This thesis, with a Class 3A hospital as the research object, aims at analyzing the status quo and causes of its costs of health materials so as to put forward corresponding methods and suggestions of cost management, thus providing scientific guidance on reducing operating costs and improve medical quality in public hospitals.

Objective To study the effects of naked DN A encoding vascular endothelial growth factor 165 (VEGF 165 )on cerebra l infarction in rats. Methods Following establishme nt of a permanent middle cerebral artery occlusion (MACO) model by nylon suture embolization in Wistar rats, the puCCAGGS/hVEGF 165 was directly injected i nto the ischemic tissues through skull hole. Seven days later, the rats were sac rificed. The infarct volume was measured by 2% TTC staining technique, then the expression of VEGF 165 gene and vascular proliferation were measured by use of RT-PCR and immumohistochemistry methods. Results Expression of VEGF 165 mRNA and VEGF protein in the therapy group increas ed. Compared with the control group, the number of vessels of the therapy group was significantly higher (50.76/HPF vs 40.67/HPF)( P

BACKGROUND: Focal ischemic model made by middle cerebral artery occlusion (MCAO) is much similar to the process of onset in human cere bral infarction, whereas in the process of modeling some problems such as selection of nylon strand with improper diameter and inserted depth would result in modeling failure. OBJECTIVE: To improve MCAO model of focal cerebral infarction. DESIGN: Single-factor design, animal experiment. SETTING: Department of Pediatrics, Affiliated Maternal and Children's Hospital of Guangzhou Medical College. MATERIALS: The experiment was conducted in the Experimental Center of Guangdong Province from January. 2002 to March 2004. A total of 24 healthy Wistar rats were randomly divided into sham-operation group and model group with 10 rats in each group.METHODS: In rats of the model group, the common carotid artery (CCA) and external carotid artery (ECA) were isolated and ligated. A strand was inserted via the incision on CCA near the furcation between CCA and ECA as deep as possible with the depth of (2.0±0.2) mm. The diameter of nylon strand was 0.2 mm, the top of nylon strand was treated by melting paraffin. The interrupted time of blood circulation was 3 hours. Rats in the sham-operation group were treated by slightly drawing back the nylon strand to the CCA immediately after inserting.MAIN OUTCOME MEASURES: ①Neurobehavioral rating: It was conducted at 3 and 12 hours after ischemia with the score ranged 0-4 points.The higher the score was, the severer the neural functional deficit was, 1-3 points signified successful modeling. ②Area of cerebral infarction: Rats wereexecuted at 12 hours after ischemia. Then, brains were quickly removed and stained with tetrazolium chloride (TTC). The percentage of cerebral infarction area was calculated. ③Observation on pathological changes under light microscope.RESULTS: All of 20 rats entered the final analysis.①Eight out of 10 rats in the model group represented contra lateral tumble or draw outward circles, positive Homer's syndrome can be seen in the ligated side (3 points);One rat was disable to completely extend the claws in the contra lateral side of ligation (1 point), one rat had no neural symptoms.②Some pathological changes can be seen in the model group such as swelled cerebral tissues in the ligated side, which were bigger than the contra lateral side and were in pale; The cortex, basal ganglia and thalamus in the ligated side after TTC staining were in pale, whereas the cerebral tissues in the sham-operation group were in red with clear border.③There was no infarct in the sham-operation group, and the percentage of cerebral infarction area in the model group was (22.40±4.52)%, the infarct area of rats in groups were fundamentally same.CONCLUSION: It is necessary to adapt the strand with appropriate diameter, inserted depth and interrupting time for successful modeling.

ABSTRACT:Objective To a rare case of double primary cancer (hepatocellular carcinoma with gallbladder)to guide clinical application.Methods and Results We reported one case of primary hepatocellular carcinoma and gallbladder.A male patient,54 years old,had main complaints of intermittent right upper quadrant pain for 4 days. The abdominal CT of the local county hospital showed gallstones,gallbladder with liver infiltration.And then he went to the First Affiliated Hospital of Xi’an Jiaotong University for further treatment.Laboratory examination revealed:HBsAg(+),HBcAb(+),alpha-fetoprotein (AFP)> 60 500 ng/mL,carcinoembryonic antigen (CEA) 5.25 ng/mL.Abdominal CT showed hilar slightly stronger light echo groups:liver cancer or gallbladder cancer? Hepatic artery and portal vein CT imaging (CTA+CTV)examination showed the malignant tumor shadow in the inside of the left hepatic lobe huge,uneven thickening of the gallbladder wall,suspected liver disease with gallbladder infringement or gallbladder disease with liver infringement. With the preoperative preliminary consideration of primary liver cancer with infiltration of the gallbladder,we chose the operation as the resection of segment Ⅳ b and Ⅴ of the liver,cholecystectomy and T tube drainage.Pathological examination postoperative showed the bulky liver carcinoma grade Ⅲ and the poorly differentiated adenocarcinoma of gallbladder.A month later,abdominal CT showed the tumor spread intrahepatic,prompting the poor prognosis.Conclusion The two which are not continuous,which is the standard of double primary cancer,are not suitable for all double primary cancers.This case provides useful experience for future similar diagnosis and treatment of disease,and also helps us with timely and accurate identification of “metastatic”or “primary”,which is the key point for clinicians to give patients an effective treatment.

Objective To explore the value of virtual touch tissue imaging (VTI) of acoustic radiation force impulse (ARFI) elastography in the differential diagnosis of benign and malignant thyroid nodules.Methods VTI features of 77 histologically proven thyroid nodules in 74 patients were analyzed and the VTI features were divided into 6 grades.The higher grade represented higher tissue stiffness.Differences in VTI grade between benign and malignant lesions were analyzed by receiver operator characteristic (ROC) curve,and the sensitivity,specificity and accuracy were calculated.Results 77 pathologically proven thyroid nodules included 61 benign and 16 malignant lesions.VTI images classification included 0 in grade Ⅰ,1 ingrade Ⅱ,1 in grade Ⅲ,9 in grade Ⅳ,3 in grade Ⅴ and 2 in grade Ⅵ for malignant diseases ; and included 18 in grade Ⅰ,28 in grade Ⅱ,10 in grade Ⅲ,1 in grade Ⅳ,2 in grade Ⅴ and 2 in grade Ⅵ for benign diseases.The best diagnostic point of VTI-grade was grade Ⅳ.When VTI-grade Ⅳ or greater was used as the diagnostic criterium for malignancy,the sensitivity,specificity and accuracy rate in differentiation between benign and malignant thyroid nodules were 87.50％,91.80％ and 90.9(％ respectively.Conclusions VTI is useful in the differential diagnosis between benign and malignant thyroid nodules.

Objective To develop the hypothesis ‘saturated or non-saturated cytotoxicity model' and explain the various phenomena of antibody mediated immunoresponses in recipients,including rejection and accommodation.Methods The imitating complement dependent cytotoxicity.The threshold set to identify as saturated or non-saturated cytotoxicity depends on antigen-antibody complex(R)whether or not above lethal number(D)in effective time.Feasibility of the hypothesis was examined through explaining various phenomena mediated by anti-donor antibodies,especially some contradictory phenomena.Results Hyperacute rejection,accelerated rejection and acute rejection could be well explained by saturated cytotoxicity.Accommodation of ABO imcompatible transplantion,de novo antibody induced injury,change of protein profile,and C4d deposition in graft could be well elucidated by the hypothesis.Conclusion The hypothesis saturated or nonsaturated cytotoxicity model' help to interpret and interconnect various phenomena of antibodies mediated immune response,such as rejection and accommodation.

Objective To investigate the effect of hepatopoietin Cn(HPPCn) on liver stem cells.Methods In this study, WB-F344 cell line was used, and MTT and flow cytometry assay were conducted to determine cell proliferation and apoptosis.Transwell assay was used to test the migration of WB-F344 cells.A 2AAF-partial hepatectomy(PH) mouse model was used to observe the effect of HPPCn on liver stem cell proliferation in vivo.Results HPPCn enhanced WB-F344 cell proliferation and migration and activated the SphK1, Erk and Stat3 signal pathways.The analysis of the 2AAF-PH mouse model showed that oval cells in the experimental group far outnumbered those in control and the regeneration of the liver was improved post PH.Conclusion HPPCn can increase the liver stem cell proliferation and survival while promoting the regenenation of the liver by augmenting oval cell proliferation.

OBJECTIVE: Aimed to analyse the clinical features of the patients with sphenoid sinus mucocele, achieve earlier diagnosis and more timely intervention and decrease the occurrence of misdiagnoses. METHOD: A retrospective study was first conducted in patients with sphenoid sinus mucoele treated in Xiangya hospital from Jan 2000 to Jan 2015. Then literature reports on this disease were collected and analyzed from China National Knowledge Infrastructure (CNKI) and Wan Fang database. RESULT: We collected 82 patients with sphenoid sinus mucocele treated in Xiangya hospital. There were 52 patients presented with headache, 31 patients presented with visual impairment, 10 patients presented with cranial nerve palsy, 2 patients presented with exophthalmos, 15 patients presented with nasal symptoms, and 5 patients with no obvious symptoms. There was no significant difference for symptoms distribution between male and female patients (P > 0.05). Among 45 patients with headache as first symptom and 10 patients with ethmoid sinus mucocele, there were 18 patients and 8 patients subsequently suffering from visual impairment, respectively. We also collected 161 patients in literature except for enrolling, the 82 patients treated in Xiangya hospital, and found that headache was the most common symptom, followed by visual impairment, in the two independent cohorts. CONCLUSION To the best of our knowledge, this is the study of maximum sample for sphenoid sinus mucocele in China. Headache and visual impairment are the most common symptoms for sphenoid sinus mucocele. Surgical treatment should be early performed when the desease accompanied with headache or ethmoid sinus mucocele, to avoid other complications such as visual impairment and even blindness.
China ; Cranial Nerve Diseases ; etiology ; Databases, Factual ; Diagnostic Errors ; Ethmoid Sinus ; Exophthalmos ; etiology ; Female ; Headache ; etiology ; Humans ; Male ; Mucocele ; complications ; diagnosis ; pathology ; Paranasal Sinus Diseases ; Retrospective Studies ; Sphenoid Sinus ; pathology ; Vision Disorders ; etiology

This study was aimed to establish an HPLC method for simultaneous content determination of valtrate, acevaltrate, and their degradation products, which were baldrinal and 11-ethoxyviburtinal, in Valeriana jatamansi Jones. The separation and quantification of 4 constituents mentioned above were performed on an Agilent ZORBAX SB-C18 (4.6 mm×250 mm, 5 μm). The mobile phase consisted of water (A) - acetonitrile (B) with an optimized gradient program. The flow rate was 1 mL·min-1. The column temperature was set at 25℃. The wavelength was set at 241 nm. And the injection volume was 10μL. The results showed that among 14 different places of V. jatamansi, the 4 contents determined were different. The contents of valtrate, acevaltrate, and baldrinal in the Yunnan Baoshan Mount were the highest. And the content of 11-ethoxyviburtinal was the highest in Yunnan Dali. It was concluded that the method was with good precision, reproducibility and stability. And it was suitable for the determination of 4 valepotriates ingredients in V. jatamansi. It also provided references for the quality control and exploitation of V. jatamansi.

OBJECTIVETo investigate the effect of miRNA-101 on the expression of the enhancer of zeste homolog 2 (EXH2) in human androgen-independent prostated cancer LNCaP cells.

METHODSWe divided LNCaP cells into a blank control, a negative control, and a miRNA-l01 transfection group, constructed the vector by transfecting synthetic miRNA-101 mimics into the LNCaP cells, and evaluated the efficiency of transfection by fluorescence microscopy. Then we determined the expression level of EZH2 mRNA by qRT-PCR in the three groups of cells and that of the EZH2 protein in the negative control and transfection groups by Western blot.

RESULTSGreen fluorescence signals were observed in over 70% of the LNCaP cells in the transfection group after 24 hours of transfection. At 72 hours, the expression of miRNA-101 was significantly upregulated in the transfected cells (P < 0.01), that of EZH2 mRNA was remarkably lower in the transfection group (0.01 ± 0.10) than in the blank control (0.95 ± 0.40) and negative control (0.86 ± 0.30) groups (both P < 0.01), and that of the EZH2 protein was increased in the negative control but decreased in the transfection group with the extension of culture time.

CONCLUSIONmiRNA-101, with its inhibitory effect on the expression of EZH2 in LNCaP cells, is a potential biotherapeutic for prostate cancer.

Androgens ; Cell Line, Tumor ; Enhancer of Zeste Homolog 2 Protein ; Genetic Vectors ; Humans ; Male ; MicroRNAs ; physiology ; Polycomb Repressive Complex 2 ; genetics ; metabolism ; Prostatic Neoplasms ; metabolism ; RNA, Messenger ; metabolism ; Transfection