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 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.

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.

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.

Myelodysplastic syndromes ( MDS ) represent a heterogeneous group of clonal hematopoietic disorders with diverse clinical course .Because of the heterogeneity and the lack of molecular markers to monitor disease progression, clinical management of MDS patients is challenging .Recently, with the development of molecular analysis techniques , an increasing number of MDS related molecular biomarkers have been reported.In this review, we will discuss the clinical applications of the newly reported molecular makers in terms of diagnosis , prognosis and treatment.These markers may improve the diagnosis and prognostic assessment systems of MDS , which may potentially be used to guide decision making in the individual therapy.

The mutation status of calreticulin gene (CALR) is helpful for the diagnosis of JAK2 / MPL mutation-negative myeloproliferative neoplasms (MPN), and is closely related to the MPN progression and prognosis.Currently, Sanger sequencing, PCR-fragment analysis, high resolution melting, Taqman RQPCRand the next generation sequencing have been reported to be used to detecting the CALR gene mutations.A proper method for CALR mutation detection and a right laboratory diagnostic procedure according to the MPN-related molecular markers will facilitate the rapid and effective diagnosis and treatment of MPN.

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.

Objective To study the anemia status and genotype of thalassemia in preschool children in Shenzhen. Methods 658 preschool with anemia hospitalized in Shenzhen Longgang Maternal and Child Health Hospital from October 2012 to September 2015 were screened by complete blood analysis . The most common mutations of thalassemia genotype (17 β thalassemia genotype mutation,3 α thalassemia genotype mutation and 3α thalassemia genotype absence change) in Chinese population were detected. Results All cases have microcytic hypochromic anemia. 426 cases were identified to be thalassemia (64.7%). 23 genotypes and 13 gene mutation type were detected. The most common genotype type were SEA/αα(46%),β654/βN(15%),β41?42/βN(12.7%). And the most common allele gene mutation type were SEA (49.1%),IVS?Ⅱ?654( C→T)(14.4%),CD41?42(?TTCT)(12.4%) re?spectively. MCV and MCH of thalassemia children was significantly lower than that of children diagnosed as without thalassemia. The differences of RBC,Hb,MCV,MCH,MCHC,RBC?SD between the two groups were statistical?ly significant. Conclusion The proportion of thalassemia among preschool anemia children in Shenzhen area was high,and it is necessary to strengthen the local thalassemia prevention and decrease anemia effect on preschool children′s health.