The authors first expound that Chinas WTO accession has made it extremely clear that hospital management is the key to competition. There are two aspects of the issue. One involves changing management concepts, enriching management connotations, broadening the management horizon, enhancing management levels, transforming management mentality, and readjusting management structure. The other involves the application of modern management technology. Then they discuss ways of changing hospital management from the perspective of the competition for the masses of people seeking medical service. These include: ①attracting patients with easily available service; ②heavily advertising the hospital with specific images; ③displaying quality with standardized management; ④winning the confidence of the people with reasonable pricing. Finally the authors give a detailed account of how to explore human resources, retain talented people, form optimal teams, set up rational structures and raise assessment criteria in the competition for medical talents.

For the purpose of creating a hospital culture, the present paper summarizes theories on research-oriented organizations, addresses the significance of developing a research-oriented hospital, summarizes the means and methods for developing a research-oriented hospital according to the model of a research-oriented organization, and demonstrates the effects of a research-oriented hospital and promoting functions for hospital culture.

Adolescent ; Humans ; Scoliosis ; surgery ; Spinal Fusion ; methods

The EU is an international bridge of traditional Chinese medicine (TCM), and TCM in EU is of strategic importance. In this paper the progress on policies and regulations and approved products of herbal medical products in EU in 10 years were briefly reviewed, registration regulations were systematically, studied and some typical cases were analyzed. To provide reference for successful registration of TCM in EU and implementation of international strategy of TCM, five key elements (i. e. registration classification, approval procedure, approval authority, application product and application enterprise) to break through the registration barriers on TCM in EU were putted forwards correspondingly.
Drug Approval ; European Union ; Medicine, Chinese Traditional ; Policy ; Publications ; Social Control, Formal

Objective:To investigate the expression of human telomerase reverse transcriptase(hTERT)gene in salivary gland tumors and to study its clinicopathological significance.Methods:In situ- mRNA hybridization method was used to detect the expression of hTERT mRNA in 10 cases of normal salivary gland tissues, 30 of benign salivary gland tumors and 43 of malignant salivary gland tumors.The relationship between hTERT mRNA expression and sex,age, tumor size, location, histologic differentiation of the malignant tumors was analyzed by using ?2 test.Results:hTERT expression was negative in all normal tissues. Positive rate of hTERT mRNA expression was 3.3%(1/30) and 83.7%(36/43) in benign and malignant salivary gland tumors respectively(P0.05).Conclusion:hTERT mRNA expression may be used to distinguish malignant salivary gland tumors from benign.

Objective To evaluate the risk factors for carotid atherosclerosis in patients with cerebral infarction.Methods A total of 180 patients with cerebral infarction were divided into no-plaque group (38cases) and plaque group (142 cases) on the results of Color ultrasonography.Plaque group was further divided into stable plaque subgroup (46 patients) and no-stable plaque subgroup (96 patients).Total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglyceride (TG),fibrinogen (FIB) and oxidized low density lipoprotein cholesterol (OXLDL) were recorded.The risk factors for carotid atherosclerosis in patients with cerebral infarction were analyzed.Results The percentage of hypertension,diabetes,stroke history,smoking were 88.7％(126/142),43.7％(62/142),53.5％(76/142),50.7％ (72/142) in plaque group and 52.6％(20/38),21.1％(8/38),31.6％(12/38),13.2％(5/38) in no-plaque group.The percentage of hypertension,diabetes,stroke history,smoking in plaque group were higher than those in no-plaque group,and there were significant differences (P ＜ 0.05).The age,TC,LDL-C,OXLDL,FIB were (65 ± 10) years old,(5.3 ±0.8) mmol/L,(3.4 ±0.8) mmol/L,(0.75 ±0.34) mmol/L,(4.8 ± 1.1) g/L in plaque group,and (56 ± 7) years old,(4.6 ± 0.7) mmol/L,(2.8 ± 0.7) mmol/L,(0.45 ± 0.21) mmol/L,(3.8 ± 0.9) g/L in no-plaque group.The age,TC,LDL-C,OXLDL,FIB in plaque group were higher than those in no-plaque group,and there were significant differences (P ＜ 0.05).The percentage of diabetes,stroke history,smoking and LDL-C,OXLDL were 50.0％(48/96),62.5％(60/96),56.2％(54/96),(3.7 ± 0.9) mmol/L,(0.84 ± 0.36)mmol/L in no-stable plaque subgroup,and 30.4％(14/46),34.8％(16/46),39.1％(18/46),(3.1 ± 0.7) mmol/L,(0.60 ± 0.32) mmol/L in stable plaque subgroup.The percentage of diabetes,stroke history,smoking and LDL-C,OXLDL in no-stable plaque subgroup were higher than those in stable plaque subgroup,and there were significant differences (P ＜ 0.05).Multivariate Logistic regression analysis showed that LDL-C (OR =1.724,95％ CI 1.326-2.285),OXLDL (OR =2.464,95％ CI 1.502-5.676) and diabetes (OR =1.484,95％ CI 1.005-1.739) were the independent risk factors for carotid atherosclerosis in patients with cerebral infarction.Conclusion LDL-C,OXLDL and diabetes are the independent risk factors for carotid atherosclerosis in patients with cerebral infarction.

Micromonospora distributes extensively in environment. But most of them have not been known because the limitation of isolation and taxonomic approach. The phenotypic information such as morphological, cultural and physiological characteristics have been applied widely in the taxonomy of Micromonospora. The functions of molecular methods become more and more important in the taxonomy of Micromonospra accompanying with the development of the polyphasic taxonomy. Micromonospora is one of the most important sources in finding new bioactive compounds, some of them can yield antibiotics, such as gentamicins, rafomicins and newmicins, some of them can degrade natural rubber and fibrin. It indicated in recent years’ study that some bioactive compounds with particular chemical construction could be found from Micromonospora. These compounds can identify cancer cells and kill them effectively.

