Under the socialist market-oriented economic system, state-owned hospitals need to overcome many problems in their traditional management system. The authors discuss a series of issues, including the property right involved in the reform of the management system of state-owned hospitals; the relationships between nonprofit hospitals run by the government and ways of handling them; the conditions of using the corporation management structure in hospitals; the responsibilities of the government in the framework of medical services and the form in which the government supervises state-owned hospitals. Lastly, the authors put forward suggestions from the perspective of policy-making on the reform of the management system of state-owned hospitals.

Objective To elucidate the clinical features and treatment of hemangiopericytomas (HPCs) in different parts of the body, especially in CNS. Methods Clinical data of 41 cases with HPC which were treated at 301 Hospital from 1993 to 2004 were retrospectively analyzed with a review of relevant literature. Follow-up periods ranged from 4 to 150 months after surgery (mean 34 months). Results Among 41 patients of HPC, 21 tumors (51.2%) were found in CNS, and the rest 20 (48.8%) in other systems. Thirteen tumors were diagnosed as malignant HPC. Surgery for tumor removal was performed in all 41 patients. Among the 62 operations, total removal of tumor was achieved in 49 cases and subtotal removal in 13 cases. Recurrence in original site of the tumor occurred 21 times (33.9%) in 14 patients. Five patients (12.1%) presented one or more distant metastasis, and 5 patients died. HPCs in CNS and in other systems displayed similar clinical characteristics and pathological morphology. Conclusions HPC is a rare angioneoplasm that may arise in any part of the body. It is a great challenge to neurosurgeons as well as other surgeons to surgically manage the tumor. HPC has an unfavorable prognosis because its high rate of recurrence and metastasis. HPC in CNS and in other parts of the body should be recognized as one disease. At the same time, HPC in CNS has its distinct features.

Objective To investigate the mechanism and significance of low density nitric oxide (NO) in-halation combined with urokinase (UK) in treatment of pulmonary thromboembolism in swine. Method PIE model was estabhshed in 12 healthy infant swines, which were subsequently assigned to UK group or UK+NO ter establishment of the PIE model;in the UK+NO group, swines received continuous NO inhalation of 10 ppm NO for two hours in addition to administration of UK no done in the UK+NO group. Volume of physiological dead space (VDphy), volume of alveolar dead space (VDalv), intrapoulmonary shunt (Qs/Qt), mean ptdmonary arteri-al pressure (PAP), systolic blood pressure (SBP), heart rote (HR), cardiac output (CO), arterial blood pH val-ue, arterial partial pressure of carbon dioxide (PaCO2) and arterial partial pressure of oxygen (PaO2) were mea-sured at 30 min before and 0 min, 30 min, 60 rain, 120 min and 180min after establishment of pulmonary em-bolism.All date were analyzed by ANOVA (SNK-q test),and P<0.05 was considered as significantly differet. Results After PE, VDphy, VDalv, Qs/Qt and PAP of both groups increased markedly compared with the pre-PE values (P<0.01), but the post-PE PAP showed a tendency of decline as time passed. Post-PE PaO2 of both groups decreased significantly (P<0.05 and P<0.01). There were no significant differences in HR, SBP, CO, pH or PaCO2 between pre-PE and post-PE (P>0.05). Both pre- and Post-PE PAP of UK+NO group were markedly less than those of the UK group (P<0.05 and P<0.01). No significant difference was found in other measurements between the two groups. Conclusions UK combined with low density NO inhalation may lower pul-monary arterial pressure promptly to alleviate PIE without distur bance in hemodynamics or gas exchange status and without pulmonary raterial pressure rebound.

