Objective To find out about the attitudes of hospital runners, academic leaders and key members of the technical force in public hospitals about structural reform in their institutions and to explore modes and methods for such reform. Methods Survey questionnaires were designed, anonymous surveys were conducted on the spot, and statistical analyses were made of the data collected. Results Surveys on 1904 people in 55 second- and third-tier hospitals indicated that 84.9% were in favor of structural reform in their institutions; 89.7% played an active part in the reform; 86.8% held that structural reform should first be carried out in large and medium-sized hospitals; 96.6% were in favor of such reform modes as government-controlled stock systems, government-owned and civilian-run hospitals, and non-governmental hospitals, with 66% of them supporting the mode of government-controlled stock systems. Conclusion The majority of hospital runners, academic leaders and key members of the technical force in public hospitals actively support structural reform in their institutions and their views with regard to the modes and methods for such reform are in accordance with the guidelines put forward by the government. Sound ideological foundations have been laid for duly promoting structural reform in public hospitals.

To programming one Child's Behavior Problems Computer Screening System (CBPCSS), a series of software for analyzing child behavior individual and group sample. According to the world-famous American ACHENBACH child's behavior checklist, to ensure the screening quality and compatibility of cultures, we revised and standardized the norms of different ages in primary schools and nursery schools in various cities based on the principle of cluster stratified sampling. Then we designed CBPCSS carefully. The system can reliably and rapidly screen an individual child behavior and output the behavior factor curve (appearing in front of the profile). With CBPCSS we can observe the child behavior clearly. It takes twenty times shorter than that of manual screening. On the other hand, CBPCSS has a function of group analysis. The clinical practice proved that CBPCSS could substitute for manual screening completely. It is a powerful tool for social, scientific and pediatric medical workers.

Presented in the paper are the Patient Clinical Complexity Level(PCCL)and Episode Clinical Complexity(ECC)models as used in Australia.Comparison of the differences between ECC model and PCCL model,and a replacement of ECC model of PCCL model in measurement of disease complexity,points the way for localized scheme design in China.

OBJECTIVE To determine distribution of pathogens and resistance characteristic in urinary infection and to provide basis for clinicians to select antibiotics correctly.METHODS A total of 272 strains of pathogens were identified and ESBLs-producing G-bacilli were detected.RESULTS Among 272 strains,68.4% of G-bacilli,19.1% of G+cocci,12.5% of fungi,41.1% of Escherichia coli and 18.2% of Klebsiella pneumoniae strains produced ESBLs.CONCLUSIONS G-bacilli are major pathogens of urinary infection and their resistance is raised.Much attention should be paid to resistance detection.It is important to control nosocomial infection and select antibiotics correctly.

Objective:To construct eukaryotic expressing vector of PcDNA3.1-rhGM-CSF and to investigate its effects of suppressing growth and inducing differentiation in K562 cells.Methods:The eukaryotic expressing vector PcDNA3.1-hGM-CSF was constructed by means of PCR and T-A clone techniques as well as directional cloning techniques.It was affirmed by the restriction map and DNA sequence analysis,and then transfected into K562 cells.It was observed that the target gene of the recombinant vector was expressed and exerted in K562 cells 72 h later,RT-PCR was used to affirm the expression of rhGM-CSF in K562 cells;Cell morphological,cell proliferation assay and immunohistochemistry were used to observe the effect of PcDNA3.1-rhGM-CSF on the growth and differentiation of K562 cells.Results:①The recombinant eukaryotic expressing vector PcDNA3.1-GM-CSF was constructed successfully;②Recombinant GM-CSF was expressed in the transfected K562 cells and the transfected K562 cells could differentiate into monocyte and macrophage cells;③ The proliferation of K562 cells was suppressed.Conclusion:The recombinant eukaryotic expression vector PcDNA3.1-rhGM-CSF was constructed successfully;Transfected K562 cell could differentiate into monocyte and macrophage cell.

Objective:To explore the determination conditions for reducing end of hydroxyethyl starch by DNS spectrophotometry. Methods:The reducing end of hydroxyethyl starch was determined using the standard curve of glucose solutions. The effects of DNS reagent with different volume, heating temperature, heating time and standing time after reaction on the determination were investiga-ted. Results:The optimal determination conditions were as follows:the DNS volume was 0. 8 ml, the reaction temperature was 85℃, the reaction time was 5 minutes, and the colored solution was determined at the wavelength of 540 nm. Conclusion: The method is simple and accurate with good reproducibility, which can be used to determine reducing end of hydroxyethyl starch.

