The new round of medical and health system reform proposed the need to explore effective ways to gradually reform the mechanism of “using medicine costs to supply medical care”, through the implementation of “medical separation”, solve patients’ problem of “difficult and expensive”. While implementing the mode of the “medical separation”, according to exploring and practicing the actual situation of the region, it describes on the main mode of “medical separation”, analyzes the advantages and disadvantages, and proposes policy recommendations of “medical separeation” according to analysis of different modes.

Objectives:To investigate the experience in insertion and management of central venous catheter. Methods:132 cases received insertion of central venous catheter.The site of catheter tip was determined with the method of electrocardiograph.The insertion depth was calculated with method of Fujii.The catheter was managed with strictly sterile technique and its lumen was washed with 0.1 mol/L NaOH 2.0 ml. Results:All catheters were inserted smoothly and its tips lay in suitable sites.128 pieces of catheter were pulled out after finished infusion. Conclusions:A right method of insertion and management is in favor for the use of a central venous catheter.

Objective To investigate the protective effects of epidermal growth factor (EGF) on pancreas of rats with acute pancreatitis(AP). Methods Seventy-two male Sprague-Dawley rats were randomly divided into 3 groups: Control group, AP group and AP-EGF group. Subcutaneously injection of EGF (0.1 ?g/g) were given to animals in the AP-EGF group after the establishment of the model of AP. The other two groups of animals received the same volume of saline. At 6 h, 12 h and 24 h after induction of AP, 8 animals in each group were sacrificed respectively, 4 ml of blood sample was withdrawn from heart,2 ml for the analysis of amylase activity and 2 ml for MDA content in serum. Ascites was sucked with dry gauzes and was weighed thereafter. Changes of pancreas morphology were evaluated at every time point. The same part of pancreas was removed for measurement of MDA content, apoptotic index (AI) and histologic changes. Results Histologic injury of the animals in the AP-EGF group was milder than that in the AP group. Ascites weight in the AP-EGF group decreased significantly compared with that in the AP group at 12 h and 24 h 〔(4.53?1.29) g vs (6.58?1.47) g, (7.64?1.85) g vs (11.96?2.13) g,P

Objective: To analyze the correlation of miR-625 expression with clinicopathological characteristics in esophageal squa-mous cell carcinoma (ESCC) and to explore the effect of miR-625 on the migration and proliferation of ESCC cells. Methods:The expres-sion level of miR-625 was determined through real-time PCR in 86 paired human ESCC tissue specimens and tumor-adjacent normal esophageal tissue specimens, ESCC cell lines, and esophageal epithelial cell line. The associations of miR-625 expression with clinico-pathological characteristics and survival in ESCC patients were analyzed. Transwell and CCK-8 assays were performed to examine the effect of miR-625 expression on migration and proliferation of ESCC cells. Results:Compared with tumor-adjacent normal specimens, miR-625 was significantly downregulated in ESCC tissue specimens (P<0.05). MiR-625 expression was decreased in ESCC cell lines com-pared with human esophageal epithelial cell lines (P<0.05). Lower miR-625 expression was associated with poorer prognosis and sur-vival. The migration and proliferation abilities of ESCC cells were inhibited by miR-625 overexpression (P<0.05). Conclusion:MiR-625 acts as a tumor suppressor gene in the development and progression of ESCC, suggesting that miR-625 may serve as an efficient prog-nosis biomarker and a potential therapeutic target for ESCC.

Objectives:To evaluate the influence of anti TNF? monocolonal antibody (anti TNF?McAb) on intestinal integrity in rats with acute pancreatitis under total parenteral nutrition. Methods:Acute pancreatitis model was induced in 32 male Sprague-Dawley rats. They were randomly divided into control group (n=16) and experiment group (n=16). Animals in control group received total parenteral nutrition (TPN). Animals in experiment group received both TPN were fed the identical TPN formula received by control group and injections of anti TNF?McAb. Rats were sacrificed on day 1 and day 5 after the induction of acute pancreatitis for measurements of intestinal permeability, absorptive capacity, mucosal wet weight, villus height and area, activities of sucrase and maltase in jejunum and bacterial translocation. Results:There was no significant difference between the two groups in intestinal permeability, absorptive capacity, mucosal wet weight, villus height and area, activities of sucrase and maltase in jejunum and bacterial translocation. Conclusions:Anti TNF?McAb has not significant influence on intestinal integrity in rats with acute pancreatitis under TPN.

Objective: To evaluate the protective effect of epidermal growth factor (EGF) on intestinal barrier functionin rats with acute pancreatitis. Methods: Thirty-two male SD rats received injection of sodium taurocholate solution(3. 5 mg?L-1) into the pancreatic duct were randomly divided into control group (n=16) and treatment group (n=16). Animals incontrol group received total parenteral nutrition (TPN), animals in treatment group were fed on the same TPN formula ascontrol group and injections of EGF at a dose of 0. 2 mg' kg l' day--'. Rats were sacrificed on d 1 and d 5 of TPN. Concen-tration of xylose and fluorescein isothiocyanate (FITC)-dextran in superior mesenteric vein (SMV), protein and DNA contentin je junal mucosa were determined. Samples from SMV, mesenteric lymph nodes, pancreas, liver, spleen were harvested forcultures. Results: FITC-dextran concentration in treatment group was significantly lower than in control group [(3. 4?0. 7)vs (7. 5?0. 9) mg. L-1, P＜0. 0l]. Protein and DNA content in je junal mucosa in treatment group were significantly higherthan in control group [(2. 65?0. 23) vs (1. 12?0. 18) mg? cm-1, (0. 25?0. 07) vs (0. 12?0. 04) mg?cm-1, P

