhibit the expression of ApoA1 bothin vivo and in vitro.

Objective To detect the effect of osthole on proliferation and apoptosis of HL-60 cells and its molecular mechanism.Methods HL-60 cells proliferation was measured through the CCK8 assay method.The cell morphological changes were observed by Hoechst33342 staining after 8 h of drug effect.Induction of apoptosis was determined by flow cytometry and fluorescent microscopy.Expressions of Bcl-2 and Bax mRNA were evaluated by RT-PCR,and the expressions of cleaved caspase-3,caspase-8,caspase-9,Fas and FasL were evaluated by using western bolt assay.Results Osthole could inhibit the proliferation of HL-60 cells,the maximum inhibiting rate was (90.7 ±4.5)％,F =138.46,P =0.000; the apoptosis rate was 33.6％,F =27.75,P =0.006.The changes of apoptosis of cells and nucleus were shown in cell morphological observation.Osthole affected the decrease of the mRNA levels of Bcl-2 and the increase of the Bax mRNA levels via a dosedependent manner(F =210.12,P =0.000).Western blotting demonstrated that osthole could lead to the increase of the expression levels of cleaved caspase-3,caspase-8,caspase-9,Fas and FasL in the HL-60 cell line via a time-dependent manner.Conclusion Data suggests that osthole inhibits proliferation and induces apoptosis of HL-60 cells through mitochondria-dependent pathway and death-receptor pathway.

Objective To investigate the clinical effect of three kinds of dose of pulmonary surfactant (PS) in neonatal respiratory distress syndrome (NRDS), and to determine the optimal dose. Methods One hundred and seventy-four cases of NRDS were divided into A group (59 cases), B group (57 cases) and C group (58 cases) according random digits table. Based on the conventional treatment, children in A group were given large dose of poractant alfa injection 250 mg/kg, children in B group were given 200 mg/kg, and children in C group were given 100 mg/kg. After treatment for 1, 6, 12 and 24 h, the arterial oxygen saturation (SaO2), inspired oxygen concentration (FiO2), arterial oxygen tension (PaO2), oxygenation index (OI), arterial/alveolar oxygen tension ratio (a/APO 2), ventilator using and oxygen using time and the incidence of complication were compared. Results After treatment for 12,and 24 h, the levels of SaO 2 in A group and B group were significantly higher than those in C group: 0.936 ± 0.018, 0.935 ±0.019 vs. 0.857 ±0.027;0.941 ±0.017, 0.946 ±0.015 vs. 0.847 ±0.053, and there were significant differences (P<0.01). After treatment for 12 and 24 h, the levels of SaO 2 in A group and B group had no significant differences ( P>0.05). After treatment for 1, 6, 12, and 24 h, the levels of FiO 2 and OI in A group and B group were significantly lower than those in C group, and the levels of PaO 2 and a/APO2 in A group and B group were significantly higher than those in C group. There were significant differences (P<0.01). The levels of FiO2, OI, PaO2 and a/APO2 in A group and B group had no significant differences ( P>0.05). The ventilator using time in A, B and C group were (108.6±23.5) , (119.6±32.8), (156.3±27.3) h, and there were significant differences (P<0.05 or<0.01). The oxygen using time in A and B group had no significant difference ( P>0.05). The oxygen using time in C group was significantly longer than that in A and B group: (186.5 ± 52.8) h vs. (148.7 ±24.4), (154.6±28.2), P<0.01. The incidence of complication in A and B group had no significant difference ( P>0.05).The incidence of complication in C group was significantly higher than that in A and B group:29.31%(17/58) vs. 13.56%(8/59), 12.28%(7/57), P<0.05. Conclusions Poractant alfa injection 200 mg/kg is optimal dosage for poractant alfa injection in the treatment of NRDS, and it can effectively improve oxygenation and ventilation function, reduce the incidence of complication, shorten the course of disease and improve the prognosis and increase the cure rate. Excessive dose is waste, and little dose can not get effective treatment.

