It elaborates the importance of designing a patient-centered hospital environment, and presents the concept of such a design. The authors hold that such a concept is mostly composed of systematic, people-oriented, informationized and variability designs, and describe the design trends in contemporary hospitals. It is also pointed out that patient-centered principle should be dominant in building a contemporary hospital, as the guideline and development trend, as a satisfactory hospital environment makes a hospital more competitive.

To investigate the formation of tissue engineered cartilage using polyglycolic acid (PGA) as three dimensional scaffold seeded with allogenic chondrocytes. First, chondrocytes were harvested from rib cartilage of one week old infant rabbits by collagenase digestion.The isolated cells were cultured in vitro for 2～3 generations, and then the cell suspension was concentrated. Next, the suspension was seeded onto PGA scaffolds soaked with poly l lysine. Then, scaffold chondrocyte constructs were transplanted into subcutaneous tissue of adult rabbits. Finally, the chondrogenesis was studied histologically at various periods. The results showed that chondrocytes were well distributed on the PGA scaffolds in the period of culture in vitro, and could secrete matrix around one week after seeding. 4 weeks after transplantation, the immature cartilage was regenerated in recipient animals. But some inflammatory cells surrounding the new cartilage and some PGA fibers were observed. 8 weeks after transplantation, mature cartilage with abundant matrix was obtained. PGA fibers were not found. This study proves that it is possible to regenerate new cartilage in animals possessing immune function by seeding allogenic chondrocytes onto PGA scaffold. Rejectionreaction is not strong.

Objective To investigate the effects of gene transfection with human growth/differentiation factor 5(hGDF5)on the differentiation and proliferation of rabbit bone marrow mesenchymal stem cells (BMSCs).Methods BMSCs were obtained from adult New zealand rabbits and purified by gradient centrifuge.Exogenous recombinant human GDF5 was transfected into BMSCs with liposome method.Then hGDF5 expression at mRNA and protein level was measured separately by reverse transcription-polymerase reaction and indirect immunofluorescence method.Activity of alkaline phosphates(ALP),expression of TypeⅡcollagen(ColⅡ),proteoglycan and growth of the cells were all measured by biological methods to evaluate the effects of hGDF5 gene transfer on the differentiation and proliferation of rabbit BMSCs.Results After hGDF5 gene transfection,BMSCs expressed hGDF5 mRNA and protein,and compared with the control groups,expression of proteoglycan and ColⅡ increased significantly,but no significant difference appeared in ALP activity and cell proliferation.Conclusion Gene transfer with hGDF5 is an effective way to enhance the expression of GDF5 at mRNA and protein.The expression of heterogenetic hGDF5 gene can induce BMSCs' differentiation to chondrogenic cells.But the gene transfection has no obvious effects on the proliferation and ALP activity of BMSCs.

Objective To evaluate the changes of QT dispersion (QTd) after successful percutaneous transluminal coronary angioplasty (PTCA) or stent implantation during the recovery period after acute myocardial infarction (AMI).Methods We studied 57 AMI patients who underwent PTCA or stent implantation and 86 normal coronary artery subjects used as control. Maximal and minimal QT interval (QT max and QT min) and QTd (QTd=QT max-QT min) were measured using 12-lead electrocardiography within 1 d before and 1 h after PTCA and stent implantation or coronary angiography.Results QTd and corrected QT dispersion (QTcd) were significantly prolonged in patients with AMI compared with control group. There was no significant difference in QTd and QTcd between anterior AMI and inferior one. QT max, QTc max, QTd and QTcd after PTCA or stent implantation were significantly decreased.Conclusion QTd and QTcd were significantly decreased after successful PTCA or stent implantation which were performed during the recovery period of AMI, which shows it can produce beneficial effects in decreasing the risk of ventricular arrhythmia and reducing mortality in AMI patients.

