The paper discusses specifically ways of putting into practice the idea of people first in developing hospital culture by starting with its three structural layers: spiritual culture, system culture and behavior culture. These include cultivating in a practical manner humanistic core values and hospital spirit, setting up and improving systems of humanistic management and adopting; a humanistic approach to employee management, and cultivating the idea of patient-centered care and delivering humanistic medical services.

Objective To investigate the effects of rapamycin which is an autophagy inducer and 3-adenine (3-MA) which is an autophagy inhibitor on motor behavior and autophagy related protein LC3 in C57BL/6 mice of Parkinson's disease(PD).Methods 40 C57BL/6 male mice were randomly divided into control group and experimental groups which consist of MPTP model group,rapamycin group and 3-MA group,with 10 in each group.Mice in experimental groups received intraperitoneal injection with MPTP to establish PD models,and mice in control group received intraperitoneal injection with the same amount of saline solution for 1 week.Mice in rapamycin group received intraperitoneal injection with rapamycin and mice in 3-MA group received intraperitoneal injection with 3-MA at the same time when MPTP was injected.Animal behavior detections were carried out on the 1 th,7th and 14th day after the last injection.After the last injection,mice were sacrificed and sections of midbrain nigra were gained for the detection of expression of autophagy specificity protein LC3 by Western Blot.Results Compared with MPTP model group,rapamycin could improve the general condition and behavioral manifestation of mice in pole test((14.89± 1.14) s vs (16.24±1.39) s,P＜0.05;(15.18±1.36) s vs(17.93±1.11s),P＜0.01),traction test((1.7±0.5) vs (1.2±0.4),P＜ 0.05;(1.5±0.5)vs (1.1±0.3),P＜0.05) and open field test which contained total activity distance((5 875.3 ± 1148.9) cm vs (5 061.5±773.1) cm,P＜0.05;(5 753.2± 1 106.7) cm vs (4 669.3±969.1) cm,P＜0.01) and average speed((19.29±2.35) cm/s vs (16.47±3.01) cm/s,P＜0.05;(18.71±2.71)cm/s vs (15.80±2.50) cm/s,P＜0.01),while 3-MA aggravated behavioral deficits of mice in pole test(19.92± 1.61s vs 17.93± 1.11 s,P＜0.05),and both total activity distance((3 879.7±575.0) cm vs (4 669.3±969.1) cm,P＜0.05) and average speed((13.34± 1.87) cm/s vs (15.80±2.50) cm/s,P＜0.05) in open field test were decreased.The results of Western Blot confirmed that rapamycin could increase the expression of LC3-Ⅱ,however 3-MA could re duce the expression of LC3-Ⅱ.Conclusion This study confirmed that rapamycin could alleviate behavioral symptoms of PD model mice and increase the level of LC3 in midbrain nigra,while 3-MA could exacerbate behavioral symptoms in PD model mice and decrease the level of LC3 in midbrain nigra.Thus it can be speculated that drugs which can regulate autophagy may be potential treatment protocols for PD.

Objective To determine the clinical significance of hepatocyte growth factor receptor (Met) and epidermal growth factor receptor (EGFR) in the clinicopathology and prognosis of pancreatic cancer.Methods 70 patients admitted with pancreatic cancer from 1995 to 2005 were retrospectively analyzed with clinicopathological and follow-up data.Expression of Met and EGFR in cancer nest embedded with paraffin were detected by immunohislostaining (EnVision method) and correlation with clinicopathologic parameters and mutual correlation between these two receptors were further analyzed.Prognosis and related risk factors were analyzed by Kaplan-Meier survival analysis and Cox regression analysis,respectively.Results Both Met and EGFR significantly correlated with TNM staging,tumor size and superior mesenteric vessels invasion (P＜0.05).Expression level of Met positively correlated with that of EGFR (r9 =0.658,P＜0.05).Both Met and EGFR significantly correlated with patients' survival (P＜0.05) and Met was an independent prognostic risk factor for pancreatic cancer.Conclusions Both Met and EGFR significantly affect development and prognosis of pancreatic cancer and correlate with each other.Simultaneously targeting both Met and EGFR pathways may provide an advisable strategy of targeted therapy in pancreatic cancer.

