OBJECTIVE:To provide reference for systematic reform in national state-owned hospital.METHODS:System reforms of township hospitals in Zhangjiagang were analyzed.Then three kinds of reform modes were summarized including privatization,town-owned-town-management and sino-foreign joint venture.Reform effects were also discussed.RESULTS & CONCLUSIONS:The achievement that the reformed township hospitals have made in Zhangjiagang in improving the medical insurance and pharmaceutical management system,reforming hospital management system and operation mechanism and creating a harmonious relationship between doctor and patient can provide a reference for domestic state-owned hospital reform.

Objective To analyze the epidemic characteristics of HIV/AIDS among older adults in Chongqing,and to provide scientific evidence for developing prevention and control measures.Methods The data were collected through the national AIDS reporting information system,SPSS 17.0 was used to analyze the data.Results From 2001 to 2015,a total of 10495 cases had been reported accumulatively,and HIV/AIDS cases was accounting for 31.1％.The study was showed that the main infection people was man and the main professional was the main farmer.Moreover,the main infection was heterosexual transmission and accounting for 91.5％.Conclusion The epidemic of HIV/AIDS aged over 50 was on the rapid rise from 2001 to 2015 in Chongqing,the publicity and education should be focused on them,to improve the relevant awareness and reduce their risk behavior.

Objective To investigate the accuracy of functional magnetic resonance imaging(fMRI) and contrast-enhanced ultrasound on evaluation of the breast cancer patients after neoadjuvant chemotherapy.Methods Forty-eight patients with breast cancer who were confirmed by biopsy,undergoing 4 cycles weekly dose-concentrated programs (wPC) neoadjuvant chemotherapy,evaluated the efficacy by fMRI and contrastenhanced ultrasound.Results In pathology,complete remission was 12 cases (25.0％,12/48),non remission was 13 cases (27.1％,13/48).In contrast-enhanced ultrasound,complete remission was 20 cases (41.7％,20/48),non remission was 10 cases (20.8％,10/48).In fMRI,complete remission was 17 cases (35.4％,17/48),non remission was 11 cases (22.9％,11/48).The P values more than 0.05 showed no statistically significant among three methods,the Kappa test showed that fMRI were superior to contrastenhanced ultrasound on evaluating the efficacy of neoadjuvant chemotherapy.Conclusions fMRI and contrast-enhanced ultrasound can be used in evaluating the efficacy of neoadjuvant chemotherapy,however,the data shows fMRI is superior to contrast-enhanced ultrasound.Contrast-enhanced ultrasound must be as the supplementary method.

Objective To compare the sensitivity and specificity of mucin 7(Muc7) mRNA test with urine cytology in detection bladder cancer.Methods In 86 patients suspected with bladder cancer,RT-PCR for Muc7 mRNA and urine cytology were conducted in the same urine samples.Fif-ty-two patients with bladder transitional cell carcinoma were confirmed histologically.The sensitivity and specificity of Muc7 mRNA and urine cytology were analyzed.Results The overall sensitivity,specificity and false positive of Mue7 mRNA test were 84.6%,85.2% and 14.7% respectively.Those of urine cytology were 34.6%,91.2% and 8.8% respectively.There were no significant differences between urine cytology and Muc7 mRNA test in the specificity and false positive; however,Muc7 mRNA had significantly higher sensitivity than urine cytology in detection of bladder cancer.Conclusion The sensitivity of Muc7 mRNA test is superior to urine cytology in detection of bladder cancer.

Background and purpose: The effects of tumor after radiotherapy and chemotherapy with tumor cell apoptosis have positive correlation. Survivin is an apoptosis suppressor gene, which is overexpressed in lung cancer. The reduction of its expression can increase lung cancer cell apoptosis. RNA interference can speciifcally and effectively blocked the expression of this gene. After accepting a dose of radiation, tumor tissues can raise the rate of gene transduction. The purpose of this study was to investigate the effects of the expression of Survivin gene suppressed by intratumor injection siRNA and radiation in lung cancer. Methods:Mouse subcutaneous transplanted with tumors were randomly divided into four groups:untreated group (group A), group with intratumor injection siRNA (group B), group with radiation (group C), group 4 Gy pre-irradiation combination with intratumor injection siRNA (group D). Two days later, mouse with different treatments were executed by cervical dislocation and stripped the subcutaneous tumors. mRNA and protein levels of Survivin gene were detected by quantitative real-time PCR (qRT-PCR) and Western blot; Cell cycle and cell apoptosis were assayed by lfow cytometry (FCM). Results:The expression of Survivin gene in mRNA and protein levels in group B, C, and D were signiifcantly reduced compared with group A. The differences of Survivin expression in mRNA level between group A and group D were statistically signiifcant. Compared with the other 3 groups, the expression of Survivin gene in group D was signiifcantly reduced, the differences were statistically signiifcant (P=0.036);The proportion of cells in S-phase of group D was (2.70±0.34)%, compared with group B [(8.93±0.75)%] and group C [(6.71±0.51)%], that was significantly reduced. The differences of the proportion of S-phase cells in group A and group D were statistically signiifcant (P=0.034);The rate of cell apoptosis in group D was (25.67 ± 0.65)%, which was signiifcantly increased compared with the rate of cell apoptosis in the other 3 groups, the differences were statistically signiifcant (F=78.82, P<0.05). Conclusion:Pre-irradiation can enhance the transduction rate of siRNA, reduce the expression of Survivin gene in lung cancer, promote cell apoptosis, and increase the sensitivity of the radiotherapy.

