Objective:To determine a new management strategy, and create a win-win in the medical equipment maintenance outsourcing situation.Methods:Hospital with third-party manufacturers to adopt bidding game analysis, game theory is the study of the behavior of decision-making body when making a direct interaction and balance problems with this decision, its main emphasis on individual research model is rational, that is, at a given pursuit of utility maximization under constraints.Results: By studying this stage the hospital with third-party companies in game analysis equipment maintenance outsourcing, improve service quality and medical management standards, and achieve win-win cooperation between the two.Conclusion: Medical equipment maintenance outsourcing game analysis presented emphasis on service and reputation, win-win strategy to follow market rules.

Objective:The purpose of this paper is to illustrate different diseases that cause this crazy-paving pattern and to correlate the thin-section CT findings with the histopathological findings. Methods: A retrospective review of the medical records of our radiological computed tomography database was performed from January 2010 until December 2012,searching for patients reported to have a crazy-paving pattern on a thin-section CT of the chest. In total, 83 patients with a crazy-paving pattern were retained and reviewed. Results:The crazy-paving pattern consists of interlobular septal and intralobular interstitial thickening superimposed on an area of ground-glass attenuation on thin-section CT scans. We identified 83 cases that presented with the crazy-paving pattern, inclould infection(bacterial infection n=6,viral infection n=16,fungal infection n=1,and mixed infection n=12); ARDS n=4; acute pulmonary oedema n=3; interstitial lung disease (UIP, NSIP) n=18; adenocarcinomas n=3; lymphangitis carcinomatosis n=3;lymphoma pulmonary infiltration n=2;radiation pneumonitis n=5;sarcoidosis n=1;alveolar proteinosis n=4;alveolar hemorrhage n=4; lipid pneumonia n=1. Conclusion: The crazy-paving pattern on thin-section CT is a non-specific signs, can be seen in infections, tumor, as well as some cryptogenetic diseases. Nevertheless, familiar with these common diseases, allows us to narrow the differential diagnosis, even prompted the diagnosis of certain diseases in the appropriate clinical setting.

Objective To evaluate the mid-term(44 months) outcomes of meniscus allograft transplantation in four patients.Methods Between June and July 2005,four patients(3 medial and 1 lateral;3 men and 1 women;aged 21,27,35,38 years) underwent arthroscopy-assisted meniscus allograft transplantation in our hospital.The clinical outcome of the patients was evaluated by assessing the symptoms and signs,IKDC,Lysholm,and Tegner scores and examining the anteroposterior and lateral radiographs of the transplanted knee,weight-bearing radiographs of the both knees,anteroposterior radiographs of the lower extremities as well as magnetic resonance imaging(MRI).One patient underwent second-look arthroscopy. Results The follow-up time was 44-45 months.During the period,all the patients showed a normal motion range of the knee without pain or effusion of the knee joints.The mean IKDC,Lysholm,and Tegner scores of the patients were 84.75?2.63,91.50?4.43 and 7.00?0.82 respectively,which were significantly higher than those detected before the operation(60.50?14.06,69.25?22.04 and 4.00?0.82).The radiological results revealed no obvious degeneration or alignment changes though a 2-mm narrowing was shown in one of the patients.MRI showed mild extrusion for the body of the transplanted medial menisci and Ⅱ to Ⅲ stage signal for the body and the posterior horn.Almost normal performance and tension of the transplanted meniscus was shown by arthroscopy. Conclusions Meniscus allograft transplantation shows good outcomes in mid-term follow-up.MRI is valuable for evaluating the implanted meniscus.

