This paper clarifies the internal connection of hospital management and medical ethics,and points out that hospital management should be based on medical ethics management,for their combination could be the future trend of modern hospital management.It is of particular importance to clarify and further strengthen the significance of medical ethics management during hospital management,thus reasonably combine hospital management and medical ethics management,in order to promote a healthy development of hospitals.

Objective To compare tacrolumus (FK506) with cyclosporine A (CsA) in clinical application to organ transplantation.Methods The literature in recent years has been reviewed and compared. Results FK506 was a powerful immunosuppression with a mechanism of action similar to that of CsA, but significantly superiori to CsA in terms of prophylaxis and treatment of allograft acute rejection, delay of chronic rejection, and withdrawal of steroid in early period. The cardiovascular mortality and chronic graft nephropathy (CGN),such as hypertension and hyperlipidemia were less frequently seen in FK506-treated patients and FK506 also had an acceptable safety profile, including a low incidence of hypertrichosis,gingival hyperplasia and infections.However, CsA had been showed a better result in prevention of posttransplantation diabetes mellitus (PTDM ) and more economic agent than FK506. Pharmacokinetic studies showed CsA in the form of Sandimmun Neoral showed less inter- an intrapatient variability than FK506.Meanwhile, the combination of MMF and FK506 or CsA has been proved effectively with excellent graft and patients survival. Conclusion FK506 and CsA are safe and effective long term maintenance immunosuppressive agents in organ transplantation with wonderful prospect.

Objective To understand the basic situation of blood donors and their anti-HIV antibody screening in a hospital of Madagascar during 2008- 2009 in order to provide the reference information for giving better medical aid and promoting the devel-opment of the clinical transfusion in Madagascar.Methods The blood doner′s personal informations were understood by inquiry and the anti-HIV antibody was detected by the rapid testing,the results were recorded,the constituent ratio of the data was calcu-lated and the chi-square test was performed.Results There were 2 298 blood donors including teenages less than 15 years old dur-ing 2008-2009,female doners were more than male donors,among them 366 cases were pregrant women.The blood donors from village were more than those from city,the education level was dominated by the middle school students,accounting for 51.65%. There were 22 tuberculosis patients in 2008,none in 2009.The detection rate of anti-HIV antibody was 0.04% for these 2 years. Conclusion The protection on the blood donors in Africa area is not optimistic.The phenomenon of pregrant women and teenages as the blood donors exists in Madagascar.

The active form of vitamin D,1,25-Dihydroxyvitamin D3 \,is a secosteroid hormone that binds to the vitamin D receptor(VDR),a member of the superfamily of nuclear receptors for steroid hormones,thyroid hormone,and retinoic acid.1,25-Dihydroxyvitamin D3 and its analogue regulate calcium and bone metabolism,control cell proliferation and differentiation,and exert immunoregulatory activities.Recent advances in understanding their functions and novel insights into the immunomodulatory mechanisms they control suggest a wider applicability in the treatment of autoimmune diseases and induction of allograft tolerance.In addition to direct effects on T cell activation,1,25-Dihydroxyvitamin D3 and its analogue modulate with different mechanisms the phenotype and function of antigen-presenting cells(APC),and,in particular,of dendritic cells(DC).In vitro and in vivo experiments have shown that 1,25-Dihydroxyvitamin D3 and its analogue induce DC to acquire tolerogenic properties that favor the induction of regulatory rather than effector T cells.These intriguing actions of 1,25-Dihydroxyvitamin D3 and its nanlogue have been demonstrated in several experimental models and could be exploited,in principle,to treat a variety of human autoimmune diseases,or inhibit allograft rejection.

