Objective: Through the analysis of the current situation of energy consumption and the energy management problems that hospital faced, elaborat the high demands of energy management in hospital effective logistics management, the saving mechanism of Energy Performance Contracting (EPC) is proposed. Methods: The process of introducing EPC to China and related concepts are described, and the main mode and implementation processes as well. Results: To explore the feasibility of the integration in energy-saving reformation and the mode of energy runing management what is the core to EPC, tell people what need to pay attention to in the implementation process, and provide scientific methods for energy management of efficiency operation and sustainable development in hospital. Conclusion:At last, pointing out that saving mechanism of EPC is suitable for hospitals and will bring significant saving benefit.

Objective By comparing the biological characteristics among Lewis lung cancer cells ( LLC) , LLC or-thotopic transplantation derivative cells ( R1-LLC) and R1-LLC orthotopic transplantation derivative cells ( R2-LLC) , we e-valuate their invasion and metastatic abilities in orthotopic transplantation models.Methods In vitro, we applied CCK8, clonogenic assay, and Transwell invasion assay to detect the proliferation ability, invasion ability and morphologic structures of LLC,R1-LLC, R2-LLC cells respectively, meanwhile observing morphologic structures by transmission electron microsco-py.In vivo, we constructed LLC, R1-LLC and R2-LLC orthotopic transplantation models.Herein, we observed their tumor growth and metastasis.The tumor formation rate and tumor-forming time were recorded for statistic analysis.Results In vitro:LLC, R1-LLC and R2-LLC cells showed no significant difference in proliferation ability ( P>0.05 ) , but significant differ-ences in invasion ability:R2-LLC>R1-LLC>LLC(P<0.05).In vivo:In the orthotopic group, the tumor formation rates of LLC, R1-LLC and R2-LLC cells were 66.67%、80%、93.33%(P <0.05).Conclusions In orthotopic implantation mouse models, R2-LLC cells present higher invasion and metastatic ability than R2-LLC and LLC cells.

A well Web-based teaching supplementary system is beneficial for saving teaching resources,arousing students’enthusiasm for study.but there is no the emotion exchange between teachers and students which exists in traditional class.Web-based supplementary teaching is an important supplementary method for medical morphology courses,but it can not replace the traditional teaching method.Combining them each other is needed for raising teaching quality.

Objective To study the expressions of survivin and caspase-9 in human primary hepatocellular carcinoma(HCC) tissues and their relationship with apoptosis.Methods Immunohistochemical staining was uesed to detect the expressions of survivin and caspase-9 in paraffin sections of 96 cases including 42 HCC tissues,42 paired adjacent noncancerous tissues and 12 normal liver tissues. Apoptosis was detected by TUNEL.Results No immunoreactivity of survivin was seen in normal liver tissues.The positive rates of survivin in HCC and paired adjacent noncancerous tissues were 73.81% and 4.76%,respectively,there was significant difference between two groups(P0.05).The expressions of survivin and caspase-9 in HCC tissues were not associated with age,sex and the size of tumor,but they were directly associated with tumor histological grade and metastasis.Conclusion High expression of survivin in HCC may inhibit apoptosis through depressing the expression of caspase-9,and it is an indicator of independent poor prognosis.

BACKGROUND: In addition to physical disability, stroke may also result in psychological impairments usually manifested by depression and anxiety.Regardless of the primary or secondary onset of anxiety, anti-depressants should be given for treatment of the anxiety and depression besides routine treatment of the primary condition underlying the symptoms.OBJECTIVE: To compare the effect of different treatment protocols with or without anti-depressants and different anti-depressants on poststroke anxiety and depression as well as the neurological functions.DESIGN: Randomized controlled double-blind clinical trial.SETTING: Departments of Psychiatry and Neurology of the Second Hospital Affiliated to Lanzhou University.PARTICIPANTS: Ninety patients aged 41-72 years with post-stroke anxiety and depression, who were admitted in the Departments of Psychiatry and Neurology of the Second Hospital Affiliated to Lanzhou University between July 1999 and December 2002, were enrolled in this study and randomized equally into Paxil group, imipramine group and control group.METHODS: After emergency management for 1-2 weeks in the acute stage, the stroke patients showed clear consciousness and stable life signs without any understanding problems. Patients in the control group received conventional treatment combined with rehabilitative training, while patients in the other two groups were given additional Paxil (20 mg/day) or imipramine (50-150 mg/day) for totally 12 weeks. The neurological deficits and capacity for independent living of the patients were assessed with Hamilton Depression Scale (24 items) and Hamilton Anxiety Scale (14items) at 2, 4, 8, and 12 weeks during the treatment. A reduction of the score for Hamilton anxiety and depression scale by over 75% suggested a cure of depression and anxiety, 50% but ＜ 75% obvious improvement,25% but ＜ 50% improvement, and ＜ 25% non-response. Basically recovered neurological function was indicated by a reduction of neurological deficit score by 90%-100%, remarkable improvement by 46%-89%, improvement by 18%-45%, and non-response or exacerbation by a reduction less than 17%.MAIN OUTCOME MEASURS: ① Neurological function recovery of recovery of the patients after treatment; ② Poststroke anxiety and depression status before and after treatment; ③ Therapeutic effects on depression,neurological functions, severity of neurological deficit, and capacity of independent living. ④ Adverse events and side effects.RESULTS: One patient in Paxil group and 3 in the control group failed to be available for follow-up study, and 3 patients in imipramine group withdrew from the study due to adverse events, so that 83 cases were analyzed.At 2 and 4 weeks in the treatment, the scores for neurological deficits and capacity for independent living exhibited obvious changes (P ＜ 0.01),which gradually stabilized at 8 and 12 weeks (P ＜ 0.05), and significantly greater improvement in the neurological function and capacity for independent living was observed in Paxil group than in the control group (P＜ 0.01), but the differences between imipramine group and the control group and between Paxil group and imipramine group were not statistically significant (P ＞ 0.05). The scores for Hamilton Depression Scale and Hamilton Anxiety Scale were obviously lower in Paxil group and imipramine group at 2, 4, 8 and 12 week than those in the control group (P＜ 0.01-0.001), but similar between the former two groups at 12 weeks (P＞ 0.05). Paxil and imipramine on resulted in curative rates of anxiety and depression of 86.6% and 85.1%, respectively, which were obviously higher than that of the control group (46.6%); the improvement rate ofneurological function in Paxil group, imipramine group and control groupwas 89.6%, 70.3% and 56.6%, respectively, with that of Paxil groupsignificantly higher than that of the control group (P ＜ 0.01), but the difference between imipramine group and control group was not signifi cant (P ＞ 0.05).CONCLUSION: Patients with poststroke anxiety and depression shouldreceive appropriate interventions with anti-depressants in addition to treat ment of neural function impairment. Paxil and imipramine haye similar effect in treating anxiety and depression, but the former can be for its less side effects, better compliance on the part of patients and good effect inpromoting neurological function recovery.

Test is an important way for getting feedback from students about teaching. The traditional examination is not suitable for the requirements of modernization teaching.Web-Based Course Examination of practice pathology simplifies the process of traditional examination greatly. It is one of the important means in modernization teaching.