Objective To investigate the internal quality control ( IQC ) on clinical chemistry , clinical immunology and clinical hematology in mutual recognition laboratories in medical institutions in Beijing.Methods By means of questionnaire survey and on -site investigation, fresh frozen serum and whole blood samples with assigned values by reference method were measured to investigate the status of IQC on clinical chemistry , clinical immunology and clinical hematology in 142 mutual recognition laboratories in medical institutions of Beijing,and results were analyzed.Results 142 copies of questionnaireson clinical chemistry, clinical immunology and clinical hematology were send out and 120, 97, and 101 laboratories returned the questionnaires respectively .The information feedback rate was 84.5%, 68.3% and 71.1%respectively .All the questionnaires were effective .Questionnaires survey results showed that more than 50%laboratories set up quality control goals and the most of the goals were probability for error detection ( Ped) 95%, probability for false rejection(Pfr)5%;About 70% laboratories usecd the same quality control plan for different tests ;The most frequently used quality control rules are 12s/13s/22s.On-site investigation showed that ,take the results of clinical chemistry for example , based on the desirable biological variation and WS/T 403 -2012 , most of the tests can't meet the quality control goalsunder the existing quality controlcondition.Conclusion Clinical laboratories should consider their actual situations , assess their own qualitylevels that they can reach , set reasonable quality standards for themselves , and make appropriateindividualized quality control plan.

Objective To investigate whether curcumin protects dopamine neurons in Parkinson's disease (PD) by activating autophagy and discuss its specific mechanism.Methods In vitro,SH-SY5Y human neuroblastoma cells were treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPP+) to induce PD cell models.In vivo,C57BL/6 male mice were performed intraperitoneal injection of 30 mg/kg 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) once daily for 7 d continuously to establish PD models.SH-SY5Y human neuroblastoma cells and C57BL/6 male mice were,respectively,divided into normal control group,model group,curcumin group,curcumin and 3-methyladenine (3-MA) group,and 3-MA group.Curcumin was used as intervention treatment,and 3-MA,an autophagy inhibitor,was used individually or concurrently with curcumin as intervention controls:curcumin (40 μmol/L),curcumin (40 μmol/L)+3-MA (4 mmol/L),and 3-MA (4 mmol/L) were added into the cells of curcumin group,curcumin and 3-MA group,and 3-MA group at the time of MPP+ addition;curcumin (80 mg/kg),curcumin (80 mg/kg)+3-MA (2 mg/kg),and 3-MA (2 mg/kg) were added into the mice of curcumin group,curcumin and 3-MA group,and 3-MA group at the time of MPTP injection once daily.In the normal control group,sterile saline was injected into the abdomen simultaneously (30 rmL/kg).In cell groups,after 48 h of drug treatment,the number of surviving dopamine neurons was detected by tyrosine hydroxylase (TH) immunofluorescence;Western blotting was used to detect protein expressions of α-synuclein (α-Syn),and autophagy related proteins lysosome-associated membrane protein 2A (LAMP2A) and microtubule-associated protein 1 light chain 3 (LC3);transcription factor EB (TFEB) levels in the cytoplasm and nucleus were detected separately by Western blotting;reverse transcription (RT)-PCR was used to detect the α-Syn mRNA expression.In mice groups,14 d after the last injection,mice were sacrificed and sections ofmidbrain nigra were gained for detection of TH level by immunohistochemistry,expressions of α-Syn and LC3 were detected by Western blotting.Results (1) As compared with model group,curcumin group had significantly larger number of surviving dopamine neurons both in vitro and in vivo,significantly decreased α-Syn protein and mRNA expressions in vitro,and significantly decreased α-Syn protein expression in vivo (P＜0.05);curcumin group had statistically increased LAMP2A and LC3-Ⅱ protein expressions in vitro and LC3-Ⅱ protein expression in vivo as compared with model group (P＜0.05).(2) As compared with curcumin group,curcumin and 3-MA group had statistically smaller number of surviving dopamine neurons in vitro and in vivo,and statistically increased α-Syn protein expression in vitro (P＜0.05).(3) In vitro,as compared with model group,curcumin group had significantly increased TFEB protein expression in nucleus (P＜0.05),and curcumin and 3-MA group had statistically increased TFEB protein expression in cytoplasm and statistically decreased TFEB protein expression in nucleus (P＜0.05).Conclusion Curcumin has protective effect on dopamine neurons of PD;one of the main mechanisms is that curcumin can activate the autophagy function and promote the clearance of α-Syn;increasing the TFEB expression,promoting the transfer of TFEB to nucleus to perform the transcription function,and then promoting the synthesis of autolysosome may be the main ways to activate the autophagy function.

