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 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 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.

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 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.

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.