In this paper,we focus on how to planning and implementing CRM system in hospital,and address this topic in three main sections.Firstly, The comprehending and urgent need of hospital leaders and managers about CRM are the most important.Secondly,before implementing CRM,the status of information management in hospital and characteristic of relationship between customers(or patients) and hospital should be sufficiently understood.Thirdly,which kind of CRM,and how much investment what you need should be analyzed.A general principle is put forward,that is "clear aim,macro planning,(uniform) disposal and stepping into implementing".

We examined diseases occurring farmed Whitmania pigra(L.) in Hebei province in the aspect of situation of disease,clinical symptoms and pathological changes.In addition,the molecular identification were conducted to representative strain,the 16S rRNA gene was sequenced and compared with that of related strains,molecular phylogenetic tree was constructed.The results showed that the disease was infected by Aeromonas hydrophila.Pure cultures of 10 strains have the same serotype.Selected representative strain was proved to be the corresponding primitive causal agent of the disease by artificial infection experiment to healthy Whitmania pigra(L.).Antibiotic sensitivity of the isolates to used thirty-seven antimicrobial agents showed that the tested strains were high sensitive to cefotaxime et al.,were sensitive to streptomycin et al.,were resistant to oxacillin et al.

Acupuncture Points ; Adult ; Aged ; Anorexia ; therapy ; Child ; Constipation ; therapy ; Female ; Humans ; Inflammation ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Pruritus ; therapy

Objective: To explore the effect of KangXin oral solution on brain mitochondrial DNA(mtDNA) deletion mutation in aged Balb/c mice.Methods: The Balb/c mice were divided into the young group(6weeks),middle-aged group(6months) and aged group(14 months),each group has 10 mice.Brain mtDNA were obtained and polymerase chain reaction(PCR) technique was used to examine the fragment deletion of brain mtDNA,thus,to confi rm there was deletion of mtDNA in aged mice,s brain.The aged Balb/c mice were divided into two groups: the aged blank control group being given 0.9% normal sodium,KangXin oral solution group.After being treated for four months,the brain mtDNA were obtained and polymerase chain reaction(PCR) technique was used to amplify wild-type and deletion from of mtDNA.Gel imaging meter was used to detect optical density,then,to compare the optical density ratios of deletion from mtDNA/ wide type mtDNA in two groups.Results: There were 304bp mtDNA deletion in brain mitochondrial of aged Balb/c mice,but same mtDNA deletions were not detected in brain mitochondrial of young and middle-aged mice.Compared with aged blank control group,the mtDNA deletion of aged Balb/c mice in KangXin oral solution group decreased obviously(P〈0.001).Conclusion: mtDNA deletion mutation accumulates with the increase of age.KangXin oral solution can inhibit mtDNA deletion of aged mice.

Cardiovascular Diseases ; Humans ; Magnetic Resonance Spectroscopy

Objective To study the clinical and pathologic features,histological criteria and pathologic factors contributing to diagnosis of mixed epithelial and mesenchymal tumors(mixed m?llerian tumors,MMT)of the uterus.Methods A retrospective study of 102 cases of MMT of the uterus (74 adenofibromas including 9 recurrent cases,3 atypical polypoid adenomyomas,2 carcinofibromas,10 adenosareomas and 13 carcinosarcomas)was undertaken.Clinical records,gross features and tissue slices were reviewed.The follow-up data were analysed.Results The most common symptom was vaginal bleeding.Clinical signs included pelvic mass,uterine polyps,and enlarged uterus.Benign MMT usually presented as exophytic polypoid masses extending into the uterine cavity or protruding through the external os,often broad-based,lobulated and papillary.It was hard to distinguish low-grade malignant MMT from the benign ones by gross appearance.High-grade malignant MMT had the common gross features of carcinoma and sarcoma.Histologically,MMT showed a biphasic differentiation of mesenchymal and epithelial components.MMT were classified according to whether these elements were benign or malignant.Nine cases of adenofibroma without unique features for the diagnosis of adenosarcoma recurred at postoperative intervals of 3 to 96 months.Recurrent tumors were almost always confined to the original site.Conclusions Uterine MMT tumors according to WHO diagnostic criteria are not rare.The differential diagnosis depends on a multifactorial analysis.The recurrent adenofibromas may be a kind of borderline tumors with benign appearances and malignant behavior.

Angiolymphoid Hyperplasia with Eosinophilia ; pathology ; Child, Preschool ; Humans ; Male