Objective To investigate the mechanism and significance of low concentration nitric oxide (NO) inhalation in the treatment of pulmonary thromboembelism in swine. Method The pulmonary thromboem-bolism(PTE) model was made in 15 healthy infantile swines which were subsequently assigned to either control group (n = 8) or NO group (n = 7). Swines of the control group were not treated with any medicine, while 10 ppm of NO was administered by continuous inhalation for 2 hours to swines of NO group. Volume of physiological dead space (VDphy), volume of alveolar dead space (VDalv), intrapulmonary shunt (Qs/Qt), mean pulmonary arterial pressure (PAP), systolic blood pressure (SBP), heart rate (HR), cardiac output (CO), arterial blood pH (pH), arterial partial pressure of carbon dioxide (PaCO2) and arterial partial pressure of oxygen (PaO2) were measured 30 min before and 0 min, 30 min, 60 min, 120 min and 180 min after establishment of VIE. Results The post-FIE VDphy, VDalv, Qs/Qt and PAP in both groups increased markedly after PTE compared with the cor-responding pre-PTE measurements (P < 0.01). Post-FIE PaO2 of both groups decreased significandy (P <0.05 and P <0.01), while significance difference was found between pre- and post-PTE HR, SBP, CO, pH or PaCO2 in neither groups (P > 0.05). Both post-PTE PAP and VDalv in NO group were markedly lower(P <0.05 and P <0.01) and beth PaCO2 and PaO2 were much higher than those of the control group (P <0.05). No signi-fieant difference were found in other measurements between two groups. Conclusions Pulmonary arterial pressure may be lowered, alveoli dead space may be reduced and PaCO2 increased by low concentration NO inhalation for the treatment of PIE without decline in haemodynamic status.

Animals ; Chickens ; physiology ; Eating ; drug effects ; Injections, Intraventricular ; methods ; Neuropeptide Y ; administration & dosage ; pharmacology

BACKGROUNDApoptosis is a major cause of ischemic heart dysfunction. Apelin, the endogenous ligand for the G-protein-coupled APJ receptor, has been reported to exert cardioprotective effects during myocardial injury. The aim of this study was to investigate the effects of apelin on apoptosis of rat cardiomyocytes induced by glucose deprivation (GD) and study the related signaling pathway.

METHODSApelin and APJ mRNA expression were determined by RT-PCR in neonatal rat cardiomyocytes during different durations of GD. Cardiomyocyte apoptosis was detected by annexin V-FITC/propidium iodide (PI) staining after GD for 12 hours with or without apelin-13 (10 and 100 nmol/L) pretreatment. Protein levels of Akt and the mammalian target of rapamycin (mTOR) as well as cell apoptosis were detected in the presence or absence of LY294002 (a phosphatidylinositol 3-kinases (PI3K) inhibitor) or rapamycin (a mTOR inhibitor).

RESULTSApelin mRNA expression was up-regulated when cardiomyocytes were exposed to GD for 6, 12, 18, and 24 hours compared with the base level (P > 0.05, P < 0.01, P < 0.01, P < 0.01). However, when cardiomyocytes were exposed to GD for up to 36 hours, apelin mRNA expression was 17% lower than the base level (P < 0.05). APJ mRNA expression paralleled that of apelin. Apelin-13 pretreatment at 100 nmol/L significantly inhibited GD-induced cardiomyocyte apoptosis (P < 0.05) and increased Akt and mTOR phosphorylation (P < 0.01, P < 0.01). At the same time apelin-13 (100 nmol/L) up-regulated Bcl-2 protein expression and down-regulated Bax and cleaved caspase-3 expression (P < 0.01, P < 0.05, P < 0.05). The anti-apoptotic effect of apelin-13 was blocked by LY294002 (P < 0.01) but not by rapamycin.

CONCLUSIONSThe endogenous apelin-APJ system is compensatorily up-regulated and ultimately down-regulated following sustained myocardial ischemia. Apelin protects against ischemic cardiomyocyte apoptosis via activation of the PI3K/Akt pathway.

Animals ; Apelin ; Apelin Receptors ; Apoptosis ; Carrier Proteins ; genetics ; physiology ; Caspase 3 ; analysis ; Cell Survival ; Cells, Cultured ; Glucose ; deficiency ; Intercellular Signaling Peptides and Proteins ; Myocytes, Cardiac ; physiology ; Phosphatidylinositol 3-Kinases ; physiology ; Proto-Oncogene Proteins c-akt ; physiology ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Receptors, G-Protein-Coupled ; physiology ; Signal Transduction ; bcl-2-Associated X Protein ; analysis

OBJECTIVETo investigate telomerase activity in rabbit bone marrow stromal cells (BMSCs) during their committed differentiation in vitro along neural pathway and the effect of glial cell line-derived neurotrophic factor (GDNF) on the expression of telomerase.

