Against the backdrop of ongoing healthcare system reform and escalating competitions among hospitals in China,more and more specialists and scholars on hospital administration begin to focus their studies on the theories and practice of hospital flows.Methodology frequently called into play in such study include out-patient flow refom,progressive flow improvement,and attention to management and service.Discussed in this paper are the advantages and disadvantages of these three methods as a reference for an appropriate choice by hospitals at large.

Objective To investigate the regulation of miR-1 and miR-133 a on L-type calcium channel β2 subunit ( Cavβ2 ) and α1C subunit during rat cardiomyocyte hypertrophy .Methods Cardiomyocyte hypertrophy was in-duced by isoproterenol (ISO, 10μmol/L).The targets of miR-1 and miR-133a were predicted by online database microCosm and Targetscan , respectively .The 3′untranslated region sequences of Cavβ2 andα1C were respectively cloned into reporter vector and then transiently transfected into HEK 293 cells.The luciferase activities of samples were measured for demonstrating the expression of luciferase reporter vector .The protein expression of Cavβ2 andα1C were evaluated by Western blot .The expression levels of Cavβ2 andα1C were inhibited by RNAi to determine theeffectsofCavβ2andα1Concardiomyocytehypertrophy.Results 1)Cavβ2wasoneofpotentialtargetsof miR-1,α1C was the one of potential targets of miR-133a.2) The luciferase activities of HEK293 cells with the plasmid containing widetype Cavβ2 3′UTR sequence or α1 C significantly decreased ( P <0.05 , P <0.01 ) . 3 ) Upregulation of the miR-1 and miR-133 a by miR-1 mimic and miR-133 a mimic transfection suppressed pro-tein expression of Cavβ2 and α1C, respectively(P<0.01, P<0.05).4)Downregulation of Cavβ2 andα1C by RNAi could markedly inhibit the increase of cell surface area ( P<0.01 ) , mRNA expression of ANP andβ-MHC (P<0.05).Conclusions Cavβ2 is the target gene of miR-1 and α1C is the target gene of miR-133a.miR-1 and miR-133a can negatively regulate the expression of L-type calcium channel Cavβ2 andα1C subunit, inhibi-ting cardiomyocyte hypertrophy.

BACKGROUND:Total knee arthroplasty mainly used fixed platform, but more and more movable platform was selected year by year in the clinic. Rotary platform theoretical y can apparently improve the curative effects, but it has not been verified in the clinic.
OBJECTIVE:To summarize the design characteristics and clinical results of Gemini MKII (Link, Germany) rotary platform.
METHODS:From January 2004 to January 2009, 108 patients (119 knees) including 31 males and 77 females were treated with total knee arthroplasty by using Gemini MKII system. There were 97 unilateral cases and 11 bilateral cases at the first stage of replacement. Preoperative diagnosis:1 case of hemophilic arthritis, 1 case of venereal Charcot’s disease, 8 cases of post-traumatic arthritis, 11 cases of rheumatoid arthritis, and 87 cases of degenerative osteoarthritis. The prosthesis was fixed with bone cement. None received patel ar replacement. RESULTS AND CONCLUSION:None experienced infection, femoral condyle fracture or nerve and vascular damage. Except bilateral replacement, the average operation time of unilateral replacement was (56±13) minutes. Average postoperative hemoglobin decreased (25±5) g/L. After replacement, hemoglobin maintained over 100 g/L in 83 patients (86%), without blood transfusion. Knee joint score and function score recovered to (92.0±4.7) points and (90.3±6.8) points at half years after replacement, and became (94.4±3.2) points and (91.6±5.9) points during final fol ow-up, which was significantly improved as compared with that pre-replacement (P<0.01). No revision surgery should be done for lining prolapse or spin out, osteolysis and prosthesis loosening. These results indicated that the early and midterm results of Gemini MKII rotating-platform prosthesis were satisfactory, but the long-term results remain to be confirmed.

