Middle sized public hospitals are facing new challenges with the introduction of the new medical reform policies and the promotion of internet information economy.In order to adapt to the new social economy and policy,medium sized public hospitals should be reformed,be more active and find their own new position according to the new environment.The following work can be done to improve medium sized public hospitals' survival and development and to better meet the needs of the society:exploring their resources,building their regional medical associations,strengthening their construction of key disciplines,utilizing the advantages of internet and information system,and reforming their personnel divisions.

Animals ; Brain Ischemia ; metabolism ; pathology ; Male ; Metallothionein ; metabolism ; Nerve Tissue Proteins ; metabolism ; Neurons ; pathology ; RNA, Messenger ; genetics ; Rats ; Rats, Wistar ; Reperfusion Injury ; metabolism ; pathology

Objective To evaluate the effectiveness of VEGF-transfected neural stem cells (NSCs) transplantation to striatum for amelioration of neural damage induced by cerebral ischemia.Methods Temporary middle cerebral artery occlusion (tMCAO) models were established and randomly divided into control group, PBS transplantation group, NSCs transplantation group (n=10) and VEGF-secreting NSCs transplantation group (n=20). The grafts in each group were transplanted into right striatum respectively 3 days after tMCAO model established. NSS was checked in all groups 2, 4, 6, 8, 10, 12 weeks respectively after transplantation. By using immunofluorescent staining, VEGF expression in transfected NSCs was detected 7 days after transplantation. Differentiation of transplanted NSCs was investigated 12 weeks after transplantation. Endothelial cells around the transplantation area were semi-quantitated by using immunohistochemistry staining.Results NSS in VEGF-secreting NSCs transplantation group was lower than in other three groups from 2-12 weeks. There was significant difference in NSS among the groups 12 weeks after transplantation (P

Objective To study the seasonal change of antibodies levels in the serum of asthma patients and Der P1 concentration in the dust samples collected from their bedrooms. Methods 36 asthma patients who were allergic to mites were treated as the patients group,21 male and 15 female,aged 43 years of average age. 20 healthy individuals were treated as the control group,11 male and 9 female,with the same age as the patients group. In September and December in 2005,and Match and June in 2006,the dust samples in the bedrooms of patients and the venous blood were collected,the samples of the control were collected only in September. Der P1 concentrations in dust samples and the levels of total IgE,mite specific IgE (s-IgE),s-IgG1,s-IgG2,s-IgG3 and s-IgG4 were detected by ELISA assay. Results In autumn,the levels of total IgE,s-IgE,s-IgG1,s-IgG2,s-IgG4 and the Der P 1 concentrations in patients were significant higher compared with the control group (P

α1-Antitrypsin (α1-AT) belongs to serine protease inhibitor (Serpin) superfamily and is the main protease inhibitor in human circulation. It can inhibit many proteases to protect tissues from digradation. The mutant Z (Glu342Lys) of α1-AT predisposes to the early onset of emphysema due to decreased functional α1-AT in the lung and to neonatal hepatitis due to accumulation of α1-AT polymers in the endoplasmic reticulum of hepatocytes, which disrupts the balance between protease and protease inhibitors. This paper reviews recent research progress on the pathogenic mechanism and the prognosis of α1-antitrypsin deficiency.

Objective To summarize the clinical characteristics , diagnosis and surgical method of intra-ductal papilloma(IP)of breast without nipple discharge .Methods The clinical data of 84 IP patients(130 le-sions)without nipple discharge admitted from Feb .2011 to Oct.2013 were analyzed retrospectively .Results The age of the 84 patients were mainly ranging from 30 to 50 years old.113(86.92%)lesions were≤10 mm in size, 84(64.42%)lesions had a distance≤20 mm to nipple, 57 accompanied by adenosis , 43 accompanied by fibro-cystic adenosis , 48 accompanied by fibroadenoma , 14 with ductal hyperplasia , and 2 with atypical ductal hyper-plasia.After a follow-up of 3 to 36 months, 5 cases had recurrence , including 4 cases of IP and 1 case of ductal carcinoma in situ.Conclusions IP without nipple discharge has no typical clinical symptoms .Ultrasound exam-ination may have positive findings , but not typical .Preoperative diagnosis is difficult and surgical biopsy is rec-ommended.Multiple and atypical ductal hyperplasia has possibility of recurrence , so follow-up is necessary.

