The developed countries have increasingly used private sector involvement in the practices of developing, financing and providing public health infrastructure and services through public-private partnerships (PPPs) in recent years.The main reasons for this uptake in these countries are manifold ranging from the rising expenditures for refurbishing, maintaining and operating public assets, and the increasing constraints on the governmental budgets stifle because of the economic downturn.As a result, the government needs funds to cover inadequate inputs and seeks innovation through private sector experts and management expertise aiming for better operational risks mitigation.In this paper, 18 risk factors in health sector of China were tracked through the literature research, and the research aims to identify the risk allocation by issuing the questionnaires and conducting interviews with experts from the academia, and public and private sectors.This paper finally provides the scheme about the appropriate risk allocation to focus on improving the mitigation of the existing risks in order to achieve successful PPP projects.

Recently, Public-private Partnerships (PPPs) are being increasingly used in the public facilities and services provision in China.The procurement system ranges from simple contracting of services to the involvement of the private sector in the infrastructure financing, design, construction, operation and maintenance.However, organizing a PPP is not an easy task due to its complexity and long term contractual obligations and this some projects to fail to attract the private sector in the partnership and in the services provision.18 critical success factors of PPP project in the Chinese health sector were undermined by the investigation of this research.The mostly identified CSFs are thorough and realistic benefit assessment, sound policies, appropriate risk allocation and risk mitigation, and the public/private sector responsibilities.This paper finally puts forward the recommendations based on the statistics that are published from the Integrated Information Platform of CPPPC in order to focus on validating them for successful PPP projects achievement.

In recent years,the role of phosphodiesterase 5(PDE5)has been highlighted in the development and progression of neurological disease.PDE5 inhibitors show significant effect of neruoprotection,which may be related with some effects such as resistance to stroke,anti-oxidation,inhibition of neuroinflammation and amelioration of cognitive deficits.Based on the domestic and overseas researches about PDE5,this review systematically summarized the neuroprotection of PDE5 and their related mechanisms.

Objective:To explore the mechanism of growth factor autocrine stimulation in human pituitary tumors. Method: Immunohistochemical analyses of EGF、TGF-αand EGFR were studied on paraffin-embeded sections of 30 pituitary tumors. Results: Expression of EGFR and its ligand EGF、TGF-αhas a variable stained cells intensity,density and type. EGFR and the ligands expressed in majority of pituitary tumors.Conclusion:The EGF autocrine stimulation exists in pituitary tumors,and tyrosine kinases inhibitors may be useful for pituitary tumors treatment.

Recombinant human epidermal growth factor (rhEGF, 20 ng/ml) and Genistein (740 μmol/ml) were added to the cells from 12 cases of human pituitary tumors and co-cultured in vitro. The 3H-thymidine uptake of tumor cells was measured by scintillation counter and tyrosine kinases activity was detected by using immunocytochemical method. The results showed that 3H-thymidine uptake and tyrosine kinases activity were increased in 10 out of 12 cases of human pituitary tumor by EGF and both declined by Genistein. It was suggested that EGF had a strong mitogenic effect on majority of pituitary tumors. Genistein could abolish the effects of EGF promoting the proliferation of the tumor cells, inhibit the growth of the tumor and might be useful in pituitary tumor treatment.

Objective To conform the risk factors of childhood asthma and to provide accordance for the healthy management of children with asthma.Methods A cross-section investigation was carried out by multi-stage random sampling in Wuhan city.The investigation included questionnaire and clinic examination.The study population was the infant and children whose age were 0 to 14 years old,and the sample size was 4 132.One hundren and seventyfour children were diagnosed as asthma,and 173 non-asthma children with similar age in the same region were selected as controls.Chi-square test and multiple Logistic regression analysis were used to screen the risk factors of childhood asthma in Wuhan city.Results Family allergy history,allergic rhinitis,eczema,food allergy and drug allergy were the risk factors of childhood asthma.Furthermore,dust mites,mould,anther dust,mugwort,cat/dog hair were main allergize source.In addition,premature delivery,abdominal delivery,mildew stain in ceiling or floor,raise pets especially cat,chemical fiber pillow and blanket bedclothes will increase the incidence,while spontaneous delivery and breast feeding were with protection effect.The results of multiple Logistic regression analysis showed that children who were with allergic rhinitis,familiar allergic history,dust mites positive test,drug allergy and blanker bedclothes were the high risk group of childhood asthma.Conclusions Childhood asthma is high relative with atopy,and these children who are with allergic rhinitis,familiar allergic history and dust mites positive test should be strictly health management.Chemical fiber pillow,blanket bedclothes,raising pet cats and mould in ceiling and floor in atopy children family should be avoided.

