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 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 analyze the etiology in pancreatic pseudocyst (PPC). Methods Medical records were reviewed and analyzed for 366 PPC patients who were admitted in Changhai hospitals from April 2000 to December 2009 in terms. Demographic data, etiology and primary disorders of PPC patients were recorded. Results The causes of 366 patients varied as follow: gallstones in 158 patients (43.2%);idiopathic in 79 (21.6%); alcohol in 50 (13.7%); trauma in 17 (4.6%); pancreatic tumor in 9 (2.5%);hyperlipidemia in 8 (2.2%); post-operative in 7 (1.9%), other in 38 (10.3%). Depending on Atlantes classification systerm the PPCs were classified into acute PPC in 204 patients (64.2%), chronic PPC in 98 patients (30.8%) and abscess in 16 patients (5.0%). The 4 most common causes of acute PPC were gallstones, idiopathic, alcohol and trauma; the 3 most common causes of chronic PPC were gallstones,idiopathic, alcohol. Conclusions Gallstones is the main etiologic cause of the PPCs in China, followed by idiopathic and alcohol, which is significantly different with that in Western countries.

Animals ; Lung ; drug effects ; metabolism ; Perchlorates ; toxicity ; Quaternary Ammonium Compounds ; toxicity ; RNA, Messenger ; genetics ; Rabbits ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Animals ; Dose-Response Relationship, Drug ; Perchlorates ; toxicity ; Quaternary Ammonium Compounds ; toxicity ; Rabbits

AIM:To evaluate the clinical characteristics in retinal nerve fiber layer ( RNFL) thickness of the 8~17 years old near sightedness, provide the basis for juvenile glaucoma diagnosis, to avoid missed diagnosis and misdiagnosis.
METHODS:A total of 165 eyes from 99 healthy subjects ( age range 8 ~ 17 years ) were divided into low, moderate, high myopia and normal group. Cirrus HD OCT was used to measure the RNFL thickness. Each subject was performed circular scans around the optic nerve with a circle size of 3. 46mm. Total average, mean quadrant and clock - hour RNFL thicknesses were recorded and compared between the four groups. The characteristics of the RNFL thickness of myopia were observed.
RESULTS: Compared myopia groups with normal group, the mean RNFL thickness decreased, there was statistically significant difference in high myopia group (P<0. 05). The mean RNFL thickness of superior, inferior and nasal quadrant decreased, temporal quadrant was thickened. Compared moderate and high myopia groups with normal group, superior, inferior quadrant RNFL thickness were thinning, temporal quadrant was thickening, the differences had statistical significance ( P< 0. 05 ). The RNFL measurements were statistically significant thinner in the myopia groups compared with normal group at 1:00, 5:00, 6:00 and 12:00 o'clock ( P<0.05) and thicker at 8:00, 9:00, 10:00 o'clock (P<0. 05). The RNFL measurement was statistically significant thicker in the low myopia group compared with normal group at 3:00 o'clock (P<0. 05).
CONCLUSION: Compared adolescent myopia with normal, the Avg ( mean RNFL thickness ) , S ( superior quadrant RNFL thickness ) , I ( inferior quadrant RNFL thickness), 1:00, 5:00, 6:00 and 12:00 o'clock RNFL thickness is thinner, which is decreased with the increasing SE. While the temporal ( T) quadrant, 8:00, 9:00, 10:00 o'clock RNFL thickness is thicker, which increased with the increasing SE. Analysis of RNFL thickness in the evaluation of glaucoma should always be interpreted with reference to the refractive status, so as not to cause misdiagnosis of glaucoma. The highest diagnosis efficiency position of glaucoma is infratemporal (7:00~8:00 o'clock) and superior temporal (10:00 ~11:00 o'clock), which is not thinner in juvenile myopia, if these positions become thinner, it may be the possibility of glaucoma.

Objective To evaluate the application value of dermoscopy in the diagnosis of genital condyloma acuminatum (CA) in men.Methods A total of 122 warts from 66 male patients with suspected genital CA were firstly diagnosed by experienced dermatologists according to macroscopic morphological characteristics of lesions and clinical history of patients.Afterwards,the warts were examined and diagnosed by dermoscopy,and the two diagnosis results were compared with histopathological findings.Results Of 122 suspected warts,100 were diagnosed as CA by naked-eye examination,112 as CA by dermoscopy and 114 as CA by pathological examination.When histopathological findings served as the gold standard,dermoscopy had a sensitivity of 97.4％ and a specificity of 87.5％,and naked-eye examination had a sensitivity of 87.7％ and a specificity of 100％.Under dermoscopy,most male genital warts were pink (98/114,86.0％) and papillary (98/114,86.0％),and had distinct vascular characteristics (107/114,95.5％),which mainly included pleomorphic vessels (102/114,89.5％) and punctate vessels (98/114,86.0％).Conclusion CA has characteristic structures under dermoscopy,so dermoscopy can be used for the diagnosis of genital CA in men.