Objective To investigate the state of microchimerism after kidney transplantation, and to evaluate the relationship between microchimerism and long term survival of transplanted kidney. Methods Leukocytes were collected from peripheral blood of 70 female recipients having received kidneys from males for the identification of microchimerism by means of amplifying the single copied sex determine region Y gene (SRY) by nested PCR. Results Half to 10 years after renal transplantation, the positive percentage of microchimerism in 70 female patients was 58.6%(41/70). These 70 patients were categorized into three groups according to the duration after the transplantation: Group 1(n=25), 0.5 to 2 years; Group 2 (n=27), 2 to 5 years; and group 3 (n=18), over 5 years. The positive rates of microchimerism for three groups were 68%(17/25), 44.4%(11/27) and 72%(13/18), respectively. The positive rates in both group 1 and group 3 were significantly different compared with that in group 2 (P

Objective To explore the effect of L-carnitine on panel reactive antibody (PRA) in hemodialysis patients. Methods 50 patients were classified randomly into 2 groups: L-carnitine group receiving intravenous injection of 2g L-carnitine after each hemodialysis for 6 months, and control group did not receive any L-carnitine treatment. The PRA in serum was measured by enzyme-linked immunosorbent assay (ELISA) before and after 6 months of L-carnitine treatment. Results L-carnitine significantly reduced PRA levels compared with control group(P

Objective: To investigate the protective effect of Schisandra chinensis extract on oxidative stress in db/db mice, and to explore its possible mechanism. Methods: Ten male 9-week-old db/m mice and ten homologous male db/db mice of the same age were randomly divided into normal control group (C + V group), S. chinensis extract control group (C + SE group), model group (DN + V group), and S. chinensis extract-treated group (DN + SE group), with five mice in each group. The S. chinensis extract control group and S. chinensis extract-treated group were respectively ig administrated with 5 mg/(kg•d) of S. chinensis extract for 6 weeks. The body weight, blood glucose and 24 h urine micro-albumin were recorded at 0, 3, and 6 weeks. After 6 weeks, the mice were sacrificed and their kidney tissue specimens were collected. The oxidative stress index of malondialdehyde (MDA) were examined by lipid peroxidation kit. The pathological changes of kidney tissues were observed by PAS staining. The expression of antioxidant factor Nrf2 and HO-1 protein of kidney tissue was detected by Western Blotting. The expression of Nrf2 and its downstream target genes of kidney tissue were detected by qRT-PCR. Results: Compared with the normal control group, the body weight, blood glucose and 24h urine micro-albumin of the model group were significantly increased and the MDA content were increased. Therefore, the renal tissue pathological damage aggravated, and the expression of Nrf2 and HO-1, as well as its downstream target genes were all down- regulated. (P < 0.01 or P < 0.05). S. chinensis extract reduced blood glucose, 24 h urine micro-albumin and MDA level in diabetic nephropathy mice, improved renal pathological damage, and up-regulated Nrf2 and HO-1 and its downstream target gene expression. (P < 0.01 or P < 0.05). Conclusion: S. chinensis extract has protective effect on oxidative stress injury in db/db mice, and its mechanism may be related to up-regulation of antioxidant factor Nrf2 and its downstream genes.

Objective To investigate the association between genetic polymorphisms and protein levels of mannose-binding lectin (MBL) and the sensitivities of common infections in a pediatric Han population lived in Zhejiang Province.Methods MBL genetic polymorphisms of patients and controls were detected by PCR-based sequencing.MBL protein levels were measured using MBL ELISA Kit.Results No mutations at positions +223 and +239 of the exon 1 were detected in either patients or controls.No mutation at position +4 of the promoter was detected in controls.The frequencies of the three genotypes HH,HL,and LL at position-550 of the promoter were different between patients and controls(P＜0.05).The frequencies of genotypes YA and XB relevant to MBL protein levels were also different between patients and controls(P＜0.05).Comparing the frequencies of genotypes YA and XB in separate infectious disease with controls,significant differences were found in the group of RRI and CMV infection.The distributions of serum MBL level frequencies in patients and controls were both characterized by skewed distributions.MBL levels of patients with CMV infection were lower than those of controls(P＜0.05).Inversely,MBL levels of patients with acute respiratory infection and localized abscess were higher than those of controls (P＜O.05).Conclusion Genetic polymorphism of MBL gene is seemed to be relative to the sensitivity of common infections in children.