Objective To investigate the value of laparoscopy combined with esophagogastroscopy in the treatment of achalasia of the cardia. Methods Twenty-five patients with achalasia of the cardia between October 2003 and April 2006 in this department underwent the HellerDor operation under laparoscopy combined with esophagogastroscopy.Results A1l the operations were successfully accomplished.The operating time was 60~240 min(mean,107 min) and the intraoperative blood loss,5~60 ml(mean,22 ml).Intraoperative mucosal perforation was encountered in 4 patients.All the patients got out of bed for activities at 8 hours after operation,with first passage of flatus,removal of the gastric tube,and liquid diet intake at 1~3 days after operation(mean,1.5 days).The esophageal manometry showed the lower esophageal sphincter(LES) pressure had decreased to normal levels at 7 days after operation.The 24-hour ambulatory pH studies showed a high reflex index in 3 patients,but without symptoms.Upper gastrointestinal barium swallow showed the dilated esophagus had a 8~26 mm(mean,18 mm) decrease in diameter at 8 days after operation.The length of postoperative hospitalization was 8~11 days(mean,8.5 days).Follow-up for 1~30 months(mean,5.4 months) in all the patients showed 23 patients were asymptomatic and 2 had intermittent dysphagia.Conclusions Heller-Dor operation under laparoscopy combined with esophagogastroscopy has advantages of precise positioning,little invasion,less pain,and good effects,increasing the quality of operation as well as decreasing the incidence of complications.

Objective To explore the clinical value of domestic harmonic scalpel in laparoscopic cholecystectomy. Methods Modified laparoscopic cholecystectomy (LC) was performed in 36 cases under general anesthesia. The operation was completed by using domestic USI harmonic scalpel in 21 cases (USI Group) and by using imported harmonic scalpel in 15 cases (GEN Group). Results The operation was laparoscopically accomplished in both of the groups, without conversions to open surgery. Of the USI Group, the operating time was 42.6?7.5 min, the postoperative drainage was 34.3?14.0 ml, the length of postoperative hospitalization was 4.9?0.9 d, the speed for cutting cystic duct was 335.1?180.3 ?m/s, the speed for cutting cystic artery was 524.2?127.8 ?m/s, and the denaturalization width of cystic duct was 2 047.6?376.3 ?m. Of the GEN Group, the operating time was 47.0?9.0 min, the postoperative drainage was 38.0?3.9 ml, the length of postoperative hospitalization was 4.3?0.9 d, the speed for cutting cystic duct was 403.5?120.1 ?m/s, the speed for cutting cystic artery was 513.5?125.9 ?m/s, and the denaturalization width of cystic duct was 2 266.7?306.3 ?m. There was no differences in these parameters between the two groups ( P

Objective To identify clinical prognostic predicators and surgery indicator of stage IIIb-T_4 in patients with lung cancer patients whose tumor invaded heart, main vessel or carina. Methods From 1988 to 2000,151 patients with pathological stage IIIb-T_4 lung cancer who underwent resection by Shandong Provincial Hospital were analyzed as control samples, 112 patients with pathological stage IIIa-T_3N_1M_0 who underwent resection at the same time were also analyzed. Factors were estimated from the date of operation using the Kaplan-Meier and Log rank analysis. The Cox regression model evaluated the influence of factors on the survival. Results The median survival period were 26.1 months and the overall of 1-year, 3-year and 5-year survivals of the 151 patients were 73.5%, 33.1% and 16.6% respectively.The significant prognostic factors (P

Objective To discuss the effect of nicotine on the growth of rabbit tendon cells.Method 1% concetration Nicotine(0 5ml/kg) was injected into rabbit's auditive vein,then femoral vein blood was extracted at 3 minutes later. Separating blood serum and add it into F-12 medium and 10% fetal bull serum,penicillin,streptomycin,vitC which was then used to culture rabbit tendon cells, observating the time of cell number growth duplication of test group and drawn up its growth curve. The control group was treated as the test group except the rabbit was not injected by nicotine.Results The time of cell number growth duplication of test group was 9?2 1 days and the control group was 7?1 1 days,there was difference significatly between the two groups.Conclusion Nicotine can restrain the growth of rabbit tendon cells and enhance tendon's adhesiveness in post-operation.