The paper systematically elaborated the concept of corporate governance structure of public hospitals and theories in relation. In addition, it analyzed the status quo and problems existing in corporate governance structure of public hospitals in China, proposing the basic principles and the council model of corporate governance structure. The authors emphasized the following responsibilities and rights of the council, the president, and the board of supervisors in such a framework: 1) As the hospital's highest decision-maker, the council exercises the rights of ownership, playing a decisive role in hospital management; 2) the president is appointed and dismissed by the council, and authorized to run the hospital; 3) the supervisors are responsible for overseeing the council and senior management. In the end, this paper summarized the external environment required for building corporate governance structure of public hospitals.

Objective To investigate the clinical features of primary Sj(o)gren syndrome (pSS) with interstitial lung disease (pSS-ILD) so as to raise the clinical diagnosis Level. Methods The clinical data were collected from 58 patients with pSS,who were admitted from March 2006 to March 2009. The patients were divided into ILD group (27 cases) and non-ILD group (31 cases). Rheumatoid factor(RF),C-reactive protein (CRP), protein electrophoresis and complement C3, C4 in serum were measured by immunoturbidimetric methods. Antinuclear antibodies (ANA) and anti-ENA antibodies were measured by indirect immunofluorescence technique and western blot. CA125 was detected by enzyme-linked immunosorbent assay and erythrocyte sedimentation rate (ESR) was detected by WS method. Pulmonaly function tests and radiology examination were performed. Results Compared with those in non-ILD group,the percentages of dry mouth,dry eye, rampant caries and velcro crackles were significantly higher in ILD group,anti-SSA antibody, ESR,CRP, CA125 and title of γ-gloulin was significantly higher in ILD group. In ILD group,diffusion dysfunction was 18 cases (66.7%),restricted ventilation dysfunction was 14 cases (51.9%),blocked ventilation dysfunction was 6 cases (22.2%), incorporated ventilation dysfunction was 8 cases(29.6%), forced vital capacity, forced expiratory volume in one second, maximum midexpiratory flow, DLCO were significantly lower in ILD group than those in non-ILD group (P ＜ 0.01). Moreover,high resolution computerized tomography (HRCT) was more sensitive than chest X-ray in the diagnosis of pSS-ILD.Conclusions The presence of pSS-ILD highly associates with the activity of pSS. Pulmonary diffusion ventilation function and HRCT play an important role in the diagnosis of pSS-ILD.

Objective:To prepare bifunction antibody of anti-human laryngocarcinoma/anti-CD 3 for the active immune therapy of laryngocarcinoma.Methods:To corss link monoclonal antibody of anti-human laryngocarcinoma and anti-CD 3 into bifunction antibody by chemical method,which can guide the killer function on carcinoma cells.Results:The killer rate of effector cells guided by bifunction antibody is higher than that of anti-CD 3 which can arise with the elevation of effect target ratio.Conclusion:Bifunction antibody of anti-human laryngocarcinoma/anti-CD 3 prepared by chemical cross linking method has the potential value for clinical application. [

Objective: To identify the related psychosocial risk factors of emotional disorders in children. Methods:To use case-control approach in which. Diagnosis was made by clinical interview according to ICD-10 criteria. Eighty eight cases and controls separately filled out general condition inventory. The results were put into Logistic regression model for analysis. Results: The children with timid personality, without kindergarten education, or with parents who were administrative or technical personnel, were apt to have emotional disorders. The children who were usually counseled by their mothers had less emotional disorders than those were beaten. Conclusion: The emotional disorders were the results of multiple factors. Prevention of children's emotional disorders should be focused on the children's personality and family education.

Objective:To explore the methods to improve the professional core competencies of medical students in the standardized residency training.Methods:A total of 82 medical students who participated in the standardized residency training ("resident students" for short) in the same period were selected in this study, and the self-edited professional core competencies textbooks were used for regular theoretical study, and at the same time, clinical practice cases were collected for regular scenario reduction teaching. When the resident students entered the department and after 12 months of the standardized training, the professional core competencies training evaluation scale was used to evaluate and compare the scores of the resident students, and the value of the above-mentioned training model to improve the professional core competencies of the resident students was evaluated. SPSS 18.5 was performed for t test between groups. Results:After being trained by the above model, the selected students had significantly improved such competencies as communication, cooperation and problems solving ( P<0.05). Compared with the scores of resident students before and after the training, there was no significant difference in communication and cooperation with other students ( P>0.05), with low satisfactory communication with the leader ( P>0.05), but the problem-solving ability had been significantly improved ( P<0.05), while the score of which was low and it should be pay more attention to in the future training. Conclusion:In the process of standardized residency training, the application of the above-mentioned training model can significantly improve the professional core competencies of resident students, and at the same time, it's necessary to strengthen the cultivation of satisfactory communication with leaders and problem solving ability.

