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 observe the effects of cinepazide maleate and nimodipine in improving the neurological function in patients with hypertensive cerebral hemorrhage after microtraumatic craniopuncture.Methods Seventy-eight patients with hypertensive cerebral hemorrhage were randomly divided into 2 groups,cinepazide maleate group (39 patients)and nimodipine group(39 patients).After 3 days operated with the microtraumatic craniopuncture,cinepazide maleate group used the amount 160mg cinepazide maleate mixed with sodium chloride injection(500ml,concentration 0.9%),and the nimodipine group uesd nimodipine(4mg)mixed with the same injection.Both the patients of the 2 groups were given intravenous drip once a day,then after continuous 14 days,the general information and the improvement of nerve were observeed.Results The total improvement rate and the improvement rate of nervous symptom was 87.2%and 61.5%respectively,in comparison,the nimodipine group was 64.1%and 39.9%.Conclusion Cinepazide maleate was better than nimodipine in improving chnical symptoms and the neurological deficit of the patients with hypertensive cerebral hemorrhage after microtraumatic craniopuncture.

Objective To investigate the CT features of pulmonary mucosa-associated lymphoid tissue (MALT)lymphoma. Methods The data of 20 cases with pathologically confirmed pulmonary MALT lymphoma were collected.All cases underwent CT plain and enhanced scan,and the CT features were analyzed retrospectively.Results Among the 20 cases,15 cases showed multiple consolidations,accompanied by mass and small nodules,1 case had solitary consolidation with multiple micronodules,2 cases had solitary consolidation,2 cases had diffuse micronodules.The sign of dilated air bronchograms was found in 10 cases with pulmonary consolidation lesions, reaching the margin of lesion.All lesions and masses were mildly and moderately homogenous enhanced.Pulmonary thin-wall cystic cavity was seen in 7 cases of diseased tissue and surrounding lung tissue.Conclusion CT manifestation of pulmonary MALT lymphoma mainly shows multiple lung consolidation,which includes the signs of consolidation with dilated air bronchograms,homogenous enhancement, and accompanying with signs such as mass,micronodules and pulmonary thin-wall cystic cavity.

Objective To observe the effects of Shengxue Tongbian Granules on colonic myoelectricity and Ca2+/CaM/MLCK signaling pathway in rats with slow transit constipation(STC)of blood deficiency and intestinal dryness syndrome;To explore its mechanism for the treatment of STC.Methods The STC model of blood deficiency and intestinal dryness syndrome was established by intragastric administration of loperamide combined with tail bloodletting.The rats were divided into control group,model group,mosapride citrate group and Shengxue Tongbian Granules group,with 8 rats in each group.The administration group was given corresponding drugs by gavage for 14 days.The general condition of rats before and after treatment was observed,the fecal water content was detected,the slow wave frequency,amplitude,and coefficient of variation of colonic electromyography were detected using a biological function experimental system,and intestinal propulsion rate was detected.HE staining was used to observe the pathological changes of colon tissue,the concentration of Ca2+ in colonic smooth muscle cells was detected by colorimetry,the expression of Cx43,calmodulin(CaM),myosin light chain kinase(MLCK)and p-MLC20 in smooth muscle tissue were detected by Western blot.Results Compared with the control group,the body mass,fecal water content and intestinal propulsion rate of rats in the model group decreased(P<0.01),the slow wave frequency of colonic electromyography slowed down,the coefficient of variation of frequency increased(P<0.01),and the amplitude and coefficient of variation of slow wave increased(P<0.01);colonic mucosal structure was damaged,with visible inflammatory changes and significant erosion,and the concentration of Ca2+ and the expressions of Cx43,CaM,MLCK,p-MLC20 proteins in colonic smooth muscle cells were significantly decreased(P<0.01).Compared with the model group,the body mass,fecal water content and intestinal propulsion rate of the rats in the mosapride citrate group and the Shengxue Tongbian Granules group significantly increased(P<0.05,P<0.01),the slow wave frequency of colonic electromyography increased and the coefficient of variation of frequency decreased(P<0.01),and the slow wave amplitude and amplitude variation coefficient decreased(P<0.05,P<0.01);the colonic mucosal structure was relatively intact,the erosion situation was improved,and the Ca2+ concentration,Cx43,CaM,MLCK and p-MLC20 protein expressions in colonic smooth muscle cells significantly increased(P<0.01).Conclusion Shengxue Tongbian Granules can improve defecation symptoms and promote colonic motility in STC rats with blood deficiency and intestinal dryness syndrome,which may be related to regulating colonic myoelectric rhythm and activating Ca2+/CaM/MLCK signaling pathway.