Objective To evaluate the possibility of keyhole approaches for surgical treatment of petroclival meningiomas. Methods We retrospectively analyzed our experience in 14 cases with petroclival meningiomas surgically treated from May 2003 to January 2004. Eight tumors involved the upper and middle clivus.five tumors were attached to the entire width of clivus and one tumor involved the middle and lower cilvus. The tumors infiltrated into parasella regions or cavernous sinus in six cases simultaneously. Retrosigmoidal keyhole approach was selected to remove the tumors in 6 cases, and subtemporal keyhole approach was selected in 2 cases,while the combined retrosigmoidal and subtemporal keyhole approaches were applied in other six cases. Results Gross total resections of the tumors were achieved in 8 cases, subtotal resections in 4 cases, large resection in two cases who had recurrent tumors. Postoperatively, neurological intact or unchanged were found in 8 cases. The main surgical complications were mild facial palsy (4 cases) , abducent dificits (3 cases) ,temporary oculomotor nerve dificits (2 cases),and lower cranial nerve palsy (1 case). One patient died from disseminated intravascular coagulation (DIC) two weeks after surgey. There were no CSF leakage and infections after surgery in all cases 11 to 19 months follow-up studies demonstrated the great improvement of the Ⅲ and Ⅶ nerve deficits,but minor improvement in the Ⅵ nerve deficits. Conclusion According to the location and extension of the tumors, retrosigmoidal or subtemporal keyhole approaches or their combined can be selected for surgical treatment. These keyhole approaches can expose sufficiently the petroclival region, shorten the surgical time, and minimize the complications. Combined usage of minimally invasive techniques including the keyhole approach and radiosurgey in the treatment of the petroclival meningiomas is suggested.

Objective To investigate the self-management behaviors in patients with liver cirrhosis and analyze its influencing factors. Methods Totally 103 liver cirrhosis patients were recruited by convenience sampling method. They were investigated by using Self- management Questionnaire for Chinese patients with liver cirrhosis. Results The total score of self-management behaviors was 63.69 ± 13.60. All subscales scoring from high to low in turn were medication, diet management, condition monitoring and daily management. Conclusions The self-management level in patients with liver cirrhosis of decompensation period need to be improved, nursing staff should pay attention to effect evaluation during the hospital health education, to ensure that patients can master disease self-management knowledge, to improve the self-management behavior of patients with liver cirrhosis.

OBJECTIVE:To establish the quality standard of Huoxuesan. METHODS:Microscopic identification method was adopted for the qualitative identification of Rhizoma pinelliae,Eupolyphaga seu,Phellodendron amurense and Fructus kochiae in the preparation. HPLC was adopted for the contents determination of phellodendrine,polydatin,jatrorrhizine,berberine and emo-din:the column was ZORBAX Eclipse Plus C18 with methanol-0.1% phosphoric acid(gradient elution)at a flow rate of 0.4 ml/min,the detection wavelength was 240 nm,column temperature was 30 ℃,and the injection volume was 5 μl. RESULTS:Micro-scopic identification map of R. pinelliae,E. seu,P. amurense and F. kochiae was clear. The linear range was 0.159-5.073 μg(r=0.997 4)for phellodendrine、0.149-4.761 μg(r=0.999 9)for polydatin、0.239-7.649 μg(r=0.995 5)for jatrorrhizine、0.165-5.268 μg (r=0.997 2)for berberine、0.012-0.382 μg(r=0.999 9)for emodin;RSDs of precision,stability and reproducibility tests were low-er than 3.0%;recoveries were 98.9%-104.1%(RSD=1.9%,n=6),96.1%-101.7%(RSD=2.5%,n=6),99.6%-105.1%(RSD=2.6%,n=6),90.3%-98.2%(RSD=2.9%,n=6)and 92.9%-96.4%(RSD=2.0%,n=6)respectively. CONCLUSIONS:The es-tablished standard can be used for the quality control of Huoxuesan.

AIM: To build an allergic rhinitis model to evaluate the effect of budesonide on the eosinophils and histamine in nasal mucosa in allergic rhinitis guinea pig.METHODS: 33 guinea pigs were randomly divided into three groups: natural controlled group,allergic rhinitis(AR) group and budesonide treatment group.Allergic rhinitis model in guinea pigs were built by using toluene-2,4-disocyanate(TDI) nasal immunization and challenge.The indexes of clinical symptoms,pathomorphological diagnosis and content of histamine in mucosa were used to evaluate the potency of budesonide when used to treat allergic rhinitis.RESULTS: The expression of eosinophils and the content of histamine in nasal mucosa in AR group both were significantly higher than that of in natural controlled group(respectively,P(0.05)).CONCLUSION: Budesonide could effectively reduce the expression of eosinophils and content of histamine in nasal mucosa,but it is invalid in releasing the symptoms of AR in guinea pig.The reason of this phenomenon may be concerned with the method of model building.