Background and purpose: AMP-activated protein kinase (AMPK) plays an important role in the regulation of cell metabolism and energy balance and is associated with cell proliferation, survival and multiple signaling pathways. Recent reports found that AMPK is involved in tumor suppression and drug resistance. The aim of this study was to explore the effect of AMPK on the anti-tumor effect of adriamycin and underlying mechanism in breast cancer MCF-7/adr cells. Methods:The anti-proliferative effects of adriamycin was detected by methyl thiazolyl tetrazolium (MTT) assay in MCF-7/adr, MCF-7/adr-vector and MCF-7/adr-AMPKαcells. The cell morphology in each group was stained with the lfuorescent dye Hoechst 33528, and the effects on apoptosis induction were examined by lfow cytometry (FCM). The intracellular concentration of adriamycin was detected by lfuorescence assay. The resis-tance-and apoptosis-related proteins were analyzed by Western blot. Results:The growth of breast cancer MCF-7/adr cells was inhibited by adriamycin in a dose-and time-dependent manner. The IC50 values at 24 and 48 h were (36.8±2.1) and (28.8±1.3) μg/mL, respectively. AMPKαover-expression enhanced the cytotoxic effect of adriamycin in MCF-7/adr-AMPKαcells in a dose-and time-dependent manner. Its IC50 values at 24 and 48 h were (16.0±0.7) and (4.2±0.2) μg/mL, respectively. Fluorescent morphological assay showed that AMPKαoverexpression contributed to adriamycin induced apoptosis in MCF-7/adr-AMPKαcells. After treatment with 1.0 μg/mL adriamycin for 48 h, the apoptosis rates of MCF-7/adr, MCF-7/adr-vector and MCF-7/adr-AMPKα cells were (12.0±1.4)%, (12.7±1.6)% and (32.0±4.2)%, respectively, indicating that overexpression of AMPKα enhanced the adriamycin-induced apoptosis in MCF-7/adr cells. Fluorescence microplate assay showed that over expression of AMPKαsigniifcantly increased the intracellular accumulation of adriamycin, in a concentration dependent manner. Western blot analysis showed that, compared with MCF-7/adr and MCF-7/adr-vector cells, the expressions of Bax, caspase-3 and cleaved PARP proteins were increased. Meanwhile, Bcl-2 and P-gp protein expressions were decreased in MCF-7/adr-AMPKαcells. Furthermore, the release of cytochrome c from mitochondria into the cytosol was also observed in MCF-7/adr-AMPKαcells. Conclusion:AMP-Kαoverexpression can enhance the chemosensitivity of breast cancer MCF-7/adr cells to adriamycin through inhibiting the drug effux transporter and regulating the expression of apoptosis-related proteins.

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Objective To investigate and summarize the clinical and high-resolution computed tomography(HRCT) characteristics of invasive pulmonary fungal infections(IPFIs)in children.Methods Clinical and HRCT data of 35 cases with IPFIs admitted in our hospital between March 2007 and July 2015 were retrospectively analyzed.The clinical and HRCT characteristics were summarized.Results Thirty-five patients consisted of 23 boys and 12 girls with mean age of(3.2±1.9) years.Host factors included acute leukemia (n=12),primary immunodeficiency disease (n=4),congenital heart disease (n=2),cerebral palsy (n=2),severe influenza A infection (H1N1) (n=2),ichthyosis (n=1),acquired immunodeficiency syndrome(n=1),systemic lupus erythematous (n=1),tubercular meningitis(n=1),mechanical ventilation(n=2).All patients were treated with broad-spectrum antibiotic,ranking by descending order:third-generation cephalosporins (28 cases),carbapenems(19 cases)and vancomycin (18 cases).Seventeen cases were treated with corticosteroids systemically and 12 cases with acute leukemia took antineoplastic medicine.The symptoms of IPFIs were intermittent or persistent fever,cough and rales.HRCT results:nodules (n=25,71.4％),subpleural patchy opacities (n=24,68.6％),mass (＞3cm) (n=4,11.4％),halo sign (n=27,77.1％),cavities (n=8,22.9％),air crescent sign (n=4,11.4％),miliary nodules (n=2,5.7％),pleural effusion (n=14,40％).Conclusion There are certain specific characteristics of IPFIs in children in clinical and HRCT aspects.The possible diagnosis of IPFIs can be made based on clinical and HRCT features.

OBJECTIVE To investigate the clinical characteristics,treatment and prognosis of laryngotracheal stenosis due to relapsing polychondritis (RP).METHODS The clinical data of 6 patients with laryngotracheal stenosis due to RP were reviewed retrospectively.RESULTS From 1996 to 2006,6 patients with laryngotracheal stenosis due to RP were managed in our hospital.Respiratory tract lesions were diffuse and extensive.Of them,4 patients accepted laryngotracheal reconstruction using surgical flaps with or without pedicle,2 accepted dilation of trachea in thoracic segments.Five patients were cured without recurrence.CONCLUSION Treatment of laryngotracheal stenosis due to RP is very difficult.If the surgical opportunity and methods were selected correctly according to each patient,good results can also be obtained.

Paroxysmalnocturnalhemoglobinuria(PNH)isadefectdiseaseofacquiredclonal hematopoietic stem cel s. It can be expressed as hemolytic anemia, hemoglobinuria, and venous thrombosis. Cerebral venous sinus thrombosis (CVST) is a rare but serious complication of PNH. Here we report a PNH patient with CVST and reviewthe relevant literature. For patients who have the risk factors for CVST and neurological symptoms, such as headache and increased intracranial pressure, should early conduct brain imaging examination and make the diagnosis clear, and give an active treatment in the aspects of anticoagulation, dehydration, eliminating the causes of disease, and controling complications.

Objective　To evaluate the diagnostic value of MR I、CT、DSA for cerebral arteriovenous malformation(AVM). Methods　A total of 40 case of AVM were examined with imaging methods in which 19 MRI, 30 CT and, 12 DSA. Combination of two or three kinds of eximinations were perfo rmed in 20 and 4, respectively. Results　Diagnostic accordance r ate rate of CT was 70%, sensitivity and specificity of MRI were 100% and 84% res pectiv ely, diagnostic accordance rate of DSA was 92%. Conclusion　MRI,CT,D SA can play important roles in the diagnosis of AVM. MR and DSA are superior to CT. DSA could reveal the circulation time and the stealing blood situation of AV M and thus suggests the applicability of interventional embolization therapy.