Biomarkers, Tumor ; analysis ; Humans ; Male ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; metabolism

With the rapid development of healthcare technologies, the improvement of patient health expecta-tions, and the increasing of the government or insurer's financial budget pressure, risk-sharing agreements has be-come the focus of the governments or insurer concerned. This article systematically analyzed Australia, New Zealand, Taiwan risk-sharing agreements from five aspects, including the operation main, scope, classification, application processes and the implementation effects. According to the results of the analysis, we suggests that China should im-prove risk-sharing agreements theoretical basis, diversify risk-sharing agreements models, establish risk-sharing a-greements standardization process and so on.

It is important and difficult to establish the market competition mechanism in the health care re-form. Medical voucher system in Hong Kong and Macao can provide policy guidelines for Mainland China to promote institutional innovation, force public hospital reform and the rational allocation of medical and health resources. This paper introduced the origin and development of medical voucher system. Based on the description of the implementa-tion background, similarities and differences and effects of medical voucher system in Hong Kong and Macao, the pa-per found that medical voucher system could help encourage the demander to make more frequent use of medical serv-ices, improve their consciousness of prevention and health care and promote family doctor system. Through analyzing the applicability of medical voucher system in mainland China, the paper pointed out it was consistent with the reform orientation and could be served as a useful supplement to the health care system to improve medical insurance, medi-cal assisstance system as well as an effective measure to develop private medical institutions.

Objectives To provide reference for the improve of health care system and healthcare insurance con-trolling method, through researching on the value-based healthcare paying system in South Korea. Methods The basic characteristics of the Korean health care system was researched, Specifically, its reform experiences of value-based health insurance review and assessment paying system,which government took. Results South Korea’s health care pay-ing system had achieved both good social and policy effects. Conclusions Value-based health care paying system is the main reason for the reducing of health care expenditures and making of scientific health policy.

Objective To summarize our experiences in the diagnosis and treatment of traumatic splenic rupture (TSR), in order to improve the diagnosis and treatment effect of TSR. Methods Retrospective (analysis) of the diagnosis and treatment of 184 patients with traumatic splenic rupture in recent 9 years was made. Results The preoperative correct diagnosis rate was 96.7% and was established on the history of (injury), clinical presentation, abdominal paracentesis, abdominal ultrasonography and CT. All the 34 of (patients) treated nonoperatively were cured. Of the 150 patients treated by operation, two died during operation and 148 patients were cured. Conclusions Combination of obtaining a detailed history of injury, physical examination, abdominal paracentesis, abdominal ultrasonography and CT can improve the accuracy rate of (preoperative) diagnosis.Under the ensurrance of the safety of the patients' life, preservation of the spleen should be performed if possible, especially for children. Both splenorrhaphy with or without ligation of splenic artery are simple, safe and effective methods to salvage the spleen.

Animals ; Glutamine ; blood ; metabolism ; Male ; Physical Conditioning, Animal ; physiology ; Physical Exertion ; physiology ; Rats ; Rats, Sprague-Dawley ; Sleep Deprivation ; metabolism ; physiopathology ; Thymus Gland ; metabolism ; Time Factors

OBJECTIVEBy observing the adipogenic and angiogenic microenvironment impact on the morphology of newly generated tissue for exploring the key factors which inducing mature adipose tissue regeneration in tissue engineering model.

METHODS24 healthy 6 months' New Zealand rabbits were picked and put into four groups according to different microenvironment. Every group has 6 rabbits and divided as follows: no axial-blood supply fat flap(0 ml), granular fat only(0.6 ml), axial blood vessel only (0.05 ml), axial vascularized fat flap ((0.6 ml). We separated or combined adipogenic and angiogenic environment within these groups. After 8 weeks, samples were harvested for histologic observation including macroscopic observation, volume analysis and HE testing.

RESULTSIn granular fat group, its volume decreased by (0.25 ± 0.10) ml after 8 weeks as the shortage of blood supply and finally it could be enveloped. In axial blood vessel group, its volume increased by (0. 37 ± 0. 04) ml after 8 weeks with fibrous tissue formation as shortage of adipogenic microenvironment. The no axial-blood supply fat flap group grew into(0.12 ± 0.03) ml, which can' t support large volume adipose tissue formation because of lacking independent blood supply. Only axial vascularized fat flap model could generate mature adipose tissue in large volume(3.45 ± 0.48) ml. The number of new capillary in every group was different after 8 weeks. By counting the numbers in every single view, no axial-blood supply fat flap group 15 ± 3.5)and granular fat only group(5 ± 2.5)had a significant difference with axial vascularized fat flap group 22 ± 5) respectively.

CONCLUSIONOnly both adipogenic or angiogenic microenvironment exist could induce mature adipose tissue in large volume in tissue engineering chamber model.

Adipogenesis ; physiology ; Adipose Tissue ; physiology ; Animals ; Neovascularization, Physiologic ; Rabbits ; Regeneration ; physiology ; Surgical Flaps ; blood supply ; transplantation ; Tissue Engineering ; methods

OBJECTIVETo study the surgical management of enophthalmos after severe malar maxillary complex fracture.

METHODSThe X-ray and CT examination were performed before operation to diagnose the orbital fracture and intraorbital tissue displacement. The fractured orbital rim was repositioned intraoperatively, followed by implantation of shaped titanium mesh to rebuild the orbital floor. The Medpor was inserted above the titanium mesh to correct the enophthalmos.

RESULTSFrom Sept. 2007 to Jan. 2009, 6 cases of enophthalmos after severe malar-maxillary complex fracture were treated. The enophthalmos was corrected or improved obviously in all the patients.

CONCLUSIONSThe enophthalmos after severe malar-maxillary complex fracture can be corrected or obviously improved. Shaped titanium mesh can be used to rebuild the orbital floor with the Medpor to reconstruct the intraorbital tissue volume.

Adolescent ; Adult ; Enophthalmos ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillary Fractures ; complications ; Middle Aged ; Orbit ; surgery ; Polyethylenes ; Surgical Mesh ; Titanium ; Treatment Outcome ; Young Adult ; Zygomatic Fractures ; complications

Objective To establish a molecular inversion probe ( MIP) method for detection of single base drug-resistance mutation in Hepatitis B virus ( HBV) gene.Methods The HBV wild type and YVDD mutant strain were isolated by Daping Hospital of the Third Military Medical University.The MIP was designed and applied to detect the HBV drug-resistance YVDD mutation in one case of wild type and one case of YVDD mutant HBV strain isolated previously.The results of MIP method were compared with that of sequencing to evaluate the detection accuracy.Results Thermal cycling single-base extension and connection reaction performed by Taq DNA Ligase and Ampligase DNA Ligase could ensure the specificity of the detection.The optimum probe concentration of MIP was 1 nmol/L.Through detection of the target gene with different DNA concentrations , the detection sensitivity of MIP was determined as 1 nmol/L.The results of MIP were consistent with that of sequencing method in detection of the clinical samples.Conclusion MIP is successfully used to detect single-base drug-resistance mutation in HBV gene.

Objective To investigate the treatment and prevention strategies of hematomas in operation area after anterior approach surgery for cervical spondylosis.Methods A retrospective review was conducted on 12 with hematoma compression in operation area out of 785 patients managed by anterior cervical surgery from January 2007 to July 2013,including 10 males and 2 females at age ranging from 40-71 years (mean 56.8 years).Surgery method was anterior cervical corpectomy and interbody fusion using titanium mesh cage plus plate and intraoperative blood loss was 300-1 200 ml.Primary clinical manifestations were neurological dysfunction in 5 patients,dyspnea in 6,and both neurological dysfunction and dyspnea in 1.There were 10 patients with the presence of symptoms at postoperative 0.5-22 hours,1 at postoperative 73 hours,and 1 at postoperative 74 hours.All the 12 patients underwent a second anterior cervical exploration.Results There were 5 patients with epidural hematoma,6 with subcutaneous hematoma,and 1 with both hematomas.After surgical interventions,the patients presented improvement in respiratory and neurological function,with inapparent respiratory abnormality and improved neurological function at discharge.One patient was died of cardiovascular-associated disease after being discharged from hospital.The left 11 patients were followed up for mean 19.8 months (range,6-43 months),with improved Japanese Orthopedic Association (JOA) score at final follow-up.Conclusions Hematoma took place frequently in the early period,especially within 24 hours in operation area after anterior approach to cervical disorders and close attention should be paid to respiratory and limb sensation and motion functions.Early detection and early surgical interventions are the key countermeasures to avoiding the severe results.