METHODSBMSCs were acquired from rabbit marrow and divided into control group, GDNF (10 ng/ml) group. Cytokine.NSCs medium (prepared by our lab, Patent No. ZL02134314. 4) supplemented with 10 percent fetal bovine serum (FBS) was used to induce BMSCs differentiation along neural pathway. Fluorescent immunocytochemistry was employed to identify the expressions of Nestin, neuron-specific endase (NSE), and gial fibrillary acidic protein (GFAP). The growth curves of the cells and the status of cell cycles were analyzed, respectively. During the differentiation, telomerase activities were detected using the telomeric repeat amplification protocol-enzyme-linked immunosorbent assay (TRAP-ELISA).

RESULTSBMSCs were successfully induced to differentiate along neural pathway and expressed specific markers of fetal neural epithelium, mature neuron and glial cells. Telomerase activities were undetectable in BMSCs during differentiation along neural pathway. Similar changes of cell growth curves, cell cycle status and telomerase expression were observed in the two groups.

CONCLUSIONSRabbit BMSCs do not display telomerase activity during differentiation along neural pathway. GDNF shows little impact on proliferation and telomerase activity of BMSCs.

Animals ; Bone Marrow Cells ; enzymology ; Cell Differentiation ; Glial Cell Line-Derived Neurotrophic Factor ; Immunohistochemistry ; Rabbits ; Stromal Cells ; enzymology ; Telomerase ; metabolism

BACKGROUND:Autologous platelet rich plasma and bone marrow mesenchymal stem cells have certain effects on bone repair,but there are rare reports on the clinical treatment of long shaft fracture bone nonunion using autologous platelet rich plasma combined with bone marrow mesenchymal stem cell transplantation.OBJECTIVE:To investigate the therapeutic effect of autologous platelet rich plasma combined with bone marrow mesenchymal stem cell transplantation on long shaft fracture bone nonunion.METHODS:Forty-seven patients with long shaft fracture bone nonunion were randomly divided into two groups:monotherapy group (n=22) and combination group (n=25).In the monotherapy group,autologous bone marrow mesenchymal stem cell transplantation was performed in the bone nonunion site.In the combination group,autologous platelet rich plasma combined with bone marrow mesenchymal stem cell transplantation was implemented in the bone nonunion site.Callus score,clinical healing time,local complications and limb function grade were recorded and compared between the two groups.RESULTS AND CONCLUSION:The healing properties and limb function in the combination group were significantly superior to those in the monotherapy group [healing time:(4.2±1.5) vs.(5.6±1.1) months,P ＜ 0.05;healing rate:92％ vs.86％,P ＜ 0.05;callus score:2.74±0.36 vs.2.32±0.53,P ＜ 0.05;limb function recovery rate:77％ vs.84％,P ＜ 0.05].Complications like local skin redness or infection were not found in the two groups.In conclusion,both of the two methods can promote bone healing,but autologous platelet rich plasma combined with bone marrow mesenchymal stem cell transplantation has a better clinical effect on bone healing.

The scholars at home and abroad pay great attention to the studies of specificities of acupoints, but the studies were superficial and non-systemic because of lacking to application of modern sciences and technology. There are not persuasive conclusive achievements for the specificities of acupoints and the key factors influencing the effect of acupuncture. The study of the specificities of acupoints should be concentrate on the diseases for which acupuncture and moxibustion are effective. And multiple modern sciences and techniques should be adopted to resolve the key problems about biological and physical characteristics, pathological response, effects and law of compatibility of acupoints usually selected for the diseases, and then to create the model of the theory about the specificities of acupoints and to richen and develop the theory of the specificity of acupoints.
Acupuncture Points ; Humans ; Research

Adrenalectomy ; methods ; Adult ; Aged ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged