Shanghai healthcare system reform is proceeded in the system engineering theory adopting the methods of making the overall plans, the combination of scientific design whole and part, the combination of microcosm and macrocosm, the combination of innovation and standard, the combination of qualitative analysis and quantitative analysis, the combination of structural optimization and improvement so as to promote the development of Shanghai healthcare system and provide successful experiences for our national healthcare system reform.

Parkinson's disease (PD) is a complicated disease, commonly diagnosed among the elderly, which leads to degeneration of the central nervous system. It presently lacks an effective therapy for its complex pathogenesis. Adverse effects from Western drug-based medical intervention prevent long-term adherence to these therapies in many patients. Traditional Chinese medicine (TCM) has long been used to improve the treatment of PD by alleviating the toxic and adverse effects of Western drug-based intervention. Therefore, the aim of this study is to evaluate the efficacy and safety of Xifeng Dingchan Pill (XFDCP), a compound traditional Chinese herbal medicine, taken in conjunction with Western medicine in the treatment of PD patients at different stages in the progression of the disease.

Objective To study the effectiveness of EEG bio-feedback in ameliorating the attention of children with attention deficit/hyperactivity disorder (ADHD) compared to a control group receiving methylphenidate treatment; and to explore the effectiveness of EEG bio-feedback in treating ADHD children refractory to methylphenidate. Methods Forty-four ADHD children were randomly assigned to an EEG bio-feedback group or a methylphenidate group. An additional twenty ADHD children refractory to methylphenidate were referred to as EEG bio-feedback group B. The two EEG bio-feedback groups received training in enhancing their beta activity and suppressing their theta activity. The methylphenidate group were treated with methylphenidate for 3 months. The subjects′ attention stability was measured using a number cancellation test. Their attention allocation and attention shift were tested using a neuropsychological behavioral test instrument, including trail-making test. All groups received re-tests during treatment, post-treatment and during a 6 month follow-up. Results During treatment, the cancellation speed of children in the EEG bio-feedback group A was slower than that of children in the MPH group. At the end of the treatment, there were no significant differences in speed between the two groups. Six months to one year after treatment the cancellation speed of the EEG bio-feedback group A was significantly faster than that of the MPH group. The EEG bio-feedback group B demonstrated significant increases in their cancellation speeds after 20 treatments and during a 1 year follow-up. During treatment and post-treatment, Q scores were significantly lower in EEG bio-feedback group A than in the methylphenidate group. Six months to one year after treatment the Q scores were significantly higher in EEG bio-feedback group A than in the methylphenidate group. There was no significant increase in the Q scores in EEG bio-feedback group B during treatment, but they increased significantly post-treatment. There was no significant difference in the trail-making time between EEG bio-feedback group A and the methylphenidate group during the treatment. Six months to one year after treatment, the trailmaking times in EEG bio-feedback group A were significantly less than in the MPH group. EEG bio-feedback group B showed significant decreases in trailmaking time post-treatment and during follow-up. Conclusions EEG bio-feedback may produce significant and long-term improvements in attention stability, attention allocation and attention shift. EEG bio-feedback may be useful for children with ADHD when methylphenidate is ineffective.

Objective: To study the effect of zinc deficiency(ZD)on the gene expression of vitamin D receptor(VDR)and CaBP in duodenal mucosa of rats. Methods: Thirty weaning male rats were randomly divided into three groups:ZD,paired-fed(PF),zinc adaquate(ZA). After 15 d feeding, took the duodenal mucosa to extract RNA,and measured the levels of VDR mRNA and CaBP mRNA in duodenal mucosa by real time fluorescent quantity PCR. Results: The VDR gene expression of ZD group was downregulated 88.89% as that of PF group,and 50.00% as that of ZA group. CaBP gene expression of ZD group was downregulated 80.16% as that of the PF group,and 88.50% as that of ZA group. Conclusion: Zinc deficiency, by changing the activity of VDR and the mRNA expression of VDR,affects the transcription of the target gene CaBP,and then the absorption of calcium that causes allo-osteogenesis.

Objective To assess surgical strategies and its therapeutic effect on treating tumors invading of the great vessels. Methods 23 patients underwent tumor resection along with reconstruction of great vessels from Jan. 2001 to Dec. 2005 were retrospectively reviewed. Results 19 cases (82.6%) experienced radical resection along with reconstruction of great vessels, 4 cases (17.4%) underwent palliative resections. 20 cases (86.9%) were followed up by various imaging examination methods. 4 cases (17.4%) died perioperatively and 7 cases (30.4%) had complications in perioperative period. Up to Aug. 2005, the postoperative survival times in patients were from 1.5 to 59.0 months. 3 cases (15.0%,3/20) existed more than 48 months, 4 cases (20.0%,4/20) more than 36 months, 6 cases (30.0%,6/20) more than 24 months, 9 cases (45.0%,9/20) more than 12 months and 12 cases(55.0%,11/20)more than 6 months. No complications related to vascular graft occlusion and tumor recurrence next to grafts occurred in these patients. In 2 cases appeared partial thrombosis in grafts in perioperatively. Conclusion Combination of radical resection of tumor and reconstruction of great vessels could extend survival time and improve quality of life in selected patients with tumor invading thoracic and abdominal great vessels.

Sequences analysis revealed Grass carp reovirus (GCRV) s10 was 909 nucleotides coding a 34 kDa protein denoted as VP7, which was determined to be a viral outer capsid protein (OCP). To obtain expressed OCP in vitro, a full length VP7 gene was produced by RT-PCR amplification, and the amplified fragment was cloned into T7 promoted prokaryotic expression vector pRSET. The recombinant plasmid,which was named as pR/GCRV-VP7,was then transformed into E.coli BL21 host cells. The data indicated that the expressed recombinant was in frame with the N-terminal fusion peptide. The over-expressed fusion protein was produced by inducing with IPTG, and its molecular weight was about 37kDa, which was consistent with its predicted size. In addition, the fusion protein was produced in the form of the inclusion body with their yield remaining steady at more than 60% of total bacterial protein. Moreover,the expressed protein was able to bind immunologically to anti-his-tag monoclonal antibody (mouse) and anti-GCRV serum (rabbit). This work provides a research basis for further structure and function studies of GCRV during entry into cells.