Humans ; Laryngeal Neoplasms ; Male ; Middle Aged ; Sarcoma

BACKGROUND: It has been considered that Cestrum nocturnum L. (CNL) has the effects of antiarrhythmia, local anesthesia and central inhibition.OBJECTIVE: To investigate the analgesic effect of CNL extract on mice,so as to find new drugs for clinical treatment of pain.DESIGN: A randomized control observation.SETTING: Center of Modern Education and Department of Pharmacology,Gannan Medical College.MATERIALS: The experiments were carried out in the laboratory of scientific research center, Gannan Medical College between March and April in 2005. ① A total of 150 healthy adult Kunming mice were used in four independent experiments. ② Drugs: CNL extract was provided by the Department of Phytochemistry, Shenyang Pharmaceutical University (batch number: 2002080901), morphine hydrochloride injection by Shenyang No.1Pharmaceutical Factory (batch number: 000305), and naloxone hydrochloride injection by Yanqiao (Hunan) Pharmaceutical Co. Ltd., (batch number:20021109).METHODS: ① Effects of CNL extract on writhing times induced by acetic acid: Forty female mice were randomly divided into four groups with10 mice in each, and they were treated with intraperitoneal injections of 0.02 mL/g saline, 0.10 and 0.20 mg/g CNL extract and 0.10 mg/g aminophenazone respectively. The intraperineal injection of 6 g/L glacial acetic acid was given after 15 minutes. The writhing times of mice within 15 minutes were observed and recorded in each group. ② Effects of CNL extract on the pain induced by hot pla in mice: Forty female mice were randomly divided into four groups with 10 mice in each, and they were treated with intraperineal injections of 0.02 mL/g saline, 0. 10 and 0.20 mg/g CNL extract and 0.10 mg/g morphine respectively. The pain responses were detected at 15, 30 and 60 minutes after administration. ③ The antagonistic effect of naloxone on morphine and CNL extract to the pain induced by hot plate in mice: Thirty female mice were randomly divided into three groups ith 10 mice in each group, and they were given intraperitoneal injections of 0.02 mL/g saline, naloxone 0.004 mg/g +morphine 0.01 mg/g and naloxone 0.004 mg/g+CNL extract 0.01 mg/g respectively. The pain responses were detected at 15, 30 and 60 minutes after administration respectively. ④ Effects of CNL extract on electrostimulation induced pain in mice: Forty mice were randomly divided into four groups with 10 mice in ach group, and they were administrated with intraperineal injections of 0.02 mL/g saline, 0.10 and 0.20 mg/g CNL extract and 1 g/L morphine respectively. Repeated electrostimulations were given at 20, 35, 50 and 70minutes after administration, and the pain responses were detected by means of electrostimulation.MAIN OUTCOME MEASURES: ① Writhing times; ② Time for the pain response induced by hot plate; ③ Analgesic rate induced by electrostimulation.RESULTS: Totally 150 healthy adult Kunming mice were used in the four independent experiments, and all were involved in the analysis of results. ①Writhing times in the mice: 0.10 and 0.20 mg/g CNL extracts and 0.10 mg/g aminophenazone had very significant analgesic effects on writhing induced byacetic acid in mice, and the writhing times after administration were all fewer than those in the saline group (20.2±10.8, 14.5±7.6, 7.6±4.5,50.6±15.5, P ＜ 0.01), and the analgesic effects of CNL extract were dosedependently. ② Time for the pain response induced by hot plate: 0.10 and 0.20 mg/g CNL extracts had significant analgesic effects on the pain in duced by hot plate, and the time for pain sensation at 15, 30 and 60 minutes after administration were all longer than those in the saline group (P ＜ 0.05 or P ＜ 0.01), and the analgesic effect was dose-dependently. The times for pain sensation at each time point after administration in the naloxone 0.004 mg/g+CNL extract 0.01 mg/g group were all longer than those in the saline group, but those were close between the naloxone 0.004 mg/g+morphine 0.01 mg/g group and the saline group. ③ Analgesic rate induced by electrostimulation in the mice: The analgesic rates at20, 35, 50 and 70minutes after administration in the CNL extract 0.10 and 0.20 mg/g groups were all higher than those in the saline group (P ＜ 0.01).CONCLUSION: Our data suggested that CNL extract has obvious analgesic effect, and the analgesic intensity is dose-dependently. Naloxone, an opiate receptor antagonist, can antagonize the analgesic effect of morphine,but cannot antagonize that of CNL extract on mice with pain induced by hot plate, which indicates that CNL extract exert its analgesic role not through binding with opiate receptor.

Background There are two types of different questionnaires in dry eye diagnosis.But the associations about two questionnaires or questionnaire and clinical examination are still unclear.To effectively quantize the symptoms is helpful for a correct diagnosis of dry eye disease.Objective This survey was to evaluate the Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index(OSDI) questionnaire for the diagnosis of dry eye and investigate the correlation between the clinical examinations and questionnaires. Methods A perspective cohort study was designed.Sixty-six patients were enrolled in this study.This study was approved by the Ethic Committee of Peking University First Hospital,and written informed consent was obtained from each subject before any ocular examination.SPEED-based and OSDI-based questionnaires were used to score the dry eye symptom and grouped according to severity of complains.Corneal fluorescence staining,tear film breakup time(BUT),Schirmer I test and tear film interferometry were performed in all patients.The correlations between two questionnaires scores and their association with clinical examinations were evaluated.Results The negative correlations were found between the SPEED-based score or OSDI-based score with BUT value(r=0.390,P=0.001 ;r=-0.395,P=0.001 ),but no significant correlations were seen between the SPEED-based score or OSDI-based score with Schirmer test( r=-0.081,P=0.515; r=-0.080,P=0.525)and tear film interferometry score(r=0.158,P=0.204;r=0.219,P=0.077).The BUT was significantly prolonged in mild symptom group compared with serious group(t=2.339,P=0.022),but no significant difference was seen in Schirmer Ⅰ test and tear film interferometry scores using SPEED-based questionnaire ( t =0.404,P =0.687 ; t =- 0.947,P =0.347 ) ; while the positive fluorescence staining rate between two groups was significantly different (x2 =0.164,P =0.685 ).When using OSDI-based questionnaire,significant difference in BUT was seen among mild,moderate and serious symptom groups ( F =11.871,P =0.000 ),and BUT in mild symptom group was delayed in comparison with moderat and serious groups( P=0.000,0.000).No significant differences were found in Schirmer Ⅰ test,tear film interferometry scores and fluorescence staining rate among three groups(F=1.432,P =0.246; F =2.799,P =0.068; x2 =6.026,P =0.050).SPEED score showed a positive correlation with OSDI score ( r =0.697,P =0.000 ). Conclusions Both OSDI and SPEED are effective tools for the evaluation of symptoms of dry eye.The two types of questionnaires are consistent in symptoms evaluation.