Objective: To establish an HPLC fingerprint of Caryophylli flos. to provide reference for the overall quality evaluation of the herb. Methods: The fingerprint of Caryophylli flos. was established by HPLC, and eugenol was used as the reference peak for the exploration of HPLC conditions. The fingerprint of Caryophylli flos. was established with acetonitrile-0. 2% phosphoric acid as the mobile phase with gradient elution. Results: A total of 17 characteristic common peaks were obtained by HPLC analysis, and among them, five common constituents including eugenol, ferulic acid, quercetin, kaempferol and isorhamnetin were calibrated. The similari-ties of chromatographic fingerprint of Caryophylli flos. from 10 different origins were above 0. 900, which was in line with the basic re-quirement of fingerprint similarity evaluation. Conclusion: The study provides experimental basis for improving the quality evaluation system of Caryophylli flos. , and provides reference for a comprehensive quality assessment of Caryophylli flos. .

Objective: To analyze and compare the volatile components in Smilax glabra Robx. and its adulterant Smilax china L. . Methods: The volatile components in Smilax glabra Robx. and Smilax china L. were analyzed by head space solid phase micro-extraction (HS-SPME) combined with gas chromatography-mass spectrometry ( GC-MS). The relative percentage of each component was calculated by area normalization method. Results: Totally 24 components were detected out from Smilax glabra Robx. , and among them, 20 components were identified, which accounted for 97. 04% of the volatile components. Totally 21 components were detected out from Smilax china L. , and among them, 15 components were identified, which accounted for 77. 76% of the volatile components. Conclusion: The composition and content of volatile components in Smilax glabra Robx. and its adulterant Smilax china L. are differ-ent. The method can provide scientific basis for the identification of Smilax glabra Robx. and its adulterants.

Objective To establish an artificial intelligence deep learning model using clinical colonoscopy images and video to assist the diagnosis by colonoscopy. Methods More than 600000 colonoscopy images were collected in endoscopic center of the Second Affiliated Hospital of Zhejiang University School of Medicine from 2014 to 2018, and endoscopic experts recorded a large number of high-quality operation video of colonoscopy as analysis data. After repeated discussion by six experts, the classified intestinal sites and pathological features were determined, and fuzzy and confusable images were deleted. The final selection result was approximately 1 out of 4. And then the features of images were marked using an independently developed software. The deep learning algorithm was developed using TensorFlow platform of Google. Results After repeated comparison and analysis of the results of machine training and judgment results combined with pathology from endoscopic experts, the sensitivity of the model for some diseases ( such as colon polyps) was 99％ under laboratory conditions. In the clinical colonoscopy test, the sensitivity, specificity, and overall accuracy of this model for diagnosis of colon polyps were 98. 30％(4187/4259), 88. 10％ (17620/20000), and 92. 92％ [2×98. 30％×88. 10％/(98. 30％+88. 10％)], respectively. The sensitivity and specificity for ulcerative colitis were 78. 32％ ( 2671/3410) , and 67. 06％(13412/20000), respectively. The diagnosis time spent on a single image was 0. 5±0. 03 s, and it was the real time for application, including system recognition, text prompt in video image, background record and storage. Conclusion The artificial intelligence assisted diagnosis model developed by our team can identify colonic polyps, colorectal cancer, colorectal eminence, colonic diverticulum, ulcerative colitis, etc. The auxiliary diagnosis model of colon disease can guide beginners to carry out colonoscopy, and can improve lesion detection rate, reduce misdiagnosis rate, and improve the overall operating efficiency of endoscopic center, which is conducive to the quality control of colonoscopy.

