Primary Research on Management Strategies of Longyan No. 1 Hospital under the New Medical Reform Systems

中文摘要 新医改制度的颁布与实施，使中国医院生存发展的内外环境发生着深刻的变化，各级各类医院面临日益激烈的市场竞争。城市大医院由于长期处于卖方医疗市场环境，在观念和经营管理模式上都难以适应这种变化，迫切需要建立新的经营模式，以应对生存和发展的威胁及挑战。本论文从龙岩市第一医院经营策略研究入手，探索在新的医疗市场环境条件下，如何将企业战略理论，市场营销理论运用到医院这个特殊的社会组织的管理中。文章采用实证研究方法，首先分析了医院的社会功能以及医疗市场的特殊性，并以波特的行业竞争力理论、现代市场营销思想以及价值链分析理论为基础，结合医院及医疗服务业的特点分别构建了“医疗服务行业竞争环境分析”，“...Summary With the publishing and practicing of the new medical reform systems, the domestic hospitals are facing sever changing of the existence and development under the circumstance. The market competition among various hospitals is increasing. Because hospitals in cities were in selling market condition for a long time, their ideas and model of management are hardly adapted to the systems. It i...学位：管理学硕士院系专业：管理学院高级经理教育中心（EMBA项目）_高级管理人员工商管理硕士(EMBA)学号：X2005019

复合大孔聚多糖止血材料对肝脏钝挫伤止血的有效性研究

目的研究具有交联微孔结构的复合大孔聚多糖止血材料(MPCHM)应用于模拟临床肝脏钝挫伤的止血效果,评价其对肝功能修复作用的有效性和安全性。方法建立动物肝脏钝挫伤模型,将24只新西兰兔按照随机数字表法分为实验组(使用MPCHM)和空白组(不使用任何止血材料),分别记录止血时间和出血量。在术后第1、4、8周采集兔的外周血进行血常规、生化分析及凝血两项检测,所得数据指标进行独立样本t检验。结果实验组止血时间为(105.00±29.15)s,空白组止血时间为(381.00±54.86)s,差异有统计学意义(t=-4.442,P<0.05)。实验组出血量为(0.45±0.26)g,空白组出血量为(1.26±0.51)g,差异有统计学意义(t=-14.048,P<0.05)。实验组淋巴细胞含量于术后第1、8周显著低于空白组,差异均有统计学意义(t=-12.595、-7.909,P值均小于0.05),丙氨酸氨基转移酶和天门冬氨酸氨基转移酶于术后第8周显著低于空白组,差异均有统计学意义(t=-5.613、-3.656,P值均小于0.05),白细胞计数术后显著高于空白组,差异均有统计学意义(t=5.521、6.433、2.399,P值均小于0.05),白蛋白于术后第1、8周显著高于空白组,差异均有统计学意义(t=3.120、5.168,P值均小于0.05)。实验组术后活化部分凝血活酶时间和凝血酶原时间处于正常值范围内。结论 MPCHM具有良好的生物安全性,能促进肝功能恢复,降低机体对于肝损伤的应激反应,不会引起机体炎症反应、排斥反应及生物毒性。本课题研究为临床肝损伤止血无法完全保存肝组织这一难题的解决提供新思路。深圳市科技计划项目(JCYJ20150616163111759);;厦门市科技计划项目(3502Z20151087

CXCL9 and CXCL10 accelerate acute transplant rejection mediated by alloreactive memory T cells in a mouse retransplantation model

Key Project of Program of Science and Technology of Fujian Province of China [MKJ 2008-59]C-X-C motif chemokine ligand (CXCL) 9 and CXCL10 play key roles in the initiation and development of acute transplant rejection. Previously, higher levels of RANTES expression and secretion were demonstrated in retransplantation or T-cell memory-transfer models. In the present study, the effect of the chemokines, CXCL9 and CXCL10, were investigated in a mouse retransplantation model. BALB/c mice were used as donors, while C57BL/6 mice were used as recipients. In the experimental groups, a heterotopic heart transplantation was performed six weeks following skin grafting. In the control groups, a heterotopic heart transplantation was performed without skin grafting. Untreated mice served as blank controls. The mean graft survival time of the heterotopic heart transplantations was 7.7 days in the experimental group (n=6), as compared with 3.25 days in the control group (n=6; P<0.001). On day three following cardiac transplantation, histological evaluation of the grafts revealed a higher International Society for Heart & Lung Transplantation grade in the experimental group as compared with the control group. In addition, gene expression and serum concentrations of CXCL9, CXCL10, interferon-gamma, and interleukin-2 were markedly higher in the experimental group when compared with the control group. Differences between the levels of CXCL9 and CXCL10 in the pre- and post-transplant mice indicated that the chemokines may serve as possible biomarkers to predict acute rejection. The results of the present study demonstrated that CXCL9 and CXCL10 play a critical role in transplantation and retransplantation. High levels of these cytokines during the pre-transplant period may lead to extensive acute rejection. Thus, the observations enhance the understanding of the mechanism underlying the increased expression and secretion of CXCL9 and CXCL10 by alloreactive memory T cells