Objective To evaluate the diagnostic value of different sequences of magnetic resonance imaging (MRI) in repaired meniscus.Methods From September 2002 to December 2008,118 patients (130 menisci) underwent arthroscopic meniscus suture in our hospital,including 94 males and 24 females,aged from 15 to 50 years (average,25.7t7.5 years).All patients underwent MRI and second-look arthroscopy postoperatively.Different sequences of MRI were taken to evaluate the grade of meniscal signal at repaired site and the slices involved by grade 3 signal.The diagnostic sensitivity,specificity,accuracy,positive predict value (PPV) and negative predict value (NPV) were calculated for each sequence by using second-look arthroscopy as the gold standard.Results The total healing rate was 80.8％ (105/130) by second-look arthroscopy,which was higher than that by different sequences of MRI.The integrated T2 sequence held the highest diagnostic value,and the sensitivity,specificity,accuracy,PPV and NPV were 76.0％,71.4％,72.3％,38.8％ and 92.6％,respectively.According to the second-look arthroscopy result,the menisci were divided into the healed group and unhealed group.In the healed group,28.6％ of cases (30/105) showed grade 3 signal in MRI,which was less than that (76.0％) in the unhealed group.The rate of the new grade 3 signal (8.6％) and the slices involved by grade 3 signal (0.8±1.0) in the healed group were less than those (16.0％ and 3.0±2.0) in the unhealed group.Conclusion The diagnostic value of the integrated T2 sequence is encouraging with high sensitivity,specificity and accuracy.The new grade 3 signal in the repaired meniscus usually implies that the meniscus is not healed.

Objective To summarize the clinical data of renal transplants survived with graft function more than 10 years and the adverse events during this period, and to discuss the main strategies for the long-term survival Methods Survival rate of renal transplants simultaneously survived with graft function > 10 years and grafts was counted respectively in total 1003 renal transplant recipients at our hospital before Dec. 31,1998 retrospectively. Their relevant survival,adverse events and initial post-operative immunosuppressive regimens were recorded simultaneously.Results As of Dec. 31, 2008, the 10-year survival rate of recipients was 62. 7% (629/1003), and recipients with graft function accounted for 85. 37 % (537/629). Of them, 94. 75 % (596/629) recipients received cyclosporine A (CsA) -based immunosuppression plus other antiproliferative immunosuppressive agents. Post-transplantation adverse events included coronary heart diseases in 57 cases (9. 06 %), liver damage in 32 cases (5. 09 %), malignancy in 29 cases (4. 61% ), diabetic mellitus in 25 cases (3. 97 %), apoplexy in 16 cases (2. 54 %), severe bone marrow depression in 14 cases (2. 23 %), femur head necrosis in 7 cases (1.11%), lower-extremity thrombosis in 3 cases (0. 48 %), sudden deafness in 2 cases (0. 32 %). There were 690 survival patients and 49 deaths including 19 (38. 78 %) due to cardiocerebral vascular accidents, 10 (20. 41%) due to malignancy, 9 (18. 37 %) due to hepatic failure, 4 (8. 16 %) due to infection, 3 (6. 12 %) due to treatment abandonment, 2 (4. 08 %) unknown reasons and 2 (4. 08 %) accidental deaths. Conclusion Long-term survival after renal transplantation is associated with the primary medication of CsA as the main immunosuppressive regimen. The non-immunologic factors such as the prevention and cure of cardioeerebral vascular diseases and the early finding of liver functional abnormality and tumor are the main points focused during follow-up.

SUMOylation is an important post-translational modification of proteins. Similar to ubiquitylation, SUMOylation is the process that the small ubiquitin-like modifier (SUMO) proteins are specifically and covalently binding to lysine residues of substrate proteins. Through SUMOylation, the physiological functions and pathological processes of cells are well controlled and balanced, and its abnormal activation has been reported in various tumors. Therefore, SUMOylation has been a potential target for anti-tumor drug development. In this review, we summarize recent advances on development of inhibitors targeting SUMOylation pathway and their antitumor properties.