China′s economy has moved into a new normal stage.It features slower GDP growth, relaxed macro-control,economic structure upgrading,new powerhouses for economic growth.In such a situation,it is imperative for the society to realize,comply with and encourage the new normal for all fields of work.As for the healthcare sector,reform of public hospitals as a top priority has entered a crucial period of system reconstruction and effective operation.In the perspective of auditing governance mechanism as a key role in public hospital′s supervision and management system,this article tried to explore how to enable public hospitals′auditing to comply with the economic new normal.This paper puts forwards that public hospital auditing should reconstruct its system as follows:Auditing entity framework should strengthen the development of functionality and linkage among national auditing,internal auditing and social auditing,and public hospitals should try to set up their auditing committee system when necessary;Auditing contents should emphasize the multiple development and innovation of public welfare auditing,economic responsibility auditing,governance performance auditing,policy implementation effect auditing and more innovative auditing services.

Objective To analysis the effective ingredients in Huanglianjiedu decoction under different decocting conditions. Methods The detecting method of HPLC was established and the ingredients in Huanglianjiedu decoction under different decocting time and times were analyzed. Result Water- soluble glycoside of gardenoside and baicalin reached balance of dissolution within 20 min and their dissolution rate were about 82% and 60% respectively. Water-soluble alkaloids of berberine and palmatine reached balance of dissolution within 30 min and their dissolution rate were about 45%. The dissolution rate of wogonin was 31% at 60 min. The dissolution rate of Crocin-Ⅰ reached top at 20 min and fell down after 20 min. Decocting times for fat-soluble constitutes was more important than water-soluble constitutes. Conclusion The decocting condition has effect on the dissolution rate and stability of the ingredients in Huanglianjiedu decoction. The decocting condition is very important to the quality control of decoction.

Objective To evaluate the diagnostic efficiency of fiberoptic ductoscope versus galactography for nipple discharge. Methods Literatures on comparing the diagnostic value of galactography with fiberoptic ductoseope (FDS) on the nipple discharge were searched from the Cochrane library, Evidence based medicine (EBM ),PubMed,China Vip database, and 8 studies were intaked. Then the data was analyzed by software Metadisc1.4 and Review Manager5.1. Results There are 1170 patients in the 8 studies. The pooled estimates for sensitivity of FDS and galactography was 82%, 78%, and the pooled estimates for specificity was 51%, 50%, respectively. The weighted AUC (area under curve) was 0.776, 0.705, Q*values was 0.715, 0.657, respectively. The sensitivities and specificity of the 2 methods were not significantly different. The overall diagnostic efficacy of FDS was better than that of galactography. Conclusion FDS is better than galaetography in the diagnostic value of nipple discharge.

Objective To investigate the changes of waist muscle density and area in the subjects with spiral CT scan examination,and through the quantitative analysis of different age and gender to get the degree of lumbar muscle degeneration.Methods 240 cases of lumbar CT scan reconstruction images (including the patients suffering from low back pain)were collected.According to the age,20 - 29 years old group,30 - 39 years old group,40 -49 years old group,50-59 years old group,60-69 years old group,and 70-79 years old group were set up.The lumbar transverse psoas muscle,lumbar side muscle,erector spinae cross-sectional areas (CSA)and mean CT values were measured at different levels.Scanning equipment:Toshiba Activion 16-slice spiral CT scanners, acquisition range from the waist 1 to S1.Results ①Compared between the measurement results of the same age groups (except 70-79 years old group),the average CSA of the male at the same level waist was higher than the female (P <0.05).②Compared between the same level groups of 20-29 years,30-39 years and 40-49 years, there were no significant differences (P >0.05).Compared between the same level groups of 50-59 years,60-69 years and 70-79 years,there was no significant difference (P >0.05).③Compared the CSA of man’s erector spinae muscle between 40-49 years group and 50-59 years group,there were significant differences (P <0.05).④Compared the same level CSA of female between 20-29 years,30-39 years,40-49 years,50-59 years,60-69 years,70-79 years groups,and the adjacent groups,there were no significant differences (P >0.05).⑤The same level average density of erector spinae muscle was lowest compared with the psoas major muscle and quadratus lumborum muscle,and falling faster,the psoas major muscle was relatively higher.The same level average density of female’s erector spinae muscle was lower than man’s,specially in 70-79 years group.Conclusion Multi-slice spiral CT can be used to diagnose the lumbar degenerative conditions.

