In response to such setbacks as inefficient medical service,costly human resources and low rate of return on capital,due to the pursuit ofMega hospitalsand extensive management of hospitals,Wuxi No.2 People's Hospital introduced the delicacy management chain to improve its management and service.This article studied its practice of delicacy management chain as follows.By means of the six gears of organization,clinic,outpatients,medical technicians,nursing,and logistics,the management chain pursues such management goals as flat management,attending-focused clinical medicine,centralized outpatient service,integrated medical examinations,vertical nursing management,and logistics outsourcing.These efforts are designed for the optimization of both scale and construction efficiency.

10.3969/j.issn.1000-8179.2013.12.009

Air Pollutants, Occupational ; analysis ; Female ; Hexanes ; analysis ; poisoning ; Humans ; Male ; Occupational Exposure ; statistics & numerical data ; Shoes

Aged ; Aged, 80 and over ; Basilar Artery ; abnormalities ; Female ; Humans ; Male ; Middle Aged ; Trigeminal Neuralgia ; etiology

To investigate the effect of Tanreqing injection on immune activity of peripheral blood lymphocytes of patients with lung cancer. The peripheral blood lymphocytes of patients with lung cancer and healthy persons were separated by the density gradient centrifugation method for subsequent experiments, with those from healthy persons as the positive control. The effect of Tanreqing injection on stimulating the proliferation of lymphocytes with phytohemagglutinin (PHA) was determined by MTT method. The effect of Tanreqing injection on the lymphocyte secretions of IFN-γ and TNF-α and the subset ratio of lymphocytes cultured separately or with Tanreqing injection of different concentrations were examined by ELISA and flow cytometry (FCM) respectively. In addition, the LDH release assay was used to detect the cytotoxicity of cytotoxic T cells (CTL) and natural killer cells (NK). According to the findings, all of immunological indexes of lymphocytes from patients with lung cancer were weaker than that of healthy persons, but with the obvious increases in proliferation activity and IFN-γ and TNF-α secretions of lymphocytes co-cultured with Tanreqing Injection (P < 0.05). Among lymphocyte subsets co-cultured with Tanreqing Injection, CD3+, CD3+ CD4+ and CD3- CD16 + 56+ cell ratios notably increased, whereas CD4+ CD25+ Treg cell ratio obviously decreased (P < 0.05). In the meantime, Tanreqing injection can markedly promote the cytotoxicities of CTL and NK (P < 0.05). In conclusion, Tanreqing injection shows a significant effect in promoting the immune activity of lymphocytes from patients with lung cancer and their anti-tumor immunity.
Cell Proliferation ; drug effects ; Cells, Cultured ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Interferon-gamma ; genetics ; immunology ; Killer Cells, Natural ; drug effects ; immunology ; Lung Neoplasms ; drug therapy ; genetics ; immunology ; physiopathology ; T-Lymphocytes, Cytotoxic ; drug effects ; immunology ; Tumor Necrosis Factor-alpha ; genetics ; immunology

Air ; analysis ; Anions ; analysis ; Chromatography, Ion Exchange ; Ions ; analysis ; Workplace

Objective:The relationship between the effect of early metabolism in 18F-FDG PET/CT and conventional CT based on the RE-CIST standard to evaluate the best objective response after chemotherapy in patients with non-small cell lung cancer (NSCLC). Meth-ods:We studied 40 patients with unresectable locally advanced or advanced NSCLC that were confirmed pathologically. The patients were 35 years old to 78 years old and included 31 males and 9 females. Three patients have unresectable stageⅢA, 8 patients have stageⅢB, 29 patients have stageⅣ, 12 patients have squamous cell carcinoma, and 28 patients have adenocarcinoma. The PET/CT for the effect of chemotherapy was evaluated in NSCLC according to the SUV standard (SUVmax reduction>30%of primary lung can-cer after one cycle of chemotherapy), and the CT for the effect of chemotherapy was evaluated on the basis of NSCLC according to the RECIST standard. The objectives of the study are as follows:compare the differences and consistency between 18F-FDG PET/CT metabol-ic response after the first cycle of chemotherapy and the RECIST best objective response after the first or second cycle of chemothera-py with the paired chi-square test and kappa test;calculate the 18F-FDG PET/CT to predict the best objective response of two cycles of chemotherapy according to RECIST on the basis of NSCLC in terms of sensitivity, specificity, accuracy, positive predictive value, and neg-ative predictive value;compare the differences in SUVmax reduction between the metabolic remission group and metabolic no relief group with the two-sample t-test. All statistical methods were 0.05 for the inspection level, and P<0.05 was considered statistically sig-nificant difference (SPSS19.0). Results:Differences were found between the first cycle of chemotherapy for the RECIST best objective response and 18F-FDG PET/CT metabolic response (χ2=5.063, P=0.021), and the results had bad consistency (Kappa=0.240, P=0.085). No differences were observed between the second cycle of chemotherapy for the RECIST best objective response and 18F-FDG PET/CT metabolic response (χ2=2.083, P=0.146);the results had good consistency (Kappa=0.413, P=0.006). The sensitivity, specificity, accura-cy, positive predictive value, and negative predictive value were 82%, 61%, 70%, 61%, and 82%, respectively. The differences in SUV-max reduction between the metabolic remission group and metabolic no relief group with the two-sample t-test were statistically sig-nificant (P<0.001). Conclusion: 18F-FDG PET/CT may predict the best objective response to chemotherapy for NSCLC patients. Com-pared with conventional CT, 18F-FDG PET/CT can be an early and accurate way to evaluate the chemotherapy effect in NSCLC.

