To a greater or lesser extent, the following shortcomings can be found in the administration of various hospitals in China: overlapping institutional functions, aging age structure, low-level specialization, low efficiency, serious lack of reserve force in the contingent of administrators, and lack of competition in the mechanism of personnel employment. To remove these roadblocks to hospital development, the hospital the author works with adopted a series of measures, including readjustment of functions and combination of office work; change of job without change of rank and transfer to other institutions; flow of personnel to service and other profit-making departments; retirement ahead of schedule. The measures resulted in the reduction of administrative personnel by 16.2%, the reduction of administrative expenditure by about 180 thousand yuan per annum, the reduction of the average age of the administrators by 3 years, the rise of the proportion of administrators with a college degree and above from 45.9% to 56.5%, and the enhancement of the administrators awareness of competition, cost, service, profit and efficiency.

The development of formulas in the Ming Dynasty surpassed the previous dynasties in range and depth.The main achievements of formulas were not only the coming out of Puji Fang and Yifang Kao,but also the diversity of formulas nomenclature and variation,initial perfection of formulas classification and composition,continuous invention of new distinctive formulas,steady increment of remedy books and wide application of preparations.

Objective To study the protective mechanism of S-adenosylmethionine ( SAM) underlying liver injury induced by lipopolysaccharides ( LPS). Methods One hundred BABL/c mice were randomly divided into LPS group and SAM group. Mice in LPS group were intraperitoneally injected with 10 mg/kg LPS,and the mice in SAM group were injected with 100 mg/kg SAM 2 h before receiving the same dose of LPS. The survival rate of mice in 2 groups was recorded in 24,48,72 and 120 h after LPS injection. Histopathological changes in liver of mice were examined in 0,1,3,6,12 and 24 h after LPS injection. Tumor necrosis factor-? ( TNF-?) and interleukin-10 ( IL-10) levels in serum were measured by ELISA analysis at above time points. Expression of Toll-like receptor 4 ( TLR4) and liver X receptor ? ( LXR?) in hepatic tissues was detected by immunohistochemistry and Western blotting. Results SAM increased the survival rate of mice from 50. 0% ,40. 0% ,30. 0% ,and 30. 0% before LPS injection to 80. 0% ,70. 0% ,60. 0% ,and 50. 0% after its injection ( P

S-adenosylmethionine(SAM) is a physiologically active molecule in all the organizations and the human body fluids, and it is important to participate in a variety of biochemical reactions, the regulation of liver regeneration, liver cells differentiation and various sensitivity of the injury. The SAM affects the liver through a variety of ways. It is confirmed that the SAM and MTA can block the LPS-induced TNF-α of Kupffer cells to protect the liver. In a word, S-adenosylmethionine may be beneficial to LPS-induced liver in-jury in clinical treatment.

Objective To evaluate the curative effect of Keli-Paoxi power for the treatment of acute paronychia. Methods A total of 144 patients with acute paronychia were randomly divided into a Keli-Paoxi power group, a mupirocin ointment group and an ethanol soaking group, 48 in each group. All patients were treated for 3 weeks and followed-up for 2 months. The time to regression of redness and swelling in the nail groove was recorded. The Visual Analogue Scale (VAS) was used to assess tenderness. The curative effects were evaluated, and recurrence of paronychia was recorded. Results The time to regression of redness and swelling in the nail groove in the Keli-Paoxi power group (2.2 ± 0.6 d) was significantly shorter than that in the mupirocin ointment group (8.1 ± 1.7 d) or ethanol soaking group (7.9 ± 1.2 d; F=344.597, P<0.01). The VAS Scores in the Keli-Paoxi power group (1.2 ± 0.2) was significantly lower than that in the mupirocin ointment group (3.2 ± 0.3) or ethanol soaking group (3.1 ± 0.3; F=831.273, P<0.01). The total effective rate in the Keli-Paoxi power group (100.0%, 48/48) was significantly higher than that in the mupirocin ointment group (83.3%, 40/48) or ethanol soaking group (81.3%, 39/48; χ2=9.700, P=0.008). The recurrence rate of paronychia in the Keli-Paoxi power group (2.1%, 1/48) was significantly lower than that in the mupirocin ointment group (16.7%, 8/48) or ethanol soaking group (14.6%, 7/48; χ2=6.000, P=0.049) at 2 months follow-up. Conclusions Keli-Paoxi power can alleviate tenderness, shorten the time to regression of redness and swelling in the nail groove, decraese recurrence in patients with acute paronychia. The curative effect of Keli-Paoxi power is superior to mupirocin ointment and ethanol soaking in the treatment of acute paronychia.

