The paper discusses the necessity and urgency of hospital ownership reform. and pinpoints the focal and difficult points of the task. It also identifies the goals of the reform, viz. establishment of a medical and health system that fits in with the development demands of a socialist market economy, which is of great significance. It can be seen both in theory and in practice that for a pretty long period of time in China, public hospitals, providing basic medical security for the broad masses of people will occupy a leading position whereas private hospitals known for their outstanding service and quality, will play a bigger role only when the living standards of the general population have reached a fairly high level.

Objective To provide the reference for early diagnosis and treatment of breast cancer by detecting its metastasis-related genes.Methods Breast cancer metastasis-related genes were searched from PubMed-covered papers with their conception matched according to the MetaMap.A gene-gene matrix was generated using data a-nalysis software.An interaction network of breast cancer metastasis-related genes was established using Ucinet 6 and its related indexes were analyzed.Results tp53, thra, erbb2, esr1, cdh1, egfr, nr4al and cd69 were the core genes for breast cancer metastasis.Conclusion Co-word analysis can show breast cancer metastasis-related genes. However, the role of cd69 in breast cancer metastasis remains unclear and is thus necessary to be further confirmed.

Objective To observe the distribution of circum-patella nerve fibers in the soft tissue to provide experimental evidence,which is significant in denervation for Total Knee Arthroplasty (TKA).Methods Patella specimens were collected from 4 cadavers (2 cases of diabetic foot,lcase of lower extremity arterial occlusive,and 1case of car accident),all 4 of which were resected soft tissue with a dimension of 0.5cm × 0.5cm and full depth thickness around patella more than 0.5cm for histology and morphology observation.The nerve fibers histology and morphology were observed in all resected specimens with HE staining and silver-gilt glycine staining in the same field of microscopic vision.Results Anatomy found that the vascular network form skins directly involved in the patella nourish hole area and in the 10,2,4,7 clock point have found that blood vessels into the patella.There have a large number of nerve fibers near to the patella under the microscope,but there were no significant difference in the nerve fibers region distribution of all specimens.There were some into patella nerve fiber paths in side of patella soft tissue,which lied in 7,11 and 13 clock point,but outside no this phenomenon.The distribution of circum-patellar nerve fibers were described as distribution of regional concentration,which lied in much more 5,6,7 clock points and 10,11,12,1,2,clock points,in which the quadriceps tendon and patellar tendon have more than the others.In the 13 clock point,the fascia and periosteum of nourish hole area were also found in a large number of nerve fibers,and there were laminar distribution in different soft tissue layers,which were collected much more in synovial layer,fat pad,tendon near to patella.Conclusion There are much more nerve fibers near to the patella and some into patella nerve fiber paths in the medial side and nourish hole area.Nerve fibers distribution of circum-patella can be described as laminar distribution and regional concentration ,which is more in the centre,bottom more than top,outside more than inside,the bipolar more than the others.The patella denervation operation by reducing the number of peripheral nociceptors to achieve desensitization is feasible in TKA.

Objective To establish a quality standard of Shutongantai Capsules. Methods Thermo C18 column was used with methanol-0.1% phosphoric acid as mobile phase. The flow rate was 1.0 mL/min, detection wavelength was 254 nm, and column temperature was 30 ℃. Results Emodin showed a good linear relationship in the range of 0.016-0.080 μg (r=0.999 6). Chrysophanol showed a good linear relationship in the range of 0.032-0.160 μg (r=0.999 8). Conclusion The established method is simple, feasible and reproducible, and can be used for the quality control of Shutongantai Capsules.

Objective To investigate perioperative nursing of interventional therapy for patients with chronic occluded internal carotid artery. Methods We retrospectively analyzed the clinical nursing data of 12 patients with chronic occlusion of internal carotid artery who were successfully performed recanalization for the occluded vessels. Results The vital signs of all patients were normal during the procedures. The patients got favorable outcomes and no complications occurred during the perioperation. Conclusions Interventional therapy for chronic occlusion of internal carotid artery is a new technology for carotid diseases. Perfect preoperative health education and psychological nursing, comprehensive monitoring of vital signs and nerve function, strengthening body position nursing can ensure prevention of complications and the success of surgery.

