The development of medical institutes needs not only marvelous hardware construction,but also software strength,such as the hospital culture,brand establishment,etc.Only by the persistent and coordinated development of hardware strength and software strength,can hospital's comprehensive strength and core competitiveness be effectively improved.To enhance hospital software strength,it is necessary to cultivate hospital culture with unique features,emphasize brand establishment,devise long-term development blueprint of medical institutes and activate hospital's potential for further development.

Different subspecies or strains of the same species produce varied clinical manifestations.The clarifica-tion of parasite taxonomy is useful for the researches of their biology, epidemiology and control.DNA molecular markers have the advantages of high polymorphism, non-pleiotropy, and clear identifying alleles, etc.This paper summarizes the first generation(restriction fragment length polymorphism, random amplified polymorphic DNA), second generation(sim-ple sequence repeat-anchored PCR, inter-simple sequence repeat) and third generation(single nucleotide polymorphism) molecular marker techniques, and their application in taxonomic identification of parasites.

Objective To evaluate the therapy effect and prognosis of upper digestive tube hemorrhage resulted from Portal Hypertension,which is dealed with combined devascularization with stitching instrument.Methods Summarized the therapy and prognosis of 41 patients of upper digestive tube hemorrhage resulted from Portal Hypertension,dealed with combined devascularization with stitching instrument.Results All the patients above had no one die for operation and no one had complication of hepatoencephalopathy.after operation 22 patients of this group had complication with medium quantity of ascite.All the patients had no complication with gastric fistulas.Conclusions Combined devascularization with stitching instrument is the best operation for upper digestive tube hemorrhage resulted from Portal Hypertension.

Abortion, Induced ; adverse effects ; Acupuncture Points ; Adult ; Biomimetics ; Electric Stimulation ; Electroacupuncture ; Female ; Humans ; Menstruation Disturbances ; etiology ; therapy ; Meridians ; Young Adult

OBJECTIVE:To evaluate the status quo and the tendency of the use of antihypertensives in our hospital. METHODS: The utilization of antihypertensives during 2005～2007 in our hospital were analyzed statistically in respect of the consumption sum, DDDs and average daily cost etc. RESULTS: Over the 3 years, the consumption sum and DDDs of the antihypertensives used in our hospital increased markedly, especially those of calcium antagonists, angiotensin, ACEI and diuretic antihypertensives. The consumption of AGT Ⅱreceptor blocking agents increased year by year. CONCLUSION: The utilization structure of antihypertensives in our hospital is basically reasonable. It is of great importance to develop effective compound antihypertensive drugs with low-cost and less ADRs.

Objective To systematic review the methodological quality of guidelines for Guillain-Barré syndrome (GBS) in children, to provide a reference for clinical evidence-based medicine. Methods Guidelines concerning GBS were electronically retrieved from PubMed, EMbase, CBM, Wanfang data, CNKI and Vip. The guide databases includes major medical institutions and industry sites such as NGC, GIN, TRIP , CDC, IDSA, AAP, WHO, Chinese Health and Family Planning Committee website, library of clinical guidelines China and Chinese clinical guidelines for collaboration. All the data were searched from inception of the database or network to Oct. 2013. Two reviews independently screened literature according to the inclusion and exclusion criteria, and assessed the quality of guideline using the AGREEⅡ. Intraclass correlation coefficient (ICC) was used to examine the conformance of the raters' evaluation scores. Results A total of 5 guidelines concerning GBS were included, with a time range from 2003 to 2012, and origins from USA, EU and Canada. The final recommendation levels of the 5 articles were level B. According to the AGREEⅡ, domain 3 and 4 showed the higher scores, and scores were generally low in domain 5. Plasma exchange (PE) and intravenous immuneglobulin (IVIG) showed positive effects on the treatment of GBS. But it was not recommended that combined PE and IVIG. Corticosteroids are also not recommended for GBS treatment. Conclusions The recommendations of medicines for GBS are basically consistent. However, the classification criteria of the levels of evidence and recommendation are still unconsistent and suboptimal. The guidelines on GBS should be improved in“Applicability”in future.