BACKGROUND: The femoral intramedul ary guides in total knee arthroplasty require high precision, complex operation, it is very important for prosthesis and joint function to choose more precise positioning method and determine the correct needle point. OBJECTIVE: To study the effect of needle point position on prosthesis arrangement when applying different femoral intramedul ary guides methods in total knee arthroplasty. METHODS: Total y 80 patients who received the treatment of total knee arthroplasty in Changshu No.1 People’s Hospital from January 2012 to July 2015 were selected and divided into test and control groups according to random number table (n=40/group). The patients in the test group accepted CT scan for femoral intramedul ary guides. The theoretical position of femoral intramedul ary guides entry point was marked using radiographic parameters. In the control group, the traditional total knee arthroplasty technology was used to mark the entry point of femoral intramedul ary guides. The needle point position when applying different femoral intramedul ary guide methods was observed. The effect of femoral intramedul ary guides on prosthesis arrangement in total knee arthroplasty was discussed. RESULTS AND CONCLUSION: Compared with the control group, the distance from entry point to femoral anatomic line on positive and lateral X-ray film in the test group was shorter, femoral prosthesis lateral angle and physiological valgus angle were closer to the theoretical value, distance from intersection of femur axis and femoral condyle to block center was shorter; the differences were statistical y significant (P < 0.05). These results demonstrate that compared with the traditional two-dimensional intramedul ary positioning, the needle point position of three-dimensional CT scan stimulative positioning is more accurate. The location more concentrates on within intercondylar fossa 2-5 mm, more front of intercondylar fossa 3-10 mm, three-dimensional CT scan stimulative positioning is a reliable choice for femoral intramedul ary guides.

OBJECTIVE: To make up the deficiency of pharmacotherapy in the treatment of SARS. METHODS: The psy-chotherapy was carried out by sending drug bag and card, with encouraging and blessing words printed on, to the patients, andthe psychotherapeutic efficacy was investigated by questionaire .RESULTS: 100% of the patients thought our service had goodeffect and was helpful to their psyche and disease, 96.9% of patients thought it was necessary .CONCLUSION: In different wayfrom doctor and nurse's,clinical pharmacist can take part in disease treatment and clinical psychological treatment.

Objective:To investigate the effect of saw palmetto extract ( SR ) on GL261 glioma in rats and immune system.Methods:The 40 rats were divided into 4 groups randomly,one was the control group without tumor( the blank group) ( n=10) ,the other 30 rats were given subcutaneous inoculation of tumor cells and then divided into 3 groups:the tumor-bearing group( n=10) ,low dose SR group( n=10) ,and high dose SR group( n=10).After 1 week fed,the rats of SR groups were given the saw palmetto extract,low dose group 50 mg/kg once a day every other day and 300 mg/kg of high dose group every other day.The tumor-bearing groups received the same dose of distilled water.After 4 weeks fed, we measured the tumor weight and the inhibition rate was calculated.The tumor cell apoptosis was detected by TUNEL staining.The activity of splenic macrophages was detected by macrophage phagocytosis of chicken erythrocytes and CD4+lymphocytes by flow cytometry.Results:①The SR groups compared with tumor group, the tumor weight was significantly reduced(F=62.678,P=0.000).The tumor inhibition rate was significantly higher in high dose group.②The apoptosis of tumor cells in tumor-bearing group was significantly less than SR groups and the apoptosis was significantly increased after treatment with SR ,especially in high dose SR group(F=1.287,P=0.000).③Compared with the blank group,the macrophage activity decreased remarkablely.SR enhanced the macrophage activity obviously, positively related to doses of SR ( F=141.205,P=0.000;F=126.903,P=0.000).④In the tumor-bearing group,the CD4+lymphocyte count decreased significantly.After SR treatment,the CD4+lymphocyte increased and were positively related to the dose of SR.Conclusion: Saw palmetto extract can strengthen the immune system.

AIM:To investigate the effect of hydrogen sulfide ( H2 S) on high glucose ( HG)-induced injury of the mouse podocyte cell line MPC5.METHODS: The cultured MPC5 cells were randomly divided into 4 groups: HG group, normal glucose (NG) group, NG+DL-propargylglycine (PPG) group, and HG+NaHS group.After treated for a certain time, the cells were collected for further detection .The expression of zonula occludens-2 (ZO-2), nephrin,β-cate-nin and cystathionine γ-lyase ( CSE) was determined by Western blotting .RESULTS:High glucose significantly reduced the expression of nephrin, ZO-2 and CSE (P<0.05), while the level of β-catenin was elevated obviously (P<0.05), all in a time-dependent manner.NG+PPG inhibited the levels of ZO-2 and nephrin significantly (P<0.05), and increased the level of β-catenin (P<0.05), all in a PPG concentration-dependent manner.HG+NaHS induced a more significant increase in the levels of ZO-2 and nephrin as compared with HG group (P<0.01), whereas a severe reduction of β-cate-nin in HG+NaHS group was observed as compared with HG group .Compared with NG group , the expression of ZO-2 and nephrin was decreased obviously , and the level of β-catenin was increased in HG +NaHS group.CONCLUSION:Down-regulation of CSE contributes to hyperglycemia-induced podocyte injury .Exogenous H 2 S protects against hyperglycemia-in-duced podocyte injury , possibly through up-regulation of ZO-2 and subsequent suppression of Wnt/β-catenin pathway .

