The paper introduced the multi-site physician practice operational in the modes of hospital departmental support,hospital trusteeship,and public-private hospital management,and summarized the merits of such a practice adopted in the background of cooperative hospital operations as follows.A cooperation of common interests enjoys supports of all stakeholders and minimum resistance;better policies and conditions mobilize physicians'incentives; better continuity of medical practice; better public benefits of the hospital.The paper also probed into such issues as setbacks of the practice in such a background,complicity of medical disputes definition and resolution,possible talent drain of public hospitals,and possible impacts on branding and core competence of public hospitals.

Hospitals are currently confronted with many problems, including distribution according to the division of administrative areas and jurisdiction; construction with complete sets of facilities on the part of all hospitals,big or small; and worsening of the unbalanced allocation of health resources due to the to assumption by big hospitals of many tasks of bssic-level hospitals. Besides, the excessively speedy incresse of expenses for outpatient and inpatient services as a result of hospitals' introduction of high technologies has inhibited some people's demands for medical services and competition among hospitals will become particularly fierce. Thus, ways out for hospitals lie in clarifion of their respective functions and development according to regional planning; regrouping of health resources by the government through measures of shutting down,stopping down, sopping production, merging, changing products or moving to other sites; structural readjustment and implementation of the system of responsibility by hospital directors within hospitals;bringing into play the initiatives of middle-level cadres; establishment of a scientific mechanism for personnel employmennt and selection; giving priority to efficiency and consideration to fairness in distribution; improvement of service quality; and making a good job of rational charging.

Objective To discuss the types,pathogenesis and treatment of early cardiac arrhyth-mias in infants after open heart surgery with congenital heart diseases. Methods 992 infants after open heart surgeries were divided into control group and arrhythmia group. Another junctionalectopictachycardia ( JET)group was separated from arrhythmia group. Various preoperative and postoperative data were com-pared. Results 197 infants suffered from cardiac arrhythmia within 3 days right after open heart surger-ies. After exactly the same surgery procedures,JET group was significantly different with control group in aortic cross-clamp time,cardiopulmonary bypass time and stay in CICU(p<0. 05). As for time of ventila-tion,no significant difference was found between the two groups. Conclusion Early diagnosis and treat-ment of cardiac arrhythmia can not only improve the success rate of open heart surgery,but also promote early recovery.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Facial Injuries ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; therapy ; Retrospective Studies ; Wounds, Penetrating ; therapy ; Young Adult

The function of hepatic stellate cell (HSC)in liver fibrosis has been well recognized.In recent years,the role of HSC in the liver tumor microenvironment have been paid increasing attention.Platelet derived growth factor (PDGF) is the most important mitogen of hepatic stellate cell,and plays an important role in the activation of hepatic stellate cell.Hepatic stellate cell is not only the target cells of PDGF,but also PDGF-secreting cells.Thus a bi-directional cycle mode of PDGF activating hepatic stellate cell has been established.The signaling pathways of HSC activation include MAPK,PI-3K,Ca2+ and JAK pathways.To explore PDGF activating hepatic stellate cell in liver tumor microenvironment and to find the new methods of targeting PDGF and hepatic stellate cell,may help us find a new direction for the treatment of hepatocellular carcinoma.

The development of community-based rehabilitation (CBR) needs to improve to meet the change of environment during the period of 12th Five-year Plan. The problems of CBR development included 3 major contradictions: administration of CBR and marketization of medical services; professionals demand of CBR and their professional development; and the demand of CBR and capacity of services. It is necessary to establish some market-oriented CBR project, pay attention to professional development, and promote the capacity of the community rehabilitation agencies.

Uarthritis is a common inflammatory arthritis, which has been well known as the White Tiger arthritis in traditional Chinese medicine. This article discussed the pathogenesis of blood stasis and the related studies in hyperuricemia, acute and chronic phase of Uarthritis. It suggested that blood stasis is a crucial pathogeny of uarthritis. Thus, the chinese herb medicine of blood circulation drugs should beapplied in all the phases of Uarthritis.

Objective To explore the effect of hyperoxia through mechanical ventilation induced lung injury(VILI) in newborn rabbit.Methods One hundred newborn rabbits aged 1-5 days were randomly divided into 4 groups: with 900 mL/L O2 and mechanical ventilation(MV),group A received high peak inspiratory pressure(HPIP),group B received moderate peak inspiratory pressure(MPIP),group C received low peak inspiratory pressure(LPIP),and group D with no mechanical ventilation with room air.There were 30 rabbits in group A,B,C,10 rabbits in D group.All rabbits were killed at 1,3,6 h after trial respectively.Wet-to-dry weight ratio(W/D) of left lung,and white blood cell(WBC)counts in broncho alveolar lavage fluid(BALF) were measured.The changes of lung histopathology were assessed by hematoxylin-eosin(HE) staining and observed under light microscope.Results Compared with group B and C,the group A demonstrated more pulmonary hemorrhage and pulmonary bullae formation,and the WBC and neutrophils counts in BALF increased and the W/D was higher compared with group B and group C.Meanwhile,alveolar epithelial cellⅡ(AECⅡ) hyperplasy transformed to AECⅠ.In group C,AECⅡswelled and lung tissue edema showed obviously,after 6 hours collagen fibers hyperplasia appeared.Part pulmonary atelectasis was obvious in group C.Conclusions HPIP ventilation can increase lung injury induced by hyperoxia in newborn rabbits,but has minimal effects on MPIP and LPIP ventilation.Pulmonary histopathologic changes participate in the newborn rabbit machine ventilation induced lung injury.

Objective To study the percentage depth dose difference (PDD) between Monte Carlo method and the measurement method.Methods Based on the detail treatment head structure designing by the manufacture,the BEAMnrc Monte Carlo code was used to simulate the 6 MV photon beams of a Siemens Primus linear accelerator.DOSXYZnrc program generated 6 MV X-ray parameters such as PDD,and it was measured by MP3 three-dimensional water of PTW corporation phantom.The deviation of PDD was calculated using formulas ((measured value-simulation algorithm value)/measured value × 100％).Results Distance from the surface of the water was less than 1.2 cm,the deviation of PDD was ＞ 2％.Distance from the surface greater than 1.2 cm,the deviation of PDD was ＜ 2％.Conclusion In the built-up areas,PDD obtained by the Monte Carlo simulation algorithm is more accurate.

Objective To study the spatial arrangement of mouse connecting tubules（CNT）and their transition to collecting duct system.Methods The renal tissues of three C57/BL/6J mice were fixed by perfusion and embedded in Epon 812.Totally 2 000 consecutive sections with the thickness of 2.5 μm were obtained from the renal surface to the papilla.The serial images under microscope were digitalized and aligned.Thirty eight CNT were traced with a series of computer programs.Results The CNT from long loop nephron ascended towards renal capsule and merged with 5 to 6 CNT from short loop nephrons to form the so-called arcade,while the latter or some of the CNT from the superficial cortex directly drained into the collecting duct in the superficial cortex.The lengths of CNT and the arcade ranged from 150 μm to 500 μm and 600 μm to 900 μm respectively.Conclusion The arcade or CNT drains into collecting duct only at superficial cortical level,which suggests that the reabsorption of the glomerular ultra-filtration in collecting ducts keeps unaffected when collecting duct runs through middle to deeper cortex.