The study focused on tertiary public hospitals in Hangzhou,investigating the comments of both hospitals workers and foreigners in the city with questionnaires and literature search.The foilowing four problems were identified in the study in the foreigner medical services in Hangzhou:Communication barriers between doctors and foreign patients,insufficient communication of medical service information,poor service environment and service attitude,and payment mechanism for medical insurance and charges.On such basis,the authors recommended policy changes for the government to improve foreigner-oriented medical services,including building the regulations up to intemational customs for medical services,reforms in the payment system,medical insurance management,as well as planning and promotions of foreigner-related service institutions,and management strategies for key elements within the hospital

[Objective]To study the possibility of drug inhibition of wear particle induced osteolysis and aseptic prosthesis loosening in vivo.[Methods]4?8 mm transverse holes were made in femur condyle and tibia plateau of 12 adult rabbits bilaterally.One milligram of CoCr alloy(mean 5.38 ?m),Ti-6Al-4V(mean 3.21 ?m) and UHMWPE(12～200 ?m) particles were implanted into the holes separately.The animals were divided into 4 groups and each group had the same particles combination.Oral drug therapy twice a day was adopted with non-selective COX inhibitor(indomethacin,0.5 mg/kg BW),membrane Ca2+ channel inhibitor(nitrendipine,0.1 mg/kg BW),osteoclast inhibitor(alendronate sodium,0.1mg/kg BW) and blank control(0.9% saline) to the 4 groups separately and randomly according to the double blind principle,which started on the 2nd day postoperatively until 12 weeks at the time of sacrifice.Routine histological observation and calculation of the ratio of bone area(BA) to total tissue area(TTA) were done under the computerized analysis system.[Results]CoCr and Ti alloy particles could seldom be seen in the slices of the groups which showed normal cancellous bone.There were obvious macrophage infiltration and fibroblast proliferation round the particulate UHMWPE in the group of blank controls.It was similar in the groups of indomethacin and nitrendipine though the histological reaction was a little bit weaker and osteotoid tissue could occasionally be seen.UHMWPE particles were totally enclosed in the cancellous bone with little fibrous tissue proliferation in the group of alendronate sodium and the BA/TTA ratio was significantly higher than those at the other groups(P0.05).[Conclusion]This indicates the possibility of inhibition or prevention of osteolysis induced by wear particles by drug therapy especially when alendronate sodium is adopted,and it has significant clinical implications for controlling the most common cause of implant failure.

Objective:To explore the characteristics and influencing factors of college students' AIDS attitudes in china.Methods:1067 college students were investigated with Attitudes toward AIDS Scale, AIDS Knowledge Scale, Attitudes Toward Homosexuality Scale, Attitudes Toward HIV Risk People Questionnaire, Perceived Partners' Attitudes Toward AIDS Questionnaire, Perceived AIDS Susceptibility and Severity Questionnaire.Results:(1)College students who had different hometowns (99.5?8.1/93.0?7.6,t=4.18,P

Objective:To evaluate the profile of mood state-short form (POMS-SF) in Chinese cancer patients. Methods:289 cancer patients were randomly assigned to experimental or control group, both groups were assessed three times (pre-, on-and post-treatment ). 385 normal people were also completed the questionnaire. Results:The correlation between the items and the TMD of the scale ranged from 0.36～0.81 (P

Objective To evaluate effects of maternal hypothermic cardiopulmonary bypass on fetal homodynamic and carbohydrate metabolism. Methods Twenty pregnant sheep were divided into four groups randomly: control group(n=5),normothermic group (35-36℃)(n=5), mild hypothermic group(32-34℃)(n=5) and moderate hypothermic group (28-31℃)(n=5).Thoracotomy was performed without CPB in the control group. Routine CPB was established with different temperature in other three groups. The temperature of normothermic group was kept normal; the left two groups were cooled down to the set point of temperature and then rewarmed back to normal level. Fetal and maternal temperatures, heart rate,mean blood pressure(BP), pulse index (PI) of fetal umbilical artery (UA) and internal carotid artery (CA) were evaluated at cooling and rewarming stages. Biochemical indicators including blood glucose and lactic acid were also measured at the same time. Results There are no differences in mesn BP of ewas and fetal lambs between the different groups (P＞0.05). CA PI value of mild hypothermic group and moderate hypothermic group were significantly higher than those of control group and normothermic group (P＜0.05). There was no difference of UA PI in the four groups, but PI increased following the prolonged duration of CPB. There was no difference change of blood glucose in the four group of fetus, which was significantly lower than the ewe groups. An upward trend of fetal blood lactic acid with time was observed in three CPB groups. The whole level of fetal blood lactic acid was much higher than that of maternal blood of lactic acid. Conclusion Cooling of maternal bypsss decreases fetal heart rate significantly,and fetal heart rate recovered to base line following rewarming phase. There was no signicant effect of CPB on fetal mean BP. However, CPB impacted on the blood flow of fetal brain and umbilical artey. Hypothermia CPB can increase fetal blood glucose and blood lactic acid dramatically.

