Objective To explore the effect of linraglutide on expressions of plasminogen activator inhibitor 1 (PAI-1) and intercellular adhesion molecule 1 (ICAM-1) in cultured rat glomerular mesangial cells (RGMCs) stimulated by tumor necrosis factor α (TNF-α).Methods Cultured HBZY21 RGMCs were divided into 6 groups:normal control cells,TNF-α stimulated cells,liraglutide low (10 nmol/L),median (100 nmol/L) and high (1000 nmol/L) concentration incubated cells stimulated with TNF-α,PDTC intervention cells.The expressions of PAI-1 and ICAM-1 of each group were measured by ELISA and RT-PCR.Results The levels of PAI-1 and ICAM-1 protein and mRNA were remarkably increased by TNF-α (P＜0.05),and liraglutide could inhibit above up-regulated expressions (all P＜0.05).Compared with TNF-α-stimulated group,the expressions of PAI-1 and ICAM-1 were decreased by PDTC intervention (all P＜0.05).Conclusion Liraglutide can partly down-regulate the expressions of PAI-1 and ICAM-1 induced by TNF-α in RGMCs.

BACKGROUND: Avascular necrosis of the femoral head occurs in the hip joints at high load-bearing areas, it is a special form of aseptic bone necrosis. Bone marrow-derived mesenchymal stem cells may have an excellent repair effect for the necrosis of femoral head. OBJECTIVE: To understand bone marrow mesenchymal stem cell transplantation for treatment of early avascular necrosis of the femoral head, and to lay a foundation for further study. METHODS: Taking avascular necrosis of femur head, femur head necrosis, osteonecrosis, bone marrow mesenchymal stem cells, mesenchymal stem cells, multipotent stem cells in English as search terms, Pubmed database from January 2000 to April 2009 was retrieved; Taking avascular necrosis and bone marrow mesenchymal stem cells in Chinese as search terms, CNKI database from January 1989 to April 2009 was searched, Literatures were limited to English and Chinese languages. Inclusive criteria: Study of the biological characteristics and functions of bone marrow mesenchymal stem cells, the etiology and pathology of avascular necrosis of femoral head, bone marrow mesenchymal stem cell transplantation for treatment of avascular necrosis; Exclusive criteria: duplication of documents. RESULTS AND CONCLUSION: More than 800 literatures were screened out by computer search, according to inclusive and exclusive criteria, 38 documents of which were involved for analysis. Marrow mesenchymal stem cells can differentiate into chondrocytes, osteocytes and dipocytes under suitable cultural condition. With the development of stem cell engineering, marrow mesenchymal stem cell transplantation becomes an effective method for repairing osteonecrosis. This article describes the cause and the pathology of avascular necrosis of the femoral head, analyzes the theory basis for the treatment of avascular necrosis of the femoral head with marrow mesenchymal stem cell, and verifies its effect through comparing both animal and clinical experiments of this aspect at home and abroad, with the hope of seeking a better treatment.

Objective: To investigate the 18F-FDG PET myocardial scintigraphy and Coronary CT angiography (CTA) combination improve coronary heart disease clinical diagnosis level, and the diagnosis of coronary heart disease treatment technology of standardization for clinical application. Methods:The use of positron radionuclide drug 18F-fluorodeoxyglucose (18F-FDG) was made in 35 patients with myocardial metabolic imaging of coronary arteries and CTA examination, 20 patients with myocardial infarction patients, the FDG PET myocardial scintigraphy and coronary artery CTA combine examination results and confirmed case comparison of results. Results: 18F-FDG PETmyocardial scintigraphy and coronary artery CTA combination in the diagnosis of coronary heart disease, sensitivity and specificity of 100%and 96%. Conclusion: 18F-FDG PET data and coronary artery CTA precision data fusion, the fusion image is accurate, can not only provide clinicians reflect coronary artery anatomy indicators, can also provide reflect myocardial pathological physiology and metabolism index, to verify and supplement each other between the indicators.

Objective:To analyze the correlated factors on the non-public hospitals efficiency performance and compare different types of them in order to provide reference for improving efficiency.Methods:Based on the result of 160 non-public hospitals total efficiency,questionnaire surveys were taken for collecting the information of region,quality,form of ownership,whether invested by the government,whether under the medical insurance,the total amount of employers,bed and service amount as the independent variables,while the total efficiency as the dependent variable to conduct the Tobit multi regression analysis.Results:Access policy,investment policy,nature of ownership,the number of beds,the proportion of physicians,the per capita services,assets and equipment had significant impact.Conclusion:The development of non-public hospital was related to the policy environment,operation mode and internal management.

In this paper, 172 non-public hospitals have been investigated covering east, central and western regions with structured and semi-structured questionnaire and group interviews. We found that the health insurance policies were the most concerned policies by non-public hospitals, accounting for 26.5% of the total. We also found that non-public hospitals from different areas, levels profit nature have different policy expectations, for example Eastern regional institutions wanted to make a breakthrough of the planning policies, the central region wanted to change the health personnel policy, while the western region is considered to be limited by land policy. Tertiary hospitals were more concerned about research projects and land policy, and secondary hospitals were more concerned about access policy. There were 44.8% of the surveyed institutions considered that regulatory policywasmore stringent public hospitals and public hospitals, and there were no difference between profit and non-profit hospitals. According to the survey results, this paper puts forward suggestion that we should implement more targeted policies, purchasing more services from non-public hospitals and enhanced supervision. Considering the survey results research team puts forward sensitive advice as: provide preferential policies in according with different kinds of institutions reinforce purchasing service and enhance non-public hospitals supervision.

