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.

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.

Objective To evaluate the accuracy of target-controlled infusion (TCI) of propofol using pharmacokinetic parameters reported by Marsh to predict plasma propofol concentration in Chinese. MethodsTwenty-two ASA I - II patients were divided into two groups: group Y aged65 yr ( n = 11). Patients with liver, kidney or cardiovascular diseases were excluded. The patients were premedicated with pethidine 50mg and phenobarhital 0.1 g im. Radial artery and internal jugular vein(IJV) were cannulated. The pharmacokinetic parameters incorporated in the Graseby 3500 pump we used were: V1=228 ml-kg-1 , K10 =0.119 min-1 ,K12=0.112 min-1, K2l=0.055min-1 , K13 =0.0419 min-1 ,K31 =0.0033 min-1. Target concentration was started with 2ug-ml-1 and increased at increment of 1ugml-1 until loss of consciousness. The patient was then intubated. When target concentration of propofol was increased, the concentration of inhalation anesthetic was reduced to maintain hemodynamic stability. When target concentration of propofol was increased, arterial blood sample was taken 1-3 times for determination of plasma propofol concentration measured by HPLC (Agilent 1100) . Then blood samples every 10-15 min. For each sample prediction error(PE) and constancy error(CE) were calculated. For each patient median prediction error(MDPE), median absolute prediction error(MDAPE) . Median absolute constancy error (MDACE) and median constancy error (MDCE) were calculated.ResultsThere was remarkable initial overshot. PE and absolute PE were 63.3 % and 66.2 % in group E and 62.1 % and 62.7% in group Y. CE and absolute CE were -0.3% and 12.7% in group E and 0.6% and 13.5% in group Y. The median value of MDPE ( = the median value of MDAPE) was 78.1 % in group E and 66.1% in group Y. The median value of MDCE was 0.2% (group E) and 0.8% (group Y) and MDACE was 12.5% (group E) and 13.5% (group Y) . The measured concentrations were significantly linearly correlated with the premedicated concentrations. Conclusion TCI system with propofolpharmacokinetic parameters reported by Marsh can lead to initial overshot and underestimate the measured plasma propofol concentration but it can maintain a stable plasma concentration