Based on a review of literature and the current reform of public hospital corporate governance,such corporate governance is divided intocombined regulation and operation,anddivided regulation and operationmodels.Then the principal-agent theory was called into play to analyze the main problems and causes of the existing models.From the perspectives of government supervision and assessment,professionalization of hospital directors,market competition mechanism,thoughts were made on how to improve such corporate governance.

BACKGROUND: Human embryonic stem cells (hESCs) are pluripotent cells which may differentiate into tissues of all three germ layers. Such research as the feeder-free growth of hESCs is few in China. Fibroblast growth factor (FGF) is a major factor to maintain the undifferentiated state of hESCs.OBJECTIVE: To evaluate the ability of FGF at different concentrations in maintaining the undifferentiated state and pluripotency of hESC lines in the long-term culture.METHODS: Two cell lines of hES-8 and hES-18 were cultured with mouse embryonic fibroblast condition medium for 3 passages and then transferred into mouse embryonic fibroblast condition medium containing different concentrations of FGF: 100, 160, 250 μg/L for 8 passages. The hESCs were removed from the petri dish, cell clusters were digested with collagenase IV and gathered. Cell differentiation and pluripotency were observed. The eighth generation of the hESCs were collected and incubated into severe combined immunodeficiency mice, so as to observe teratoma formation. Morphologies of the cells were evaluated. Alkaline phosphatase staining, surface labeling immunocytochemical analysis and RT-PCR assay method were utilized to determine the OCT-4 expression and tumorigenesis in vivo.RESULTS AND CONCLUSION: Cultured in mouse embryonic fibroblast condition medium containing 160 and 250 μg/L FGF, two cell lines of hESC could maintain undifferentiated state: Clones were round with a high ratio of nucleus to cytoplasm. Large areas in the center of clones were undifferentiated cells, while surrounding the clones were differentiated cells; Strong positive expression for alkaline phosphatase staining was observed; Two cell lines showed high levels of OCT-4 transcription factor protein; The surface markers SSEA-4, TRA-1-60, TRA-1-81 were all positive on both two lines; The hESC clusters could form embryoid body in vivo 10 days later; 3 germ layers of teratomas were also obtained after implanted into severe combined immunodeficiency mice. Mouse embryonic fibroblast condition medium containing 100 μg/L FGF was not sufficient to maintain the long-term proliferation of hESCs, and most of the cells differentiated and died after 4 passages. Alone with concentration 160 μg/LbFGF or more could maintain two hESC lines undifferentiated stably in vitro, has no influence on the differentiation and totipotency of two cell lines.

Objective To investigate the effect of GABAB receptor in spinal cord by detecting semi-quantitatively the mRNA for isoforms of GABAB receptor in a chronic neuropathic pain model. Methods Twenty-four male SD rats weighing 200-250g were anesthetized with intraperitoneal pentobarbital. Lamina of L5 vertebra and superior articular process of L6 were removed and posterior root of left L5 spinal nerve was exposed and tightly ligated with 7/0 atraumatic suture. The animals were randomly divided into 4 groups of 6 animals in each group: group A in which animals were observed for 7 days after sham operation; group B in which animals were observed for 7 days after ligation of posterior root of L5 spinal nerve; in group C animals were observed for 14 days after sham operation and in group D animals were observed for 14 days after ligation. Pain threshold was measured by heat stimulation of bilateral hindlimbs before and on the 1st , 3rd , 7th , 10th and 14th day after operation. Lumbar spinal cord was removed on the 7th or 14th day after operation and mRNA for isoforms of GABAB receptor in the spinal cord was detected semi-quantitatively by digoxin hybridization in situ.Results Pain threshold of left hindlimb (ligated side) was significantly lower than that of right hindlimb on the 7th, 10th and 14th day after operation as measured by heat stimulation. There were less mRNA for three isoforms of GABAB receptor in group B and D as compared with group A and C respectively. Conclusion The gene expression of three isoforms of GABAB receptor in the spinal cord has plasticity and is reduced during chronic neuropathic pain.