Objective To study the expressions of keratin 10, 14 and 17 (KI0, K14, K17) in psoriatic lesions before and after the treatment with acitretin. Methods Thirty patients with moderate or severe plaque psoriasis were included in this study. The cohort consisted of 19 males and 11 females with an average age of 33.9 years, and disease course of 4 months to 30 years. Patients were treated with acitretin for 8 weeks which started with an initial dose of 20 mg per day for 1 week, then switched to 0.5-0.75 mg per kilogramme of body weight per day until symptom improvement, finally maintained at a dose of 10-30 mg per day. The expression of K10, K14 and K17 was detected by immunohistochemical technique before and after treatment with acitretin. The relationship between the disease severity and levels of keratins was evaluated. Results Prior to the treatment, increased expression of K14 and K17 was observed in lesions of patients along with the decreased expression of K10 compared with the normal controls. After treatment, the expression of K14 and KI7 significantly decreased (both P < 0.01), while that of K10 increased (P < 0.01), and there was still a statistical difference between the patients and normal controls (P < 0.01). A significant decrease was observed in the PASI score of patients (P < 0.01). The changes in the expression levels of K10, K14 and KI7 before and after treatment were somewhat correlated with the clinical course and severity of psoriasis. Conclusions Systemic aeitretin can affect the expression of K10, K14 and K17 in psoriatic lesions, but the extent of changes in their expression is not always consistent with the improvement of clinical manifestations.

Purpose Lipotoxicity plays an important role in the progression of diabetes and its complications,and the gold standards for organs' lipid quantification are biopsy or histochemical staining,which are invasive and have their own limitations.Thus,our research was to identify the difference in organ lipid deposition between type 2 diabetic patients and healthy volunteers by using noninvasive three-point T2* corrected Dixon imaging.Materials and Methods Sixty-five type 2 diabetic patients and 34 healthy volunteers were included in this study.All participants underwent three-echo Dixon with 3.0T MR imager.Dixon imaging parameters [hepatic fat fraction (HFF),splenic fat fraction (SFF),pancreatic fat fraction (PFF)] were collected.All of the MRI parameters were compared.The relationship between HFF,SFF,PFF and BMI,age were analyzed.Results The hepatic and splenic lipid percentage in diabetic group [HFF=(5.4±4.3)％;SFF=(3.7± 1.4)％] was significantly higher than healthy volunteers group [HFF=(2.9± 1.3)％;SFF=(3.0± 0.9)％;P＜0.05,respectively].However,there was no significant difference in pancreatic fat fraction between diabetic and healthy groups (P＞0.05).There were positive correlations between HFF,SFF,PFF and BMI (r=0.379,0.305 and 0.306,P＜0.05).Moreover,only the positive correlation between pancreatic fat fraction and age were observed (r=0.261,P＜0.05).Conclusion The three-point T2* corrected Dixon revealed the abnormalities of hepar and spleen lipid accumulation in diabetic patients.Thus,the three-point Dixon imaging may potentially aid in evaluating the lipid deposition of abdominal organs.

BACKGROUND: Thoracolumbar fracture is most common seen in spinal fractures. The paraspinal muscle is subjected to extensive detachment and traction in traditional posterior approach, so the muscular ischemia and denervation lead to muscle atrophy further inducing intractable low back pain. Thereafter, minimally invasive spinal surgery becomes more and more popular.OBJECTIVE: To investigate the clinical efficacy of pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement for single-level thoracolumbar fracture.METHODS: Clinical data of 52 patients with single-level thoracolumbar fracture without nerve injury were analyzed retrospectively, and were then assigned to observation (n=28) and control groups (n=24) according to the treatment method. The patients in the observation group were treated with pedicle screw fixation through Wiltse approach plus implanted with injectable calcium sulfate bone cement, and those in the control group were subjected to pedicle screw fixation through posterior approach plus implanted with injectable calcium sulfate bone cement. The operation time, blood loss and hospitalization time were compared between two groups. The low back pain was observed at baseline, 1 week and 3 months postoperatively, and the percentage of anterior vertebral height revealed on X-ray was observed at baseline, before ambulation, and during last follow-up. Moreover, the complications, loosening and rupture of the screws were recorded.RESULTS AND CONCLUSION: (1) All patients were followed up, and the follow-up time was 16-24 months. (2) The operation time, blood loss and hospitalization time in the observation group were significantly less than those in the control group (P < 0.05). (3) The postoperative visual analogue scale scores in the two groups were significantly lower than those before surgery, and the scores showed significant differences between two groups (P < 0.05). (4) The percentage of anterior vertebral height before ambulation and during last follow-up in the two groups was significantly improved, and the percentage showed significant difference between two groups at each time point (P < 0.05). (5) These findings suggest that based on strict indications, the pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement is safe for single-level thoracolumbar fracture, which restores the anterior vertebral height rapidly, alleviates pain and exhibits satisfactory long-term efficacy. Furthermore, it holds shorter operation time and less blood loss than the traditional approach.