Objective To explore the effect of exercise on the expression of the LINGO-1 gene after intra cerebral hemorrhage (ICH).Methods Seventy-two Sprague-Dawley rats were randomly divided into a sham operation group,a control group and an exercise training group,each of 24.The three groups were further divided into 1 d,3 d,7 d and 14 d groups.ICH was induced using intra-parenchymal injection of autologous blood.The exercise training group was then forced to exercise on a treadmill.Any recovery of neurological functional was evaluated using Longa scoring,and the expression of LINGO-1 mRNA and protein were detected using the reverse transcription-polymerase chain reaction and western blotting.Results The sham operation group displayed no obvious neurological deficiency,with little expression of LINGO-1 mRNA or protein at any time point.The control group's average Longa score reached a maximum of 3 seven days after the operation,decreasing to 2 after another 7 days.The average expression of LINGO-1 mRNA and protein in that group peaked at 1.335±0.393 three days after the ICH,then decreased to 0.429±0.035 on the 7th day and 0.371±0.038 on the 14th day.In the exercise training group the average Longa score on the 7th day was 2,the average LINGO-1 mRNA level was 0.257±0.042 and the average protein level was 1.142±0.287,all significantly lower than in the control group.Moreover,in the exercise group there was a significant positive correlation between LINGO-1 protein expression and the Longa scores.Conclusion Exercise can decrease the expression of LINGO-1 mRNA and protein and promote the recovery of neural function after ICH.

Objective To systematically review the safety and efficacy of enhanced recovery after surgery (ERAS) in perioperative management of pancreaticoduodenectomy.Methods A search was performed in databases (including PubMed,EMASE,Cochrane library,Sinomed,Wangfang,VIP,and CNKI) for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) up to September 2016 on use of ERAS in patients undergoing pancreaticoduodenectomy.After quality evaluation and data extraction,meta-analysis was performed using RevMan 5.3.Results Four RCTs and Twelve NRCTs involving a total of 2 828 patients were included.1 401 patients were in the ERAS group,and 1 427 in the control group.Meta-analysis results showed that compared with the control group,the ERAS group had shorter length of hospital stay (SMD =-0.36,95 ％ CI =-0.44--0.28,P＜ 0.05) and lower incidence of delayed gastric emptying (RR =0.61,95％ CI=0.51-0.73,P＜0.05).However,no significant differences were observed in pancreatic fistula rate,bile fistula rate,readmission rate,reoperation rate,and overall mortality morbidity rate between the two groups (all P＞0.05).Conclusion It is reasonably safe and efficacious to adopt ERAS in periopetative management of patients undergoing pancreaticoduodenectomy.