Objective To evaluate the effects of inhaled aerosolized different doses of lidocaine on lung injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Thirty ASA physical status Ⅱ or Ⅲ patients of both sexes,aged 18-58 yr,weighing 35-70 kg,undergoing elective cardiac valve replacement with CPB,were randomly divided into 3 groups (n =10 each) using a random number table:control group (group C),lidocaine 100 mg group (group L1) and lidocaine 200 mg group (group L2).Anesthesia was induced with iv injection of midazolam,etomidate,fentanyl and vecuronium.The patients were endotracheally intubated and mechanically ventilated.The aemsolized normal saline 10 ml,2％ lidocaine 5 ml + saline 5 ml and 2％ lidocaine 10 ml were inhaled in C,L1 and L2 groups,respectively,starting from 10 min after induction.At 10 min after induction (T0),1 and 10 min after opening of vena cava (T1,2),and the end of CPB (T3),blood samples were collected from the left radial artery (LRA) and right atrium (RA) for determination of plasma interleukin8 (IL-8),tumor necrosis factor-α (TNF-α) and malondialdehyde (MDA) concentrations (using ELISA) and the expression of CD11 b on polymorphonuclear leukocytes (by flow cytometry).Blood samples were collected from the left radial artery at T0,immediately after beginning of CPB,at T3 and at 2 and 6 h after termination of CPB for blood gas analysis.The oxygenation index (OI),respiratory index (RI) and dynamic lung compliance (Cdyn) were calculated.Results Compared with group C,the ratio between IL-8 concentration in LRA and in RA (concentration of IL-8LRA/RA) was significantly decreased at T2,3,the concentration of MDALRA/RA was decreased at T3 (P ＜ 0.05),no significant change was found in the expression of CD11bLRA/RA at each time point (P ＞ 0.05),and RI was decreased at T3 in L1 and L2 groups (P ＜ 0.05).There were no significant differences in the concentration of IL-8LRA/RA,TNF-αLRA/RA and MDALRA/RA,expression of CD11bLR A/RA,RI,OI and Cdyn at each time point between group L2 and group L1 (P ＞ 0.05).Conclusion Aerosolized lidocaine inhalation can attenuate lung injury and improve lung function in patients undergoing cardiac valve replacement under CPB by reducing inflammatory responses and lipid peroxidation in lung tissues.

Objective To explore the effect of D-galactose(D-gal) on murine pancreatic injury and its pathogenesis.Methods C57BL/6J mice were randomly divided into control group and D-gal model group [D-gal 120 mg/(kg · d) for 42 days].On the 2nd day after drug injection completed,the peripheral blood was taken for measuring the level of fasting blood glucose(FBG) and fasting insulin(FINS);and then the organ index of pancreas was calculated by the ratio of pancreatic wet weight(mg) and mouse body weight(g);HE stain was routinely prepared to observe the histologic structure of pancreatic tissue;the TEM was used to analyze ultrastructural changes of pancreatic cells;the pancreatic frozen sections were prepared to test senescence-associated β-galactosidase (SA-β-gal) and its relative absorbance(RA) of positively stained cells in the pancreatic islets;immunohistochemistry assays to study advanced glycation end products (AGEs) and its RA;pancreas tissue homogenate was made to detect the content of superoxide dismutase(SOD),malonaldehyde(MDA) and total antioxidant capacity(T-AOC).Results In D-gal group mice,the FBG increased(P＜0.05) and FINS reduced;pancreas wet weight and organ increased obviously (P＜0.01);light microscopic structure of the pancreas presented without typical pathologic change,however the single nucleated cell's area within the islet was increased significantly(P＜0.05);the pancreas endocrine and exocrine cells were showed the ultrastructure damaged and lipofuscin formation increased;the RA of positive pancreas cells in SA-β-gal staining increased(P＜0.05);the RA of AGEs positive regional expression markedly increased (P＜0.01);the content of SOD and T-AOC decreased (P ＜ 0.05),the content of MDA increased (P ＜ 0.01).Conclusions Aging mice model replicated by D-gal can cause the pancreatic injury,its mechanisms may be closely related to oxidative injury of pancreatic cells caused by D-gal.

Objective To investigate the application value and quality control of breast cancer cells PR,ER C-erbB-2,P53,Ki67 expressions in the patients with breast cancer.Methods The specimens were obtained by the fine needle aspiration cytological smear or intraoperative imprint cytology.The biological expressions of ER,PR,C-erbB-2,P53,Ki67 were detected by the immuno-cytochemical staining,the detection results with those detected by the immunohistochemical staining were performed the compara-tive analysis.Results The biological expressions of ER,PR,C-erbB-2,P53,Ki67 in 53 cases of breast cancer were 73.56%, 58.49%,56.60%,68.63%,81.13% respectively;ER,PR,C-erbB-2,P53,Ki67 had no statistical significant differences in positive cases and positive intensity between the immunocytochemical staining and the immunohistochemical staining (P >0.05).Conclusion The immunocytochemical staining can replace the immunohistochemical staining and has the important significance in the preop-erative diagnosis of breast cancer,therapeutical scheme selection and prognosis judgment.The whole process quality control is the key to do the breast cancer immunocytochemical staining well.

Objective To investigate the expression of Nek8 in esophageal squamous cell carcinoma(ESCC) tissues and cell line , and to evaluate its correlation with the clinicopathological features of ESCC and the survival rate of ESCC patients after operation . Methods The expression of Nek8 mRNA in human ESCC Eca109 cell line and two pairs of ESCC tissues and adjacent normal e‐sophageal mucosal epithelium were detected by semi‐quantitative reverse transcription polymerase chain reaction (RT‐PCR) .Immu‐nohistochemistry and tissue microarray technique were used to examine the expression of Nek 8 protein in ESCC tissues and tumor‐adjacent tissues .The correlation between Nek8 expression and clinicopathological features of ESCC and survival rate of ESCC pa‐tients was then analyzed .Results The expression of Nek8 mRNA was positive in Eca109 cells and two cases of ESCC tissue ,and it was negative in paired normal esophageal mucosal epithelium specimens .In tissue microarray ,the expression of Nek8 protein in ES‐CC tissues ,which was mainly in the cytoplasm ,was significantly higher than that in tumor‐adjacent tissues(P= 2 .16E‐13) .The high expression of Nek8 was associated with tumor size (P=0 .008) ,but not with sex ,age ,histological grade ,infiltration degree , lymph node metastasis ,and the survival rate(P>0 .05) .Conclusion The expression of Nek8 is up‐regulated in ESCC tissues and cell line ,and may be involved in tumorigenesis and development of ESCC .Nek8 could act as a potential biomarker for ESCC diag‐nose and target for therapy .