This paper reviewed the policies on private medical institutions in Henan province since the new healthcare reform.Combined with relevant statistical data,the authors found that conceptual obstacles,policy implementation,lack of unified management and restriction of human resource flow as important constraints of the development of such institutions in the province.In view of this finding,the authors made in-depth study of the development positioning,general role of planning and market functions,as well as support and regulation in parallel of such institutions,in order to promote the healthy and sustainable development of private medical institutions in China.

Objective To investigate the injury effects and mechanisms of circulating histones on the hepatocytes in patients with hepatitis B virus (HBV )-related liver failure (HBV-LF) .Methods Serum samples from patients with HBV-LF were collected . The levels of serum histone H3 , histone H4 , prothrombin activity (PTA ) ,total bilirubin (TBil) ,creatinine (Cr) and international normalized ratio (INR) of the patients were measured .Model for end-stage liver disease (MELD) score was calculated in the patients .The serum levels of histones were compared between patients and the healthy volunteers . The correlation of histones with the MELD score and PTA was analyzed .The human liver cell line L-02 cells were cultured and treated with the serum of patients or L-02 cellular lysate supernatant preincubated with or without anti-histone H3 and H4 antibodies .The cellular morphology and rate of apoptosis were observed .Intracellular calcium ion concentration and Caspase-3 activity were detected in the cultured L-02 cells treated with histones .Mean of two independent samples was compared using t tests .Relationship between histones and the MELD score or PTA was conducted using Spearman correlation analysis .Results The levels of serum histones in the patients with HBV-LF were much higher than those in the healthy volunteers (H3 :[5 390 .3 ± 1 032 .0] μg/mL vs [42 .7 ± 12 .8] μg/mL , t = 32 .76 , P < 0 .01 ; H4 :[4 205 .1 ± 662 .3] μg/mL vs [40 .3 ± 14 .6] μg/mL ,t = 39 .74 , P< 0 .01) .In addition ,serum histones (H3/H4) levels in patients were negatively correlated with serum PTA (r= - 0 .325 ,P= 0 .038 and r =- 0 .572 ,P= 0 .028 ,respectively) ,but positively correlated with the MELD score (r= 0 .359 ,P= 0 .021 and r = 0 .568 , P = 0 .007 , respectively ) . Both serum of patients with HBV-LF and L-02 lysate supernatant were toxic to cultured L-02 cells .The injury effect was inhibited by anti-histone antibodies ([9 .3 ± 1 .5]% vs [14 .3 ± 0 .6]% , t = 4 .259 , P= 0 .02) .L-02 cells treated with calf thymus histone were cultured for 4 h . Cellular toxicity of histones resulted in Caspase-3 activation . The effect was inhibited by anti-histone antibodies ([3 .5 ± 0 .5]% vs [5 .2 ± 0 .6]% ,t= 4 .243 ,P= 0 .02) .Conclusion The elevated circulating histones in the patients with HBV-LF may aggravate the liver damage .

Objective To compare the clinical curative effect between sequential therapy and triple therapy for helicobacter pylori positive peptic ulcer.Methods 92 patients with peptic dcer were randomly divided into the observation group and the control group,46 cases in each group.The observation group was treated with sequential therapy,control group with triple therapy.The two groups were observed and compared in helicobacter pylori eradication rate,ulcer healing and relief of symptoms.Results After 4 weeks treatment,the observation group Hp clearance rate was 93.5％ (43/46),ulcer healing rate 91.3％ (42/46),the control group were 73.9％ (34/46),78.3％(36/46),two groups had significant differences(x2 =2.714,3.028,all P ＜ 0.05) ;observation group after treatment of symptomatic integral average (0.94 ± 0.21),and the control group (0.92 ± 0.17) divided the difference was not statistically significant (t =0.483,P ＞ 0.05).Conclusion The sequential therapy on helicobacter pylori positive peptic ulcer curative effect is remarkable,and can be more effective in the eradication of helicobacter pylori infection,promote ulcer healing.

Objective To investigate the year rhythm of laryngeal cough.Methods To record the attack months,the syndromes of TCM and degrees of symptoms in detail and analyze the data by percentage and Ridit analysis.Results The periods of laryngeal cough are in spring(March to May) and in autumn(September to November).The syndromes of TCM such as wind violating lung are commonly coughed in spring and primarily mild degree.The syndromes of TCM such as fire hyperactivity are commonly coughed in autumn and primarily moderate degree.Conclusions There is significant year rhythm in laryngeal cough.To master the rhythm can help the diagnosis and treatment.

Objective To investigate the effect of high altitude aviation on the pressure and diameter of the trachea cannula cuff after injecting air or water. Methods In the circumstance 5 km height and 795 hPa cabin pressure, the air injected cuffs were divided into two groups, one was under the ground circumstance, the other was in the high altitude aviation environment. The volumes of injected air were 5 ml, 7 ml, 9 ml, 11 ml, 13 ml, 15 ml, 17 ml, and the cuff pressure and its diameter were measured. The water injected cuffs were also divided into two groups of ground and high altitude aviation environment. The volumes of injected water were 10 ml, 12 ml, 14 ml, 15 ml, 16 ml, and the cuff pressure and its diameter were measured. The results were compared between the ground circumstance and high altitude aviation environment. Results The diameter of injection air group versus under the ground circumstance group had the statistical significance (t=5.000-9.449, P<0.05), when the injection air was larger than 15 ml, the pressure effect had statistical significance (t=5.000, 8.000, P<0.05). Water injection group had not statistically significant. Different water volume injection had no effect on pressure and diameter (P>0.05), while different air volume injection had significant effect on pressure and diameter (F=5.132, 5.980, P<0.01). When the water volume was 10 ml, the cuff pressure was (24.00±4.62) cmH2O (1 cmH2O=0.098 kPa) , which was appropriate to the range of cuff pressure (20-30 cmH2O). Conclusions In high altitude aviation environment the trachea cannula cuff should adopt water injection, and the best water volume is about 10 ml.