A total of 55 children aged under 14 years with cholecystolithiasis were treated at our hospital between January 2005 to December 2011.Their clinical data were collected and analyzed.The etiologies included pseudolithiasis (n =36),chronic hemolytic disease (n =2),obesity (n =9) and unknown (n =8).Among 50 cases on conservative treatment,42 cases were cured.Four cases underwent laparoscopic cholecystectomy.During a follow-up period of 2-4 years,there was no occurrence of significant complications.The removal of gallbladder stone was performed via laparoscopy plus choledochoscope in 1 case.There was no recurrence during a follow-up period of 2 years.Ceftriaxone sodium and obesity were the major cause of pediatric cholecystolithiasis.A proper selection of treatment regimens should be based upon the considerations of etiologies and symptoms.

AIM　To investigate the effect of 4-aminopyridine (4-AP) on ion channels of myocytes. METHODS　L-type calcium channel and sodium channel currents were recorded in guinea pig single ventricular myocyte using whole-cell patch-clamp techniques. RESULTS　4-AP, 0.1, 0.5 and 1.0 mmol*L-1 were shown to inhibit L-type calcium channel currents (ICa,L) and sodium channel currents (INa) concentration-dependently. The percentage of inhibition were (11.6±1.7)%, (37.5±8.3)% and (54.5±6.9)% (P<0.01) respectively for ICa,L, and (22.1±14.3)% (P<0.05), (39.4±8.8)% and (62.3±6.8)% (P<0.01) respectively for INa. 4-AP 0.5 mmol*L-1 shifted the I-V curves of ICa,L and INa upwardly. CONCLUSION　4-AP blocked L-type calcium channel and sodium channels in guinea-pig ventricular myocytes concentration-dependently.

Objective To discuss function of the fusion cells of human bone marrow stromal cells (BMSCs) and human myeloma cell RPMI 8226 in the pathogenesis of multiple myeloma bone disease.Methods The cells,labeled by cell tracer green fluorescent probe (CMFDA) and red fluorescent probe (CMTMR),respectively,were induced into fusion by chemical polyethylene glycol (polyethyleneglycol,PEG-1000),and cell fusion model was set up.Whether fusion cells had nucleus fusion was determined by Karyotype analysis.The expressions of stemness-related genes,SIRP α gene and DC-STAMP gene in fusion cells were identified.Results Polyethylene glycol (PEG-1000) could mediate the integration of BMSCs and RPMI 8226 cells.The number of chromosomes in more than 80 ％ the hybrid cells was about 80.Fusion cells not only showed that BMSCs,stemness-related genes of c-myc,Klf-4 and OCT-4 genes expressed positively,but also the fusion-related genes SIRPα and DC-STAMP expressed positively.Conclusion BMSCs and RPMI 8226 cells can form fusion cells,and the cells have the potential for further integration,which is one of the important reasons for the promotion of muhiple myeloma bone destruction.

Objective To discuss the correlation between SIRT3 protein and clinicopathological parameters of gastric carcinoma.Methods Immunohistochemistry and Western blot were used to detect the expression of SIRT3 in the gastric carcinoma and normal gastric tissue.The correlation between the expression of SIRT3 and clinicopathological parameters was analyzed.Results The immunohistochemistry showed that the positive expression rate of SIRT3 protein in gastric carcinoma tissue (53.8 ％,43/80) was obviously lower than that in normal gastric tissue (86.0 ％,43/50),and the expression of SIRT3 protein showed close relationship with invasion depth,lymph node metastasis and TNM stage (P ＜ 0.05),rather than the age,gender,tumor size,or differentiation status (P ＞ 0.05).The Western blot showed that the expression rate of SIRT3 protein (SIRT3/β-actin) in gastric carcinoma tissue (0.655±0.317) was lower than that in normal gastric tissue (0.803±0.329) (P ＜ 0.05).Conclusion The expression of SIRT3 protein is lower in gastric cancer than that in normal gastric tissue,and relates to invasion depth,lymph node metastasis and TNM stage.SIRT3 may inhibit the occurrence and development of gastric cancer.