Objective To explore the effects of the extracellular regulated protein kinase’s (ERK1/2) inhibitor PD98059 and ino-sitol triphosphate kinase (PI3K/PKB) signaling pathway’s inhibitor LY294002 on extracellular matrix (ECM) deposition in pulmonary arterial smooth muscle cells (PASMCs) stimulated by connective tissue growth factor (CTGF). Methods PASMCs of SD rat were cul-tured in vitro. The PASMCs were divided into control group, CTGF group, CP (CTGF+PD98059) group, CL (CTGF+LY294002) group and CPL (CTGF+PD98059+LY294002) group. Real-time lfuorescent quantitative RT-PCR was used to detect the expression of colla-gen III and ifbronectin mRNA of PASMCs, and the expression of collagenШprotein of PASMCs was detected by immunohistochem-istry and western-blot. Results The expressions of collagenШand ifbronectin mRNA of PASMCs stimulated with CTGF (50 ng/ml) for 48 h were signiifcantly higher than those in control group, and the collagen proteinШof PASMCs was decreased signiifcantly after stimulation with CTGF (50 ng/ml) for 72 h (P<0.05). The expressions of collagenШand ifbronectin mRNA in PASMCs cultured with PD98059 (20μmol/L) and/or LY294002 (10μmol/L) for 48 h was signiifcantly lower than those in CTGF group (P<0.05). The collagen proteinШin PASMCs cultured with PD98059 (20μmol/L) and/or LY294002 (10μmol/L) for 72 h was increased (P<0.05). The expres-sions of collagenШand ifbronectin mRNA of PASMCs stimulated with both PD98059 and LY294002 were more signiifcant. Conclu-sions CTGF may increase the expression of collagenШand ifbronectin mRNA in PASMCs, which may contribute to the deposition of ECM in PASMCs during pulmonary vascular remodeling. PD98059 and LY294002 may repress ERK1/2 and PI3K/PKB signaling pathways and interfere with the biological effect of CTGF.

Objective To investigate the effect of saw palmetto extract (SR) on GL261 glioma in rats and immune system.Methods The 40 rats were divided into 4 groups randomly,one was the control group without tumor (n =10),the other 30 rats were given subcutaneous inoculation of tumor cells and then divided into 3 groups:tumor-bearing group (n =10),low dose SR group (n =10),and high dose SR group (n =10).After 1 weeks feeded,the rats of SR groups were given the saw palmetto extract,low dose group 50 mg/kg once a day every other day and 300 mg/kg of high dose group every other day.The tumor-bearing groups received the same dose of distilled water.After 4 weeks feeding,we measured the tumor weight and the inhibition rate was calculated.The tumor cell apoptosis was detected by TdT mediated dUTP nick-end labeling (TUNEL) staining.The splenic T lymphocyte proliferation was tested by methyl thiazolyl tetrazolium (MTF).Results (1) The SR groups compared to tumor group,the tumor weight was significantly reduced (F =62.678,P =0.000).The tumor inhibition rate was significantly higher in high dose group.(2) The apoptosis of tumor cells in tumor-bearing group was significantly less than SR groups and the apoptosis was significantly increased after treatment with SR,especially in high dose SR group (F =1.287E3,P =0.000).(3) Compared to SR groups and control group,T lymphocyte proliferation of tumor-bearing group reduced obviously.After treated with SR,T lymphocyte proliferation significantly increased and was higher in high-dose group (F =103.565,P =0.000).Conclusions Saw palmetto extract can activate T lymphocytes and induce apoptosis to tumor cells.Its function was related to SR concentration.

Objective To investigate the cleaning effects of two different methods (modified ultrasound method VS traditional cleaning method) on endoscopy buttons,including suction button and water/gas injection button,and to provide effective clinical evidence for seeking better methods in cleaning endoscopy buttons.Methods A total of 200 endoscopy buttons were randomly divided into two groups:modified ultrasound cleaning group (experimental group) and traditional cleaning group (control group).The combination of multienzyme abluent and ultrasound vibration was applied to the experimental group and multienzyme abluent was used in the control group.ATP bioluminescence detection technology was applied to detect the residual status of organic substance and this parameter was used to evaluate the disinfection status of two different cleaning methods.Results The average organic substance residual was (217.0 ± 29.8) RLU and (42.74 ±8.6)RLU in control group and experimental group,respectively(P ＜0.01).The pass rates were 26％ (26/100) and 87％ (87/100) in in control group and experimental group respectively (P ＜ 0.01).Conclusion Modified ultrasound cleaning method combined with multienzyme abluent and ultrasound vibration has great cleaning effects on endoscopy buttons before disinfection.It can be regarded as a new method for cleaning endoscopy buttons.