The paper introduced the multi-site physician practice operational in the modes of hospital departmental support,hospital trusteeship,and public-private hospital management,and summarized the merits of such a practice adopted in the background of cooperative hospital operations as follows.A cooperation of common interests enjoys supports of all stakeholders and minimum resistance;better policies and conditions mobilize physicians'incentives; better continuity of medical practice; better public benefits of the hospital.The paper also probed into such issues as setbacks of the practice in such a background,complicity of medical disputes definition and resolution,possible talent drain of public hospitals,and possible impacts on branding and core competence of public hospitals.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Facial Injuries ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; therapy ; Retrospective Studies ; Wounds, Penetrating ; therapy ; Young Adult

The function of hepatic stellate cell (HSC)in liver fibrosis has been well recognized.In recent years,the role of HSC in the liver tumor microenvironment have been paid increasing attention.Platelet derived growth factor (PDGF) is the most important mitogen of hepatic stellate cell,and plays an important role in the activation of hepatic stellate cell.Hepatic stellate cell is not only the target cells of PDGF,but also PDGF-secreting cells.Thus a bi-directional cycle mode of PDGF activating hepatic stellate cell has been established.The signaling pathways of HSC activation include MAPK,PI-3K,Ca2+ and JAK pathways.To explore PDGF activating hepatic stellate cell in liver tumor microenvironment and to find the new methods of targeting PDGF and hepatic stellate cell,may help us find a new direction for the treatment of hepatocellular carcinoma.

Objective To discuss the types,pathogenesis and treatment of early cardiac arrhyth-mias in infants after open heart surgery with congenital heart diseases. Methods 992 infants after open heart surgeries were divided into control group and arrhythmia group. Another junctionalectopictachycardia ( JET)group was separated from arrhythmia group. Various preoperative and postoperative data were com-pared. Results 197 infants suffered from cardiac arrhythmia within 3 days right after open heart surger-ies. After exactly the same surgery procedures,JET group was significantly different with control group in aortic cross-clamp time,cardiopulmonary bypass time and stay in CICU(p<0. 05). As for time of ventila-tion,no significant difference was found between the two groups. Conclusion Early diagnosis and treat-ment of cardiac arrhythmia can not only improve the success rate of open heart surgery,but also promote early recovery.

Uarthritis is a common inflammatory arthritis, which has been well known as the White Tiger arthritis in traditional Chinese medicine. This article discussed the pathogenesis of blood stasis and the related studies in hyperuricemia, acute and chronic phase of Uarthritis. It suggested that blood stasis is a crucial pathogeny of uarthritis. Thus, the chinese herb medicine of blood circulation drugs should beapplied in all the phases of Uarthritis.

Hospitals are currently confronted with many problems, including distribution according to the division of administrative areas and jurisdiction; construction with complete sets of facilities on the part of all hospitals,big or small; and worsening of the unbalanced allocation of health resources due to the to assumption by big hospitals of many tasks of bssic-level hospitals. Besides, the excessively speedy incresse of expenses for outpatient and inpatient services as a result of hospitals' introduction of high technologies has inhibited some people's demands for medical services and competition among hospitals will become particularly fierce. Thus, ways out for hospitals lie in clarifion of their respective functions and development according to regional planning; regrouping of health resources by the government through measures of shutting down,stopping down, sopping production, merging, changing products or moving to other sites; structural readjustment and implementation of the system of responsibility by hospital directors within hospitals;bringing into play the initiatives of middle-level cadres; establishment of a scientific mechanism for personnel employmennt and selection; giving priority to efficiency and consideration to fairness in distribution; improvement of service quality; and making a good job of rational charging.

The development of community-based rehabilitation (CBR) needs to improve to meet the change of environment during the period of 12th Five-year Plan. The problems of CBR development included 3 major contradictions: administration of CBR and marketization of medical services; professionals demand of CBR and their professional development; and the demand of CBR and capacity of services. It is necessary to establish some market-oriented CBR project, pay attention to professional development, and promote the capacity of the community rehabilitation agencies.