Objective To evaluate the diagnostic value of the level of plasma D-dimer, lipoproteins and carcino-embry-onic antigen(CEA) in gastrointestinal cancer.Methods The plasma D-dimer ,lipoproteins,CEA and clinicopathological data of 139 gastrointestinal cancer patients and 155 normal controls were collected and analyzed .Lipoproteins included high-density lipoprotein(HDL),low-density lipoprotein(LDL) and lipoprotein a[LP(a)].SPSS 13.0 statistical software was used to analyze the sensitivity and specificity of each examination method and to find the appropriate combination .Results The plasma D-dimer,LDL,LP( a) and CEA levels were distinctly higher in patients than those in normal controls ( P<0.001).HDL levels were significantly lower in patients than those in normal controls (P<0.001).The cutoff of D-dimer was 0.495 μg/ml , the sensitivity of D-dimer was 62.6%,and the specificity was 86.5%.The cutoff of HDL was 1.025 mmol/L, the sensitivity was 72.7%,and the specificity was 85.2%.The cutoff of LDL was 3.375 mmol/L, the sensitivity was 54%,and the specificity was 82.6%.The cutoff of LP(a) was 27.3 mg/dl, the sensitivity was 58.3%,and the speci-ficity was 87.1%.The cutoff of CEA was 2.14 ng/ml, the sensitivity was 59.7%,and the specificity was 76.8%.The sensitivity and specificity of HDL +CEA were 77.7%and 88.4%, respectively.The sensitivity and specificity of HDL +D-dimer were 70.5% and 96.1%, respectively.The sensitivity of HDL +LP(a) was 76.3%,and the specificity was 93.5%.The sensitivity of D-dimer +HDL+LP(a) was 84.2%,and the specificity was 92.3%.The sensitivity of D-dimer +HDL+CEA was 87.1%, and the specificity was 85.8%.The sensitivity and specificity of HDL +LP(a) +CEA were 85.6%and 92.3%, respectively.The sensitivity of D-dimer +HDL+CEA +LP(a) was 89.9%while the specificity was 92.3%.Conclusions Plasma D-dimer and lipoproteins can serve as tumor markers in gastrointestinal cancer .Combined detection has higher sensitivity and specificity .

Objective:To evaluate the changes of metamorphopsia in patients with rhegmatogenous retinal detachment (RRD) who underwent primary vitrectomy and to analyze the correlation between macular microstructure changes and metamorphopsia.Methods:It was a retrospective clinical study. From January 2017 to January 2019, 57 patients (57 eyes) with RRD were examined and diagnosed in the Department of Ophthalmology of Baoding First Central Hospital were enrolled in this study. All patients underwent 23G PPV. All patients had retinal anatomical reduction after the first PPV. The best corrected visual acuity (BCVA), intraocular pressure, slit-lamp microscope, indirect ophthalmoscope, changes of metamorphopsia, and optical coherence tomography (OCT) were examined before PPV and 1, 6, 12 months after the operation. The BCVA examination was performed using the international standard visual acuity chart, which was converted into a logarithm of the minimum angle of resolution (logMAR) BCVA for the record. The macular fovea retinal thickness (CRT) was measured by Carl Zeiss Cirrus HD-OCT5000 instrument from Carl Zeiss Company, Germany, and the microstructural changes in the macular area were recorded, including the presence of the anterior macular membrane (ERM), cystic macular edema (CME), subretinal fluid (SRF), and the integrity of the ellipsoid zone (EZ) and outer membrane (ELM). The value of metamorphopsia (M value) was measured by the M-Chart table. The changes of BCVA, M value, and the microstructure of the macular area before and after operation were analyzed. The correlation between BCVA and M value was analyzed by Pearson correlation. Spearman correlation analysis was used to analyze the correlation between the changes of macular microstructure and BCVA and M values.Results:The mean logMAR BCVA before the operation was 1.15±0.43. At 1, 6, and 12 months after the operation, the mean logMAR BCVA was 0.62±0.17, 0.39±0.18, and 0.34±0.13, respectively. The visual acuity improved significantly after operation compared with before operation, and the difference was statistically significant ( F=119.731, P=0.000). The mean CRT before the operation was 476.0±104.1 μm. At 1, 6, and 12 months after the operation, the average CRT were 299.8±29.9, 272.2±17.8, and 261.0±19.3 μm, respectively. The average CRT after the operation was significantly lower than those before the operation ( F=185.518, P=0.000). At 1, 6, and 12 months after the operation, the mean M values were 0.62±0.54, 0.43±0.41, and 0.32±0.36, respectively; the difference was statistically significant ( F=6.568, P=0.020). After the operation, 48 eyes (84.2%, 48/57) had microstructural abnormalities in the macular area, including EZ and ELM integrity disruption, SRF, CME, and ERM. Correlation analysis showed that M value was significantly positively correlated with BCVA, CRT, and SRF height before operation ( r/ rs=0.672, 0.385, 0.932; P<0.05). There was no correlation between M value and BCVA ( r/ rs=0.503), EZ and ELM integrity ( r/ rs=0.497, 0.472), SRF ( r/ rs=0.416), CME ( r/ rs=0.821) and ERM ( r/ rs=0.632) after operation ( P>0.05). Conclusions:The BCVA is significantly increased and the metamorphopsia is improved after anatomically successful RRD surgery. Postoperative M value is highly correlated with preoperative BCVA, CRT, and SRF.