Through a comparison of the differences between China and Australia in the models of hospital management and the roles of hospital managers, the paper expounds the specific features of the model of “decentralized powers” and “professional presidents” and the model of “centralized powers” and “expert-turned presidents”. It argues that under the pressures of both internal and external changes, including rapid socioeconomic development, the deepening of the health care reform, the effect of China's accession to the WTO on the medical and health industry, the development of a contingent of professional health care managers in China has become an inevitable trend.

Objective To summarize the nursing care experience for right ventricular dysfunction after orthotopic heart transplantation.Methods Clinical data of 67 patients underwent heart transplantation were retrospectively analyzed from January 2007 to December 2010.Results 58 patients were discharged after they were cured,9 patients died.67 patients were affected by different degrees of increasing central venous pressure (CVP)early postoperation and right ventricular dysfunction,28 cases received extracorporeal membrane oxygenation(ECMO) assistant,6 cases received continuous renal replacement therapy(CRRT).Among 58 discharged patients,the heart function level showed class two in 54 cases and class three in 4 cases.Conclusions After heart transplantation,followed with intensive care and close observation of right heart failure symptoms,providing effective care and support,active prevention and treatment for right heart failure,maintaining vital organs function were key to successful heart transplantation.

Objective To investigate the clinical efficacy of joint-corresponding point selection plus exercise acupuncture in treating acute ankle sprain.Method Enrolled 70 patients with acute ankle sprain were randomly allocated to two groups.The treatment group received joint-corresponding point selection plus exercise acupuncture and the control group,elastic bandage fixation.Both groups were given ice compress,mobilizationand elevation as auxiliary measures.Treatment was provided seven days as one coursefor a total of two courses.The pain, tenderness, swelling andrange of activitieswere scored in the two groups of patients before and after treatment.Thetherapeutic effects were compared.Result The total efficacy rate was 88.6% in the treatment groupand54.3% in the control group.The therapeutic effect was significantly better in the treatment group than in the control group (P<0.01). Joint pain, tenderness, swelling and activity scores decreased in the two groups after treatment (P<0.01). Joint tenderness and activity scores were lower in the treatment group than in the control group after treatment (P<0.01).Conclusion Joint-corresponding point selection plus exercise acupuncture has clinically a marked therapeutic effect on acute ankle sprain.

Vascularization is the basis of tissue regeneration. To get engineered tissue, it is necessary that timely and enough nutrition be available to the seed cells, especially those within the biomaterials. Therefore reconstruction of blood supply is the key step leading from basic research to clinical application. Thee major methods have been used to reconstruct blood supply: promotion of vessel growth by means of VEGF, combined grafting of vascular endothelial cells and osteoblasts and microsurgical techniques. The microsurgical techniques, such as wrapping around with pedicled fascia flap, wrapping around with vascularized muscle flap and blood vessel implanting, can help reconstruct blood supply when engineered tissue is fabricated. When engineered tissue is used in clinic to repair defects in vicinity, vascularization can be done in the defect area. But when no fascia flap, muscle flap or vessel can be used in the defect area, the local defects can be repaired through reconstruction of vascularized engineered tissue in other areas and through second stage transplantation with microsurgical techniques.

Adult ; Aged ; Electrocardiography ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Silicosis ; complications ; diagnostic imaging

Objective To explore the association between the polymorphism in IL-28B gene and the interferon virological response in HBeAg-posi-tive chronic hepatitis B patients. Methods A literature search was performed on PubMed,web of Science,China Bio Medicine(CBM)and wan-Fang database. The references was screened with the inclusion and exclusion criteria,and then data were extracted and methodological quality of the studies was judged. Statistical analysis was carried out with RevMan 5.3 and STATA 11.0. Results Totally 7 publications were recruited for the study,including 1 345 patients. The meta-analysis showed that there was no significant difference of interferon response between HBeAg-positive chronic hepatitis B patients with rs8099917TG/GG alleles and rs8099917TT alleles (P= 0.20). There was no statistical difference between Rs12979860CC and CT/TT allele for the sustained virological response(P=0.75). Conclusion Our current meta-analysis suggests that there was no correlation of rs8099917,rs12979860 polymorphism in IL-28B with the sustained virological response to interferon in HBeAg-positive chronic hepatitis b.

