The management is a science,which can generalize as the manmgement to people and to things,as well as manager and person managed;the essence of any management is the management to people.Ldeological and political work is always the differentiated point of Chinese Communist Party from other parties,also is an important advantage of our party.Health care units,under the condition of Socialist market economy,must insist on and strdngthen the importance of ldeological and political work in the management of hospital,if they want to achieve the success of Reform and opening-up.Countless histories and realitids tell us that one dynamic socialistic hospital must have a powerful ldeological and political working group and atmosphere.Ldeological and political work can remedy the insufficient of prordssional level,and create the scientific,democratic and upward health care colleatives.

Objective To evaluate the efficacy and safety of self-management anticoagulation treatment for low pulmonary embolism severity index (PESI) outpatient with acute pulmonary embolism (APE).Methods Sixty-eight patients with APE of PESI grade Ⅰ-Ⅱ were divide into inpatient group and outpatient group with 34 cases each by random digits table.All the patients were treated with low molecular heparin followed by oral anticoagulation,and self-management was used in outpatient group.The efficacy was observed within 14 days and 3 months.The efficacy outcome included recurrent venous thromboembolism (VTE),standardization time of international normalized ratio (INR),VTE-related emergency department visit times,bleeding events and total mortality.Results There were 2 cases(5.9％,2/34) in inpatient group and 1 case (2.9％,1/34) in outpatient group with recurrent VTE,and there was no statistical significance between two groups (P ＞ 0.05).Standardization time of INR in inpatient group [(8.5 ± 2.9) d] was shorter than that in outpatient group [(16.1 ± 4.4) d],and there was significant difference (P＜ 0.01).There was no significant difference in the VTE-related emergency department visit times between two groups (P ＞ 0.05).There was 1 case with major bleeding and 1 death respectively in outpatient group.Conclusion It is effective and safe to give early self-management anticoagulation treatment to APE patients with PESI grade Ⅰ-Ⅱ,which could shorten time spending in hospital and release burden both physically and mentally.

Objective To study the effective method of improving the diagnosis and treatment of blunt liver injury.Methods The clinical data of 135 cases with blunt liver injury hospitalized in Daxing District People' s Hospital from January 2000 to October 2010 were reviewed retrospectively.Results By standard grading of American Society of Trauma Surgery (AAST) in 1994,36 cases were grade Ⅰ,42 cases gradeⅡ,33 cases gradeⅢ,14 cases grade Ⅳ,10 cases gradeⅤ.Fifty-one cases were treated by non-operative therapy,among which 42 cases were crued,9 cases underwent operative surgery.Ninety-three cases were treated by operative therapy,seven cases died.The morbidity related to blunt liver injury was 5.19％.Conclusions Non-operative therapy may be used firstly in patients with stable hemodynamics,but close monitoring should be done for changes of the life signs.Timely and reasonable choice of time and the way of surgery is important to avoid complications and reduce the mortality rate.

Three widely used methods of sediment toxicity evaluation were introduced in the present paper, including organism toxicity tests, toxicity identification evaluation(TIE) and sediment quality guidelines(SQGs). Compared with the chemical analysis, toxicity tests have an advantage of taking the bioavailability of POPs into account, however, it fails to identify the causative toxicants. TIE, integrating with physicochemical analysis, implicates the specific pollutants in a tiered approach, and by which effective remediation can be designed accordingly. The sediment toxicity can be identified more quickly and appropriately by SQGs than by the former two methods. The differences among the different SQGs constituted by different standards may affect their values for toxicity evaluation. Extensive and reliable SQGs had been acquired to improve their utility. Finally, the combination of chemical analysis, toxicity tests and in situ bioassays will be the trend of sediment toxicity evaluation in the future.

Obiective To study the clinic characteristics of young women with breast cancer, and analyse the reason of delayed diagnosis and treatment. Methods A retrospective review was made in 121 cases of young women with breast cancer (age ≤35 years as young group) and 40 cases of breast cancer patients of control group (age≥40 years), who all underwent definitive surgical treatment. Results There were significant differences in the positive rate of invasive tumor and the positive rate of axillary lymph node between the two groups(P

Objective Use the automatic microbiological analysis system which for the streptococci (ATB rapid 32 Strep) to identify streptococci, and compare the examination speed and accuracy with the internationally recognized bacterium identification golden method API 20 Strep (streptococci identification biochemistry system) to enable the clinical microorganism room use ATB rapid 32 Strep identification system correctly, and provide the etiology basis to clinical promptly.Methods Isolate the bacterium from patient blood, cerebrospinal fluid, pig heart, pork and so on, then separate the streptococci in form to the blood plate, lay them in carbon dioxide incubator, after 35 ℃ 24 hours. Use ATB rapid 32 Strep,API 20 Strep and the traditional manual method to identify 18 strains of bacterias and carry on the medicine sensitive experiment.Results ATB rapid 32 Strep identified 16 strains as streptococcus suis II, 2 strains as streptococcus bovis II; API 20 Strep identified 17 strains as streptococcus suis II, 1 strain can not be identified; the tradition manually method identified all of the 18 strains as streptococcus group D . These 18 strains all sensitive to the Chloramphenicol , clindamycin, erythromycin, levofloxacin, penicillin, quinupristin/dalfopristin, cefotaxime, vancomycin and sulfafurazole , and resistant to the tetracyclin.Conclusion ATB rapid 32 Strep can identify the streptococcus suis in 4 hours , and the coincidence rate with API 20 Strep is 94.4%.So ATB rapid 32 Strep is one kind of system which could identify bacterium simply,quickly,accurately,and provide infectious disease etiology information for clinical immediately, satisfy the requirement of clinician and the microorganism examines.