[Objective] To discuss Professor JI Wei's clinical experience in treating ankylosing spondylitis.[Methods] To expound Professor JI Wei's academic thoughts and clinical experience in ankylosing spondylitis from aspects of etiology,pathogenesis,and syndrome differentiation and treatment variation, summarizing the characteristics of her prescriptions and ways of treatment as well as exemplifying them. [Results] Professor JI Wei believes that the basic pathogenesis of this disease is kidney deficiency and governor vessel vacuity,with wind,coldness,dampness,heat,phlegm,and blood stasis obstructing channels and collaterals. In her opinion,the major task of the early- and middle-term of this disease is to dispel wind and eliminate dampness and to alleviate impediment and free the vessels,and that of the late-term is to supplement the kidney and reinforce the governor vessel and to transform phlegm and disperse blood stasis. When treating the disease,we should correlate all four examinations,differentiating carefully the primary from the secondary, paying attention to the unique use of aconitum,monkshood,triptolide and other toxic drugs,as well as the black snake,scorpion,centipede and other animal medicinals,and attaching importance to ankylosing spondylitis complicated with inflammatory bowel disease ,treatment of uveitis and syndrome. [Conclusion] Professor JI Wei's clinical experience in treating ankylosing spondylitis is effective and worthy of wide application.

Encouraging and providing guidance to social forces to invest in health care industry is one of the key elements determined to deepen the health care reform.From four aspects of the unclear conception and undefinable functions of non-public hospitals, ambiguity of property rights of non-profit non-public hospitals, gradual reduction of traditional management measures, and deficiency of effective supervision on daily operations, this paper summarizes the major policy issues in non-public hospitals.To solve these problems, this paper conducts a systemic analysis of the historical experiences of the United States, Germany, Japan, and Taiwan.On this basis, this paper suggests that the government should clearly determine the connotation and extension of non-public hospitals, improve non-profit non-public hospital policy system, play a guiding role in planning and health insurance guidance, and strengthen the supervision of business operations.

Objective:To analyze the financial auditing method after changing the settlement method of outpatient medical income in hospitals under the background of launching “Jing Yi Tong” business line in public hospitals of Beijing.Methods:It summarized the key point of financing audit in outpatient medical income of hospitals under the settlement mode of “Jing Yi Tong”business,proposed the effective settlement method and suggestions on auditing.Results:Through close financial auditing,it effectively ensure the acuteness and completeness of outpatient medical income of hospitals,prevent the leak and man-made fraud in settlement process.Conclusion:The effective hospital financing audit was the main task for internal control,which played key role on improving hospital financing management level.

Objective:To evaluate the technical efficiency and scale efficiency of non-public hospitals in China to provide references for improving efficiency of non-public hospitals with the comparison with the differences among different non-public hospitals with different types.Methods:Input and output data of 160 non-public hospitals in 2014 were collected;C2R and BC2 models were adopted to evaluate the annual total efficiency,technique efficiency and scale efficiency.Results:There were 16 total efficient hospitals(10.00％),41 technical efficiency hospitals(25.63％) and 20 scale efficiency(12.50％),43 at IRS stage,99 at DRS stage.Conclusion:The overall efficiency of non-public hospitals was low relatively and most of them were lower than public hospitals at same level.Scale was an important factor affecting the efficiency of non-public hospitals.

Objective To investigate the effect of intmopemtive intravenous penehyclidine hydrochloride on pulmonary function in patients undergoning thoracotomy.Methods Sixty ASA Ⅰ or Ⅱ patients aged 30-64 yr scheduled for elective radical esophagectomy for cancer were randomly divided into 2 group(n=30 each):penehyclidinc hydrochloride group and control group.Penehychdine hydrochloride 0.01 mg/kg(in nolmal saline 2 ml)was injected iv 20 min after opening the thoracic cavity in penehyclidine hydrochloride group.The equal vohlme of normal saline was injected iv in control group.Anesthesia was induced with fentanyl 2μg/kg,propofol 0.4μG/ml and rocuronium 0.6 mg/kg.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remlfentanyl 0.1μg·min-1,propofol 2.0-2.5 μg/ml and intermittent iv injecfion of rocuronium.The use of remifentanyl and pmpofol was stopped 5 min before operation.Dynamic lung compliance (Cd) and peak airway pressure were monitored and recorded immediately before penehychdine hydrechlofide administration (T0) and at 3 min(T1),5 min(T2),10 min(T3),30 min(T4),1 h(T5),2 h (T6)after penehyclidine hydrochloride administration.Results There was no significant difference in Cd and peak airway pressure among different time points in control group(P>0.05).Cd was significantly higher,while peak airway pressure lower at T1-6 than at T0 in penehychdine hydrochlofide group(P<0.05).Cd wag significantly higher,while peak airway pressure lower at T1-6 in penehyclidine hydrochloride group than in control group(P<0.05) .Conclusion Intraoperative intravenous penehyclidine hydrochloride can improve the pneumodynamics and is helpful for ventilation in patients undergoing thoracotomy.