In order to arouse the working enthusiasm of the entire staff and give expression to the value of labor and skills, our hospital has implemented reform in the distribution system. Bonus given to clinical departments is linked both to the amount and quality of work and to economic profits; bonus to medico technical departments is given by means of deducting a percentage from the income and expenditure surplus in a way of progressive decrease; bonus given to functional departments is equivalent to 90% of the average bonus given to medical service departments; and bonus to logistical service departments is given, if possible, by the piece and mark. As a result of the reform, the distribution system has become more rational, the working enthusiasm and efficiency of the staff have been enhanced, operational income and income structure have improved, and social benefits bave been raised, with the satisfaction rate reaching over 90%. Of course, there still exist some difficulties in the reform.

Objective To construct the multi-epitope antigen(mea) gene of G2 glycoprotein of Hantavirus SEO type L99 strain.Methods The B cell epitopes was chosen and connected by three-peptide GPG after the amino acid sequence of G2 protein was analyzed and predicted by bioinformatical soft wares.The corresponding gene mea was constructed by overlap PCR,and cloned into the prokaryotic expression plasmid pET32a(+).Results The mea gene was successfully constructed by the five epitopes being chosen.The recombinant plasmid pET32a-mea was acquired by directional cloning.Conclusion The mea and its expression system E.coli BL21/pET32a-mea were constructed for the first time.The foundation was laid for the expression of the mea and its immunological applications.

ABSTRACT:Objective To validate that relaxin can resist hepatic fibrosis at the cellular level and explore its molecular mechanism in order to provide experimental basis for the treatment of liver cirrhosis.Methods Cultured HSC-T6s were treated with different concentrations (20,50 and 100 ng/mL)of recombinant human relaxin-2 (RLX-2).The proliferation of HSC-T6 was measured by MTT colorimetric assay.The content of type Ⅰcollagen in the cell culture supernatant of each group was detected by ELISA at 48 h of drug intervention;RT-PCR was used to detect the mRNA expressions of CTGF and TGF-β1 in HSC-T6 at 48 h of drug intervention.Results RLX-2 inhibited the proliferation of HSC and reduced type Ⅰ collagen content of HSC cells.It also inhibited the CTGF mRNA expression of HSC,but did not have a significant effect on the expression of TGF-β1 mRNA. Conclusion In the experiment of culturing HSC-T6 in vitro,RLX-2 may play a role in rat liver fibrosis by inhibiting cell proliferation and type Ⅰ collagen and CTGF mRNA expressions.

Objective To observe the variation of mortality and discharge against medical advice in major trauma patients admitted to the ICU and thus to improve the level of trauma care.Methods A retrospective analysis was performed on major trauma patients who died or discharged against medical advice in the emergency 1CU from 2003 to 2011.Patients were categorized as the dying,worse,and improved according to their situation at discharge.The dying was included into the death group.Annual variation of mortality and discharge against medical advice were analyzed in these 9 years.These parameters were also compared among three diverse periods (2003-2005,2006-2008 and 2009-2011).Results Ultimately,452 patients were recruited from the 3,343 major trauma patients admitted to the emergency ICU from 2003 to 2011.There were 231 deaths occupying 6.91％ (135 patients died in hospital and 96 patients were dying at discharge) and 221 discharges against medical advance occupying 6.61％ (175 patients deteriorated and 46 patients improved).Within the 9 years,a significant decrease was found in the annual rate of inhospital death,dying at discharge,and total death.Meanwhile,there was an increase in the rate of deterioration at discharge (x2 =15.305,P ＞0.05).However,no significant difference was found in the rate of total death plus deterioration at discharge.During the three periods of 2003 to 2005,2006 to 2008,and 2009 to 2011,number of patients admitted to the emergency ICU was 687,1,143,and 1,513 respectively.Age and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) of the dead,the patients with deterioration at discharge,and the dead plus the patients with deterioration were gradually higher through the three periods; on the contrary,GCS lowered.Total mortality decreased from 11.06％ to 4.63％ (x2 =31.174,P ＜0.01) ; rate of deterioration at discharge increased continuously from 2.77％ to 6.35％ (x2 =12.203,P ＜0.01) ; rate of death plus deterioration at discharge was declined from 13.83％ to 10.97％ (x2 =4.09,P ＞ 0.05).Conclusions From 2003 to 2011,the level of severe trauma care in emergent ICU is obviously improved.Ratio of deterioration at discharge increases with more aged patients.Discharge against medical advance interferes with the accurate assessment of trauma care and should be paid more attention.

Objective To study the clinical and pathologic changes in gigantomast.Methods Tissue sections were prepared from 180 cases of breast hypertrophy and 45 cases of normal breast tissues.The morphological changes and the expression and localization of ERRγwere evaluated on the HE and immunohistochemistry stained sections between hypertrophy and normal breast tissues.Results Compared with normal breast,hypertrophic breast showed expended ducts and obvious hyperplasia of the duct epithelial papillary.Hypertrophic breast tissues demonstrated strong expression of ERR-γ in ducts and lobules.Conclusions Upregulated expression of ERRγ is identified in hypertrophic breast tissues that may associate with the development of gigantomastia.

The effect of nateglinide or sequential treatment with metformin on glycemic stability in newly diagnosed type 2 diabetes was investigated. Thirty-four cases of newly diagnosed type 2 diabetes received nateglinide therapy, or sequential treatment with metformin according to fasting and postprandial blood glucose, and were classified into isolated nateglinide therapy group(n=14) and sequentially treated with metformin group(n=20). Glycemic stability, reflected by mean amplitude of glycemic excursions(MAGE) and HbA1C, was determined in all patients before and after therapy for three months. HbA1C and MAGE in two groups were all improved after treatment(P＜0.05). The therapy of nateglinide alone or combined with metformin can significantly improve glycemic stability in newly diagnosed type 2 diabetes.