Objective:To investigate the levels of AP-1 in hippocampus of rats at different time points after carbon monoxide poisoning.Methods: Carbon monoxide poisoning delayed encephalopathy model by using intraperitoneal injection of carbon monoxide.Uesd HE observed the pathological changes in hippocampus of rats.The levels of AP-1 was observed by immunohistochemistry and Western blot analysis.TUNEL was used to detect apoptotic neurons in hippocampal CA1 area.Results: HE dyeing conditions,the hippocampus cell of air group (AC) and blank group (BC) were normal at each time point.Pathological changes occurred in the hippocampus cell of Carbon monoxide group (CO),reduction in the number of cells,disorder of cells,intercellular space expansion,nuclear fragmentation,anachromasis and pyknotic.Immunohistochemical results,the AP-1 expression level at each time point in group CO were higher than group AC and BC.On 3th day it reached a peak.The comparison at all time points among the groups in the first three days were significantly different in statistics(P<0.05).Western blot results,the expression of AP-1 was consistented with the immunohistochemical results on the time distribution trend.TUNEL results,AI in group CO was higher than those in group AC and BC at all time points,there were significant differences(P<0.05) and 7th reached the peak of apopotsis.Conclusion: Inside the hippocampus of rats,there are increasing in AP-1 . Maybe it is one of the important pathogenesis of DEACMP .

Objective To study the effects of nuclear factor E2-related factor 2 (Nrf2) in delayed encephalopathy in rats after acute carbon monoxide poisoning. Methods One hundred and sixty-eight rats were randomly divided into three groups: forty-eight rats in the blank control group (BC group), sixty rats in the air control group (AC group) as well as in the carbon monoxide poisoning group (CO group). The DEACMP model was established by improved intraperitoneal injections. The animals were valuated at 1st ,3rd, 7th, 14th, 21th, 28th day after acute carbon monoxide poisoning. Tunnel method was used to test the pyramidal cell apoptosis in the hippocampal CA1 area. The expression of Nrf2 was tested by immunohistochemical method and Western Blot method. Result In the CO group, the apoptosis index (AI) started to increase from first day and achieved it's peak at the 7th day (20.20 ± 1.78), then began to decrease slowly. The apoptosis index was still higher than that in the other groups at 28th day. And the apoptosis index of the CO group was markedly higher than the other two groups at each time point. The Nrf2 protein started to increase from 1st day in the CO group , reached its peak at 3rd day (8.20 ± 1.08), reduced later, maintained at a high level at 28th day, and expressed significantly higher than other groups at each time point. Conclusions The Nrf2 has a linear correlation with apoptosis , and plays a dual role in DEACMP because it rapidly increased in first three days to against apoptosis. But it continuously has been excessive expressed from 7th to 28th day in promoting the apoptosis of hippocampus pyramidal cells and may be a positive factor in DEACMP.

OBJECTIVE:To systematically review the related evidence-based guidelines of purulent meningitis in children,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,CBM,Wanfang Data-base,CJFD and VIP,NGC,GIN,TRIP and websites of domestic and international medical associations and industry bodies,the treatment guidelines about purulent meningitis in children were collected. Evidence-based evaluation was performed after data extrac-tion and quality evaluation. RESULTS:Finally 3 guidelines were enrolled in total,with development time ranging from 2004 to 2012,from USA,Britain and Australia,respectively. All of the recommendations were level B,scope and purpose and clarityshowed the higher scores in AGREEⅡ,more than 70%,and applicability showed generally low scores. Penicillin and cefotaxi-me were recommended in purulent meningitis of neonates,and vancomycin combined with cefotaxime or ceftriaxone were recom-mended for infants and children(it was combined with vancomycin when Streptococcus pneumoniae infection was suspected). The dose and duration of each guideline were certain different,and the period of treatment should be longer in neonates. In addition, the glucocorticoid was recommended in all guidelines. CONCLUSIONS:The recommendations of medicines for the treatment of pu-rulent meningitis are basically unanimous,with no regional difference,but there are some differences about dose and the course of treatment. In addition,the classification criteria of the levels of evidence and recommendation are still suboptimal,which needs fur-ther improvement. And guidelines on purulent meningitis should be improved inrigourandapplicabilityin future.

AIM: To investigate the dynamic expression of Rho kinase(ROCK I) and transforming growth factor ?1(TGF-?1) in pulmonary arterioles of rat with chronic thromboembolic pulmonary hypertension.METHODS: Sixty-four male Wister rats were randomly divided into eight groups: beginning control group,embolism for 3 d,1 week,2 weeks,4 weeks,8 weeks,12 weeks groups and end control group.The pulmonary thromboembolism(PTE) model was established by injecting thrombin into jugular vein two times in two weeks and each rat underwent peritoneal injection with tranexamic acid one time a day during experiment to prevent thrombolysis.The mean pulmonary artery pressure(mPAP),right ventricular hypertrophy index(RVHI),relative medial thickness of small pulmonary arteries(PAMT) and vessel wall area/total area(WA/TA) were measured.The levels of ROCK I mRNA and TGF-?1 protein in rat pulmonary artery were determined by in situ hybridization,immunohistochemistry and image analysis,respectively.RESULTS: mPAP,PAMT and WA/TA were higher respectively in embolism from 4 weeks group to 12 weeks group than those in beginning control group(mPAP: all P