Objective To probe the clinical values of the human serum glycoprotein profiles for the diagnosis of common gynecological tumors. Methods A total of 123 clinical serum samples which included 31 breast cancer, 24 cervical cancer, 19 ovarian cancer and 49 healthy individuals were collected. A lectin microarray consisting of 15 lectins with different glycan binding specificities was used to determine the glycoprotein profiles of serum sam-ples. Stepwise discrimination analysis method was adopted to establish function model of clinical serum samples classification with SPSS 15. 0 software. Results Two grades of diagnostic discrimination function models were es-tablished. The first grade discrimination function could differentiate gynecological tumors from healthy individuals, the diagnostic accuracy rates of retrospective inspection were 85. 7% and 83. 8% respectively, and the total diag-nostic accuracy rate was 84.6%. The second grade discrimination function was used to differentiate breast tumor, cervical tumor and ovarian tumor, the diagnostic accuracy rates of retrospective inspection were 96.8%,75.0%and 78.9% respectively, and the total diagnostic accuracy rate was 85.1%. Conclusion The human serum gly-coprotein profiles are associated with gynecological tumors, and the established discrimination function models based on lectin microarray data have a helpful reference value for the clinical diagnosis of gynecological tumors.

Objective　To investigate the relationship of proximal femur geometry and hip fracture in elderly women. 　Methods　 We compared proximal femur measurements made from the uninvolved hip of 48 plane anteroposterior pelvis radiographs of elderly women without fracture to those of the contralateral hip in a group of 43 cases with hip fracture. Measurements of Singh index, head diameter(HD), neck diameter(ND), femoral neck length(NL), neck shaft angle(NSA) and cortical thinckness of proximal femur were analyzed. 　Results　 The cortical thickness of proximal femur in hip fracture and without hip fracture groups was (10.9±3.1) mm and (13.2±2.9) mm, and the Singh index below Ⅲ° was 86.05% and 66.67%, respectively. No difference in HD,ND,NL and NSA could be demonstrated.　Conclusions　 Singh index and cortical thickness of proximal femur may be used to predict the occurrence of the hip fracture in elderly women.

Objective By surface-enhanced laser desorption / ionization time-of-flight mass spectrometry(SELDI-TOF-MS), the serum pmteomic fingerprints related with the changing of malignant tumor patients' serum glucose after chemotherapy was selected and constructed as an predictive model. Methods By SELDI-TOF-MS, the serum of 182 malignant tumor patients who had received chemotherapy were tested, and the pmteomic fingerprints were received. After 2 years follow-up, all the patients were divided into 3 groups: the euglycemia group(136 people), the carbohydrate tolerance abnormality group(27 people), and the diabetes mellitus group (19 people). The proteomic fingerprints were analyzed by Biomarker Wizard Software and the idio-proteomic fingerprint of protective models were constructed by BPS (biomarker pattern software). Results The diagnosis model composed with 2 proteins (M/Z values were 5298 and 9608) could classify the carbohydrate tolerance abnormality group, and the diabetes mellitus group correctly. In the test model, the sensitivity and specificity were 81.48 %(22/27) and 100.00 %(17/17) respectively, the accuracy was 88.64 % (39/44). The diagnosis model composed with 3 proteins (M/Z values were 10324, 2761 and 4084) could classify the diabetes mellitus group and the euglycemia group correctly. In the test model, the sensitivity and specificity were 62.35 %(53/85) and 88.24 %(15/17) respectively, the accuracy was 66.67 %(68/102). The diagnosis model composed with 6 proteins (M/Z values were 5895,6010,6099,3930,5430 and 2495) could classify the diabetes mellitus group and the the carbohydrate tolerance abnormality group correctly. In the test model, the sensitivity and specificity were 77.65 %(66/85) and 96.30 %(26/27) respectively, the accuracy was 82.14 %(92/112). Conclusion SELDI-TOF-MS could be utilized to analyze protein profiling in screening serum glucose changing-related biomarkers and developing diagnostic and predictive patterns, and the developed patterns may be used to predict the changing of serum glucose after chemotherapy in malignant tumor patients.

BACKGROUND:Lumbar disc herniation is the most common cause of lumbago in clinic, which seriously affect the patient's daily life, study and work. Therefore, studies on biomechanics of lumbar intervertebral disk benefit to prevent and treat the diseases associated with lumbar intervertebral disk. OBJECTIVE: To summarize the biomechanical progress of lumbar intervertebral disk. METHODS: The first author retrieved China National Knowledge Infrastructure and PubMed database for literatures published from 2009 to 2014. The key words were intervertebral disc, nucleus pulposus, biomechanics, fibrosis annulus, cartilage in Chinese and English, respectively. Articles regarding biomechanical characteristics of lumbar intervertebral disk, nucleus pulposus, fibrosis annulus and cartilage were included, and repetitive studies were excluded. Totaly 5 072 articles were retrieved initialy. In accordance with inclusion and exclusion criteria, 41 articles were included in result analysis. RESULTS AND CONCLUSION:We can fuly understand the pathogenesis, development and adverse consequences of diseases related to the lumbar intervertebral disk by summarizing the structural features and internal pressure of lumbar intervertebral disk and the effect of different loads, biomechanical characteristics of lumbar intervertebral disk with degenerative changes and establishment of mechanical model of lumbar intervertebral disk. It is of directive significance for daily health care of the lumbar intervertebral disk and how to better use force, a physical factor, to solve the lumbar intervertebral disk problems.