Objective To examine the barbiturate infusion for intractable intracranial hypertension and its effect on brain tissue oxygen ( PbtO2 ). Method 60 patients with intractable intracranial hypertension were divided into tow groups, experimental group and control group. PbtO2 and intracranial pressure (ICP) were continuous monitored. Follow-up was more than 3 months and the prognosis was compared between two groups. Results When pentobarbital administration began, the mean PbtO2 [ 72 h: (26. 7 ±6. 7)mmHg] at 24h, 48h and 72h in experimental group were significantly higher than that of control group [ 72 h: ( 21. 1 ± 7. 2) mmHg ] ( P < 0. 05 ). The mean ICP [ 5 d: (2. 48 ± 1.11 ) kPa ] in the third and fifth day of experimental group were lower than that of control group [ 5 d: (3. 12 ± 1.09 ) kPa ]. Prognosis of pentobarbital group was better than control group( P < 0. 05 ). Conclusions Pentobarbital can effectively reduce intracranial pressure in patients with refractory intracranial hypertension and improve brain tissue oxygen. PbtO2 is an ideal monitoring marker, and it can predict prognosis to a certain extent.

Objective To evaluate the value of 18F-FDG PET/CT in early in vivo monitoring of tumor response to cisplatin,and analyze the relationship between 18F-FDG uptake in tumor and the corresponding pathological changes.Methods Thirty VX2 rabbits were divided into 5 groups by random number table with 6 in each group,including 4 treatment groups and 1 control group.18F-FDG PET/CT were performed before and after (6,12,24 and 36 h post-injection respectively) intravenous administration of cisplatin (7 mg/kg) in the treatment groups,respectively.The control group was injected with physiological saline followed by 18F-FDG PET/CT.The ROI was drawn and the SUVmax and T/NT ratio were calculated.The tumor necrosis rate and apoptosis index were observed by histopathologic examination.Paired t test,GamesHowell test and arcuation correlation analysis were used to analyze the data.Results Significant differences were found in SUVmax and T/NT of the control group before and after injection of physiological saline (6.58±1.67 vs 9.77±2.45,52.93±3.90 vs 29.34±3.31;t=-5.480,17.593,both P＜0.05).18F-FDG uptake decreased after 6 h post-injection of cisplatin,with the mean SUVmax decrease rate of (11.83±8.89) ％ and the mean T/NT decrease rate of (59.00±8.22)％.In the 24 h treatment group,18F-FDG uptake decreased most,and the mean SUVmax decrease rate was (42.33±33.80)％,the mean T/NT decrease rate was (83.50± 7.69) ％.The SUVmax and T/NT of those 2 groups were significantly different from those of the control group,and no difference was found between the 2 treatment groups(all P＜0.05).The changes of SUVmax and T/NT were positively correlated with apoptosis index and tumor necrosis rate (r=0.750,0.794,0.804,0.874,all P＜0.05).Conclusion 18F-FDG PET/CT is a sensitive method for monitoring early response to tumor chemotherapy in VX2 tumor-bearing rabbits at 24 h after treatment.

Objective To study the characteristics of mismatch negativity(MMN) in patients with depression.Methods MMN was recorded from 31 patients with depression and 28 age-matched controls. Results Compared with the controls, the patients with depression had prolonged latency ([189?22] ms vs [206?26] ms, P