Objective To study the transfer of ropivacaine across the single cotyledon of the term human placenta and the effects of maternal hypoproteinemia and fetal acidemia on the transfer. Methods Eighteen placentas were obtained from healthy full term parturients within 5 min after vaginal or cesarean section delivery. The dual perfused human placental model was made. The placentas were randomly divided into three groups of 6 placentas : (A) control group in which 100% fresh frozen plasma was used in both maternal and fetal circulation with pH maintained at 7.4 on both sides; (B) fetal academia group in which 100% fresh frozen plasma was used in both circulations but fetal pH was reduced to 7.0; (C) maternal hypoproteinemia group in which 50% fresh frozen plasma used in maternal circulation and 100% fresh frozen plasma in fetal circulation, pH was maintained at 7.4 on both sides. Samples were taken from the perfusate in the reservoir at 15, 30, 60, 90, 120 min after ropivacaine (2?g?ml-1) and antipyrine (10 ?g?ml-1 ) were added in maternal circulation for determination of concentrations of ropivacaine, antipyrine, glucose and lactate. Glucose consumption rate, lactate generation rate and relative and absolute transfer ratio of ropivacaine were calculated. Results Absolute transfer ratio of ropivacaine was gradually increasing with perfusion time, reaching 8.7?1.0% (A) , 10.5 ?1.6% (B) and 11.8?1.1% respectively at 120 min. Relative transfer ratio of ropivacaine was relatively constant during 120 min perfusion and was significantly higher at each time point in group B and C than in group A ( P

Phospholipase A_2 (PLA_2) inhibitor quinacrine was used to explore protective effect on multiple organ dysfunction (MOD) caused by intestinal ischemia-reperfusion (I/R) in rats. Gut I/R caused the increase of gut PLA_2 activity and induced endotoxemia and bacteriemia. Pretreatment with intravenous quinacrine 10mg?kg~(-1) attenuated bacteria and endotoxin translocation,markedly lowered the levels of thromboxane A_2 and prostacyclin I_2 in blood,and provided protection from the development of vital organs dysfunction. As a result,the survival rate in pretreatment group increased by 25%. The results demonstrate that gut I/R promotes gut barrier failure,then contributes to the development of MOD by allowing bacteria or endotoxin reaching the circulation. PLA_2 and PLA_2-dependent lipid mediators play an important role in the development of gut I/R injury and MOD. Intravenous quinacrine has protection against MOD resulting from gut I/R.

Objective: We investigated experimentally the changes of intestinal immunity following shock and resuscitation after trauma. Method:The experimental model was made in rats, which underwent laparotomy, then bleeding and reinfusing through the right fetmoral artery. Result: The concentration of IgA following shock and resuscitation were significantly higher than that before shock.. The concentration of IgA 24 h following resuscitation was the lowest, and was significantly lower than that at the end of shock.. The endotoxin in portal vein following shock and resuscitation were higher than that before shock.. The endotoxin level 24 h following resuscitation was the highest, and markedly higher than that at the end of shock. Conclusion: The traumatic shock and resuscitation are capable of causing intestinal immunosuppression and endotoxemia.

To compare the clinical effect and side-effect of intravenous PCA(PCIA) with epidural PCA (PCEA). Method: One hundred and eighty postoperative patients, who were randomly divided into three groups: group PCIA, group PCEA and control, were observed for 3 days after operation. Result: Overall patients in two PCA groups were satisfied with the postoperative analgesia. The incidence of urinary retention in group PCIA were significantly lower than that in group PCEA (P0.05). 10% in group PCIA were in medium sedation whereas no eases in group PCEA were in sedation. At 6th hour after operation,serum cortisol level of control patients was much higher than that of PCA patients. Conclusion=Both PCIA and PCEA have excellent analgesia and reduce stress response after operation. PClA has lower incidence of urinary retention and is performed easily,but inhibits gastrointestinal motility much more and has higher sedative incidence compared with PCEA.

Objective: To investigate the effects of pentoxifylline (PTX) on oxygen free radicals induced myocardial injury. Method: An in vivo myocardial impairment model was developed in SD rat with exogenous oxygen free radicals. The changes cardiac performance and serum malonylaldehyde (MDA), lactic acid, cretine phosphokinase (CK) levels were tested before and at different interval after I. V. administration of oxygen free redieal. Result: Myocardial performance after oxygen free radicals administration was significantly depressed compared to the baseline values (P

0.05 ),the O- 2 production increased significantly (P

Objective To evaluate the efficacy of PTX on the global cerebral ischemia reperfusion injuryMethods The global cerebral ischemia of gerbils was induced by clamping bilateral carotid arteries for 30 min , then declamping with the reperfusion lasting 90 min At the beginning of ischemia , PTX 25mg?kg -1 or 50mg?kg -1 was administered intravenously by mini infusion pump In another group , PTX 25mg?kg -1 was infused at the beginning of reperfusion In sham operated and control groups the same volume of 0 9% NaCl were infused 0 2% Even's blue 1ml?100g -1 was injected intraperitoneally At the end of experiment , The gerbils were decapitated to be preserved at -70℃ for measurement of water contents of whole hemispheres , cerebral superoxide dimutase (SOD) activity, malonyldialdehyde (MDA) content and Even's blue content Results As compared with those in control group, at the beginning of ischemia or reperfusion ,the administration with PTX 25mg?kg -1 significantly reduced the cerebral water content (P