The paper analyzes the current status of and problems in the development of non-government medical institutions in Shanghai, the advantages non-government medical institutions possess and the difficulties they face in the process of development. It advances the development orientation of non-government medical institutions, arguing that it is imperative to create circumstances and conditions for fair competition, formulate perfect supporting policies, and lead non-government medical institutions to the integration of their own development with the reform and development of the medical and health cause of the country. It argues, on the other hand, that non-government medical institutions must stress simultaneously the accumulation and the operation of capital so as to have a niche in the fierce competitions of the medical market.

Objective To assess the clinical significance of antibodies against cyclic citrullinated peptide(anti - CCP) in a cohort of patients with juvenile idiopathic arthritis (JIA). Methods The anti - CCP was tested by an enzyme linked immunosorbent assay (ELISA) in serum samples from 22 patients with JIA(9 boys, 13 girls), with a mean age of 9.1 years(range 1.1 - 16). As control groups, anti - CCP were also tested in sera of 20 healthy children, and 30 adult patients with rheumatoid arthritis(RA). Results Positive anti - CCP were found in sera of 2 patients with JIA(9.1 %), both with lower titre comparing with those of adult patients with anti - CCP positive. In the control groups, none of healthy children was positive for anti - CCP, but 16/30(53. 3%) adults with RA showed anti - CCP positivity. Conclusion Anti - CCP can be detected in children with JIA, but are less frequently present than in adults with RA, so anti - CCP has limited diagnostic value to JIA.

To improve the solubility of quercetin ( QT) , one of flavonoids that can inhibit the proliferation of vari-ous types of cancer cells, the novel amphiphilic polymer N-( 4-methylimidazole)-hydroxyethyl-chitosan ( MHC) , synthetized by chemical derivatization from chitosan, was used as the self-assembly micelles of QT. The formed polymer was characterized by 1 H NMR, elemental analysis and pyrene fluorescence spectrometry. The formulation of MHC micelles loading quercetin was optimized through single factor experiment. Then the optimized formulation was obtained as follows:the concentration of MHC was 0. 67% and the ratio of drug and carrier was 1 ∶10. The micelles particle size was ( 99. 21 ± 1. 71) nm, Zeta potential was +( 20. 01 ± 0. 72) mV and drug loading was ( 5. 42 ± 0. 32 )%. The in vitro release curve was investigated and was found to conform to Higuchi equation of Q=0. 1101 t1/2 -0. 064. The results of in vivo experiment showed that the mean rentention time and bioavail-ability of the MHC-QT micelles were 21. 42 h and 57. 49 μg h/mL, respectively, compared to 0. 30 h and 2. 50 μg h/mL of the free QT solution. These indicated that the MHC micelles could significantly improve the solubility of QT, the drug sustained-release effect and bioavailability, which would used as carrier for the anti-tumor drugs.

Objective To study the different oral compound polyethylene glycol electrolyte powder on the effect of bowel preparation before colonoscopy.Methods A total of 602 inpatients or outpatients were selected from department of gastroenterology,and they were randomly divided into tranditional group(n =288)and improvement group(n =314).All patients took a dose of two box of compound polyethylene glycol electrolyte powder 4 hours before colonoscopy.Endoscopic doctor investigated the antibiotic tolerance,adverse reactions,heart rate,blood pressure,blood electrolytes and blood glucose during treatment in form of questionnaire with single blind Bosdon bowel preparation scale (BBPS)score.Results The BBPS scores of the tranditional group and improvement group were (7.03 ± 1.24)points,(7.82 ±1.12)points,the score of the improvement group was significantly higher than the traditional group(t =2.259,P <0.05).The taste scores were (1.89 ±0.07)points,(1.25 ±0.09)points (t =2.624,P <0.05),the fully taking rates were 90.28%,95.86%(χ2 =7.375,P <0.05 ),and the second taking rates were 88.54%,93.95%(χ2 =5.566,P <0.05).In contract,the score of adverse reactions of the improvement group was significantly lower than that of the traditional group [(2.58 ±0.07)points vs(2.22 ±0.09)points,t =2.068,P <0.05].There was no significant difference of colonoscopy time between the two groups[(10.78 ±4.34)min vs (9.89 ± 1.77)min,t =1.766,P >0.05 ],althought the improvement group was shorter than the tranditional group. Conclusion The modified way of oral compound polyethylene glycol electrolyte powder not only can improve the qulity of intestinal cleaning,but also acts as a more effective method in preparation of colonoscopy due to its high tolerance, good comfort,less pain and high acceptance of patients.Therefore,it is worthy of clinical promotion and application.

To explore novel coumarin derivatives with more potent anti-proliferative activity, a series of novel compounds were designed and synthesized by linking Schiff base and N, N-bis (2-chloroethyl) amine pharmacophore of nitrogen mustards to the coumarin's framework. Their structures were confirmed by 1H NMR, MS and element analysis techniques. In vitro anti-proliferative activities were evaluated against HepG2, DU145 and MCF7 cell lines by the standard MTT assay. The results showed that some of the target compounds exhibited strong anti-proliferative activities against selected tumor cells, and compounds 7c, 7f, 7g, 7h and 7q were better than or equal to the activities of positive control, they deserved further development.
Antineoplastic Agents ; chemical synthesis ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Coumarins ; chemical synthesis ; pharmacology ; Drug Design ; Drug Screening Assays, Antitumor ; Humans ; Nitrogen Mustard Compounds ; chemical synthesis ; pharmacology ; Schiff Bases ; Structure-Activity Relationship

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; DNA, Neoplasm ; genetics ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Infant ; Lymphoma, B-Cell ; diagnosis ; genetics ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; genetics ; Male ; Middle Aged ; Paraffin Embedding ; Polymerase Chain Reaction ; Young Adult

Objective:To explore the preventive function for sweating gustatory syndrome and esthetic effect of restoring parotid gland area defect by using platysma flap. Methods: Nine patients who underwent parotidectomy and restored parotid gland area defect with platysma flap were analyzed retrospectively in this study. Observed whether there was an incidence of subjective sweating gustatory syndrome and introcession in the operation region. Results: There was no incidence of subjective sweating gustatory syndrome. Moreover, introcession in the operation region was not obvious. Conclusion: Restoring parotid defects with platysma flap can reduce introcession in the operation region. Application of platysma flap as an interpositional barrier between the skin flap and the parotid bed after parotidectomy can reduce the incidence of sweating gustatory syndrome.