Objective:To observe the efficacy of acupuncture plus tuina therapy for insomnia.
Methods:Totally 100 eligible patients were randomized into a treatment group (n=51) and a control group (n=49) by using the random number table. The treatment group was intervened by acupuncture at Baihui (GV 20), Fengchi (GB 20), Wangu (GB 12), Shenting (GV 24), Anmian [Extra, locates at the midpoint between Yiming (EX-HN 14) and Fengchi (GB 20)], and Neiguan (PC 6) plus tuina treatment; the control group was intervened by acupuncture alone. For both groups, the treatment was given once a day, 10 sessions as a treatment course, and the efficacies were evaluated and compared after 3 treatment courses.
Results:Of the 51 subjects in the treatment group, 46 cases completed 3 treatment courses, and 17 cases were cured, 18 cases showed marked efficacy, 7 cases were improved, 4 cases had invalid result, and the total effective rate was 91.3%. Of the 49 subjects in the control group, 46 cases completed 3 treatment courses, and 8 cases were cured, 12 cases showed marked efficacy, 14 cases were improved, 12 cases had invalid result, and the total effective rate was 73.9%. The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05).
Conclusion:Acupuncture plus tuina can calm the mind and activate meridian qi in treating insomnia, and it can produce a more significant efficacy than pure acupuncture treatment.

Objective To analyze clinical distribution and change in drug resistance of Acinetobacter baumannii (A.baumannii)in 2009-2013,guide clinical rational antimicrobial use,and reduce healthcare-associated infection rate.Methods 919 A.baumannii isolates were isolated from inpatients and outpatients in a hospital between Janu-ary 2009 and December 2013,specimen and department sources,as well as change in drug resistance of A.bauman-nii were analyzed.Results A total of 10 273 pathogens were isolated from 2009 to 2013,the constituent ratio of A.baumannii in each year was 7.98%(n=93),11.31%(n=155),10.22%(n=185),7.73%(n=217),and 8.62%(n=269)respectively;the constituent ratio of imipenem-resistant A.baumannii was 24.73%,38.06%,71.89%, 64.52%,and 86.99% respectively;the main specimen source was sputum (83.68%);the major department sources were intensive care unit(ICU,39.28%),department of neurology (20.78%),and department of respiratory medi-cine(8.60%).The resistant rate of A.baumannii to most antimicrobial agents increased,the resistant rates to imi-penem and piperacillin/tazobactam increased from 24.73% and 4.44% in 2009 to 86.99% and 86.25% in 2013 re-spectively;resistant rate to sulphamethoxazole/trimethoprim decreased from 91.30% in 2009 to 27.14% in 2013;in 2013,except resistant rates to amikacin and sulphamethoxazole/trimethoprim were low (20.82% and 27.14%respectively),resistant rates to the other 11 kinds of antimicrobial agents were all >83.64%.Conclusion The iso-lation rate of A.baumannii is high in this hospital,the main specimen source is sputum,the main department source is ICU;antimicrobial resistant rate of A.baumannii is high,prevention and control of infection and trans-mission of A.baumannii should be strengthened.

Objective To investigate the distribution of the Bauman acinetobacter baumannii (IRAB) resisted to imipenem and character of drug resistance.Methods Retrospective analyzed 517 strains of IRAB and 319 strains of imipenem drug resistance of acinetobacter baumannii from South Africa (not IRAB) by VITEK 2 compact automatic bacterial culture identification.Results IRAB positive rate was 61.8％ (517/836).The main source of IRAB was from sputum(85.5％ (442/517)).The constitute ratio of main areas in IRAB was ICU ward (55.9％) and only 7.8％ in non-IRAB.The resistant rate of IRAB to amikacin was 27.2％.The resistant rate of non-IRAB to Amikacin and piperacillin/tazobactam were 8.0％ (21/262),8.2％ (26/317),suggesting the good antibacterial activity.In terms of rate of resistance drug,apart from Cefazolin,Cefotetan,Cotrimoxazole,Nitrofurantoin,the sort of antibacterial drugs against IRAB was obviously higher than that of non-IRAB,and difference was statistically significant (P ＜ 0.05).Conclusion Drug resistance surveillance should be strengthened because of high detection rate and drug resistance in ICU in terms of IRAB.Combination therapy and related intervention measures might effective control of infection and IRAB.

Objective To compare distribution and drug resistance of Acinetobacter baumannii specimen in the intensive care unit(ICU) and the ICU.Methods Retrospective analysis ICU of 1 079 strains isolated and the 8 413 strains of bacteria isolated from ICU , Bacteria identification and drug sensitive test instrument using VITEK 2 Compact automatic bacterial culture identification .Results Most ICU Acinetobacter baumannii separation , form (29.2%) was significantly higher than the ICU (6.2%),the difference was statistically significant (χ2 =625.955, P<0.05).ICU imine resistant Acinetobacter baumannii from south (IRAB)detection rate(91.7%)was significantly higher(43.5%) than the ICU,difference was statistically significant (χ2 =193.541,P<0.05);Specimens of ICU and the ICU isolated bacteria were mainly comes from sputum ,constitute a ratio of 64.0%and 32.9%respectively. ICU and the separation of the ICU Acinetobacter baumannii to amikacin resistant rate was low (20.0%-21.6%),the separation of ICU Acinetobacter baumannii for three or four generation of cephalosporin , composite inhibitor drugs , penicillium carbon alkene ,quinolone antibacterial drugs ,significantly higher percentages of ICU ,difference was statis-tically significant(χ2 =146.124,104.407,253.171,195.646,186.580,all P<0.05).Conclusion Multiple drug resistance of Acinetobacter baumannii in ICU detection rate is high ,the bacteria monitoring should be strengthened , and the rational use of drugs ,reduce the drug resistance of bacteria .