Objective To investigate the CT manifestations in mesenteric injury.Methods CT imaging data were analyzed retrospectively in 28 patients with mesenteric injury caused by abdominal trauma,of which 26 patients were confirmed by surgery and 2 patients received conservative treatment.Results CT showed simple mesenteric injury in 5 cases,and multiple organ injury in other 23 cases.Only 18 cases were dignosed by preoperative abdominal CT,and the rate of missed diagnosis was 36%.Conclusion Multi-slice CT is an important evaluation method for the detection of acute mesenteric injury.

Objective To provide references for rational clinical usage and purchase of TCM decoction pieces for blood-activating and stasis-removing. Methods Excel 2013 software was used to conduct statistical analysis on categories, consumption quantity, consumption sum and annual average growth rate of TCM decoction pieces for blood-activating and stasis-removing during 2011-2015 in TCM Hospital of Jiangsu Province (hereinafter refered to as our hospital). Results The consumption quantity and consumption sum of TCM decoction pieces for blood-activating and stasis-removing in our hospital increased year by year. Among all types of TCM decoction pieces for blood-activating and stasis-removing, TCM decoction pieces for activating blood and adjusting maridians occupied the largest amount, followed by TCM decoction pieces for activating blood and relieving pains, breaking up the static blood and eliminating masses, and blood-activating and wound - curing. The TCM decoction pieces with the biggest annual consumption quantity were Salviae Miltiorrhizae Radix et Rhizoma, Chuanxiong Rhizoma, and Curcumae Radix, and the TCM decoction pieces with the biggest annual consumption sum were Notoginseng Radix et Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, and Carthami Flos. Conclusion Both the consumption quantity and the consumption sum of the TCM decoction pieces for blood-activating and stasis-removing in our hospital have been increasing year by year. However, the proportion consumption quantity and the consumption sum of TCM decoction pieces and medicine utilization structure have kept stable, and in basically rational use.

Objective To study the feasibility and outcome of minimally invasive percutaneous antegrade and transurethral antigrade ureteroscope technology in treatment of ureterovesical anastomosis obstruction in transplanted kidney.Method Endo-incision, dilation and indwelling internal ureteral stents by minimally invasive percutaneous antegrade and transurethral antigrade ureteroscope tech -nology were performed in 16 transplanted kidney patients with ureterovesical anastomosis obstruction. Renal function was valuated.Results Retrograde ureteroscope balloon dilation and indwelling an internal ureteral stent were carried out in one case. Percutaneous endo-incision, dilation and indwelling internal ureteral stents under ureteroscopy were preformed on 13 patients. Two patients accepted open operation because the length of the obstruction segment was more than one cm. After a follow-up of 1-24 months, internal drainage and renal function were normal in 13 patients. Serum creatinine ranged from 45 ?mol/L to 113 ?mol /L. The renal function of 3 patients didn’t recover completely and the serum creatinine was 158-315 ?mol /L.Conclusion Minimally invasive percutaneous antegrade and transurethral antigrade ureteroscope technology in treatment of ureterovesical anastomosis obstruction in transplanted kidney were relatively effective, and safe and simple to manipulate.

Objective To investigate the Influence of FOXC1 downregulating on biological behavior of nasopharyngeal carcinoma (NPC) 5-8F cell lines. Methods Western blotting was used to detect the protein levels of FOXC1 in human immortalized nasopharyngeal cell lines NP69, nasopharyngeal carcinoma cell lines 6-10B with lower metastasis potential and nasopharyngeal carcinoma cell lines 5-8F with higher metastasis potential. siRNA was used to downregulate the expression of FOXC1 in 5-8F cell lines, and then ability of migration and invasion were observed. Results FOXC1 protein expression level in NP69 cell lines, 6-10B cell lines and 5-8F cell lines were (0.27 ± 0.04), (0.7 ± 20.06), (1.08 ± 0.05) respectively, and the difference was statistically significant (P < 0.05). Also ability of cell migration and invasion significantly weakened after FOXC1 depletion in 5-8F cell lines (P < 0.05). Conclusion FOXC1 might regulate invasion and metastasis of nasopharyngeal carcinoma through changing expression of Fibronectin and Vimentin, and FOXC1 may be an available target for molecular target therapy of nasopharyngeal carcinoma.

Posterior reversible encephalopathy syndrome is a clinical imaging syndrome associated with multiple pathogenic factors.The main clinical manifestations were headache,seizures,psychotic symptoms,visual disturbance,disturbance of consciousness,etc.The parieto-occipital reversible white matter lesions are the main manifestations of the imaging.If this disease can be diagnosed and treated in time,the clinical symptoms and imaging changes of most patients can be disappeared.If the diagnosis and treatment cannot be obtained in time,it may happen some irreversible damage,serious and even life-threatening,so it is very important to strengthen the understanding,diagnosis and treatment of this disease.At present,the pathogenesis of the disease is still not clear,now reviewed its pathogenesis and imaging manifestation in order to strengthen the clinician's understanding of the disease's pathophysiological mechanism and improve the level of diagnosis.