Objective To explore the effect of hyperoxia through mechanical ventilation induced lung injury(VILI) in newborn rabbit.Methods One hundred newborn rabbits aged 1-5 days were randomly divided into 4 groups: with 900 mL/L O2 and mechanical ventilation(MV),group A received high peak inspiratory pressure(HPIP),group B received moderate peak inspiratory pressure(MPIP),group C received low peak inspiratory pressure(LPIP),and group D with no mechanical ventilation with room air.There were 30 rabbits in group A,B,C,10 rabbits in D group.All rabbits were killed at 1,3,6 h after trial respectively.Wet-to-dry weight ratio(W/D) of left lung,and white blood cell(WBC)counts in broncho alveolar lavage fluid(BALF) were measured.The changes of lung histopathology were assessed by hematoxylin-eosin(HE) staining and observed under light microscope.Results Compared with group B and C,the group A demonstrated more pulmonary hemorrhage and pulmonary bullae formation,and the WBC and neutrophils counts in BALF increased and the W/D was higher compared with group B and group C.Meanwhile,alveolar epithelial cellⅡ(AECⅡ) hyperplasy transformed to AECⅠ.In group C,AECⅡswelled and lung tissue edema showed obviously,after 6 hours collagen fibers hyperplasia appeared.Part pulmonary atelectasis was obvious in group C.Conclusions HPIP ventilation can increase lung injury induced by hyperoxia in newborn rabbits,but has minimal effects on MPIP and LPIP ventilation.Pulmonary histopathologic changes participate in the newborn rabbit machine ventilation induced lung injury.

OBJECTIVETo assess the DNA damage of copper 8-quinolinolate (CuQ) and to elucidate the plausible mechanisms.METHODSHepG2 cells were treated with CuQ0-4 μmol·L-1 for different time,DNA damage was measured by Comet assay.Catalase (CAT) activity,glutathione(GSH) level and thiobarbituric acid reactive substances (TBARS) were measured.NF-κB was examined using Western blotting.8-Hydroxydeoxyguanosine (8-OHdG) was measured by immunoperoxidase staining analysis.RESULTSCuQ 0.5 -4 μmol·L-1 caused significant increase of DNA migration in HepG2 cells.CuQ significantly decreased levels of GSH and activity of CAT in HepG2 cells (P ＜0.05).Moreover,CuQ significantly increased accumulation of the p65 subunit of NF-κB into nucleus,levels of lipid peroxidation product TBARS and the formation of 8-OHdG (P ＜0.05).The intracellular GSH level was modulated by pre-treatment with buthionine-(S,R)-sulfoximine (BSO),depletion of GSH in HepG2 cells pre-treated with BSO dramatically increased susceptibility of HepG2 cells to CuQ-induced DNA damage.CONCLUSIONCuQ exerts DNA damage by oxidative stress and increases accumulation of p65 subunit of NF-κB into nucleus in HepG2 cells.

Objective To explore the relationship between blood lipids and creatinine clearance (Ccr)in aged patients with coronary heart disease(CHD).Methods According to coronary artery angiography(CAG)and Ccr,784 subjects aged 65 years and over were divided into groups and Their lipid levels were compared.Results With increasing lesion of coronary branches,the level of Ccr was obviously decreased(F=5.35,P＜0.01).The level of apolipoprotein A1(ApoA1)was reduced and apolipoprotein B(ApoB)enhanced in renal function of moderate-severe injury(CCr＜0.83 ml ·s-1 · 1.73m-2)(F=5.31,F=4.91,both P＜0.01).The level of ApoA1 was decreased(F=3.52,P＜0.05)and Apo B increased(F=5.65,P＜0.01)in male renal function of moderate-severe injury.The levels of ApoA1 decreased(F=5.79,P＜0.01),ApoB increased(F=4.56,P＜0.05)and high density lipoprotein-cholesterol reduced(F=3.39,P＜0.05)in CHD with renal group of moderatesevere injury.Multi-logistic regression analysis showed that Ccr,HDL-C,ApoA1 and ApoB were influencing factors of CHD.Conclusions Abnormal blood lipid and renal dysfunction are risk factors of CHD,dyslipidemia may induce renal dysfunction.It is important to control lipids and improve other organ functions in the aged patients with CHD.