Objective To compare the dosimetric differences of the targets and organs at risk (OARs) for early stage breast cancer patients receiving intensity modulated radiotherapy (IMRT) with supine or prone setups after breast conserving surgery.Methods After breast conserving surgery,15 left breast cancer patients with large and pendulous breasts were selected.Their planning CT images were acquired with supine and prone orientations respectively,based on which IMRT plans of 2 tangential fields were developed using the same optimization parameters.Treatment plans of the two setups were evaluated by comparing the target dose distribution,the doses and irradiated volumes of the heart,left lung,and right breast,and the monitor units (MUs).Results Superior conformal index (CI) was observed in the plans of prone setup than the supine cases (0.79 ± 0.05 vs.0.72 ± 0.04,W =138,P ＜ 0.01).The homogeneity index (HI) of prone positioning was also better than that of supine setup (1.09 ±0.01 vs.1.12 ± 0.02,t =-4.7,P ＜0.01).The planning target volume (PTV) receiving 95％ of prescribed dose (V95％),and the minimum doses (Dmin) of the prone cases were significantly higher than the supine patients (t =7.1,6.4,P＜0.01).Higher mean doses (D) were observed in prone cases (W=153,P＜0.01).The maximum doses (Dmax) of the supine plans were lower than the prone cases (t =-3.6,P ＜0.01).The right breast volumes receiving 5 Gy doses or higher (V5) were less in the supine cases than the prone plans (W=160,P ＜0.01).The heart volumes received no less than 30 Gy (V30),D of the heart,and the left lung volumes received higher than 20 Gy or 5 Gy (V20,V5) of the supine plans were significantly higher than the prone cases (W =133,120,120,P ＜0.01).No significant difference was observed on the MUs.Conclusions For cancer patients with large and pendulous breasts receiving IMRT after breast conserving surgery,prone setup leads to better homogeneity of target dose distribution,and reduces the doses and irradiated volumes of the heart and lungs.

Objective To evaluate the efficacy and safety of etoricoxib and meloxicam in the treatment of patients with acute gout. Methods A randomized,active comparator study was conducted at outpatients and inpatients in our hospital from January 2009 to July 2010.A total of 84patients aged (63.7± 11.0) years with an acute attack of gout were treated with etoricoxib 120 mg/d (n =48),or meloxicam 15 mg/d (n =36) for 7 d.The patient's assessment of joint pain (0- 4 point Likert scale) at drug treatment for 2-5 d was considered as the primary efficacy end point,4 h after firstly takiug the drug and 2-8 d after treatment as the secondary efficacy end point.The starting efficacy was determined until pain relieved by patient himself. The safety was assessed by adverse experiences and indexes including leucocyte, platelet,crcatinine, uric acid,alanine transaminase (ALT),aspartate transaminase (AST) and mean artery pressure(MAP). Results In 84 patients,3cases (8.3％) in meloxicam treatment and 15 cases (31.2％) in etoricoxib treatment (among which 13 cases finished treatment) discontinued therapy.The improvement scores of joint pain were (-0.41 ±0.35 vs.-0.19±0.30,P=0.005) at4 h after firstly taking the drug,(-1.66±0.58 vs. 1.38±0.44,P=0.018)at drug treatment for 2 -5 d,( - 1.83 ± 0.60 vs.- 1.85 ± 0.53,P=0.9) at 2 8 d after treatment,and (-2.64±0.45 vs. - 2.38±0.37,P=0.000) post-treatment higher than pre treatment.The starting time of pain relieving were (4.0 ± 4.6) h in etoricoxib treatment and (12.1±5.7) h in meloxicam treatment. The levels of leucocyte were decreased after treatment as compared with before treatment in both two drug treatments(P＜0.05),while no differences were found in platelet.creatinine,uric acid,ALT and AST.MAP after etoricoxib treatment was increased compared with pretreatment ( P ＜ 0.05 ). Drug related adverse experiences appeared in 15 cases (31.2 ％ ) in etoricoxib treatment and 12 cases(33.3 ％ ) in meloxicam treatment(P=1.000).The ratio of gastrointestinal tract-related adverse effects in meloxicam treatment was higher than in etoricoxib (22.2％ vs.6.2％,P＜ 0.05),while adverse effects on cardiovascular in etoricoxib treatment were comparable to that of meloxicam (16.7 ％ and 11.1 ％,P＞0.05). Conclusions Etoricoxib at a dose of 120 mg once daily may be more effective than meloxicam for acute gout in aspects of safety and tolerance.

Purpose: To explore the clinical value of 99mTc-MIBI imaging in differentiating malignancies from benign breast masses. Methods: 195 patients underwent the examination for 99m Tc-MIBI. Comparative diagnosis was done by postoperative pathology in all cases. Results: 69 of the 84 cases of breast cancer were preoperatively diagnosed by 99mTc-MIBI, the causes of false-negative results were small size of the mass and the higher degree of malignancy. 102 of the 111 patients with benign lesions were scintimammographically negative, the cause of false-positive results was large fibroadenomas with surplus blood supply. The sensitivity was 82. 1%, specificity was 92.0%, and the diagnostic accuracy was 89.2%. Conclusions: 99mTc-MIBI examination is an effective, simple and noninvasive diagnostic method for primary breast cancer.