BACKGROUND:Studiesin vitro have suggested that icarin can attenuate lipopolysaccharide (LPS)-induced acute pneumonia. Is the anti-inflammatory effect of icarin stil valid in the presence of wear particles? OBJECTIVE:With studiesin vivo andin vitro, to investigate the regulatory effect of icarrin on titanium particle-induced inflammatory reaction. METHODS:(1) Studiesin vivo: Eighty male C57BL/6 mice aged 6-8 weeks were randomly divided into four groups: control group, icarin group, titanium particle group, and titanium particle+icarin group. Mice in the titanium particle group and titanium particle+icarin group received surgical procedure, and sterile and endotoxin-free titanium particles were implanted on the calvaria surfaces to induce inflammatory reaction. Mice in the control group and icarin group received the same surgery, but no wear particles were implanted. Then icarin was given oraly to mice in the titanium particle group and titanium particle+ icarin group with a dose of 200 mg/kg per day for 2 weeks from the day of modeling. Mice in the control group and icarin group were given oraly the same dose of placebo. Two weeks later, tumor necrosis factor-α and interleukin-1β at protein and mRNA levels were respectively detected with enzyme-linked immunohistochemical (ELISA) and quantitative real time reverse transcription PCR (qRT-PCR) analysis. (2) Studiesin vitro: Mouse monocyte/macrophage RAW264.7 cels were cultured with different conditioned media: control group, nuclear factor receptor ligand кB (RANKL); icarin group, RANKL+icarin; titanium particle group, RANKL+titanium particles; titanium particle+icarrin group, RANKL+icarin+titanium particles. Titanium particles stimulated RAW264.7 cels were co-cultured with RANKL and icarin for 72 hours. Tumor necrosis factor-α and interleukin-1β at protein and mRNA levels in the supernatant were detected with ELISA analysis and qRT-PCR, respectively. RESULTS AND CONCLUSION: (1) Resultsin vivo: icarin treatment obviously decreased titanium particle-induced inflammatory cellinfiltration and made the thickness of periosteum thinner, down-regulated tumor necrosis factor-α and interleukin-1β expressions at protein and mRNA levels. (2) Results in vitro: when RAW264.7 cels were stimulated with titanium particles for 72 hours, tumor necrosis factor-α and interleukin-1β expressions at protein and mRNA levels in culture media increased obviously; when icarin was administrated, tumor necrosis factor-α and interleukin-1βexpressions at protein and mRNA levels down-regulated significantly. These results suggest icarin can obviously suppress titanium particle-induced inflammatory reactionin vivo andin vitro.

Objective To investigate lymph node metastasis on the middle and lower segment of lⅡ and Ⅲ stage of esophageal squamous cell carcinomas,understand the factors influencing the lymph node metastasis,and provide the basis for the key areas of lymph node cleaning.Methods A retrospective study was made on the specimens of 186 patients who were middle and lower segment of Ⅱ and Ⅲ stage of esophageal squamous cell carcinomas,who had underwent radical operation through left thoracic,thoraco abdominal two field lymph node cleaning.All the cases were patients from April 2010 to December 2013 at the Inner Mongolia Medical University Clinical Medical College of Chifeng.Results A percentage (67.9％) of patients (126/186) was found with lymph node metastasis.A total of 4259 lymph node was dissected,with an averaged cleaning of (22.9 ± 8.1) lymph nodes for each case.A total of 622 lymph nodes (14.6％ =622/4 259) existed metastasis.The rate of mediastinum metastasis for middle and lower segment of esophageal cancer was 56.1％ and 16.5％,respectively.The rate of metastasis to the lower mediastinal lymph nodes was 34.6％ and 54.4％,respectively.The rate of metastasis to the celiac lymph nodes was 23.4％ and 46.8％,respectively.A significant difference was found in the metastasis locations of middle and lower segment of esophageal carcinomas (P ＜ 0.05).The top three locations of lymph node metastasis in the middle segment of esophageal squamous cell carcinomas were the lymph nodes of left artery paraesophageal,carina,and gastric bypass.The top three locations of lymph node metastasis in the lower segment of esophageal squamous cell carcinomas were paraesophageal,cardia,and gastric lymph nodes.The depths of tumor invasion,differentiation,intravascular cancer embolus were statistically significant effect on lymph node metastasis rate (P ＜ 0.05).Tumor location,and lesion length had no significant effect on the lymph node metastasis rate (P ＞ 0.05).Conclusions The lower segment of Ⅱ,Ⅲ stage esophageal squamous cell carcinoma with lymph node metastasis occurs in the lower mediastinal and abdominal lymph nodes.The middle segment Ⅱ,Ⅲ stage esophageal squamous cell carcinoma with lymph node metastasis occurs in the thoracic and abdominal lymph nodes with Jump transfer characteristics.The lymph node cleaning of the mid-dle segment includes the left artery near the stomach,paraesophageal,and carina lymph node.The lymph node cleaning of the lower segment includes paraesophageal,cardia,and gastric lymph nodes.The metastasis rate of vascular tumor thrombus is related to the depth of tumor invasion and differentiation degree.