This article introduced the experiences of nongovernmental capital running hospitals in US,Germany,India and Israel and put forward some suggestions that need to be considered in China, such as innovating supply model of health care service,treating social capital running hospitals equally and strengthening supervision.

Angiography ; methods ; Coronary Angiography ; methods ; Coronary Vessels ; pathology ; Humans ; Magnetic Resonance Angiography ; methods ; Mucocutaneous Lymph Node Syndrome ; diagnosis ; diagnostic imaging

Antineoplastic Agents, Phytogenic ; therapeutic use ; Camptothecin ; analogs & derivatives ; therapeutic use ; Humans ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms ; drug therapy ; pathology ; Remission Induction

Objective To evaluate the kinetics of peripheral blood cells in DTC patients before and after 131I treatment.Methods A total of 64 patients were divided into 2 groups with different therapeutic doses:high-dose group (3.70-5.55 GBq,n =24) and low-dose group (1.11 GBq,n =40).The WBC,neutrophils (NEUT),lymphocytes (LY),RBC and PLT were counted before operation,before 131I treatment,and on 3 d and 7 d after 131I treatment.One-way analysis of variance and two-sample t test were used to analyze the data.Results The counts of WBC and NEUT in both groups along with the LY in high-dose group varied significantly before,and on 3 d and 7 d after 131I treatment(WBC:high-dose group,(6.30±1.04),(8.86±2.07),(6.59±1.64) × 109/L;low-dose group,(6.65±1.48),(10.17±3.04),(7.17± 1.57) ×109/L; NEUT:high-dose group,(3.75±0.88),(6.42± 1.91),(4.53± 1.54) × 109/L; low-dose group,(3.88±0.90),(7.12±2.77),(4.40±1.17) × 109/L;LY:(2.11±0.67),(2.06±0.74),(1.59±0.49) × 109/L;F values:3.88 to 30.20,all P＜0.05).The counts of WBC and NEUT in both groups were significantly higher on 3 d after 131I treatment than that before treatment (all P＜0.05).The counts of WBC and NEUT in both groups along with the LY in high-dose group decreased significantly on 7 d compared to that on 3 d after 131I treatment (all P＜0.05).The counts of LY in high-dose group also significantly decreased on 7 d after 131I treatment than before treatment(P＜0.05).The counts of RBC before 131I treatment and LY on 7 d after 131I treatment were significantly different between the 2 groups(t=2.36,-4.30,both P＜0.05).Compared with the counts before operation,LY,RBC and PLT were significantly higher (t values:from-4.92 to-2.45,all P＜0.05) during hypothyroid state induced by thyroxine withdrawal before 131I treatment.Conclusions Short-term kinetics of WBC and NEUT present as an increase first followed by a decrease after 131I treatment; while LY of high-dose group presents as a gradually decrease.Hypothyroid state induced by levo-thyroxine withdrawal leads to increased counts of LY,RBC and PLT before 131I treatment.

Objective To explore the clinical effects of atlantoaxial pedicle screw instrumentation in treatment of intractable atlantoaxial dislocation in children. Methods A total of 7 patients with intractable atlantoaxial dislocations were treated with aflantoaxial pedicle screw instrumentation plus atlantoaxial bone grafting from June 2002 to January 2001. Results The dislocation in all patients reached complete reduction, with no complications. All patients were followed up for average 10 months (8-14 months). Radiographs showed successful bone fusion in all patients. Conclusion Atlantoaxial pedicle screw fixation and fusion is an effective method for treatment of intractable atlantoaxial dislocation in chil dren.

Objective To investigate the risk factors for nosoeomial pneumonia in elderly stroke patients(aged 60 years and over). Methods The clinical data of 259 patients with nosoeomial pneumonia from Jan 2002 to June 2007 were collected and the risk factors were retrospectively analyzed. Results The morbility rate of nosocomial pneumonia in elderly stroke patients was 41.3%,and the risk factors were aging,Iong hospitalization,unconsciousness,type of stroke,and underlying diseases,smoking,tracheal intubation,tracheotomy,application of respiratory machine (all P＞0.05). Conclusions The morbility rate of nosoeomial pneumonia in elderly stroke patients was high,and the risk factors are aging,long hospitalization,unconsciousness,type of stroke,and underlying diseases,smoking,tracheal intubation,tracheotomy,application of respiratory machine.