Objective To observe the bacteriostasis of herba houttuyniae liquid in bladder irrigation for treatment of rabbit bladder infection model, and to offer a new way for prevention and treatment of urinary tract infection.Methods Twenty male New Zealand long-eared white rabbits were divided into gentamicin control group and three different concentrations herba houttuyniae groups according to random number table method, each group 5 rabbits. The rabbit bladder infection model was replicated by injecting coli liquid 1 mL (105 cfu/mL) into the urinary bladder through a urethral catheter, and clipping the catheter for 1 hour. After model establishment for 3 days, in the three herba houttuyniae groups, 0.25, 0.50, 1.00 g/mL herba houttuyniae liquid 50 mL were injected into the bladder respectively, and in the gentamicin control group, 160 kU gentamicin was injected into the bladder. Before molding and after molding for 3, 5, 7, 9 days, ear blood in rabbit was taken, and white blood cell (WBC) count and neutrophil percentage (N%) were tested; at the same time, the middle segment morning urine was taken to detect bacteriuria and urine WBC positive rates; after the experiment, the animals were sacrificed, the urinary bladder tissues were taken, and the pathological changes in urinary bladder tissue were observed by a light microscope.Results Before molding, the bacteriuria in animals of each group was negative and the results of urine WBC, blood WBC and N% were within normal range. After molding for 3 days, bacteriuria and urine WBC positive rates reached 100%; with the prolongation of treatment after molding, the above two rates in each group were gradually decreased, and herba houttuyniae 0.50 g/mL and 1.00 g/mL groups appeared statistical significance on the 5th day (bacteriuria positive rate was 60% and 40%, urine WBC positive rate was 60% and 40% respectively, while the gentamicin control group and herba houttuyniae 0.25 g/mL group was still 100% positive, allP < 0.01); on the 9th day, the bacteriuria positive rate in both higher dosage herba houttuyniae groups was 0, in 0.25 g/mL group, it still had the positive rate 20%, showing herba houttuyniae 0.50 g/mL and 1.00 g/mL had stronger inhibitory effect than herba houttuyniae 0.25 g/mL. WBC and N% were increased in each group after molding, and on the 3rd day, WBC and N were significantly higher in each group than those before molding [WBC (×109/L): gentamicin control group 13.00±5.23 vs. 8.95±2.69, herba houttuyniae 0.25 g/mL group 14.52±10.28 vs. 8.73±3.16, herba houttuyniae 0.50 g/mL group 12.97±11.33 vs. 7.83±4.51, herba houttuyniae 1.00 g/mL group 13.03±9.17 vs. 6.45±3.85. N%: gentamicin control group 80.99±14.93 vs. 63.41±7.96, herba houttuyniae 0.25 g/mL group 89.62±9.41 vs. 70.01±9.13, herba houttuyniae 0.50 g/mL group 87.69±11.34 vs. 67.75±8.91, herba houttuyniae 1.00 g/mL group 85.67±12.81 vs. 65.12±4.63]. On the 7th day, WBC and N% fell, and on the 9th day, the WBC and N% were restored to normal range in herba houttuyniae 0.50 g/mL and 1.00 g/mL groups [WBC (×109/L): herba houttuyniae 0.50 g/mL group 8.56±5.38, herba houttuyniae 1.00 g/mL group 7.93±4.82. N%: herba houttuyniae 0.50 g/mL group 65.97±8.35, herba houttuyniae 1.00 g/mL group 65.57±9.12]. Under light microscopy, it was shown that the morphological appearances of tissue cells in various layers of bladder mucosa were normal in herba houttuyniae group, demonstrating that herba houttuyniae fluid in bladder did not cause allergic inflammatory reaction, etc.Conclusion The bacteriostatic action of herba houttuyniae liquid for bladder irrigation in treatment of rabbits with urinary tract infection is better than that of gentamicin.

The relationship of the nose tip position and the skull figures which were measured from the lateral craniographs in 49 ladies of 17～19 age living in Shenyang was studied. The figures measured on craniographs were analyzed by multiple stepwise regression analysis on IBM-PC/XT computer, and the regressoin equations for estimating the nose tip position of female in Shenyang were obtained. Cases in which the errors were within 2 mm were 71.43 to 77. 55 percent.