Objective To investigate the combined detection of serum cystatin C (Cys‐C ) and homocysteine (Hcy) for the diagnosis of early renal damage in diabetic children. Methods Data of 97 cases of diabetic children were collected in our hospital. According to the levels of 24 hUAER ,diabetic children were divided into <30 mg group (n=34) ,30~299 mg group (n=42) ,and ≥300 mg group (n=21). 40 cases of healthy children were selected as control group (NC). Laboratory indexes were compared among different groups. The critical values of Cys‐C and Hcy in early diagnosis of renal damage were calculated by receiver operating curve (ROC). Results The levels of Cys‐C and Hcy in <30 mg group were significantly higher than in NC group [Cys‐C (1.04 ± 0.26 ) vs(0.79 ± 0.21 ) mg/L ,Hcy (13.09 ± 2.15) vs(8.57 ± 1.24)μmol/L ,respectively ,P< 0.05]. When Cys‐C cutoff point took 1.02 mg/L ,the diagnosis sensitivity for diabetic nephropathy diagnosis was 86.09% and the specificity was 83.28% ,the maximum diagnostic index reached 1.6937 ,ROC area under the curve was 0.841.When Hcy threshold took 13.00 μmol/L ,the sensitivity was 83.98% and the specificity was 79.24% ,with the maximum diagnostic index 1.6322 and ROC area 0.795.Cys‐C combined with Hcy had a sensitivity of 92.38% and a specificity of 89.17% ,with the maximum diagnostic index 1.764 and ROC area 0.928. Conclusion Cys‐C combined with Hcy detection for early diagnosis of renal injury in diabetic children has important clinical value.

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.

The authors probed systematically into the delicacy management measures adopted by the hospital in its internal mechanism reform, innovative medical service model, human resource optimization, and its performance appraisal system reform. Discussions in the paper include such topics as flat management for hospitals,intensification,centralization and integration in diagnose and treatment, as well as vertical nursing management, and the outsourced logistic services. The methods and paths to achieve these goals are summarized as “preciseness, accuracy, carefulness, and strictness”.

Objective To investigate the role of NF-κB in aldosterone-1％NaCl-induced renal injury in uninephrectimized SD rats and the potential mechanisms.Methods Thirty-teo male SD rats were uninephrectomized and treated for 4 weeks.Rats were divided into four groups randomly:control group (n=8),1％NaCl group (1％NaCl in chow,n=8),aldosterone group (1％NaCl in chow,0.75 μg/h aldosterone delayed relase by osmotic mini-pump,SC,n=8),PDTC group (1％NaCl in chow,0.75 μg/h aldosterone,SC,100 mg/kg PDTC,IG,n=8).Systolic blood pressure (SBP),urinary protein,renal function and renal morphologic were observed.The expression of intercellular cell adhesion molecule 1 (ICAM-1) and connective tissue growth factor (CTGF) were measured respectively by Western blotting and real-time PCR.The activity and location of NF-κB in renal cortex were detected by electrophoretic mobility shift assay (EMSA) and immunohistochemisty.Results Rats of aldosterone group exhibited higher blood pressure and more serious renal injury characterized by proteinuria,glomerular sclerosis compared with rats of the 1％ NaCl group.Protein and mRNA levels of ICAM-1 and CTGF were significantly increased inaldosterone group rats than those in 1％NaCl group (all P＜0.05).Moreover,all these changes were associated with an increase in NF-κB activity.Treatment with PDTC which is a specific inhibitor of NF-κB notably alleviated SBP,proteinuria and renal injury in aldosterone-infused rats.Furthermore,PDTC markedly reduced the expression of ICAM-1 and CTGF (all P＜0.05).Conclusion PDTC can alleviate aldosterone-1％NaCl-induced renal injury in uninephrectimized SD rats by preventing the expression of ICAM-1 and CTGF.

Aim To evaluate the effects of ferulic acid ( FA ) on lipopolysaccharide ( LPS )-induced neuroin-flammation in microglia cells and its potential mecha-nisms. Methods Microglial activation was induced by stimulation with LPS, and the effects of FA pretreat-ment on microglial activation and production of proin-flammatory mediators, nitric oxide/iNOS were investi-gated. The role of the mitogen-activated protein kinases in the antiinflammatory actions of FA in LPS-stimulated microglia was further elucidated. Results Cell viabil-ity experiments revealed that FA did not produce cyto-toxicity in microglia. FA significantly inhibited LPS-in-duced production of tumour necrosis factor-alpha ( TNF-α) , interleukin-6 ( IL-6 ) , interleukin-1 beta ( IL-1β) , and nitric oxide ( NO ) . Protein and mRNA levels of COX-2 and inducible nitric oxide synthase ( iNOS) were also attenuated by FA. Further experi-ments on intracellular signalling mechanisms showed that inhibition of extracellular regulated kinase ( ERK) contributed to the anti-neuroinflammatory actions of FA. Conclusion The results suggest that FA inhibits LPS-induced microglial inflammation by partial targe-ting of ERK signalling and attenuation of ERK.