Objective To explore the CRP harmonization by calibration using commutable trueness verification materials. Methods High and low level of CRP concentrations trueness verification materials(H and L) were prepared by Beijing center for clinical laboratories. Thesetrueness verification materials were diluted to 5 calibration points(5L, 4L+1H, 3L+2H, 1L+4H, 5H) by weighing method, respectively. These 5 points were used to calibrate four different brands of CRP detection system (Diasys, Leadman, Siemens and Roche) instead of the original procedure. Sera from 21 patients and the international standard ERM DA-474/IFCC were used to compare harmonization and trueness after calibration. Each sample above was measured twice. Results After calibration, the median of CV was reduced from 19.33％ to 2.92％ among 21 patient samples, less than the optimal CV based on biological variability (CV=10.6％). Compared with Desai, the slopes were closer to 1 from 0.90-1.09 to 0.93-0.96 after calibration. Meanwhile, if ERM-DA474/IFCC was used as the trueness verification materials, the absolute bias wasreduced from 3.08-11.07 mg/L to 0.52-2.97 mg/L which was close to theuncertainty of itself (2.5 mg/L). Conclusions Afterthe calibration which contained five linear concentration points of CRP trueness verification materials by weighing method, both harmonization and trueness of CRP were improved.

Objective To prepare the trueness verification materials of C-reactive protein (CRP) and evaluate its homogeneity, stability and commutability. Methods The high and low CRP concentrations trueness verification materials were from patient leftover sera which were pooled, mixed thoroughly, filtered and aliquoted. The homogeneity, stability and commutability of these materials were evaluated according to CNAS(China National Accreditation Service for Conformity Assessment, CNAS)-GL29:2010 "Reference materials-General and statistical principles for certification (ISO Guide35:2006)"and the Clinical and Laboratory Standards Institute (CLSI) EP30A. The trueness verification materials were used to evaluate the commutability in 10 clinical CRP detection systems, using forty-five patients' leftover sera with different CRP concentration evaluated by Deming regression in EP30A of CLSI. Meanwhile, the commutability of dilution series of ERM DA-474/IFCC were evaluated using the same method. Results A total of two CRP concentration level trueness verification materials were prepared, with high and low concentration levels of 754 and 743 vials, 1 ml each, respectively. The preparation showed good homogeneity (F

PURPOSE: The intermediate stage of hepatocellular carcinoma (HCC) (Barcelona Clinic Liver Cancer [BCLC] B) comprises a highly heterogeneous population, and the treatment strategy is still controversial. Because of the heterogeneity, a subclassification of intermediate-stage HCCs was put forward by Bolondi according to the ‘beyond Milan and within up-to-7' criteria and Child-Pugh score. In this study, we aim to analyze the prognosis of BCLC-B stage HCC patients who received hepatic resection according to the Bolondi's subclassification. MATERIALS AND METHODS: One thousand and one hundred three patients diagnosedwith HCC and treatedwith hepatic resectionwere enrolled in our hospital between 2006 and 2012. According to Bolondi's subclassification, the BCLC-B patients were divided into four groups. Recurrence-free survival (RFS) and overall survival (OS) were analyzed. RESULTS: According to Bolondi's subclassification, the BCLC-B patients were divided into four groups: B1 (n=41, 18.7%), B2 (n=160, 73.1%), B3 (n=11, 5.0%), and B4 (n=7, 3.2%). Significant difference was observed between B1 and other groups (B1 vs. B2, p=0.022; B1 vs. B3, p < 0.001; B1 vs. B4, p < 0.001), but no difference for B2 vs. B4 (p=0.542) and B3 vs. B4 (p=0.542). In addition, no significant differences were observed between BCLC-A and BCLC-B1 group for both RFS (p=0.087) and OS (p=0.643). In multivariate analysis, BCLC-B subclassification was not a risk factor for both OS (p=0.263) and RFS (p=0.892). CONCLUSION: In our study, HCC patients at B1 stagewere benefited from hepatic resection and had similar survival to BCLC-A stage patients. Our study provided rationality of hepatic resection for selected BCLC-B stage HCC patients instead of routine transarterial chemoembolization.
Carcinoma, Hepatocellular* ; Hepatectomy ; Humans ; Liver Neoplasms ; Multivariate Analysis ; Population Characteristics ; Prognosis ; Risk Factors