Objective To analyse quality assurance(QA) and quality control (QC) during the process of X-ray stereotactic treatment.Methods The dosage of body X-ray irradiation,the treatment room of linear accelevator and the position of targe were measured using the standard inonizing and film dosage methods.Results The maximum error rate of body X-ray irradiation treatment system was 3%,it was in keeping with the national standard level which is 5%.Conclusion It is an essential to establish a comprehensive QA and QC program to guarantee a good treatment precision of X-ray stereotactic irradiation.

Objective To investigate the changes of cholesterol efflux,the scavenger receptor class B type Ⅰ(SR-BI) protein expression in THP-1 maerophage derived foam cells treated with Lippolysaecharide (LPS), and to discover the role of NF-κB pathway in this process.Methods The foam cells were treated with LPS along or treated with N-p-Tosyl-L-phenylalanine chloromethyl ketone(TPCK) for 24 h.The protein levels of SR-BI and intranuclear NF-κB p65 were measured by Western blotting.Cellular lipid accumulation was determined by high performance liquid ehromatograpby analysis.Cholesterol efflux was determined by FJ-2107P type liquid scintillator.Results The expression of SR-BI was decreased after treated with LPS,while the intranuclear NF-κB p65 protein level was increased by LPS.The results also showed that cellular lipid accumulation was increased ,while the cellular cholesterol efflux was decreased in THP-1 maerophage derived foam cells after exposed to LPS for 24 h and these changes can be reversed partly by pretreatment with TPCK.Conclusion LPS could down-regulate the expression of SR-BI, promote the accumulation of lipid and decrease cellular cholesterol efflux in THP-1 maerophage derived foam cells ,which should be related to the TLR4/NF-κB dependent pathway.

[Objective] To investigate the m vitro effect of asiaticoside on the proliferation of and connective tissue growth factor (CTGF) expression by keloid-derived fibroblasts.[Methods] Tissue samples from patients with keloid were obtained for primary culture of fibroblasts.After 3 to 7 passages,the fibroblasts were incubated with different concentrations (100,10,1,0.1,0.01 mg/L) of asiaticoside or dimethyl sulfoxide (DMSO) for 24,48 and 72 hours followed by the determination of cell viability by methyl thiazolyl tetrazolium (MTT) assay.Immunohistochemistry and Western blot were carried out to quantify the expression of CTGF in the fibroblasts at 48 hours after treatment with different concentrations of asiaticoside.The morphology of fibroblasts was observed before and after the treatment with asiatieoside.[Results] As morphological observation showed,different concentrations of asiaticoside induced an obvious apoptosis and growth inhibition in fibroblasts.The growth of fibroblasts was suppressed by asiaticoside of 1-100 mg/L in a dose-dependent manner (r =0.95,0.90,0.92 for 24-,48- and 72-hour treatment respectively,all P ＜ 0.01 ),and one-factor analysis of variance revealed statistical differences in the growth inhibition rate in fibroblasts between different treatment durations for each tested concentration of asiaticoside (all P ＜ 0.01 ).There was a strong expression of CTGF in untreated fibroblasts,which was weakened by the treatment with asiaticoside for 48 hours.The number of CTGF-positive fibroblasts per 100 cells was 73 in untreated fibroblasts,significantly higher than that in fibroblasts treated with asiaticoside at 1 mg/L (54,t =4.34,P ＜ 0.01 ) and 10 mg/L (46,t =6.26,P ＜ 0.01 ),and statistical differences were observed between the fibroblasts treated with asiaticoside at 1 mg/L and 10 mg/L (t =1.95,P ＜ 0.05).Western blot also showed that the expression of CTGF was inhibited by 48-hour treatment with asiaticoside,and the inhibitive effect displayed a trend to increase with the rise in the concentration of asiaticoside.[Conclusion] Asiaticoside can effectively inhibit the oroliferation of and CTGF expression by fibroblasts in vitro.

ObjectiveTo observe the effect of ischemic preconditioning (IPC) on apoptosis of transplanted pancreas cells in rats.Methods6 normal SD rats were assigned as control group. 18 steptozozin-induced diabetic SD rats were randomly divided into 3 groups: the I/R group (n= 6, received pancreas transplantation alone), DIPC group (n=6, received pancreas transplantation exposed IPC with 5 min ischemic and 5 min reperfusion twice) and RIPC group (n=6, received pancreas transplantation exposed IPC with 5 minutes ischemic and 5 minutes reperfusion induced by ligating donors' posterior limbs three times before anastomosing vessel). The blood glucose in serum, superoxide dismutase (SOD), myeloperoxidase (MPO), TUNEL cells in graft were monitored.ResultsAfter reperfusion, compared with the I/R group, the mean blood glucose levels, MPO levels and apoptotice index of graft reduced, the mean SOD levels of graft heightened in DIPC and RIPC groups significantly (all P<0.01).ConclusionIschemic preconditioning induced by graft and ligating donors' posterior limbs can reduce apopotosis of transplanted pancreas cells.