ObjectiveTo investigate personal reflections of head nurses on 360-degree performance assessment system. Method Twenty-three head nurses being involved in 360-degree performance assessment received semi-structured interviews and the data were analyzed with content analysis.ResultThe head nurses were positive about the assessment system,believing that the assessment system was helpful for detecting the weak links of daily work and thinking that the assessment indexes varied in weights with different clinical disciplines.ConclusionsThe 360-degree performance assessment was beneficial for ability promotion of head nurses and continuous improvement of nursing quality.Hospital administrators should continuously improve and promote 360-degree performance assessment system.

Objective To explore the prospects for applying a brain-computer interface system in the reha-bilitation of dyskinesia by testing the brain-electricity signals of spinal cord injury patients and stroke patients during motor imagery. Methods The brain-electricity signals of 5 healthy people, 4 spinal cord injury patients and 2 stroke patients were tested during motor imagery, and the results were analyzed with a computer. Results All of the 5 healthy people showed event-related synchronization and desynchronization (ERS/ERD) in the α and β bands in the motor related cortex. Three of the 4 spinal cord injury patents showed similar characteristics, and 1 showed ob-vious and stable characteristics, but the 2 stroke patients did not show meaningful characteristics. Conclusions Spinal cord injury patients have brain-electrlcity characteristics similar to those of healthy people when they are expe-riencing motor imagery, whilst in the affected hemisphere of stroke patients the brain-electricity characteristics are not similar to those of healthy people.

Objective To analyze the difference of soft and hard tissues between beautiful face and ordinary face in young Han women for providing data basis for modification of lower facial contour.Methods 38 cases of young Han women were selected with craniofacial spiral CT scanning,three-dimensional reconstruction and histomorphometry of the mandibular angle region (12 cases of beautiful face and 26 cases of ordinary face).Results The difference of bony bigonial breadth,lower face width,angle of mandibular angle,mandibular branch width and height,the distance between the mandibular angle point and pogonion in mandibular angle region had statistical significance (P ＜ 0.05);the difference of mandibular angle thickness had no statistical significance (P＞0.05);the difference of masseter muscle length,width and thickness had statistical significance (P ＜ 0.05).Conclusions In clinical lower facial contour modification practice,we can refer to the data of soft and hard tissue of mandibular angle region of beautiful face,combining with the specific circumstances of the pursuit of beautiful people and select the appropriate surgical approach for lower facial contour modification.

Objective To observe the effects of secoisolariciresinol (SECO) and its metabolites, enterolactone (ENL) and enterodiol (END), on proliferation of MCF-7 cell line and to the probable mechanism. Method Effect of SECO, END, ENL and genistein (GEN) on MCF-7 proliferation was investigated by MTT assay. Cell cycle arrest was measured by flow cytometry (FCM). Cell morphology was observed by optical microscope. The anticarcinogenic mechanism of SECO was analyzed. Results SECO had promotive effect on the cell growth at lower concentration (≤40 ?mol/L) but inhibition effect at higher concentration (100 ?mol/L). ENL and END, however, showed significant inhibition effect at all tested concentrations (10~100?mol/L). The cell cycle progression was arrested at G2/M phase and apoptosis was observed by optical microscope. Conclusion Effect of SECO on the MCF-7 cell proliferation depends on its concentration. Inhibition effect of SECO may relate to its metabolites ENL or END.

Objective To investigate the expression of human epididymal protein 4 (HE4) in chronic kidney disease (CKD) and its clinical value.Methods From April 2014 to December 2015,Serum samples of 92 non-cancer patients diagnosed as CKD and 84 healthy controls were collected in Nantong University Hospital.HE4,BUN,Scr,Cys C and β2MG were detected.The difference of HE4 expression in different stages of CKD and the correlation of HE4 with Urea,Scr,Cys C and β2MG were analysized,respectively.ROC curve was used to evaluate the auxiliary diagnostic value of HE4,BUN,Scr,Cys C and β2MG.Results The serum HE4 expression in patients with impaired renal function was 388.2 (130.1～1 659.5)mIu/ L,(F=16.237,P=0.001).Which was significantly higher than that in the control group [38.1 (32.77 ～ 48.17)mIu/L].The serum HE4 expression was increased by the stage of renal damage and the difference was existed among different groups (P＜0.05).HE4 expression was positive related with Cys C and β2MG.The AUC of HE4,BUN,Scr,Cys C and β2MG were 0.878,0.785,0.816,0.874 and 0.819,respectively.Conlusion It needs to consider the exsits of impaired renal function when the HE4 was detected.The HE4 might be a novel early diagnostic indication for CKD.