Middle sized public hospitals are facing new challenges with the introduction of the new medical reform policies and the promotion of internet information economy.In order to adapt to the new social economy and policy,medium sized public hospitals should be reformed,be more active and find their own new position according to the new environment.The following work can be done to improve medium sized public hospitals' survival and development and to better meet the needs of the society:exploring their resources,building their regional medical associations,strengthening their construction of key disciplines,utilizing the advantages of internet and information system,and reforming their personnel divisions.

Adolescent ; Child ; Child, Preschool ; Female ; Fructose ; analogs & derivatives ; therapeutic use ; Humans ; Infant ; Male ; Tourette Syndrome ; drug therapy

Objective To study the influence of different routes of keyhole limpet hemocyanin ( KLH) immuniza-tion on the T-cell-dependent antibody response in mice.Methods SPF Kunming mice were divided into four groups: the intravenous injection group, subcutaneous injection group, intraperitoneal injection group and control group.Each mouse was injected 200 μg KLH intravenously, subcutaneously or intraperitoneally daily for consecutive 10 days, respectively. Mice in the control group were given solvent injection only.Serum concentration of IgG stimulated by KLH antigen was measured 7 days after the last dosing.Spleen was isolated to calculate the organ coefficient and examined by pathology u-sing hematoxylin and eosin staining.Results Intravenously, subcutaneously and intraperitoneally administered KLH stimu-lated the generation of secondary lymphoid follicles and germinal center to varying degrees, B cell apoptosis, increased a-mount of cells in the marginal zone and other pathological changes were observed in the spleen.Intravenous and intraperito-neal administration of KLH led to more pronounced pathological changes compared with that in the subcutaneous injection group.All of the three administration routes of KLH induced generation of IgG antibody, significantly higher than that in the control group (P<0.05).Intravenous injection of KLH generated the highest concentration of IgG and organ coefficient among the three administration routes ( P<0.05) .Conclusions Different immunization routes do affect the production of IgG antibody, organ coefficient and pathological changes in the spleen, and these differences should be taken into consider-ation when analyzing the T cell dependent antibody response in mice.

A total of 55 children aged under 14 years with cholecystolithiasis were treated at our hospital between January 2005 to December 2011.Their clinical data were collected and analyzed.The etiologies included pseudolithiasis (n =36),chronic hemolytic disease (n =2),obesity (n =9) and unknown (n =8).Among 50 cases on conservative treatment,42 cases were cured.Four cases underwent laparoscopic cholecystectomy.During a follow-up period of 2-4 years,there was no occurrence of significant complications.The removal of gallbladder stone was performed via laparoscopy plus choledochoscope in 1 case.There was no recurrence during a follow-up period of 2 years.Ceftriaxone sodium and obesity were the major cause of pediatric cholecystolithiasis.A proper selection of treatment regimens should be based upon the considerations of etiologies and symptoms.

Objective To investigate the situation and change of antifungal resistance in clinical Candida and other fungal iso- lates from 5 hospitals in diverse geographic region of China.Methods Antimicrobial susceptibility testing of 8 000 fungat iso- lates collected during 2001 and 2005 were carried out with 25?g fluconazole disk and 1?g voriconazole disk using disk diffusion method as recommend by CLSI/NCCLS M44-A.Disk test plates were automatically read and results were recoded with the BIOMIC Image Analysis System.The equivalent MICs were automatically calculated by the BIOMIC System software.Results The proportion of Candida atbicans and non-Candida albicans (e.g.Candida glabrata) in the total fungal isolates did not change significantly from 2001 to 2005.The susceptibility rate of C.albicans to fluconazole and vorieonazole were stable during 2001 and 2005.However, the resistance to fluconazole and voriconazole increased variably in C.glabrata and other non-Can- dida albicans fungal isolates during the same period.Conclusions The voriconazole demonstrated higher activity against all yeast species in comparison with fluconazole.The increasing resistance to fluconazole and voriconazole in non C.albicans fungal isolates including C.glabruta suggests the importance of surveillance of fungal resistance in Candida isolates.

Objective To study the clinical therapeutic effect of acupuncture in the treatment of depressive neurosis.Methods The 60 selected patients of depressive neurosis were randomized into treatment group(acupuncture regulating the liver group)and con- trol group(near-by sham-point acupuncture group),with 30 in each.The scores of Symptom Checklist 90(SCL-90),Self-rating De- pression Scale(SDS),and Hamilton Depression Scale(HAMD),and the total effective rate after treatment were observed.Results The total effective rate of the treatment group and the control group was 92.6% and 56.0% respectively,and the difference was sig- nificant(P

AIM: To observe the effect of Retinervus luffae fructus (RLF) on the myocardial ischemia in mice. METHODS: Mice were supplied with RLF (166.7,333.3, 666.7 g/L) twice daily (0.01 mL/g, ig). One week later, 30 U/kg pituitrin was injected intraperitoneally. The electrocardiogram was recorded, and the content of lactose dehydrogenase (LDH) in the serum and the activities of superoxide dismutase (SOD), maleicdialdehyde (MDA) in the myocardium were examined. RESULTS: RLF reduced the height of T wave in electrocardigram in myocardial ischemia mice and inhibited the decrease in heart rate. RLF also reduced the content of LDH in serum and the content of MDA in myocardium. The increase in the activity of SOD in myocardium was also observed. CONCLUSION: RLF may protect myocardium against ischemia injury. The mechanism may be related to the increase in activity of SOD and the suppression of the lipid peroxidation.

