The financial objective of the health non-operating state-owned assets(NSA) value-running is defined as non-profit, an empirical test is designed; the non-profit objective function and for-profit objective function is established and the impact of fix asset and staff cost on financial objective in multiple regression functions are compared.

Objective To explore the value of combined application of qualitative detection of TB-DNA serum anti-PPD-IgG and acid-fast staining methods in the diagnosis of tuberculosis infection .Methods Totally 278 pulmonary tuberculosis patients and 121 non-pulmonary tuberculosis patients were collected from Qingyuan people′s hospital during the period from January 2013 to June 2015 .Tuberculosis in patients with TB-DNA qualitative and serum anti-PPD-IgG and acid-fast staining test results was analyzed . Sputum TB-DNA qualitative and serum anti-PPD-IgG detection and joint application of acid-fast staining in the diagnosis of tuber-culosis infection .Results Sensitivities of acid-fast staining ,TB-DNA and serum anti-PPD-IgG in the TB group were 32 .01% , 51 .44% and 48 .56% respectively .The detectable rate of combining TB-DNA with serum PPD-IgG was 67 .63% .The detectable rate of combining TB-DNA with acid-fast staining was 54 .68% .The detectable rate of combining serum anti-PPD-IgG with acid-fast combined rate was 57 .55% .The detectable rate of combining three assays improved to 68 .71% .Conclusion Serum anti-PPD-IgG detection in the diagnosis of tuberculosis is simple ,effective ,qualitative detection of acid-fast staining sensitivity better than TB-DNA ,but it had a poor specificity .Bacteriologic diagnosis are tuberculosis diagnostic gold standard,but the detectable rate for acid-fast bacilli is low .The qualitative of TB-DNA test had a better sensitivity and specificity than other two assay .Combining with three assays could increase detectable rate and improve diagnosis of tuberculosis disease .

Objective To investigate the clinical features and prognosis of adult dermatomyositis with gastrointestinal bleeding and perforation. Methods The clinical data of a adult dermatomyositis with gastrointestinal bleeding and perforation were retrospectively analyzed. And the clinical characteristics of this patient were analyzed, combined with 7 cases reported in the literature. Results Among the 8 cases, 6 cases were females and 2 cases were males, aged 18 to 63 years. The 5 cases had melena, 3 cases had hematemesis, 3 cases had hematochezia and 1 case had hemoptysis. The main treatment was glucocorticoids, immunosuppressive agent, intravenous immune globulin (IVIG), endoscopic hemostasis and angiographic embolization. Four of the 8 cases died. Conclusions Adult dermatomyositis with gastrointestinal bleeding and perforation is rare, but the condition is dangerous and the mortality is high. Dermatomyositis with early onset of abdominal pain, vomiting, melena should be alert to serious complications such as gastrointestinal bleeding and perforation.

Comet Assay ; DNA Damage ; Humans ; Occupational Exposure ; Population Surveillance ; methods

Obstructive sleep apnea (OSA),the most common type of sleep disordered breathing was closely associated with the occurrence of ischemic stroke.It has been demonstrated that OSA is an independent risk factor for ischemic stroke.Its pathogenic mechanism includes atherosclerosis,coagulation abnormalities and cerebral hemodynamic changes caused by long-term periodic hypoxia hypoxemia and hypercapnia.The prognosis of ischemic stroke patients with OSA is poor.Therefore,it needs to be treated early to avoid further damage to brain tissue and reduce the mortality.

Objective To explore the curative effects,prognostic factors,and adverse reactions of different treatment modalities of chemotherapy in patients with non-small cell lung cancer (NSCLC).Methods151 NSCLC patients were randomly assigned into 3 groups to undergo concurrent chemoradiotherapy ( n = 43 ) ,sequential chemo-radiotherapy ( n = 49 ) ,or pure chemotherapy (n = 59).The clinical data were analyzed.ResultsThe short-term effective rates of the concurrent and sequential chemo-radiotherapy groups were 81.4% and 73.5% respectively with no significantly difference between them,but both significantly higher than that of the pure chemotherapy group ( 39.0% ,both P ＜ 0.05 ).The mortality of the concurrent cherno-radiation group was 53.5% ,significantly lower than those of the sequential chemo-radiotherapy and pure chemotherapy groups (67.3% and 67.8% respectively,both P ＜0.05).The median survival time of the concurrent chemo-radiotherapy group was 26 months,significantly longer than those of the sequential chemo-radiotherapy and pure chemotherapy groups ( 12 and 11 months respectively,both P ＜ 0.05).The l-year survival rates of the 3 groups were 80.2% ,47.1%,and 45.6%.The 2-year survival rates were 58.2% ,38.5% ,and 24.4% ,and the 3-year survival rates were 32.7% ,27.5% ,and 0,respectively.The white blood cell decrease rates of the grades Ⅲ～Ⅳ of the concurrent chemo-radiotherapy group were significantly higher than those of the other 2 groups (both P ＜0.05 ).There were no significant differences in the rates of radiation esophagitis and radiation pneumonitis between the concurrent and sequential chemo-radiotherapy groups.Age,performance status score,clinical staging,and treatment modality were the 4 influencing factors in the prognosis of NSCLC ( all P ＜ 0.05 ).Conclusion Relatively safe with tolerable adverse reactions,concurrent chemo-radiotherapy is superior to sequential chemo-radiotherapy,particularly to pure chemotherapy,in increase of median survival time and survival rate in treatment of NSCLC.Age,PS,clinical staging and therapy method are independent indicators influencing the prognosis.