OBJECTIVE To investigate the antibiotic resistant phenotyping of Acinetobacter spp on NC21 panel. METHODS A total of 275 strains were isolated from clinical specimens.Acinetobacter were identified and antimicrobial susceptibility test performed.Phenotyping was according to David Livermore.Resistance phenotyping analysis included 13 antibiotics. RESULTS The susceptible results of 13 antimicrobial agents in 275 strains of Acinetobacter spp showed imipenem,amikacin,ampicillin-sulbactam,ciprofloxacin,tobramycin,ceftazidime,cefepime,gentamicin and trimethoprim had the greatest susceptibility(97.8%,88.4%,86.6%,82.2%,81.9%,9.6%,76.8%,73.8% and 73.6%,respectively).Beta-lactam agent-resistant phenotypes Ⅰto Ⅴ(wild type,penicillinase,cephalosporinase,penicillinase+cephalosporinase,multi-drug resistance mechanism) and nontyping were 67.3%,1.8%,1.8%,19.6%,0.7% and 8.8%,respectively.74.2% of 275 strains were susceptible to gentamicin,amikacin and tobramycin.Aminoglycosides resistant phenotype(gentamicin-resistant,gentamicin-amikacin-resistant,gentamicin-amikacin-tobramycin-resistant) and nontyping were 7.3%,1.1%,10.9% and 6.5%,respectively.8.7% were the penicillinase-cephalosporinase and gentamicin-amikacin-tobramycin-resistant phenotyps,those strains were all susceptible to imipenem and half to ampicillin-sulbactam. CONCLUSIONS Resistance phenotyping system should be useful in epidemiological studies of Acinetobacter and avoiding unnecessary antibiotics treatment,ampicillin-sulbactam as imipenem shows high antibacterial activities,aztreonam has a lower antimicrobial susceptibility than other 12 antibiotics.

Objective,To evaluate the value of magnetic resonance imaging(MRI) in clinical diagnosis of tuberculous meningitis.Methods,Forty-six patients (29 men,17 women,age ranged 11-72,mean age 41.5) with tuberculous meningitis were examined with MRI.The MRI findings of tuberculous meningitis were analyzed retrospectively.Results,On pre-contrast T1WI and T2WI,meningeal lesions in the basal cistern region were detected in twenty cases.Abnormal meningeal thickening and enhancement were found in 38 patients.Meningeal and cerebral miliary tuberculous foci were demonstrated in 21 cases.Ependymal involvement was found in six patients and cranial nerves were affected in other two patients.No abnormal meningeal enhancement was detected in eight mild cases.On the follow-up images in nine patients,the abnormal findings alleviated in varied degree or,remained unchanged.Conclusion,The pathological changes in tuberculous meningitis could be demonstrated effectively by specific findings on MRI.MRI,especially the post-contrast MRI,proved a reliable modality in clinical diagnosis and assessment of tuberculous meningitis.

Objective To study the treatment effect of self-made huoxue tincture for treating skin injury and phlebitis caused by extravasation of chemotherapeutic drugs.Methods Patients(30 cases)with skin injury and phlebitis caused by extravasation of chemotherapeutic drugs were divided into the observation group(20 cases)and the control group(10 eases).The observation group underwent treatment with huoxue tincture,while the control group adopted local hydropathic compress with 50%magnesium sulfate.Results The effective rate of the observation group was higher than that of the control group,P<0.05.Conclusions Hydropathic compress with huoxue tincture was effective in the treatment of skin injury and phlebitis caused by extravasation of chemotherapeutic drugs.It may be widely applied in clinic.

Objective To study the diagnosis and treatment of iatrogenic bile duct injury(IBDI).Methods The clinical data of 92 patients with IBDI who had been admitted to our hospital from January 1994 to December 2007 were retrospectively analyzed.Results The diagnosis of IBDI was based on the clinical findings,diagnostic abdominocentesis and imaging examination.Sixteen patients gave up treatment because of economic reasons,and 2 patients who were complicated with sepsis and multiple organ dysfunction syndrome died shortly after being transferred to our hospital.Forty-eight patients were treated by Roux-en-Y choledochojejunostomy,14 by endoscopic treatment.2 by bile duet repair+T tube drainage,3 by percutaneous catheter drainage,1 by choledochoduodenostomy,4 by percutaneous transhepatic cholangiodrainage,and 2 by ultrasound guided percutaneous puncture drainage.Sixty-two patients were followed up for 4 month to 10 years(mean,3.6 years),and satisfactory results were obtained.Conclusions Detection of IBDI during operation and prompt repair yield favorable outcome.Roux-en-Y choledochojejunostomy is the best choice for bile duct injury complicated with biliary stricture.Endoscopic and interventional treatments are important auxiliary measures in the treatment of bile duct injury.

ObjectivesTo explore the clinical significant for change o f serum enzyme with ACVD.MethodsThe serum enzyme of 150 cases wi th ACVD were investigated.ResultsThe serum enzyme of 150 cases with ACVD were significantly higher than that of the control group (P

0.05). Conclusion Both CD54 and LRP expression have negative correlation with the effective rate of short-term therapeutic effects, therefore can be taken as indexes for prognostic evaluation for patients with non-small cell lung cancer.