In order to confirm the existence of indoleamine 2, 3-dioxygenase (IDO) gene in swine, and to clone the novel gene followed by the molecule structure properties and expression pattern analysis, the porcine mRNA sequences homologous to human IDO were obtained from GenBank database by bioinformatics method. By using RT-PCR, the IDO gene was cloned from porcine endothelial cell line and the accuracy of the nucleic acid sequence was confirmed, and the expression pattern of the gene was detected. The three-dimensional structure model of porcine IDO was built referring to the tertiary structure of human IDO using biological sequence analysis software and database. The results showed that the porcine IDO was identified by sequencing. The nucleotide sequences were confirmed as a novel gene after submitted to Genbank. Porcine IDO was expressed in the lung, thymus, epididymis and anterior chamber with a basic level, however in peripheral blood mononuclear cells (PBMCs) the IDO gene was highly expressed. The three-dimensional structure model of porcine IDO was similar to that of human IDO. It was suggested that identification of the structure information of porcine IDO is essential to further investigate the immunologic function of the gene. Study of IDO on NK cells-mediated xenograft rejection will be a novel therapeutic target for the development of xenotransplantation.

ObjectiveTo investigate the effect of β-adrenoceptor (β-AR) blockers on G protein and heart function changes in rats with acute myocardial infarction (AMI) MethodsWistar rats with AMI induced by left anterior descending coronary branch ligation were randomly divided into compared with sham operation group. Eight weeks after therapy, hemodynamics was assessed by inserting catheters and the level of G protein was detected by Western blot analysis. ResultsCompared with the sham operation group, systolic blood pressure(SBP), diastolic blood pressure (DBP), left ventricular systolic pressure(LVSP) and left ventrieular pressure maximal rate of rise and fall(±dp/dtmax) in AMI group were significantly decreased, while left ventricular end diastolic pressure (LVEDP) and Gs and Gi protein levels were significantly increased (all P<0.05). Compared with AMI group, LVSP and ± dp/dtmax were increased, but LVEDP and Gi protein level were significantly decreased in metoprolol and carvedilol group. LVEDP and Gi protein level were decreased in carvedilol group compared with metoprolol group. ConclusionsCarvedilol can effectively suppress the change of G protein and improve the heart function after AMI, and the effect is better than that of metoprolol. This may be related with its β2-AR blocking effect.

Objective To construct the recombinant plasmid containing human filaggrin gene,purify and identify the immunoreactivity of the recombinant protein,and establish the indirect ELISA to detect AFA for diagnosis of RA.Methods The constructed plasmids were transformed into E. Coli Rosettagami(DE3).This fusion protein was purified by NAT chromatography.ELISA coated with the fusion protein Was established to detect the AFA in serum of patients,which included 114 cases of RA,56 cases of SLE,32 cases of OA and 40 cases of normal controls. The correlation between the results of AFA and anti-CCP in RA group were compared. Results 321 bp fragment of filaggrin gene was amplified and the recombinant expression vector pET-28a( + )-filaggrin was constructed. The sequence of filaggrin gene was the same as the sequence reported in the literatures. The Rosetta-gami (DE3) strains of E. Coli with recombinant vector showed high level of filaggrin protein after induction. The SDS-PAGE showed that the plasmid expressed the filaggrin fusion protein with molecule weight of 14 000 Da. The expression protein could be purified by Ni-NAT with activity. The absorbance value of AFA in RA group was 0.473 ±0. 248 while they were 0. 160 0. 088, 0. 121±0. 070, 0.050 0. ±018 in SLE, OA and normal groups respectively. There were significant differences of absorbance values of AFA between RA and SLE, OA, control group (t = 12.004, 14. 464, 18.078, P<0. 01, respectively). The positivities of anti-filaggrin in RA, SLE and OA were 48.2%, 5.4% and 3. 1% respectively. The positivities of AFA were significantly different between RA, OA and normal control groups (x~2 = 67. 088, P < 0. 01). There was positive correlation of results between AFA and anti-CCP antibody (r = 0.42, P < 0. 05 ) . The consistency rate of results between AFA and anti-CCP was 70. 1%. Anti-CCP was negative in 10 out of 114 patients with AFA positive. AFA can be used to diagnose RA with sensitivity of 48. 2% , specificity of 96.9% , positive predictive value of 93. 2% and negative predictive values of 67. 9% . Conclusions The purified human filaggrin fusion protein is successfully purified. The indirect ELISA method based on the recombinant protein shows good sensitivity and specificity. Joint detection with AFA and anti-CCP can improve the positive rate of detection.