The paper gives an account of the concept of the PPP model and its application abroad, discusses the feasibility of adopting the model in the investment construction of public hospitals in China, and argues on the basis of a detailed analysis that compared with the traditional model of government investment, the PPP model has the advantages of improving efficiency and quality, transferring risks, lowering costs, avoiding short-term investment decisions, making up for a deficiency in public funds, promoting reform, and bettering services. It will benefit the government departments, the public hospitals, the patients and the private investment sectors.

Adult-onset foveomacular vitelliform dystrophy (AFVD) is characterized by gradually loss of vision,subretinal vitelliform macular lesions and retinal pigment epithelium (RPE) atrophy.The electrooculogram (EOG) is usually normal or reduce slightly.On optical coherence tomography (OCT),there are vitelliform substance which deposited between the photoreceptor layer and the RPE layer,and thinner outer nuclear layer above these deposits.OCT angiography can show the superficial and deep retinal capillaries plexus (DCP) above the yolk-like deposits,the choroidal capillary blood flow is reduced and the DCP blood flow is increased near macular.On indocyanine green angiography (ICG),there is choroidal neovascularization under vitelliform substance at early stage and fluorescence leakage in the corresponding retinal region at late stage.There is no effective treatment for AFVD at present,monogenic gene therapy is the most worth looking forward to.Understanding AFVD clinical manifestations,multi-mode imaging features and new advances in treatment can provide a reference for diagnosis and treatment options

The paper described the significance of strategic planning and management for hospitals and analyzed the presence practice of such strategic planning and management in the country. It focused on the practices of 23 tertiary hospitals in Shanghai in making and implementing their development plan for the "12th Five-year Plan"; summarized their three characteristics in public benefic guidance, better operability and better services. In addition, it introduced the initial achievements made in enhancing service quality and patient satisfaction, tapping resource potentials, enhancing operation efficiency and sustainable development.

The patient-physician relationship can be understood from the two aspects of patients′ trust and patients′ satisfaction.Compared with patients′ satisfaction,dimensions and attributes of patients′ trust indicate to better match with the measuring capacity of patients.Thus,the evaluation of the quality of medical services based on patients′ trust is justified theoretically.The existing literatures assert that the research on patients′ trust could help understand patient-physician relationship and eventually improve the quality of medical services.The conceptual model in this paper entails the concept,dimensions and attributes of patients′ trust.Also,this paper points out its effect on the measurement of the quality of medical services through the comparison of patients′ trust and patients′ satisfaction.

Objective To study the effects of methylmercury chloride(MMC) on protein kinase C(PKC) activities in rat developing cerebellum.Methods The animals in experimental groups were fed standard rat chow with(0.75 mg) MMC(ExpⅠ),1.5 mg MMC(ExpⅡ) and 3.0 mg MMC(ExpⅢ)respectively for 90 d before gestation to(30 d) post parturition.Cerebella of pups from each group on postnatal days(PND) 3,7,17,21 and 30 were dissected. All the samples were separated into cytosol and membrane subcellular fractions and assayed for PKC activity by the improved method from Takai′s.Results Membrane and cytosolic PKC activities of pups′ cerebella from certain experimental groups were significantly higher than those of corresponding control group,PKC activities of rats from ExpⅡ,ExpⅢ and PND 3,7,14 in ExpⅠwere significantly higher than those in control group((P

Performance appraisal is an important means for keeping hospitals on correct tracks for their medical services and their public interest nature,in addition to its importance in enhancing internal performance management within public hospitals.Since 2006,Shanghai Shenkang Hospital Development conducted performance appraisal for directors of 23 public hospitals in Shanghai.This paper highlights the importance of performance appraisal for these directors,and its significance in keeping the correct director of hospital operation.

Tanshinones are the bioactive components of the Chinese medicinal herb Salvia miltiorrhiza, while its biosynthetic pathway remains to be characterized. Rapid identification and characterization of the genes correlated to tanshinones biosynthesis is very important. As one of the intermediates of tanshinones biosynthesis, the ferruginol content is relative low in both root and engineered bacteria. It is urgent to construct an efficient system for conversion of miltiradiene to ferruginol to obtain large amount of ferruginol as the substrates for further identifying other downstream genes involved in tanshinones biosynthesis. In this study, we constructed the whole-cell yeast biocatalysts co-expressing miltiradiene oxidase CYP76AH1 and cytochrome P450 reductases (SmCPR1) from Salvia miltiorrhiza, and then characterized it with RT-PCR. After permeabilization, the yeast whole-cell could catalyze turnover of miltiradiene to ferruginol efficiently through single-step biotransformation with a conversion efficiency up to 69.9%. The yeast whole-cell biocatalyst described here not only provide an efficient platform for producing ferruginol in recombinant yeast but also an alternative strategy for identifying other CYP genes involved in tanshinones biosynthesis.

Based on the Australian AR-DRGs, this research gathered the diagnosis related information on the first page of medical records and accomplished the computerization of data collection and analysis through the data-base of Shanghai Shenkang Hospital Development Center.According to the clinical practices, the DRGs model has been adjusted to complete the localization and a severity-based-DRGs model and grouping tool have been established for the municipal hospitals in Shanghai.

The severity of disease can be used to evaluate the current situation of patients as well as to predict the diseases outcome.In the meantime, the severity among different diseases has been more and more applied in the evaluation of the patients at hospital level.This study collected and summarized different types of international disea-ses grouping tools'characteristics and applications based on the severity of disease, and their suitability and practical values in hospital performance evaluation were compared and analyzed.

The performance evaluation is an effective method to guide the public hospitals behavior and pro-mote their sustainable development.The introduction of disease severity could make the performance evaluation sys-tem more scientific and reasonable, and encourage the hospitals to improve their technical skills and services ability. Based on the Shanghai diagnosis related groups system, a case-mix index ( CMI) was introduced and a severity score of disease was developed after the relative weight ( RW) adjustment to evaluate different types of disease severity in hospitals.The results have shown that CMI effectively reflects the patients'disease severity and the intensity of treat-ment in those hospitals taken into consideration.Therefore, the scientific indicators should be selected and the evalu-ation system should be improved thereby establishing an effective monitoring and dynamic adjustment mechanism and further developing the diagnosis related group application.