BACKGROUND:Cataract is not the necessary symptom for myotonic dystrophy(DM).But it may be the early and even only clinical symptom of DM.Molecular diagnosis can provide the important evidence for the diagnosis of DM.OBJECTIVE:To explore the characteristics of cataract in 26 patients with myotonic dystrophy of 3 pedigrees from Shanghai Songjiang area.DESIGN:Analysis on the Genealogy of Pedigree.SETTING:Department of Neurology,Shanghai Changhai Hospital.PARTICIPANTS:Twenty-six patients of 3 pedigrees,aged 7 to 71 years old,which were preliminarily diagnosed as DM patients or were suspicious DM patients,admitted to Department of Neurology,Shanghai Changhai Hospital between May 2001 and August 2003,were recruited in this study.Among the involved patients,13 corresponded to the clinical diagnosis standard from Practical Neurology,and the other 13 patients have adverse symptoms and (or) body signs of partial or mild DM,suspecting with DM patients.METHODS:①Peripheral blood of 1 mL was taken and genome DNA was extracted.By using a thermocycler,a polymerase chain reaction (PCR) was carried out to examine the CTG repeats according to criteria of molecular diagnosis (CTG repeats from 80-3350).②In addition,slit-lamp examination for specific lens opacity was carried out and the association between DM and cataract was analyzed.MAIN OUTCOME MEASURES:①CTG trinucleotide repeat numbers.②Association between DM and cataract.RESULTS:Of the 26 patients,25 participated in the final analysis except 1 who suffered from sterility clinically.①25 patients were consistent with the molecular diagnostic criteria of DM (CTG repeats from 80-3 350).The remaining 1 with CTG repeats of 13 was clinically sterility and therefore belonged to the normal individual.The (CTG)n triplet repeats of 17 patients with cataract were 2380±80,while 8 patients with cataract were 2298±105(P＞0.05).②Cataract was characterized as iridescent lens opacity or blue posterior cortical lens opacity in 17 patients.Among the 17 patients,cataract in 8 patients was the only early clinical sign whose(CTG) n triplet repeats were higher than the normal ones.CONCLUSION:In the pedigrees with DM patients,characteristic cataract,as a main and even only early clinical sign,will provide important clinical evidence for the early diagnosis of DM.

ObjectiveTo observe the effect of the combined therapy of ginkgo-dipyridimolum and mecobalamin for diabetic peripheral neuropathy (DPN).MethodsA total of 102 DPN cases were randomly divided into treatment group(n =50) and control group(n =52).The treatment group was given ginkgo-dipyridimolum and mecobalamin, and the control group was given only mecobalamin for 4 weeks.We observed the change of symptom and sign of both groups before and after treatment,and the MNCV and SNCV of median nerve,ulnar nerve and peroneal nerve were detected.ResultsIn the treatment group, the improvement of DPN symptoms (x2 = 10.090, P ＜ 0.01) and nervous conducting speed were much more obvious than that in the control group(MNCV of median nerve, ulnar nerve and peroneal nerve was(49.12 ± 3.32) m/s, (52.11 ± 3.12) m/s and(47.32 ± 3.21) m/s respectively; SNCV of median nerve,ulnar nerve and peroneal nerve was(47.13 ± 2.56) m/s, (55.12 ± 2.31) m/s, (46.78 ± 2.66) m/s respectively,all P ＜0.05).ConclusionThe combined therapy of ginkgo-dipyridimolum and mecobalamin could effectively improve the therapeutic outcome of DPN, and the treatment was safe and worthy of widespread use.

Objective To study the effects of new triple therapy with clarithromycin plus amoxicillin and omeperazole combined into 3 therapeutic therapies, and 3 therapeutic courses to treat children with helicobacter pyloric(Hp) infection.Methods Two hundred and four patients who were diagnosed by gastroscopy as Hp-related gastroentestinal diseases and divided into 3 groups,randomly.Group A was treated with amoxicillin 50 mg/(kg?d)+bismuth citrate 7-8 mg/(kg?d)+metronidzole 15-20 mg/(kg?d) for six weeks;group B took the same drugs but for two weeks;group C was treated with clarithromycin 15 mg/(kg?d)+omeperazole 0.8 mg/(kg?d)+amoxicillin 50 mg/(kg?d) for 2 weeks.Results The rates of eradicate of Hp:group A 73.4%,group B 75%,group C 92%.The differences between group B and group C were very significant.Conclusion Triple therapy is more effective, less duration,well tolerated, less resistant,with higher rate of eradication.

Objective To investigate the transportation of chemico-biological particles(CBP) through the micropassage inside the human body in order to improve chemico-biological protection.Methods Dissipative particle dynamics (DPD) method was used to study CBP transportation through micropassages inside the human body.Results The Poiseuille flow could be ensured by imposing boundary conditions including pressure gradient and no-slip.The axial velocity between fluid particles and CBPs was well matched except the area close to the passage wall.However, CBPs tended to accumulate and the density of CBPs slightly increased, leading to the jam effect and producing particle accumulation.Conclusion The characteristic of CBP transportation is better understood,which can help develop some chemico-biological protection devices according to movement of CBPs and improve the performance of CBPs during chemico-biological protection.