The health care alliance in county was the vertical integration of medical service system,which was conductive to improve the overall efficiency of the county medical service,achieve tiered health care system,optimize regional health resources and enhance the capacity of primary health care services.It took Tianchang County,Anhui as a case study.It investigated and analyzed how the local took measures to carry out the health care alliance reform in organization structure,interest distribution,health human resources construction,information construction,division and coordination mechanism,medical service pattern,etc.,so as to provide references for implementing county medical alliance reform in other regions.

Adoption of the board of directors system in a public hospital is conducive to straightening out its internal management system and enables its head to more effectively exercise his power of supervision while giving full play to his functions. In addition, when major issues are concerned, decision-making is more democratic and scientific, reducing disputes over trifles. The board of directors system may after all be accepted as an effective form of management.

Study of the strategic objectives chosen by hospitals from the perspective of stakeholders is now under the spotlight of researchers at large. To identify whether there exist differences in strategic objectives among various groups in the hospital and probe into the causes, the author called into play the competing values framework as the analysis tool. An evidenced-based study on public hospitals in Hangzhou identified marked differences on choices of strategic objectives among various internal stakeholders in the hospital For example, hospital administrators tend to focus on internal control, while medical doctors tend to focus on interactions between the hospital and the external environment. On this basis, further studies are proposed.

Objective To investigate the repeated dose toxicity of doxorubicin liposome injection and doxorubicin injection in rats. Methods Ninety SD rats ( body weight 180-220 g, male:female=1:1 ) were divided into 3 groups (30 rats in each group), and were administered intravenously with physiological saline, doxorubicin liposome injection (1 mg·kg-1 ) and doxorubicin injection ( 1 mg·kg-1 ) , respectively, once every three days for thirteen times. The body weight, blood biochemistry, hematology, organ coefficient and histopathology were analyzed for the overall toxicity assessment. Results The rats administered with doxorubicin liposome injection (1 mg/kg) showed hair loss and skin ulcer, significantly reduced growth of body weight, increased levels of urea nitrogen ( BUN ) , alanine aminotransferase ( ALT ) , blood platelet ( PLT ) , and kidney and heart coefficients, decreased thymus and testicular coefficients, myofibrillar rupture and lysis, and partial loss of cell nuclei, hyaline casts in the renal convoluted tubules, interstitial edema and loss of spermatogenic cells in the testicular tubules. Compared with the doxorubicin liposome injection group, similar abnormal changes were also observed in the doxorubicin injection group, but the hair loss and skin ulcer were milder and the heart and kidney toxicities were severer. Conclusions Compared with doxorubicin injection, the doxorubicin liposome injection causes milder heart and kidney toxicity but more serious skin toxicity.

Objective to investigate the role of Pim‐3 and NF‐κB in the development and progression of infiltrating ductal carcinoma of the breast .Methods Here ,we used immunohistochemistry to detect expression of Pim‐3 and NF‐κB in 75 samples of infiltrating ductal breast carcinoma ,21 samples of intraductal breast carcinoma and 30 normal breast tissues .The relationship of their expression ,as well as their correlation with clinicopathological features and patient survival were assessed .Results In con‐trast ,both Pim‐3 and NF‐κB were more commonly detected in infiltrating ductal carcinoma than in intraductal carcinoma and normal tissue .In the infiltrating ductal carcinoma ,the positive expression rate of Pim‐3 was 77 .3% ,and that of NF‐κB was 68 .0% ;in duc‐tal carcinoma of the breast ,the positive expression rate of Pim‐3 was 52 .4% ,and that of NF‐κB was 42 .9% ;in the normal breast tissue ,the positive expression rate of Pim‐3 was 23 .3% ,and that of NF‐κB was 16 .7% ;the positive expression rate of Pim‐3 was correlated with tumor size ,histological grade ,and clinicopathological stage ;and that of NF‐κB was correlated with tumor size ,histo‐logical grade ,lymph node metastasis of breast cancer .Spearman rank correlation analysis revealed a positive correlation between Pim‐3 expression and NF‐κB expression in infiltrating breast cancer (r=0 .243) .Conclusion Our results demonstrate that Pim‐3 and NF‐κB play a role in the initiation and development of breast cancer ,thus ,these proteins may serve as useful diagnostic and prognostic markers of invasive breast cancer .

With the understanding of the development and pro-gress of the cancer,the research of targeted cancer drug devel-opment reaches into a new era.p53 is an important tumor sup-pressor gene,the protein coded by p53 plays a critical role in tumor suppression mainly by inducing cell cycle regulation, DNA repair and apoptosis.Nowadays,p53 becomes a relatively attractive target for anti-cancer drug development and there are some drugs targeting p53,moreover,APR-246 which targets mutant p53 is in Phase II clinical trial.In addition,it facilitates drugs discovery programmes in the challenging area of protein-protein interactions and mutant protein conformational change. The review discusses the research progress of drugs which target p53 and elucidates the characteristics and mechanisms of these compounds.