Objective: To analyze and compare the difference in volatile components in Achyranthesbidentatae Radix, salt-pro-cessed product of Achyranthes bidentatae Radix and wine-processed product of Achyranthes bidentatae Radix. Methods:Headspace sol-id-phase microextraction ( HS-SPME) was used to extract the volatile components from Achyranthes bidentatae Radix and the two pro-cessed product of Achyranthes bidentatae radix. The chemical compositions were analyzed by gas chromatography-mass spectrometry ( GC-MS) , and their relative mass fraction of each component was determined by an area normalization method. Results:A total of 38 chemical components were identified, and 23, 16 and 15 components were respectively identified from Achyranthes bidentatae Radix, the salt-processed product of Achyranthes bidentatae Radix and the wine-processed product of Achyranthes bidentatae Radix accounted for 79. 14%, 49. 80% and 44. 57% of the total content of volatile components, respectively. There were 4 types of common volatile chemical constituents in the three products. Compared with Achyranthes bidentatae Radix, 10 types of new compounds were produced and 17 types of old compounds disappeared in the salt-processed product, and 9 types of new compounds were produced and 17 types of old compounds disappeared in the wine-processed product. Conclusion:Different processing methods have some influence on the type and the content of the volatile components in Achyranthes bidentatae Radix. Using HS-SPME-GC-MS combination technique can quickly and effectively obtain the volatile components information for Achyranthes bidentatae Radix, which can provide scientific reference for the quality evaluation and application of the processed products of Achyranthes bidentatae Radix.

Objective: To analyze and compare the difference in volatile components in Achyranthesbidentatae Radix, salt-pro-cessed product of Achyranthes bidentatae Radix and wine-processed product of Achyranthes bidentatae Radix. Methods:Headspace sol-id-phase microextraction ( HS-SPME) was used to extract the volatile components from Achyranthes bidentatae Radix and the two pro-cessed product of Achyranthes bidentatae radix. The chemical compositions were analyzed by gas chromatography-mass spectrometry ( GC-MS) , and their relative mass fraction of each component was determined by an area normalization method. Results:A total of 38 chemical components were identified, and 23, 16 and 15 components were respectively identified from Achyranthes bidentatae Radix, the salt-processed product of Achyranthes bidentatae Radix and the wine-processed product of Achyranthes bidentatae Radix accounted for 79. 14%, 49. 80% and 44. 57% of the total content of volatile components, respectively. There were 4 types of common volatile chemical constituents in the three products. Compared with Achyranthes bidentatae Radix, 10 types of new compounds were produced and 17 types of old compounds disappeared in the salt-processed product, and 9 types of new compounds were produced and 17 types of old compounds disappeared in the wine-processed product. Conclusion:Different processing methods have some influence on the type and the content of the volatile components in Achyranthes bidentatae Radix. Using HS-SPME-GC-MS combination technique can quickly and effectively obtain the volatile components information for Achyranthes bidentatae Radix, which can provide scientific reference for the quality evaluation and application of the processed products of Achyranthes bidentatae Radix.

Objective:To analyze the volatile components in Violae herba and its mixed product Corydalis bungeanae herba, and distinguish Violae herba from Corydalis bungeanae herba. Methods:The volatile constituents in Violae herba and Corydalis bungeanae herba were extracted by solid phase micro-extraction(SPME),and then analyzed by GC-MS. Results:A total of 62 constituents were detected out,and among them,42 compounds were identified, which mainly were olefins, ketones and aldehydes. Totally 43 peaks were isolated from Violae herba,and among them,28 components were identified, which accounted for 66.93% of the total volatile oil. Totally 22 peaks were isolated from Corydalis bungeanae herba,and among them,17 components were identified,which accounted for 97.02% of the total volatile oil. Conclusion:The volatile components in Violae herba and its mixed product are different in their peak types of total ion chromatograms and chemical compositions with only three same components in total. The highest content of the volatile components in Violae herba is 2-pentanoyl furan (18.01%), and that in Corydalis bungeanae herba is 1-caryophyllene (46. 06%). This test method is fast and stable,which can be used to distinguish Violae herba from Corydalis bungeanae herba.