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.

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 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.

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 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 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.

Objective: To investigate the efficacy of gemcitabine in chemotherapy of cervical carcinoma. Methods:10 untreated cervical carcinoma patients had been divided into two groups,5 cases were treated with neoadjuvant chemotherapy and radiotherapy,others were treated only with radiotherapy. All patients were operated and compared the pathologic changes of cancers. Moreover 3 cases with recurrent tumors had been treated with gemcitabine and other agents . Results: The rate of complete response(CR) was 60% in group of neoadjuvant chemotherapy and 20% in patients with only radiotherapy. Only one case achieved partial response (PR) in patients with recurrence. Conclusion: The neoadjuvant chemotherapy in cervical carcinoma with gemcitabine is helpful for achieving good response .As radiation sensitizer or radio-potentiator,gemcitabine can promote efficacy of neoadjuvant chemotherapy in cervical carcinoma.

Objective: To study the factors relating the prognosis of ovarian granulosa cell tumor and the characteristics of its clinical presentations. Methods: The clinical records and pathological sections of 24 cases with granulosa cell tumor of ovary were reviewed retrospectively. The clinical characteristics, the clinical stage, and the therapeutic programs and the results were summarized respectively. Results:The 5-years survival rate showed that the clinical stage influenced the prognosis of ovarian granulosa cell tumor obviously. Conclusion: The early dection is the major factor which influences the patients' survival rate.