BACKGROUND: There is often a physical and psychosocial effect in burn injury, and the degree of mental stress reaction is related to social support, individual experience and personality characteristics.OBJECTIVE: To investigate the mental stress reaction, the degree of social support and the Minnesota Multiphasic Personality Inventory (MMPI)personality characteristics in acute burn patients, and to analysis the influence factor of mental stress reaction.DESIGN: Cross-sectional study.SETTING: West China Mental Health Center of Sichuan University, Burn Department of Mianyang Municipal Central Hospital, and Burn Department of General Hospital of Panzhihua Iron and Steel Company.PARTICIPANTS: From April 2003 to April 2005, totally 104 mild, moderate or severe burn patients, including 92 males and 12 females, aged 12-60 years, selected from Mianyang Central Hospital and Department of burn of General Hospital of Panzhihua Iron & Steel Co., Ltd took part in the study.METHODS: The emotional problems and personality characteristics were measured with the Hamilton Rating Scale for Depression (HAMD), the Hamilton Rating Scale for Anxiety (HAMA), the Minnesote Multiphasic Personality Inventory (MMPI), the Social Support Rating Scale (SS) as well as general clinical data,by the rating scales 3 day after burn. The patients were divided into anxiety-depression group (n=51) and normal emotion group (n=53) according to their anxiety-depression scores (anxious score＞ 7,depressive score＞ 8), those influencing factor included burning total area,age, sex and society support, Stepwise Regression was introduced to get the main factors that influenced mental stress reaction.MAIN OUTCOME MEASURES: ① Scores of each scale and comparison of general clinical data in each group; ② stepwise regression analysis of depression and anxiety of burn patients.RESULTS: Data of Totally 104 patients was entered the final analysis. ①The scores were 10.4±2.46 and 16.8±5.94 of anxious and depressive patients during acute burn period, which were higher than those in normal group (4.29±2.26, 5.48±2.06, P=0.01). ② The main influential factor for depression were burning area and social supporting availability, and those for anxiety were age, burning area, social supporting availability and subjective social supporting degree. ③ MMPI test results show that T scores in anxiety-depression group were below 60 points, however T-scores were above 60 points in normal group including cheating points, hypomania,schizophrenia, psychasthenia and paranoid ideation CONCLUSION: Burn is a mental crisis to burn patients, which can lead to abnormal emotional reaction and personality change. The depressive and anxious score are positively related with burning area, and are negatively correlated with society supporting availability. The good social support system is benefit to over mental crisis period.

Objective To investigate the associated factors of complete virological response (CVR) in Entecavir treatment among chronic hepatitis B (CHB) patients with positive HBeAg.Methods Data of 166 CHB patients with positive HBeAg receiving Entecavir treatment in Yantai Infectious Diseases Hospital during December 2009 and May 2014 were collected.Clinical data including age,gender,genotype,baseline alanine aminotransferase (ALT),HBV DNA load,HBsAg and HBeAg levels as well as CVR cumulative rates at different time points during Entecavir treatment were retrospectively analyzed.The cumulative rate of CVR was estimated using Kaplan-Meier method,and the difference in cumulative CVR rates was studied with Log-rank test.Cox's proportional hazards regression model was used to analyze the factors associated with CVR during Entecavir treatment.Results The cumulative rates of CVR during Entecavir treatment in HBeAg positive CHB patients were 54.5％ (87/157),74.3％ (106/129),80.2％ (109/119) and 86.8％ (110/112) at 48,96,144 and 192 weeks,respectively.Log-rank test showed that female patients and patients with genotype B,high baseline ALT level or low baseline HBV DNA load had higher CVR rates (x2 =15.601,11.542,17.021 and 10.094,all P ＜ 0.01).Cox's proportional hazards regression model showed that female was the only associated factor for CVR in Entecavir treatment among HBeAg positive CHB patients [hazard ratio (HR) =3.015,95％ confidence interval (CI):1.875-4.968,P ＜ 0.01].Conclusion CVR rate is increasing with the course of Entecavir treatment in HBeAg positive CHB patients,and CVR is more likely to occur in female patients.

Antisense oligonucleotides (ASODN) for therapy is a genetic technology which is based on the base-complementary principle. DNA or RNA sequence synthesized by biotechnology is transferred into the target cells to form mRNA-DNA or mRNA-RNA double strand for inhibiting the expression of target genes. In this way we can control and treat some diseases. The development of antisense oligonucleotides drugs has opened a new area of genetic pharmacology. This paper reviews its classifications, mechanics and its wide application in the treatment of viral infection, tumor and cardiovascular diseases. At the same time we pose the problems that need solving.
Arterial Occlusive Diseases ; therapy ; Humans ; Neoplasms ; therapy ; Oligonucleotides, Antisense ; pharmacology ; therapeutic use ; Virus Diseases ; therapy

Recurrence rate after cessation of nucleos(t)ide analogues remains high in clinical practice. According to current evidences, age, HBsAg level, HB VRNA level, time of consolidation therapy and HBV DNA load were considered to be associated with off-treatment responses after cessation of nucleos(t)ide analogues. Combinative factors of several predictors might perform better in future accompanying with further studies of HBV related markers.