Objective To evaluate the change of left ventricular(LV) function by real-time three dimensional echocardiography(RT-3DE) and to explore the clinical value of change of serum adiponectin level in patients with metabolic syndrome (MS).Methods One hundred and twenty patients were divided into MS group and control group according to the diagnostic standard of the nternational Diabetes Federation.Transthorasic 2D ultrasound and RT-3DE examination were performed in all study objects, and serum adiponectin levels were measured.Results Parameter index [including Tmsv16-SD, Tmsv12-SD,Tmsv16- Dif, Tmsv12-Dif, Tmsv16-SD (％), Tmsv 12-SD (％), Tmsv16-Dif (％), Tmsv12-Dif (％)] of 17segment time to minimal systolic volume in MS group was more than that in control group (all P ＜0.05).Some regional systolic index of LV and serum adiponectin level were less than that in control group (all P ＜0.05).Compared with the control group, E/E' was lower (P ＜ 0.05).There were significant relations between serum adiponectin level and E/A of mitral valves, E'/A' of mitral annulus and E/E'(r = 0.368,0.493,and -0.347 respectively, P ＜0.05).Conclusions RT-3DE can rapidly evaluate LV systolic and diastolic synchrony in MS patients.E/E' show an excellent correlation with serum adiponectin level,and it may be a new promising method for routine evaluation of LV diastolic function.

Objective To investigate the epidemiological and clinical characteristics of human coronovirus (HCoV ) infection in hospitalized children with acute lower respiratory tract infection (ALRTI)in Shanghai.Methods A retrospective cohort study was conducted between October 2009 and September 2012.Five hundred and fifty-four cases of ALRTI in children under 5 years were enrolled. HCoV and other respiratory viruses in archival nasopharyngeal aspirate specimens were detected by a commercial Seeplex RV12 ACE detection kit.HCoV pan-family reverse transcription polymerase chain reaction (PCR)was performed to screen all known six HCoV,including HCoV-229E,HCoV-OC43, severe acute respiratory syndrome (SARS)-CoV,HCoV-NL63,HCoV-HKU1 ,and real-time PCR was performed to screen Middle East respiratory syndrome (MERS)-CoV.MEGA5 .0 software was used to perform sequence alignment and phylogenetic tree analysis.Results In 554 samples,at least one virus was identified in 273 cases (48.56%)and HCoV was detected in 18 cases (3.25 %),among which 13 were HCoV-OC43/HKU1 positive,5 HCoV-229E/NL63 positive.No high pathogenic MERS-CoV and SARS-CoV were detected.The median age of 18 children with HCoV infection was 18 months (1 -48 months)with 12 boys and 6 girls.Seventeen cases had fever,11 cough,9 tachypenea and 1 wheeze. Seven received oxygen therapy,and 6 were admitted to intensive care unit for treatment.Two who was in ordinary ward were coinfected with adenovirus and human rhinovirus.All 18 cases recovered or improved on discharge.Six was infected in autumn,5 in winter,3 in spring and 4 in summer.Of 8 HCoV-positive samples which were sequenced,each 3 samples belonged to HKU1 and 229E subtypes,respectively,and each 1 belonged to OC43 and NL63 subtypes,respectively.Conclusions HCoV is a relatively common viral pathogen among hospitalized young children with ALRTI in Shanghai.No high pathogenic MERS-CoV is detected.HCoV can cause severe infection with favorable outcome.

Lp-PLA2 is widely concerned in recent years as a vascular inflammation factor that plays an important role in the development of atherosclerosis .The level of plasma Lp-PLA2 is related to the stability of carotid artery atherosclerotic plaque .it is an independent predictor of coronary heart disease risk . Its specific inhibitor Darapladib also becomes a hotspot of clinical cardiovascular pharmaceutical research . However,two randomized, placebo-controlled, double-blind, international, multicenter, event-driven trials, STABILITY and SOLID-TIMI 52, have shown that Darapladib could not significantly reduce the risk of cardiovascular events.

For the minimized phase transtorming risk, the most stable polymorph is generally considered as the desirable solid form for pharmaceutical applications. However, occasionally, the stable form may have some shortcomings such as low solubility, dissolution rate and bioavailability, etc. In that case, the metastable form which is kinetically stable at room or lower temperature could be selected. Using metastable form may result in polymorph transformation in pharmaceutical manufacture and storage. Hence, the knowledge of the transformation between solid forms is essential to the development of the drug materials. In this paper, we will review the recent studies in the area of crystal conversion of polymorphs and hydrates, to illustrate some cases to introduce the types, conditions and mechanisms of the crystalline solid transformation.