At present,the main methods for medical devices procurement includes centralized procurement,tendering through a procuratorial agency,tendering organized by regional government,bid assessments by tenderer,purchasing by negotiation and direct purchase.Medium and large sized medical equipment are usually purchased by centralized procurement or tendering,and other medical devices can be purchased by negotiation or directly purchase,while high-valued implantable medical devices can be purchased according to the bidding results organized by regional government.

Stereotactic body radiotherapy (SBRT) is a treatment of high dose radiation in a single or small number fractions to the target areas.Compared with conventional radiotherapy,SBRT has the features of higher dose and better precision.The application in lung cancer can be summarized as the following three points:① SBRT has established the status of standard treatment for early (T1-2 N0 M0) nonsmall cell lung cancer (NSCLC) patients who unable or unwilling to undergo surgery.② The resuhs of preliminary application of SBRT in the operable NSCLC are not inferior to surgery.③ As for isolated metastases (1-3),the combination of systemic treatment and SBRT has been gradually accepted.This article makes a summary of this.

BACKGROUND: The improvement in production technology of new materials including artificial ligament reduces material rupture caused by fatigue and histocompatibility-related synovitis and other complications, leading to a wide application of artificial ligament. OBJECTIVE: To evaluate the histocompatibility and clinical curative effects of reconstruction of the anterior cruciate ligament (ACL) of the knee with ligament advanced reinforcement system (LARS) artificial ligament using arthroscopy. DESIGN: A completely randomized clinical design. SETTING: Department of Orthopedics, Second Affiliated Hospital of Soochow University. PARTICIPANTS: Thirty-two cases of ACL injury received LARS artificial ligament in the Department of Orthopedics, Second Affiliated Hospital of Soochow University From June 2005 to June 2006 and were recruited for this study. The 32 patients averaged 21 years old and were injured in sports. Prior to surgery, MRI showed injury to ACL and semilunar valve in all patients. Written informed consent for therapeutic contents was obtained from each patient. METHODS: Thirty-two patients with injury to ACL of the knee underwent arthroscopic ACL reconstruction. LARS was used to reconstruct the ACL. The LARS was produced by Laboratoire d'Application et de Recherche Scientifique, France (Certification No. CE0459, 1SO9002-EN46002). Artificial ligament was made of polyethylene terephthalate, which had the material type L021201 (left knee) and L021202 (right knee). Artificial ligament was designed to imitate the anatomic structure and biomechanical principle of artificial ligament with specification No. AC120 2BL(left knee) and No. AC120 2BR(right knee). The lot number for artificial ligament in China [import 03460468 (in 2004)]. All reconstructions were performed by a group of physicians who have worked for more than 10 years in the Department of Orthopedics, Second Affiliated Hospital of Soochow University and directed by a physician titled with doctor's tutor and chief physician. All included physicians were qualified to perform the surgery. The protocol of treatment was approved by the hospital's Ethics Committee. MAIN OUTCOME MEASURES: Biocompatibility of LARS artificial ligament was observed. Patients were followed up for 24 months on average to score knee function by Lysholm test and subjective satisfaction by Tegner test. RESULTS: All of 32 cases were followed up. The follow-up periods were 18 months (3 cases), 20 months (7 cases), 24 months (8 cases), 28 months (12 cases) and 30 months (2 cases). No complications, such as acute or chronic synovitis, LARS artificial ligament rupture, or limited range of motion were found. The knee joint function was ideal with the range of motion [0° to (128±11.56)°]. The postoperative scores with 85.6 ± 2.24 were significandy higher than the preoperative scores with 45.3±1.31 according to the Lysholm knee joint function evaluation system (P < 0.05). The instability of every knee disappeared with anterior drawer sign negative. Tegner's scores were also increased. CONCLUSION: The biocompatibility of LARS is optimal. LARS artificial ligament reconstruction showed excellent knee joint function and subjective satisfaction degree.

BACKGROUND: Of the many growth factors that can enhance bone formation, the bone morphogenic proteins (BMPs) are probably the most effective and most widely studied for applications requiring new bone growth. To analyze the effects, the gold standard is patient randomized control trials, however, only BMP-2 and BMP-7 have reached this level of investigation. OBJECTIVE: In this meta analysis the recent findings concerning the application of recombinant human bone morphogenic protein-2 (rhBMP-2) in tissue engineering and gene therapy, the options of its transfer means, as well as the ideal time of delivery is discussed. RETRIEVAL STRATEGY: The relevant articles published between January 1997 and December 2006 were searched for in Pubmed database by researcher of this article with the key words "recombinant human bone morphogenic proteins (rhBMPs), tissue engineering, gene therapy" in English. A total of 81 articles were selected and reviewed by the standards of: ① Having close relations with the application of rhBMP-2 in tissue engineering and gene therapy; ②The most recently published articles and articles in authority journals were chosen in the same field. Exclusion criteria: repetitive studies. LITERATURE EVALUATION: The main sources of literature are the application of rhBMP-2 in tissue engineering and gene therapy. Among the 52 selected articles, 12 are reviews or meeting reports, others are clinical or elementary experimental studies. DATA SYNTHESIS: BMPs are members of the TGF- β superfamily, which are released by osteoprogenitor cells and typically improve bone growth. The use of scaffolds, cells, and growth factors for bone regeneration is called bone tissue engineering. The application of rhBMP-2 in tissue engineering holds great promise for the augmentation and manipulation of bone and soft tissue repair. One potential alternative to direct rhBMP-2 delivery is to develop a biologic cellular delivery vehicle via gene therapy to enhance bone formation. The application of rhBMP-2 in gene therapy holds great promise for the augmentation and manipulation of bone and soft tissue repair. The research indicated that the dosing, time, and transfer mode of rhBMP-2 to the desired targets remain a facing challenge. Further studies should focus on the ideal dosing, time and method of delivery, which should be easily and reliably displayed, cost effective, and clearly controlled. CONCLUSION: The future of bone and soft tissue repair will likely be based on biologic augmentation of healing and tissue regeneration. The use of rhBMP-2 holds great promise for the augmentation and manipulation in tissue engineering and gene therapy.

