By analyzing the situation of market competition by modern hospitals, the paper identifies the core competitiveness of the hospital as the key force to be nurtured and promoted by the hospital in its competition in the medical services market; the basic force that spaces out service levels and profits of hospitals at the same level; the unique cultural force shaped by the hospital in a long period of time; the dynamic force rising constantly to mans needs for medical and health care; the main force driving the sustainable development of the hospital in market competition. The paper also proposes five major core competitive capacities to be especially nurtured and promoted by the hospital, viz. the integrative capacity in management, the influencing capacity of specialized fields, the fighting capacity of the team, the cohesive capacity of culture, and the scheming capacity for marketing.

Objective To explore the feasibility of anti-85B and ESAT-6 monoclonal antibodies targeted contrast agent of CT by the murine acute tuberculosis animal model.Methods Preparation the targeted contrast agent of computed tomography by iodine atoms coupled with anti-85B and ESAT-6 murine monoclonal antibodies after purified.Calculate the label rate and the quality of 127Ⅰ of the targeted contrast agent solution,and dilute the contrast agent solution to the required concentration (5μg I/ml) to spare.There were twenty mice of acute tuberculosis animal model,which were divided into four groups by completely randomized digital table and each group was five animals.According to the different antibody named as 85B group and ESAT-6 group of targeted contrast agent,common contrast agent and blank control separately.The common contrast agent group was injected with diluents of iohexol,which was diluted into the same concentration with the targeted contrast agent.The control group was injected with antibody diluents pH 7.4 Phosphate Buffered Saline (PBS).All the animals were scanned before and after injection the contrast agent in different time,such as immediate,6 hours,12 hours and 24 hours.Observe the display and changes of the murine tuberculosis lesions,and measurement the CT value,which was regarded as evaluating mark.Enhancement ratio was also calculated.Two sample mean differences with t test and the multiple sample mean differences with ANOVA.Results The volume of anti-85B contrast agent solution was 2.52 ml,and the quality of antibody and 127Ⅰ were range from 210 to 255 μg and 10.5 to 16.6 μg respectively.The volume of anti-ESAT-6 contrast agent solution was 2.93 ml,and the quality of antibody and 127Ⅰ were 147 μg and 20.58 μg respectively.The lesions of the control group showed no visible density changes before and after injection of PBS.The CT value of the lung lesions in the targeted contrast agent group were gradually increased with time,and the lesion showed visible enhancement after the contrast injection twelve hours(t12),and also remained visible enhancement after injection twenty-four hours(t24)[85B group t12 =(-125.04 ± 13.58) HU,t24 =(-117.37 ± 12.28) HU and ESAT-6 group t12 =(-122.14 ± 19.01) HU,t24 =(-114.23 ± 17.08) HU],which is significant difference compared to the common contrast agent [t (85B-24 h) =4.05,t (ESAT-6-24 h) =6.39,P ＜ 0.05].Conclusions The targeted property of anti-85B and ESAT-6 murine monoclonal antibody contrast agent of CT had been partly proved by the acute tuberculosis animal model.Also provided an experimental basis for further study of tuberculosis targeted contrast agent.

Objective:To explore the possible pharmacodynamic material basis and mechanism of Shaogan Fuzi Decoction in the treatment of rheumatoid arthritis through ultra-high performance liquid chromatography-high-resolution tandem mass spectrometry (UPLC-HRMS/MS) combined with network pharmacology and molecular docking method.Methods:The blood components of Shaogan Fuzi Decoction were analyzed by UPLC-HRMS/MS; the targets of blood components in Shaogan Fuzi Decoction were predicted by PubChem database and Swiss Target Prediction database; DrugBank database, Therapeutic Target Database (TTD) and GeneCards database were used to screen rheumatoid arthritis-related targets, and Venn map of common targets was obtained; the protein interaction network was constructed by STRING database, and the key targets and key components were screened; GO function enrichment analysis and KEGG pathway enrichment analysis were performed by DAVID 6.8 database; the "blood component-target-pathway" network was constructed by Cytoscape 3.2.1 software; Autodock software was used to verify the molecular docking between the predicted key components and key targets in the network.Results:Totally 26 blood components of Shaogan Fuzi Decoction, 526 related targets, 478 related targets of rheumatoid arthritis, and 111 common targets were obtained; the key components such as tangeretin, kaempferol, glycyrrhetinic acid, liquiritigenin, quillaic acid and glabrolide were screened, which acted on key targets such as TNF, IL6, VEGFA, PTGS2, JUN and PPARG. They were mainly involved inflammatory response, steroid metabolic process, response to lipopolysaccharide, extracellular region, cytoplasm, RNA polymerase Ⅱ transcription factor activity, steroid bindingand other biological processes. It mainly regulated steroid hormone biosynthesis, PI3K-Akt signaling pathway, apoptosis, IL-17 signaling pathway, rheumatoid arthritisand other signaling pathways. Molecular docking results showed that the key components had good binding activity with key targets.Conclusion:Shaogan Fuzi Decoction may act on TNF, IL6, VEGFA, PTGS2, JUN, PPARG and other targets through tangeretin, kaempferol, glycyrrhetinic acid and other blood components to regulate PI3K-Akt and other signaling pathways, inhibiting cell proliferation and promoting apoptosis, reducing inflammation, to treat rheumatoid arthritis.