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.

Through the suvey, we find that freshmen are generally suited for college physics studies. ln this paper, high school and college students’ interest in Learnig, their initiatives, the change of their study methods and the teachers’ teaching methods are discussed.

Objective To investigate the expressions of CXCR4 in Barrett esophagus (BE), esophageal adenocarcinoma (EADC) and esophageal squamous cell carcinoma (ESCC), and its relationship with pathology, clinical staging and lymph node metastasis. Methods The expressions of CXCR4 in 56 cases of normal esophageal mucosa, 80 BE (including 22 BE with multifocal dysplasia), 25 EADC and 48 ESCC were examined with immunohistochemical method. Results CXCR4 was expressed in most samples of BE (80. 8% ), EADC (68. 0% ) and ESCC (78.4%) without significant difference ( P ＞ 0. 05 ), which was significantly higher than that in normal esophageal mucosa (39. 3%, P ＜0. 01 ). The level of CXCR4 expression in BE, EADC or ESCC were not related with gender, age, or location of the foci ( P ＞ 0. 05). There was no significant difference in CXCR4 expression between BE without dysplasia or BE with multifocal dysplasia ( P ＞ 0. 05 ). CXCR4 expression level in well-differentiated EADC was significantly higher than that of mild or poorly differentiated (P ＜ 0. 05 ). CXCR4 expression level was higher in EADC with lymph node metastasis than those without ( P ＜ 0. 05 ). CXCR4 level in ESCC with TNM staging grades Ⅲ -Ⅳ was higher than that of grades Ⅰ - Ⅱ, and this variable was also higher in cases with lymph node metastasis than those without (P ＜ 0. 05), so was the case of well and poorly differentiated ESCC (P ＜ 0. 01 ). Conclusion Increased expression level of CXCR4 may be a common feature of EADC and ESCC, which is irrelevant to pathological types. CXCR4 level rises at the stage of BE, which is associated with the degree of tumor differentiation, lymph node metastasis and TNM staging. CXCR4 expression is of guiding significance in the diagnosis of BE, EADC and ESCC, and is the potential drug target.

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 analyze the mierosurgery treatment and prognosis of cavernous hemangioma loca-ted in pons. Methods 12 cases with cavernous hemangioma located in ports underwent mierosurgery. 11 lesions lo-cated in dorsal tons were resected through midline suboccipital trans- rhomboid fnssa approach. 1 lesion located in ventrolateral pous was resected with suboceipital retrosigmoid approach. Results All the 12 cavernous hemangiomns were rosected totally and confirmed by the postoperative pathology. Clinical improvement was gained in 6 cases, no change in 3 ,aggravation of facial palsy in 1 ,death in 1. The mean follow-up time was 3 months,and Mill scan dem-onstrated good restoration of brain stem tissue with no recurrence signs of lesion. The symptoms due to the operation recovered to some extent. Conclusion The cavernous hemangioma located in brain stem can be resected safely and effectively given the selection of surgical indication and optimal surgical approach.

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.