OBJECTIVE To describe the clinical features,prognosis and antimicrobial resistance of Enterococcus infection.METHODS We had cultured and identified the bacteria of infected patients with normal methods and tested the resistance of Enterococcus to 6 antimicrobial agents.RESULTS A total of 130 cases of Enterococcus infection were occurred among the severe patients of ICU.Major sources includecl urine,sputum and ascites.A majority of them occurred together with other pathogens and had bad complications.The resistant rate of Enterococcus to penicillin,ampicillin,vancomycin,gentamicin,streptomycin and levofloxacin were 91.5%,23.4%,0,27.0%,32.0% and 24.0%,respectively.The cure rate and mortality attributed to Enterococcus infection after ampicillin,levofloxacin and/or third generation cephalosporins were 63.61% and 11.9%,respectively.The patients infected by Enterococcus and others bacteria together had bad prognosis.CONCLUSIONS The results hint that we should emphasize clinical and laboratory diagnosis to guide the application of antimicrobial agents rightly and improve prognosis.

OBJECTIVE To evaluate the disc diffusion method on the clinical antifungal susceptibility test for yeast-like fungi.METHODS The fluconazole susceptibility test was detected by disc diffusion method and NCCLS broth microdilution method with 113 yeast-like fungus strains isolated from clinical specimens.Three standard strains were used as the quality control.RESULTS The coincidence rate of the two methods was 89.4%.The sensitive strains detected by one method didn′t show resistance in another detection method,and the resistant strains detected by one method yet didn′t show sensitivity in another one.CONCLUSIONS Disc diffusion method can be used in clinical detection instead of NCCLS broth microdilution method.

Objective To evaluate the estrogen activity of DDE by using MCF-7 cell proliferation bioassay.Methods The estrogen activity of DDE was tested by using the MCF-7 cell multiplication experiment in vitro and the mechanism was explored preliminarily through growth curve analysis.Results DDE showed an obvious estrogenic activity in the MCF-7 cell proliferation and the cell cycle analysis indicated that cell proliferation index in DDE group was significantly higher than that in the control group.Conclusion DDE has the estrogenic activity and the mechanism may be the same as that of E2,that is,binding with the estrogen receptor is the first step of the following biological effects.

Objective;To revise the third time the norm of Combined Raven's Test(CRT-C2) applied for 10 years by standardized sampling.Methods;According to the population distribution of national survey in 2001,sampling was chosen from 17 provinces of 6 administration districts.The range of each age group was one year(male;female 1;1).It was designed to have 240 children in each age group,from 7 to 16 years old in city and 7-14 years old in rural areas,with original CRT text book and instruction.Results;The averages of raw score among age groups had an obviously increase along with the age.The differences of same age group between city and countryside were showed significance.However,no difference of gender among all age groups was founded.The Cronbach's coefficient,reliability of re-test and split-half of rural children were 0.94,0.88 and 0.91 respectively.The correlation coefficients of test scores with the performances of Chinese and mathematics subject were 0.35 and 0.40.Conclusion;Two age norms of city(CRT-CC3)and countryside(CRT-RC3)were established based on new standardized sampling.

China ; Humans ; Tinnitus

AIM: To observe the expression of COX-2 in rat corneal neovascularization (CNV) and its relationship to CNV, and to explore the inhibition of Celecoxib, a COX-2 inhibitor, to CNV.METHODS: The distribution and quantification of COX-2and VEGF was detected by immunohistochemistry. Expression of COX-2 and VEGF mRNA was quantified by RT-PCR.The difference in protein and mRNA expressions of COX-2and VEGF was analyzed to find the correlation between them.RESULTS: Expression of activated COX-2 and VEGF protein and mRNA in CNV had a dynamic change. VEGF and COX-2co-localized. Compared with the control group, expression of both protein, mRNA of COX-2 and VEGF in experimental group Ⅱ and Ⅲ had significant difference (P＜0.05), indicating the correlation between COX-2 and VEGF, while that in experimental group I had no statistical difference (P＞0.05).CONCLUSION: COX-2 expression was up-regulated in inflammatory CNV. COX-2 modulates the expression of VEGF,playing a very important role in CNV. Celecoxib inhibit COX-2expression so as to hold back the CNV.