Objective To investigate the therapeutic mechanism of umbilical cord mesenchymal stem cell(UC-MSCs)trans-plantation for the graves disease(GD)mice .Methods Thirty two mice were divided into 3 groups as following :normal control group (G0) ,GD control group (G1) ,UC-MSCs group(G2) .Enzyme linked immunosorbent assay(ELISA)was used to measure the level of TSAb in blood serum and the expression of FT4 was measured by chemiluminescence .Thyroid sections were stained with hema-toxylin and eosin(HE)for histological examination .Splenocytes were stained with multicolor immunofluorescence and detected by flow cytometry to analyze the percentages of CD1dhiCD5+CD19+ regulatory B cells(Bregs) .Expressions of IL-10 and TGF-βmR-NA in spleen organization were measured by Real-time PCR .Results At 26 weeks ,the level of TSAb in blood serum in G2 was more significantly decreased than in G1(P<0 .05) ,and the level of CD19+ B in spleen in G2 was also more significantly decreased than in G1(P<0 .05) ,however ,the percentage of CD1dhiCD5+CD19+ Bregs splenocytes and the levels of IL-10 and TGF-βmRNA in spleen organization were more significantly increased than in G1(P<0 .05) .The concentration differences of TSAb in serum was negatively correlated with the percentage differences of CD1dhi CD5+ CD19+ Bregs ,however ,positively correlated with the expres-sion differences of IL-10 and TGF-βmRNA in spleen before and after transplantation .Conclusion Activation of Bregs may be one of the mechanisms of UC-MSCs therapeutic effect on GD mice .

BACKGROUND:The mechanical index is an important method for the evaluation of the therapeutic efficiency of drug treatment for osteoporosis animal models. OBJECTIVE: To explore the effects of various drug treatments on osteoporosis through a mechanical performance test about the femoral compression of rats. METHODS: Thirty-six Wistar female rats were randomized into six groups: normal control group, model group, Dan Qiparticles group, alpha-D3 group, premarin group, ipriflavone group, with six rats in each group. Osteoporosis models were made in al groups except for the normal control group, and after modeling, the rats in different groups were treated withDan Qi particles, alpha-D3 group, premarin and ipriflavone, respectively. After 15 weeks, the rats were kiled by abdominal aortic bloodletting to take out the left and right femurs that were placed on a universal testing machine to perform a compressive test at a speed of 5 mm/min. RESULTS AND CONCLUSION:The maximum load, maximum stress, maximum displacement, maximum strain, and elastic modulus were significantly lower in the model group than the other four groups (P < 0.05). There was no difference in different mechanical parameters between alpha-D3 group and model group as wel as between Dan Qi particles group and normal control group (P> 0.05). These findings indicate that osteoporosis leads to the variation of compression mechanical properties of the femur. There are good compression mechanical properties of the femur after treatment with premarin and ipriflavone, andDan Qi particles has the best effect.

BACKGROUND:Sodium alginate and chitosan are the polycation and polyanion natural polymer materials respectively, and they can be crosslinking agents complementing each other to form composite gel and avoid the cytotoxicity resulting from some common crosslinking agents .
OBJECTIVE:To prepare the chitosan-sodium alginate composite gel and evaluate its cytotoxicity in vitro. METHODS:Chitosan was dissolved in 0.25 mol/L acetic acid to make a 30 g/L mass concentration solution, and 0.1 mol/L NaOH solution was added to neutralize its acidity. Neutralization of the chitosan solutions leads to the formation of a precipitate in ultrasmal particles. Then the chitosan and 3%sodium alginate solution in deionized water were mixed in 1:1 volume ratio by high frequency oscil ating to produce composite gel. The composite gel were detected by scanning electron microscopy and Fourier transform infrared spectrometry after freeze-drying. The 24-hour and 72-hour leaching solutions of composite gel, 24-hour and 72-hour leaching solutions of polyethylene and phenol solution were added to the L-929 cells’ culture medium respectively in order to evaluate the cytotoxicity of composite gel in vitro.
RESULTS AND CONCLUSION:The results of Fourier transform infrared spectrometry showed the variation of characteristic peak values of composite gel which were different from sodium alginate and chitosan;and under scanning electron microscope, a spatial network structure formed with abundant intervals. Result of the cytotoxicity valuation was qualified for the chitosan-sodium alginate composite gel. These findings indicate that the chitosan-sodium alginate composite gel can be used as tissue engineering scaffold materials.

Objective To study the effects of He-Ne laser irradiation on histological changes and the expression of proliferating cell nuclear antigen ( PCNA ) and B-cell lymphoma/leukemia-2 ( Bcl-2 ) in the gastric mucosa of rats with chronic atrophic gastritis (CAG) so as to elucidate the relationship of He-Ne laser irradiation with precancerous lesions and apoptosis in the gastric mucosa. Methods The rats were divided into a normal group,a model group and a laser group.A model of CAG was established by gastric perfusion with a mixture of sodium salicylate and alcohol combined with irregular fasting and forced exercise.A He-Ne laser was used to irradiate the rats at 3.36 J/cm2 for 7 min daily for 20 d.Histopathological changes including the severity of inflammation in the gastric mucosa and the morphology and structure of the parietal cells were observed with a light microscope,and the expression of PCNA and Bcl-2 was detected with immunohistochemical methods. Results The pathologic morphological changes in the gastric mucosa of the model group were atrophy of the glands of the gastric mucosa and notable inflammatory infiltration.But in the laser group inflamed cells decreased,and the morphology,structure and volume of the cells all recovered close to normal.The immunohistochemistry results showed that during the atrophy of the gastric mucosa the expression of PCNA and Bcl-2 was elevated,and it was significantly higher in the model group than in the normal group.After irradiation the expression of PCNA and Bcl-2 was significantly lower. Conclusions There was hyper-proliferation in the gastric mucosa of the CAG model rats,with high expression of apoptosis suppressor PCNA and Bcl-2 proteins.Laser irradiation can reduce the expression of PCNA and Bcl-2,enhance cell proliferation and induce apoptosis,preventing the development of cancer.Laser irradiation has a good adjuvant therapeutic effect for all the pathological changes observed.