Objective To explore the efficacy of intraductal chilled saline perfusion (ICSP) to reduce the thermal bile duct injury during the treatment of radiofrequency ablation (RFA) associating with occlusion of hepatic blood supply in rabbits.Methods 16 healthy New Zealand white rabbits were divided into 2 groups.Rabbits of the ICSP group were placed tubes in the common bile duct after laparotomy,and ICSP was performed during the RFA procedure accompanied with hepatic blood occlusion.While for rabbits of the non-ICSP group,hepatic blood occlusion and RFA were performed without ICSP.RFA electrodes were placed about 5 mm away from the hilus hepatis approximately.Contrast-enhanced ultrasonography (CEUS) was administrated to evaluate the sizes of the ablative zones after the procedure.On post-procedure 6 week,ultrasonography was prerformed to evaluate the changes of the biliary structure,and liver specimens of rabbits wcrc obtained for histopathologic observation of main bile ducts.Results Post-procedure CEUS examination showed that there was no significant difference in the size of the ablative zone between the groups (P ＞0.05).On post-procedure 6 week,rabbits of the ICSP group appeared with biliary dilatation more frequently by ultrasonography (P ＜0.05),and a higher degree of the injury of main bile duct by histopathologic observation (P ＜0.05).Conclusions In treatment of RFA accompanied with hepatic blood occlusion,RFA-induced bile duct injury may be decreased significantly with ICSP.

N6-(2-Hydroxyethyl) adenosine, HEA (1), an active ingredient isolated from cultured mycelia of cordyceps species which is a famous traditional tonic in China, showed brain protective, sedative hypnotic activity in pharmacological tests. In order to explore novel non-benzodiazepine sedative-hypnotic agents, HEA was treated as the lead compound. Twenty three target compounds were designed and synthesized. Their chemical structures were characterized by 1H NMR, MS and elemental analysis. Pharmacological test in vivo showed that target compounds 8, 4, 13 were more active than HEA on locomotor and gasping activities of mice. Structure-activity relationships showed that the ribose moiety at N-9 position of adenine base was critical for activity.

Objective To explore the effects of peripheral stem cell transplantation on extremely severe bone marrow form of acute radiation sickness.Methods One patient was radiated aecidently with the radiation dosage of 9～15 Gy and diagnosed as extremely severe bone marrow form of acute radiation sickness.Pretreatment was performed at 4th day after the accident and 3 days later,HLA- matched allogeneic stem cell transplantation on the patient was performed.Graft versus host disease (GVHD) was prevented with cyclosporin A (CsA) and mycophenolate mofetil (MMF).Results The haematopoiesis was recovered at 9th day after transplantation.At 11th day after transplantation, WBCs were increased to 14.74?10~9/L and returned to the normal levels subsequently,number of platelets risen to 51?10~9/L and hemaglobin was over 80 g/L.TRS-PCR and blood type dynamic detection testified that the donor's cells were stably implanted,the chromosome aberration and micro- nuclei disappeared after transplantation,and the patient's blood type changed into the donor's at 27th day after transplantation.But the radiation injury were still getting worse complicated with multiple infections,At 68th day after transplantation (75 days after the accident),the patient was died of mul- tiple organs failure.Conclusion Extremely severe bone marrow form of ARS can achieve hematopoie- sis recovery by allogeneic stem cell transplantation,but only hematopoiesis recovery can not cure the immunodefficiency and the radiation injury of the whole body.

Background and purpose: Human epidermal growth factor receptor 2 (HER-2) is the member of tyrosine kinase receptor family. Its differential expression plays the key role in choosing targeted drug for breast cancer. This study focused on screening the breast cancer cell clones of different HER-2 expression levels, and studying the bi-ological characteristics of these cells. Methods: Breast cancer SK-BR-3 cells were clonally purified, and the expression level of soluble HER-2 (sHER-2) from the culture supernatant was detected by the ECLIA on ADVIA Centaur CP System. Cell clones with high expression (>50.0 ng/mL), medium expression (15.8-50.0 ng/mL) and low expression (<15.8 ng/mL) of sHER-2 were identified, respectively. This study observed the morphological changes of cell strains with differential expression levels of sHER-2 by cell culture. Besides, biological characteristics were compared by a series of experiments in vitro, such as clone formation, scratch assay, and transwell detection. Results: Compared with normal breast cells, sHER-2 was overexpressed significantly in SK-BR-3 breast cancer cells. Furthermore, the abilities of clone formation, mobility and invasion of sHER-2 high expression cell strain [(51.3±3.4)%, (50.0±0.6)% and (53.5±4.2)%] were signifi-cantly higher than those of sHER-2 medium expression [(42.0±3.7)%, (19.5±3.4)% and (33.2±3.9)%] or sHER-2 low expression [(26.7±2.9)%, (13.6±1.0)% and (28.9±5.4)%], and the differences were all statistically significant (P<0.05). Conclusion: Breast cancer cell strain with high expression level of sHER-2 can enhance cell proliferation, promote cell motility and other biological effects, which may lay the foundation for clinical screening of targeted drug therapies for breast cancer.