Drug Resistance, Viral ; genetics ; Hepatitis B virus ; drug effects ; genetics ; Mutation

Objective To build a method for determination of berberine, epiberberine, coptisine and palmatine in Shutongantai Capsules by HPLC.Methods Thermo C18 column (5μm, 4.0 mm× 250 mm) was used with acetonitrile-0.05 mol/L potassium dihydrogen phosphate solution (50∶50, 0.4 g sodium dodecyl sulfate was added in each 100 mL solution, to adjust the pH 4.0 with phosphoric acid) as mobile phase;the flow rate was 1.0 mL/min;detection wavelength was 345 nm;column temperature was 30℃.Results Berberine hydrochloride showed a good linear relationship in the range of 0.180 34-0.901 68μg (r=0.999 8).Conclusion The method is simple, accurate and reproducible, and can be used for the quality control of Shutongantai Capsules.

Objective To study problems related to drug-induced liver lesion caused by antituberculotic therapy (DLL).Methods Totally, 172 cases of DLL occurred in 1 464 patients with pulmonary tuberculosis after antituberculotic therapy, hospitalized during January 1995 to December 2002, were reviewed and analyzed retrospectively.Results Patients aged 20 to 60 years with DLL by antituberculolis therapy accounted for 70.3% of the total. Symptoms of digestive tract and change in liver function usually occurred within 8 weeks of intensive treatment (73.8%), and discontinuation of autituberculotic drugs was not needed for the mild cases, but needed for the severe cases with liver protective therapy. In total, 157 of the 172 cases (91.3%) recovered completely and 13 case improved (7.6%), two cases deteriorated and discharged, and doses of autituberculotic drugs should be reduced or stopped in 41 cases (23.8%) affecting their treatment efficacy.Conclusions DLL was liable to occur in patients of pulmonary tuberculosis with antituberculotic therapy, especially in the elderly men with body weight less than 50 kilograms, those with previous liver damage or infected with hepatotropic virus, alcohol drinking, complicated with extrapulmonary tuberculosis, with combination of isoniazid rifampicin and pyrazinamide.

Objective To evaluate the usefulness of MRI in the diagnosis of adenomyosis. Methods Sagittal Turbo SE T 1WI, T 2WI, T 1SPIR and T 2SPIR MRI examination were performed on 30 cases with adenomyosis. Results The lesions in 12 cases with diffuse adenomyosis were demonstrated as diffusely thickened junctional zone (JZ) measured 10～35 mm (mean 18 mm) On T 2WI. 6 of them were of homogenous hypointensity. Another six had hyperintensive foci within the hypointensive lesions on T 2WI, and these hyperintensive foci could also be found on T 1WI in 5 lesions. 23 focal lesions (adenomyomas) in 18 cases were oval, irregular or round masses with hypointensity that were the same as the intensity of JZ on T 2WI. They were from 2.0-7.5 cm in diameter (mean 3.9 cm), and all but one showed ill-defined margins. 15 masses hadhyperintensive foci within the hypointensive lesions on T 2WI and 12 of 15 presented hyperintensity on T 1WI. The diffusely thickened JZ and focal masses correspond to the hyperplastic and hypertrophic musculature around the heterotopic endometrial islands. The hyperintensive foci were correlated with the heterotopic endometrial islands. The hyperintensive foci showed only on T 2WI corresponded to the heterotopic endometrial islands without hemorrhage. The hyperintensive foci shown on both T 2WI and T 1WI were the heterotopic endometrial islands with hemorrhage. Conclusion MRI is the modality of choice for the diagnosis of adenomyosis. T 2WI is the most useful sequence. T 2WI combining with T 1WI, T 1SPIR, and T 2SPIR can improve the accuracy in the diagnosis of adenomyosis.

Objective To introduce the outcome of compound defect in the hand treated by compound flap transfer or combined flaps transfer. Method From Dec.1983 to June 2001,thirty-five cases with five kinds of compound defect in the hand were treated surgically.Among them,four cases with defect of skin and extensor tendon in the dorsum of hand were repaired by dorsalis pedis flap with tendons;Three cases with longitudinal subtotal loss of distal thumb and one case with longitudinal subtotal loss of distal middle finger were reconstructed with fibular segmental osteo-onychocutaneous flap from great toe or tibial segmental osteo-onychocutaneous flap from second toe;Eight cases with total or subtotal defect at middle part of thumb or fingers were reconstructed with segmental second toe; seventeen cases with defect of thumb and hand skin were reconstructed with combined transplantation of second toe and free skin flap;Two cases with middle finger defect at the base of proximal phalanx were reconstructed with bridging transplantation of bilateral second toe. Result Thirty-three cases were successful.Follow-up period ranged from 0.5 to 5 years postoperatively.The excellent and good rate was 82.9% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery. Conclusion The compound flap transfer or combined flaps transfer was an ideal method in repair of compound defect in the hand.