Adoption of the board of directors system in a public hospital is conducive to straightening out its internal management system and enables its head to more effectively exercise his power of supervision while giving full play to his functions. In addition, when major issues are concerned, decision-making is more democratic and scientific, reducing disputes over trifles. The board of directors system may after all be accepted as an effective form of management.

Objective To investigate the potential roles of tumor necrosis factor -related apoptosis -indu-cing ligand(TRAIL)signaling system in the pathogenesis of colorectal cancer.Methods Immunohistochemistry tech-niques were used,the TRAIL and its receptor(TRAILR3,TRAILR4)protein were analyzed in both 41 colorectal cancer samples(colorectal cancer group)and normal samples beside cancer tissue(normal group).Results The lev-els of TRAIL and TRAILR3 protein expression in the colorectal cancer group were significantly lower than those in the normal group[(0.237 ±0.036)vs.(0.289 ±0.069);(0.226 ±0.052)vs.(0.281 ±0.068),t =4.125,4.025,all P <0.01],while the positive rate of them were nonsignificant difference between the two groups(88% vs.90%;95%vs.93%,χ2 =0.125,0.213,all P >0.05).The expression levels of them in the colorectal cancer group with poorl differentiation were notably lower than those with high -moderate differentiation[(0.205 ±0.021 )vs (0.245 ± 0.034);(0.185 ±0.032)vs (0.236 ±0.051),t =4.025,2.664,P <0.01,P <0.05],but they were not strongly correlated to lymph nodes metastasis[(0.235 ±0.035 )vs (0.241 ±0.338);(0.216 ±0.048)vs (0.231 ± 0.054),t =0.448,0.862,all P >0.05].Moreover,the positive rate and expression levels of TRAILR4 protein was non -statistic significant difference between the two groups[93% vs 98%;(0.196 ±0.085)vs (0.219 ±0.061),χ2 =1.051,t =1.353,all P >0.05],and it was also non -significantly correlated with cancer cell differentiation and lymph nodes metastasis[(0.176 ±0.052)vs (0.201 ±0.091);(0.194 ±0.054)vs (0.197 ±0.100),t =0.667, 0.448,all P >0.05].Conclusion The levels of TRAIL and TRAILR3 expression are attenuated at colorectal cancer tissue.The expression of them are correlated with cancer cell differentiation grade.These findings indicate that TRAIL system may be associated with the malignant phenotype in colorectal cancer.

Third party custody system at the Second Affiliated Hospital ot Zhejiang University has reduced hospital costs,raised efficiency and optimized resources.The standardized management system featuring 5S+ 1 achieved such outcomes as +5 and -5,and 0 inventory.A three-year review of the economic performance at the hospital has saved three million yuan of costs,proving that the system can help build an effective material supply system for contemporary general hospitals.

ZJ-XD-I multifunctional internal sterilization machine for medical instrumentation is applied in medical instrumentations with circulatory loop such as anesthetic machine and respirator. The machine can generate ozone and hydrogen peroxide, and then the two gases are mixed and introduced into the internal loop to eliminate adnexed hydrogen peroxide such as the virus and germ, and thus the nosocomial infection due to repeated uses of medical instrumentations. The machine is composed of the gas compression component, atomization unit, gas extraction component, control circuit and the filtrating unit.

Objective To investigate the cost-effect of tele-wound treatment platform with cellular phone terminator and traditional outpatient treatment on chronic lower limb ulcers in remote district.Methods Thirty seven cases with chronic lower limb ulcers from the key hospitals in the district of west Hunan Province were collected by cluster sampling,and randomly divided into the intervention group (25 cases)and the control group (12 cases).They chose remote wound treatment platform intervention with cellular phone terminator and traditional dressing change in clinic.All patients received a 1.5-year follow-up,or cure and amputations were set as the endpoint of the study.The cost-effect,including the incidence of complications in the course of treatment,number of switches,treatment time,the cost of treatment,as well as medical human resources consumption was analyzed and compared between the two groups.Results The incidence of complications in the course of treatment in the intervention was (76.0％) significantly lower than the control group(91.7％).There was a significant increase in the dressing times and the duration of treatment; and there was no significant difference in the cost of treatment and medical human resources consumption between two groups.Conclusions Compared to the traditional outpatients wound treatment,the multimedia message-based tele-wound treatment platform unlikely increased medical human resources consumption and the cost of treatment,and may reduce the incidence of complications and the treatment time.

