Mixed-ownership hospitals constitute an experiment of such ownership in the health care sector,attracting high attention as of its birth.This paper introduced the background of such ownership,and analyzed the development of such hospitals in terms of policy,present situation and external effects.The authors,arguing against major challenges,stated their views on such hospitals along with in-depth analysis of key issues in their development.

Based on a field survey of typical hospitals in Zhejiang,this paper drew a conclusion on three models of the mixed-ownership hospitals development in Zhejiang.It summed up the experiences learnt in the practice about how to maintain the public welfare of the public hospitals,how to ensure the essential health services supply as well as the incentive mechanism for social capital.Suggestions were proposed to develop the mixed-ownership hospitals based on the analysis.

AIM: To investigate the effect of intracellular calcium free calcium ([Ca~(2+)]i) on zinic finger transcription factor (GATA_4) and fetal heart gene in cardiomyocytes. METHODS: Cardiomyocytes from fetal rat were cultured primarily. Angiotensin Ⅱ (Ang Ⅱ) and ryanodine (RY) were used to stimulate transmembrane calcium inflow and intracellular calcium release. Fura-2/AM ratio imagine analysis was applied to detect intracellular Ca~(2+) signal. Western blotting were used to measure calcineurin (CaN), nuclear activated T cell factor (NFAT_3), GATA_4 and ?-actin. RT-PCR was applied for observing ?-myosin heavy chain (?-MHC). RESULTS: AngⅡ and RY promoted intracellular free calcium concentration ([Ca~(2+)]i) in cardiomyocytes (P

Objective　To evaluate open reduction and miniplate rigid fixation for condylar fractures. Methods　Ninty-seven condylar fractures (unilateral 47, bilateral 25) in 72 consecutive patients were studied. In them, 12 were old fractures, 81 were condylar neck and subcondylar fractures, 90 displaced or dislocated. Eighty-nine fractures were treated by operation, including removal of 7 broken condyles, reduction for 6 condyles with the aid of ramus osteotomy and directe anatomical reduction for 76 condyles. Fifty-nine fractures were fixed with a single miniplate, 21 with a double miniplates and 2 only with screws. Sixty-eight fractures were approached by retromandibular incision and 21 by periarticular incision. Postoperative follow-up period was 1 to 3 months in 9 cases, 3 to 6 months in 36 cases and 27 cases over 6 months, all cases were radiologically and clinically examinated to confirm the post-operative position of reduced fragment and complications secondary to operation. Results　There were 2 wound infection, 2 malocclusion, 2 nonunion, 3 plate fracture, 2 plate deformity, 7 inaccurate reduction, 6 fractured bone absorption, 7 mouth open, 5 TMJ chronic pain, 9 facial nerve damages, all above accounted 33% morbidity; however 91% (70/77) severely displaced or dislocated condylar neck and subcondylar fractures got accurate reduction and satisfactory final outcomes. Conclusions　miniplate rigid fixation based on anatomical reduction is an effective procedure in limitation of treating severely displaced or dislocated condylar neck and subcondylar fractures, biomechanical placement of plate is very important in successful application of this technique.

BACKGROUND:Valgus knee deformity is rare in the clinic. The therapeutic effects of artificial knee arthroplasty are worse than varus knee deformity. There is no unified opinion for replacement approach, soft tissue release method and procedure and prosthetic choice at present.
OBJECTIVE:To summarize case data and to observe clinical effects of total knee arthroplasty for valgus knee deformity.
METHODS:Clinical data of 37 cases of valgus knee deformity (42 knees) undergoing total knee arthroplasty, who were treated by the same group of physicians in the First Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were retrospectively analyzed. There were 11 males (13 knees) and 26 females (29 knees), at the age from 56 to 78 years, with an average age of 63.7 years. The differences in range of motion, femorotibial angle and Hospital for Special Surgery knee score were compared before and after replacement. Clinical effects of total knee arthroplasty for valgus knee deformity were evaluated.
RESULTS AND CONCLUSION:The postoperative fol ow-up lasted from 6 to 36 months. Knee joint range of motion increased from preoperative 68.5° to an average of postoperative 108.5°. Femorotibial angle reduced from preoperative 16.82° to postoperative 5.62° on average. The average Hospital for Special Surgery knee score increased from preoperative 39 points to postoperative 88 points (P<0.05). These results suggested that the curative effect of total knee arthroplasty for valgus knee deformity is proved. Total knee arthroplasty is an effective way to improve deformity.