The ongoing health reform is bringing reforms of public hospitals under spotlight in China, attracting growing attention onto its progress and roadblocks. Probing into the "three steps" of public hospital system reform in Wuxi, this article analyzed such a reform in the city. It described the measures and initial outcomes gained in such fields as the hospital trusteeship reform, the separation of hospital regulation from its administration, and the hospital board system. Citing the case of Wuxi No. 2 People's hospital as an example, the authors introduced the innovative efforts made in hospital internal mechanism, management innovation, medical service model, hospital connotation construction, and talents cultivation.

Objective To construct a recombinant adenovirus vector containing the gene of major histocompatibility complex(MHC)class Ⅱ transactivator(C Ⅱ TA).Methods The restriction fragment of CIITA was inserted into pUC57 vector with EeoR Ⅰ and Xho Ⅰ.Then,recombinant plasmid pShutde-GFP-CMV CⅡTA was constructed with EcoR Ⅰ and Sal Ⅰ,and was confirmed by restriction enzyme digestion and sequeneing.After the treatment with Ⅰ-Ceu Ⅰ and Ⅰ-See Ⅰ,the fragment C Ⅱ TA from recombinant plasmid DShuttle-GFP-CMV.CⅡTA Was inserted into vector pAdxsi.And the pAdxsi-GFP-C Ⅱ TA wag packed into liposome,and was transfected to 293 cens.Results Recombinant plasmid pShuttle-GFP-CMV-C Ⅱ TA Was constructed successfully. After packed into vector pAdxsi, and transfected to 293 cells, significant virus Dlaques were observed,which showed the successful homologous recombination.The titer of the purified AdC Ⅱ TA was 2.0×10~(11) PFU/ml.Conclusions Recombinant adenovirus AdC Ⅱ TA containing gene of MHC class Ⅱ transactivator was established successfully.

Objective In order to choose a suitable method in detecting MRS,the detection rate,sensitivity and specificity of Vitek-32 auto microbacteria indentity system,oxacillin agar dilution test,cefoxitin disk diffusion test and PCR for mecA gene are evaluated.Methods MRSA and MRCNS are detected by the four methods metioned above in 175 staphylococci,then comparing the postive detection rate by Chi-square test and calculating sensitivity and specificity of the other three methods based on PCR for meeA gene as a gold standard.Results The detection rate of four methods have no difference in detecting MRSA,but the detection rate of Vitek-32 auto microbacteria indentity system and oxacillin agar dilution test is better than that of PCR for mecA gene in detecting MRCNS.Sensitivity and specificity of Vitek-32 auto microbacteria indentity system,oxacillin agar dilution test and cefoxitin disk diffusion test in detecting MRSA are 100%、96.3%、96.3% and 88.2%、100%、100% respectively,the sensitivity of detecting MRCNS are all 100%,the specificity of detecting MRCNS are 50%、46.1% and 65.4% respectively.Conclusions Both mecA gene and the determination for MIC of Oxacillin should be considered in final decision for MRS,Furthermore.the MRS mediated by mecA gene and the MRS mediated by non-mecA gene should be treated differentially.

To explore the status of the job satisfaction of the authorized and contract staff in a university affiliated hospital in the dilution situation of the hospital staffing management, and to discuss the key factors and reasons affecting the satisfaction difference. The questionnaire was developed based on Minnesota Satisfaction short form with extra items covering “the comprehensive satisfaction evaluation”. According to the hospital population of staff, the cluster random sampling method was used, and survey was conducted on the spot. Both authorized staff and the contract staff showed high degree of satisfaction. But the contract staff showed higher degree of satisfaction of leadership and their own responsibility sense than the authorized staff. The contract female staff showed higher degree of overall satisfaction than the authorized female staff. The discussion based on the results showed that new human resource management mode, new mechanism of flexible management of staff, targeted staff with targeted management.

To explore the patterns and ideas of medical cooperation between Beijing and Hebei Chinese Medicine hospitals under the background of the integration of Beijing-Tianjin-Hebei regions. By searching the 2015 China statistical yearbook for health, a survey was conducted among doctors and patients in a Hebei hospital, which is cooperate with the Beijing hospital. We found that Beijing-Tianjin regional medical resources were imbalanced, and Hebei medical resources were insufficient, and patients and doctors were satisfied with the cooperation. There are still some difficulties in Chinese medicine hospital of Beijing and Tianjin cooperation, and many departments need to work together to promote Beijing-Tianjin-Hebei rational allocation of medical resources.