Aim To synthesize 8-bromo-ethoxy Rhein and investigate its mechanisms and inhibition effect on hepatitis B surface antigen ( HBsAg ) and e antigen ( HBeAg) in HepG2.2.15 cells.Methods 8-bromo-ethoxy Rhein was synthesized based on the chemical structure of Rhein , and its structure was identified by IR,1 H-NMR and 13 C-NMR spectra.MTT assay was used to test the inhibitory effect of 8-bromo-ethoxy Rhein on HepG2.2.15 cells.After the cells treatment by 8-bromo-ethoxy Rhein , the HBsAg and HBeAg in cell supernatant were detected by ELISA .The expres-sion of hepatitis B virus X gene ( HBx) was detected by Western blot .The cell cycles were examined with flow cytometry.The intracellular free calcium concentration was detected by laser scanning confocal microscopy . Results The structure of 8-bromo-ethoxy Rhein was confirmed by IR,1 H-NMR and 13 C-NMR.MTT results showed that synthetic product and Rhein could inhibit the cell proliferation in HepG2.2.15 cells.After trea-ted with 8-bromo-ethoxy Rhein and Rhein for 72 h,the half inhibitory concentration 50%( IC50 ) was 14.29 mg? L-1 and 11.59 mg? L-1 , respectively .Using non-cytotoxic dose of 8-bromo-ethoxy Rhein , the inhibitory effect on HBsAg and HBeAg was gradually enhanced with increasing 8-bromo-ethoxy Rhein concentration . The inhibitory effect of synthetic product on hepatitis B virus was better than that of Rhein .8-bromo-ethoxy Rhein could down-regulate the expression of HBx , in-tracellular calcium ion concentration and block the hepatitis B virus ( HBV ) replication.Flow cytometry results showed 8-bromo-ethoxy Rhein didn′t affect the cell cycle .Conclusions Compare with Rhein , the synthesis of 8-bromo-ethoxy Rhein shows stronger inhi-bition on hepatitis B virus in HepG2.2.15, and its mechanisms may involve down-regulating the expres-sion of HBx and reducing calcium ion concentration .

Abstrct Objective To develop a new type of paste for external trauma or surgical incision.Methods The paste is consisted of 6 parts,which are outer package;stickiness-proof soft membrane;aeration absorption layer;sticking fixation surface;neodymium,iron,boron and lanthanon magnet;cuticle.Different sizes of paste are made to observed the clinical effect.Results The product can accelerate wound healing,lower wound infection rate,and release pain,reduce the formation and soften scar.Conclusion The new type paste is a relatively reliable wound dressing,which can be applied in relative department.

AIM: To observe the changes of polymorphonuclear leukocytes (PMN), neutrophil elastase (NE) and myeloperoxidase (MPO) expression in rat asthma. METHODS: Eighteen rats were randomly divided into two groups on average, including asthma group and control group. The rat model of asthma was established by the ovalbumin (OVA) challenge methods. Blood PMN were isolated and purified. The protein expression of MPO were detected by immunohistochemistry and chromatometry techniques. NE was detected by ELISA. RESULTS: (1) Immunohistochemistry showed that the levels of MPO expression around bronchus and in purified PMN in asthma group were significantly increased compared with those in control group (P

Objective To study the clinicopathologic characteristics of triple-negative breast cancer (TNBC) and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochcmically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% (88/500) of the 500 breast cancers. The histological types of the TNBC included mainly infihrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72.7% (64/88) of all the TNBC and was more common than that in hormone receptor positive breast cancers (HR+ group ) and Her-2 overexpression breast cancers (Her-2 group)(P=0.000). The positive rates of CK5/6 and EGFR in the TNBC were 30.7% (27/88) and 34.1% (30/88), respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% (25/88) and 34.1% (30/88), respectively, Both of which were higher than those in the HR + group and Her-2 group, respectively (P=0.032 and P=0.026). 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group (P=0.021) and not significantly different from that of Her-2 group (P=0.474). Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.

In the context of the construction of " double sinking and double upgrading" in Zhejiang province, a provincial hospital explored a pilot talent working mechanism of " provincial hospital recruit staff and county hospital get experts" in the process of cooperating with county hospitals. In view of the problem that high-quality medical human resources were difficult to sink, with the flexibility of the reform of post filing and staffing, we put forward the idea of " provincial hospital recruit staff and county hospital get experts" , established key support disciplines, recruited staff by provincial hospitals, and arranged experts to precisely " sink as needed" to help disciplines of county hospitals. It helped to explore the establishment of a long-term mechanism to promote the flow of excellent medical talents to remote mountain areas, built a " specialized community" of provincial and county hospitals, and improved the medical service capacity, medical quality and discipline construction of county hospitals.