Objective To analyse the recurrence rate of patients with Budd-Chiari syndrome (BCS) after radical correction.Method We retrospectively analyzed the clinical characters and follow-up of patients who underwent radical correction and suffered recurrence.Patency rate of inferior vena cava (IVC) and hepatic veins (HVs) were examined.We present the causes of recurrence and clarify risk factors for recurrence by survival analysis.Result Among the 102 patients undergoing radical correction,34 patients suffered from postoperative recurrence,including 32 cases of IVC lesions,21 cases of HVs lesions (19 patients suffered concurrently from IVC and HVs lesions).One patient received reoperation,16 patients received balloon angioplasty of IVC or HVs,3 patients received stent implantation,and 14 patients received conservative treatment.Conclusions The recurrence rate is high after radical correction for BCS.Once the abnormal syndrome recurs,the patients can be managed by radical correction,balloon or stent angioplasty.The main causes of recurrence are thrombosis of IVC,compression of caudate lobe,scar contracture,and the risk factors for recurrence are concurrent hypercoagulation status,too short period of postoperative anticoagulation (less than 6 months).

Objective To investigate the physicochemical characteristics of urinary stone induced by ceftriaxone.Methods Two children cefriaxone-associated urinary stone samples were received for component analysis in our hospital in April 2012,of which one was from a boy whose clinical data was not available,and the other was from a boy who suffered acute lower abdominal pain and vomiting after treatment with ceftriaxone for 5 d in early April.Ultrasound demonstrated a stone in his right upper ureter.Computed tomography showed right upper ureteral stone,which was radiolucent on plain abdominal radiograph.After a conservative treatment for 3 d,the stone in right upper ureter was spontaneously passed,which was confirmed by the ultrasound and intravenous pyelography.The two received stone samples were analyzed by infrared spectroscopy,scanning electron microscopy and energy disperse spectroscopy for component analysis.Results The compositions of two stone samples were free ceftriaxone and calcium ions combined with a molar ratio of 1:1.Conclusions The ceftriaxone could induce urinary stone in children.This special stone has radiolueent imaging,and it is composed of calcium ceftriaxone salt.

Objective To probe the etiology and management of restenosis after artificially grafting bypass for chronic ischemia of the lower extremities. Methods In this study 52 cases suffering from postoperative restenosis and obliteration were compared with 32 cases whose artificial grafts remain patent during the same postoperative follow-up period of 3～62 months.Possible risk factors that lead to restenosis were evaluated.Resuits FIB(4.48±1.68)g/L,CRP(9.5±2.6)mg/L and LDL(4.5±1.7)mmol/L were significantly higher in the restenosis group than FIB(3.50±0.72)g/L,CRP(4.0±3.2)mg/L and LDL(2.8±0.9)mmol/L in the patent group(P＜0.01).There were no significant difference between HDL(1.02±0.32)mmol/L in the restenosis group and HDL(1.12±0.28)mmol/L in the patent group (P＞0.05).Reoperation in these 52 cases found severe intima hyperplasia and secondary thrombosis within anastomosis in 42 cases and the remaining 10 cases were found with artificial vessel primary thrombosis.After reoperation,artificial graft remain patent in 28 cases,limb amputation was performed in 10 cases,the grafted bypass were removed due to infection in 3 cases. Five patients died postoperatively.Conclusion The main reason for restenosis after artificially grafting bypass is intima hyperplasia in vascular anastomosis.Higher levels of FIB,CRP and LDL maybe the major high risk factors that lead to intima hyperplasia and artificial graft obliteration.

OBJECTIVE: To evaluate the effect of hypoxia improvement in Hep-2 cell on cisplatin-induced apoptosis. METHOD: Human laryngeal squamous cell carcinoma Hep-2 cells and HIF-1α-RNAi-Hep-2 cells were cultured in normoxic, hypoxic and reoxygenation condition. The inhibition of cisplatin on cell proliferation was evaluated by MTT assay. The influence of cisplatin on cell cycle and apoptosis were detected by flow cytometry. RESULT: The inhibition of cisplatin on cell proliferation was reduced by hypoxia. After HIF-1α gene was silenced, the inhibition of cisplatin on Hep-2 cell proliferation was increased apparently, but was still interfered partly by hypoxia. Hypoxia could induce cell apoptosis decreased and enhance chemotherapeutic resistance. After reoxygenation, cell apoptosis induced by cisplatin was increased significantly (P < 0.05). HIF-1α-RNAi-Hep-2 cells under hypoxia also showed certain resistance to apoptosis but the sensitivity to cisplatin was higher than that of Hep-2 cells. When cells were returned from hypoxic condition to normoxic condition for some time, the apoptosis induced by cisplatin was increased significantly (P < 0.05). CONCLUSION The improvement of hypoxic microenvironment with HIF-1α gene knockout could increase the sensitivity of Hep-2 cells to chemotherapy.
Apoptosis ; Carcinoma, Squamous Cell ; pathology ; Cell Cycle ; Cell Hypoxia ; Cell Line, Tumor ; drug effects ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Flow Cytometry ; Gene Knockout Techniques ; Head and Neck Neoplasms ; pathology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Laryngeal Neoplasms ; pathology ; RNA Interference ; Squamous Cell Carcinoma of Head and Neck