BACKGROUND:The biological substances fixed onto the implant surface, including specific proteins, enzymes, polypeptides, could promote the proliferation and differentiation of osteogenic cells in order to achieve a good osteogenic effect.
OBJECTIVE:To introduce the biological characteristics of the arginine-glycine-aspartic acid (RGD) peptides, cellbiological behavior and implant osseointegration in osteoporosis.
METHODS:Authors retrieved the relevant articles in PubMed database (January 1984 to January 2013), Wanfang database (January 2002 to December 2012) and CHKD database (January 2002 to December 2012) using the key words“RGD peptides, osteoporosis, bone marrow mesenchymal stem cells, osseointegration, osteoblast, induced differentiation”. Papers were included concerning the biological characteristics of RGD peptides, the biological behavior of cells and the bone-implant integration in osteoporosis.
RESULTS AND CONCLUSION:Osseointegration on the surface between implant and bone tissue can be further improved by grafting biological y active substance. Bionics modification, to simulate the extracellular matrix environment in vivo, can promote celladhesion and growth, which is an effective way to improve osseointegration and is also an important direction of research in the field of tissue engineering recently. The future research is focused on designing specific and efficient polypeptides and simple and effective fixation methods.

Some biological characteristics of human bone marrow mesenchymal stem cells (MSCs) cultured in vitro were observed. hMSCs were isolated from bone marrow and purified by density gradient centrifugation method, and then cultured in vitro. The proliferation and growth characteristics of hMSCs were observed in primary and passage culture. MSCs of passage 3 were examined for the purify by positive rate of CD29 and CD44 through flow cytometry. Human bone marrow MSCs showed active proliferation capacity in vitro. The purify of MSCs separated by our method was higher than 90%. It was concluded that hMSCs have been successfully cultured and expanded effectively. It provided a foundation for further investigation and application of MSCs.
Antigens, CD29/analysis ; Antigens, CD44/analysis ; Bone Marrow Cells/*cytology ; Cell Proliferation ; Cell Separation ; Cells, Cultured ; Flow Cytometry ; Mesenchymal Stem Cells/*cytology

Objective To assess the value of shear-wave elastic modulus for differential diagnosis of benign and malignant breast lesions using Meta-analysis.Methods Relevant Chinese and foreign articles about shear-wave elastography for differentiating benign and malignant breast lesions were collected from the literatures published before Apr.2016.Meta-analysis was conducted to assess the overall ability of the shear wave elastic modulus including Emax,Emea,Eratio and Esd.Results Totally 31 studies were brought into the Meta-analysis.The summarized sensitivity (SSEN) and summarized specificity (SSPE) of Emax were 0.87(95％CI [0.83,0.91]) and 0.91 (95％CI [0.87,0.93]).The SSEN and SSPE of Emea were 0.84 (95％CI [0.77,0.89]) and 0.88 (95％CI [0.84,0.91]),The SSEN and SSPE of Eratio were 0.88(95％CI [0.83,0.91]) and 0.87 (95％CI [0.80,0.91],the SSEN and SSPE of gsd were 0.85 (95％CI [0.80,0.89]) and 0.90 (95％CI [0.85,0.94]).The summarized receiver operator characteristic analysis showed that the area under the curve of E E Eratio and Esd were 0.95,0.93,0.93 and 0.93.Conclusion The shear wave elastic modulus contribute to differentiate benign and malignant breast lesions.Among these indices,Emax is the best one.

Objective To evaluate the efficacy, advantages and shortcomings of micro-percutaneous nephrolithotomy in treatment of uncomplicated ureteral calculi.Methods Clinical data were collected from 126 patients with a failure treatment of history by ESWL (extracorporeal shock wave lithotripsy) and RIRS (retrograde intrarenal surgery) in treatment of upper ureteral calculi (< 3.0 cm) from June 2015 to May 2016. Antegrade percutaneous access was obtained by B-type ultrasound guidance. Micro-PCNL was done using YAG laser fiber or pneumatic through the ureteroscope (F4.5~F6.5、F6.0~F7.5, 315 mm) to disintegrate the stones. The calculi clearance rate, operation time, operative hemorrhage, length of hospital stay and complications of the patients were analyzed after operation.ResultsThe calculi clearance rate was 88.9%, the operation time was 15~75 min, the operative hemorrhage was 15~35 ml, the length of hospital stay was 5~10 d. Only one patient need the second stage surgery because of intraoperative hemorrhage affected the surgical ifeld. No patients occurred massive hemorrhage, pneumothorax, bowel and other complications such as organ damage.Conclusion Micro-PCNL had a good clinical curative effect and security in treatment of uncomplicated ureteral calculi, which was worthy of promoting clinically.

BACKGROUND: Our former studies have shown that bone marrow mesenchymal stem cells (BMMSCs) can be induced differentiation to vascular smooth muscle-like cells (VSMLCs) and vascular endothelium-like cells (VELCs), which are compatible with collagen-embedded polyglycolic acid scaffolds. OBJECTIVE: To investigate the possibility of constructing small diameter tissue-engineered blood vessels via subcutaneous implantation. METHODS: The cells-scaffold complex was produced by separately seeding VSMLCs and VELCs derived from BMMSCs on polyglycolic acid collagen scaffolds. The two layers were separated by ECMgel. The cells-scaffold complex was subcutaneous implanted into small diameter tissue-engineered blood vessels.RESULTS AND CONCLUSION: Histological analysis of the small diameter tissue-engineered blood vessel walls revealed a typical artery structure, which was similar to natural vessels. The tissue-engineered blood vessels were not broken down under a force of 26.6 kPa. Eight weeks after implantation, the Brdu-labeled seed cells were found in the three layers of the vessel walls. The results revealed that the subcutaneous tissue was a good bioreactor to construct small diameter tissue-engineered blood vessels.