Objective To investigate factors related to chronic pain in those injured with fractures 27 months after the Sichuan earthquake.The correlation between intensity of pain and quality of life was also analyzed.Methods A total of 705 victims were investigated on site.Their residual pain was categorized using a visual analogue scale (VAS) score as no pain,mild pain,moderate pain or severe pain.The pain-related biological,psychological and social factors were analyzed using the Barthel Index ( BI ),Life Satisfaction Questionaire-11 ( LiSat-11 )and the SF-36 health questionnaire. Rehabilitation and surgical interventions,employment,income and emotional status were also investigated. Results The incidence of chronic pain was 88.5％ in this population,of which mild pain and moderate pain were 35.7％ and 33.3％,respectively.The percentage of the victims who had received fracture surgery was 65.8％ ; the percentage of those who had recovered was 96.9％.BI scores for the victims without pain,with mild,moderate and severe pain were 92.7 + 10.2,92.8 + 8.4,91.2 ± 9.9 and 90.4 + 14.7,respectively ; the differences between these groups were all statistically insignificant.The influence of pain intensity on life satisfaction showed a significant linear trend.The percentages of the victims with restricted occupational ability in the four groups were 38.3％,61.5％,75.7％ and 62.8％ respectively.The median of personal annual income were ￥ 3550,￥ 2500,￥ 2000 and ￥ 2500.The VAS scores were significantly related to abnormal emotions,life satisfaction,employment and annual income.The subjects with different levels of residual pain also showed significant differences in the physical functioning,role-physical,bodily pain,general health,vitality,social functioning,role-emotional and mental health sub-scales of the SF-36.The total SF-36 scores were highest among victims without pain (70.6 + 17.5) and declined significantly in those with mild (61.3 + 14.3 ),moderate (52.7 + 14.3 ) and severe pain (52.3 + 14.7 ).This negative correlation between pain intensity and SF-36 total score was statistically significant. Conclusions Chronic pain remains common among fracture victims 27 months after the earthquake.Its intensity is correlated with psychological and social factors as well as quality of life.

Objective To investigate the diagnosis and surgical treatment of intracaval venous tumors. Methods Clinical data of 6 cases were retrospectively analyzed, including signs and symptoms diagnostic means such as type-B ultrasound, CTA, MRA, surgical procedures and prognosis. Results All six cases received type-B ultrasonic examination, final definite diagnosis was achieved by CTA exam in 2 cases and through MRA in 4 cases. Heart involvement was found in 3 cases. All patients underwent a surgery. According to the extent of the tumor,3 cases had thoraco-abdominal incision,3 cases with extracorporeal circulation and right atrium opening. All of the tumors were completely resected. Pathological exam revealed that 4 cases were of leiomyomatosis and 2 cases were of leiomyosarcoma. One case with leiomyosarcoma died of liver disfunction postoperatively.The other 5 cases recovered without major complications. An average 51 months of follow-up found no recurrence. Conclusions CT and MRI are the mainstay for the diagnosis,and MRI can provide clear anatomy image to the surgeons, help choose the surgical procedures. The one-stage operation is effective. During the operation, the main branches of the vena cava system should be detected, and the attachment of the tumor should be found and removed thoroughly to prevent the recurrence of the tumor. When the attachment point is lower than the iliac vein level, ligation of the involved iliac vein should be mandatory.

Objective To evaluate the predictability of MSCT perfusion in the restorability of renal function of hydronephrotie kidneys with unilateral partial ureteric obstructed rabbit model as to explore a method to predict the restorability of renal function of hydronephrotic kidneys and to investigate the changes of MSCT perfusion parameters during the course of the restore of renal function.Methods Establish a unilateral partial ureteric obstructed rabbits hydronephrotie model.Hydronephrotie rabbits were grouped as control,2,4 and 8 week(G_2w,G_4w and G_8w)after obstruction and the later 3 groups of rabbits were reared for further 4 weeks after the obstruction was released.MSCT perfusion scanning was performed and the specimen was made into histological slices with HE staining.Results BF and BV value of renal cortex and medulla of G_2w after obstruction [(864?32)ml?100 g~(-1)?min~(-1),(19.5?0.9)ml/100 g (cortex ); (182.1?7.5)ml?100g~(-1)?min~(-1),(8.37?0.51)ml/100g(medulla)]was released restored in substance and approached that of control[(899?63)ml?100g~(-1)?min~(-1),(21.6 + 1.4)ml/100 g (cortex);(193.5?16.5 )ml?100g~(-1)?min~(-1),(8.50?0.54 )ml/100 g (medulla)]while there was no significant restore in that of G_4w and G_8w after obstruction[(525?15)ml?100g~(-1)?min~(-1),(12.8? 0.6)ml/100g (G_4 w);(512?10)ml?100g~(-1)?min~(-1),(9.4?1.0)ml/100 g (G_8w)] was released. Histologically,there was a positive correlation between the duration of obstruction and the seriousness of pathologic changes.Conclusion MSCT perfusion can provide information not only morphologically but also about renal perfusion of hydronephrotic kidneys.