Objective To study the relationship between the expression of nm23- H1 gene product and early distant metastases in nasopharyngeal carcinoma (NPC). Methods The S- P immunohistochemical method was used to detect the expression of nm23- H1 in 95 cases of NPC. Results The positive rate of nm23- H1 was 47.4 % (45/95). The positive rate of nm23- H1 in early distant metastases group (26.7 %) was much lower than those without distant metastases group (60.0 %) (P

It is found that gambogic acid can play anti-tumor effects through different mechanisms in a variety of tumor cells,including induce apoptosis,inhibit telomerase and topoisomerase activity,inhibit the expression of heat shock protein and channel protein,inhibit tumor angiogenesis and metastasis and reverse multidrug resistance.Gambogic acid is expected to become a new anti-tumor drug,still need to be further explored its value in the field of anti-tumor.

Objective To evaluate the correlation between intracranial hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery(FLAIR) and the degree of the stenosis of internal carotid artery (ICA).The effect of carotid endarterectomy(CEA) on HVS was assessed.Methods A retrospective analysis of MR FLAIR sequence and cerebral-cervical computed tomography angiography(CTA) was performed in 1 total of 491 patients.Of the 491 patients,41 treated with CEA were evaluated using their pre-and post-operative image data.Patients were divided into ICA stenosis group and non-stenosis group according to the CTA imaging findings.The ICA stenosis group was subdivided into unilateral group and bilateral stenosis group.Furthermore,we measured and graded the ICA of the unilateral stenosis group into seven stenotic degrees,they were＜50％(n=40),50％-＜60％(n=15),60％-＜70％(n=17),70％-＜80％ (n=6),80％-＜90％ (n=7),90％-＜100％ (n=23),100％ (n=24),respectively.Chi square test was used to analyze the occurrence rates of HVS between ICA stenosis and non-stenosis group,and between ICA unilateral and bilateral stenosis group,respectively.Spearman rank correlation was performed to evaluate the correlation between the presence of HVS and stenotic degrees of the ICA.For the 41 patients who underwent CEA,pre-and post-operative image data were compared,focusing on the presence or disappearance of the HVS on MR FLAIR imaging.Results HVS on FLAIR images were observed in 81 of 177 patients(45.76％) with ICA stenosis,and in 59 of 314 patients(18.79％) without ICA stenosis.The occurrence rate of HVS was significantly higher in patients with ICA stenosis than those without ICA stenosis (x2=40.40,P＜0.01).There was no statistical significance in the occurrence rates of HVS between ICA unilateral stenosis group and bilateral stenosis group(x2=0.24,P＞0.05).The occurrence rates of HVS of ICA graded as the seven stenotic degrees were 22.00％(8/40),26.67％(4/15),35.29％(6/17),33.33％ (2/6),42.86％ (3/7),69.57％ (16/23),83.33％ (20/24),respectively.There was a significant positive correlation between the occurrence rates of HVS and the degrees of ICA stenosis(r=0.964,P＜0.01).HVS disappeared in 19(86.36％) out of 22 patients with HVS on pre-operative MR images after CEA in The remaining HVS in 3(13.64％) patients was attributed to the failure of completely recanalization of ICA.Conclusions A close relationship exists between HVS and ICA stenosis.The presence of HVS indicates a high probability of the existence of severe ICA stenosis.A further assessment for ICA stenosis is warranted.HVS disappearance after successful CEA indicates that HVS can be a useful marker for the the evaluation of consequence associated with CEA.

Objective To investigate the expression of p73 gene and its protein and their relation with clinicopathologic features in nasopharyngeal carcinoma (NPC) tissues.Methods Expression of p73 mRNA and protein in 52 NPC and 25 normal nasopharyngeal tissues was detected by real-time fluorescent quantitative PCR and immunohistochemistry.Results Expression of p73 mRNA and protein was significantly higher in NPC than that in normal nasopharyngeal tissues (mRNA:73.1％ vs 24.0 ％,protein:71.2 ％ vs 36.0 ％),there were significant statistical differences between the two groups (P ＜ 0.05),and their expression was closely related to tumor invasion depth,degree of differentiation and clinical stage (P ＜ 0.05).Expression of p73 gene and protein was not closely related to age and gender (P ＞ 0.05).Conclusion Detection expression of p73 mRNA and its protein can be helpful in the diagnosis and prognostic evaluation in NPC.