Objective Plasma levels of matrix metalloproteinase-9 ( MMP-9 ) and serum level of high-sensitivity C reactive protein (hs-CRP) were detected to investigate their distributions between patients with stable stroke and those with asymptomatic intracranial artery stenosis and to explore their clinical significance. Methods The mean level of the serum hs-CRP of the group with recurrent stroke (2.34 mg/L)was the highest, followed by that of the group with the stable stroke( 1.45 mg/L),asymptomatic intracranial artery stenosis ( 1.31 mg/L) and control group (0.96 mg/L) ( P = 0.001 ). The level of the MMP-9 was in sequence of recurrent stroke group ( 121.82 ± 72.99 ) μg/L ＞ asymptomaticintracranial artery stenosis group ( 119.18 ± 80.01 ) μg/L ＞ stable stroke group( 112.76 ± 59.66) μg/L,while no statistical significance was found among groups( P = 0.947 ). However, the level of MMP-9 of three patient groups( 118.08 ± 71.06 ) μg/L was significant higher than control group( 57.55 ± 10.44 )μg/L (P ＜0.001 ). The spearman analysis for the relationship showed that the concentration of MMP-9 was positively associated with that of hs-CRP ( r = 0.337, P ＜ 0.001 ). Conclusions The hs-CRP maintained a high level in stable stage of stroke. The MMP-9 level in the patients group was significant higher than control group and the level of MMP-9 was positively associated with that of hs-CRP which suggested MMP-9 might be correlated with atherosclerosis other than stroke occurrence.

AIM: To investigate the protective effect of calcium antagonists on anoxia/reoxygenation (A/R) injury of cardiomyocytes. METHODS: Primary-cultured cardiomyocytes were divided into four groups, namely A/R, A/R+nifedipine(Nif), A/R+ruthenium red(Ru)+heparin (Hep) and control groups. The following parameters were measured in all groups: intracellular calcium concentration ([Ca 2+ ]i), cardiac cell viability, ATP content, lactate dehydrogenase (LDH) activity in the medium, PKC and MAPK activity and -Leucine(-Leu) incorporation. RESULTS: In comparison with A/R group, A/R+nifedipine(Nif) and A/R+ruthenium red(Ru)+heparin (Hep) groups showed a marked decrease in [Ca 2+ ]i and LDH content, and a significant increase in cell viability ,ATP content, activity of PKC and MAPK and -Leu incorporation(P

AIM: To investigate the contribution of angiotensin-converting enzyme inhibitor (ACEI) to the regulation of calpain system in infarcted myocardium. METHODS: Rat myocardial infarction (MI) model was established by permanent ligation of the left coronary artery. The treatment with the ACEI inhibitor rampril (1 mg?kg~-1 ?d~-1 ) was started 7 days prior to surgery. On day 1, 3, 7 and 14 after MI, protein levels of calpainⅠ, Ⅱ and calpastatin were determined in left ventricular free wall (LVFW), interventricular septum (IS) and right ventricule. RESULTS: CalpainⅠprotein level was increased in IS 14 d post MI, whereas the protein level of calpainⅡ was maximally increased in LVFW 3 d post MI. Rampril decreased protein up-regulation of calpainⅠ and Ⅱ, and reduced infarct size and interstitial fibrosis. Calpastatin protein expression was not affected by ACEI. CONCLUSIONS: CalpainⅠ is involved in cardiac remodelling in the late and calpainⅡ contributes to cardiac tissue damage in the early phase of MI. The heart protective effect of ACEI may be related to the inhibition of calpain system in the pathogenesis of myocardial infarction.

BACKGROUND:Bone marrow mesenchymal stem cells (BMSCs) are a kind of stem cells with multi-directional differentiation ability and play an important role in the healing of fractures. Therefore, it is of great significance to explore how to promote the BMSCs migration in vivo, thereby promoting bone defect repair.OBJECTIVE:To study the effects of different concentrations of musk ketone on in vivo migration of exogenous BMSCs, and to preliminarily explore the mechanism of fracture healing and cited theory.METHODS:A rat model of skull defects was made. Passage 3 BMSCs were harvested by using adherence method,labeled with DAPI, and then injected via the tail vein into the model rats. After that, the rats were intragastrically administrated with 0 (blank control), 42 (low dose), 84 (middle dose), 168 μL/kg (high dose) musk ketone, respectively.RESULTS AND CONCLUSION:The number of exogenous BMSCs in the defect region, and the expression of stem cell factor and Fractalkine showed a significant increase in the low- and middle-dose groups compared with the high-dose and blank control groups. These findings indicate that the low- and middle-dose musk ketone can promote the in vivo migration of exogenous stem cells.