We reconstructed and compared 3D digital models of basal ganglia of human and rat. After selecing the sections con-taining basal ganglia from sterotoxic atlases of human and rat, 3D digital model of basal ganglia of human and rat was recon-structed by using general-purpose 3D modeling and animation software 3D Studio MAX and its 3D loft function. Several modifi-cation processes were done then to make the digital model more smooth. The 3D digital models of basal ganglia of human and ratwere successfully constructed and the comparative neuroanatomy study was conducted. The virtual reality technics was then in-troduced into this study, using internet browser, digitalized basal ganglia could be rotated, detached and resembled arbitrarily.Our study showed: (1) No matter on their morohology or their components, there were little differeces.(2) Due to ortho-statism, the rostro-caudal axis of human brain was rotated with certain angle, as the result, the relative positions among nucleiof human basal ganglia did differ from that of rat. (3) The projection fibers arrived the correspoding part of their target nucleiwith the shortest way, which might become the basis of the basal ganglia intrinsic topological projection.

Although the Shanghai's basic health insurance always takes the leading position nationwide in the aspects of coverage, funding level, security level, etc, it still cannot avoid the contradictory problems brought by the rapidly rising demand for health care, poor results of funds management, etc. Commercial health insurance has its u-nique advantages in terms of funds and personnel management. Therefore, they can play their complementary role to the basic medical insurance in order to improve the basic health insurance system. Based on the perspective of com-mercial health insurances, this paper explores the basic health insurance system in Shanghai from the aspects of man-agement patterns, governing body, insurance objects, funding modalities and insurance programs.

Objective To evaluate the hematological toxicity of craniospinal irradiation,and determine the short-term clinical efficacy and prognostic factors in medulloblastoma.Methods Eightseven patients who underwent craniospinal irradiation were retrospectively analyzed with respect to the changes in hematology during craniospinal irradiation.The effect of sex,age,tumor location,interval between surgery and radiation,interval time during radiation and radiation sequence on survival were also studied.Results The 1,2,3-year overall survival (OS) and progress-free survival (PFS) rate were 95.0％,92.4％,84.9％ and 93.7％,89.8％,80.8％,respectively.The incidence of 2-3 grade leucopenia was 90.8％,while the incidence of 1-2 grade thrombocytopenia was 70.1％,and the incidence of 3 grade thrombocytopenia was 1.1％.The incidence of 1-2 grade hemoglobin reduction was 16.1％.No patient had grade 3-4 hemoglobin reduction.Kaplan-Meier analysis shows that more favorable prognoses in terms of 3-year PFS were evident for 0-1 grade thrombocytopenia compared with 2-4 grade thrombocytopenia (x2 =3.936,P ＜ 0.05).And 3-year PFS and 3-year OS were evident for 0 grade hemoglobin reduction compared with 1-4 grade hemoglobin reduction (x2 =10.269,9.336,P ＜ 0.05).The 3-year PFS between interval time during radiation ＜ 3 days and ≥ 3 days was 84.6％ and 68.6％ (x2 =4.413,P ＜ 0.05).Conclusions Hematological toxicity during craniospinal irradiation and the interval time during radiation were prognostic factors.

Objective To evaluate the prognostic factors and treatment results of intracranial ependymomas (EPs).Methods Thirty-one intracranial EPs patients who received postoperative radiotherapy in Beijing Shijitan Hospital between January 2009 and June 2012 were analyzed retrospectively.Twenty-two males and 9 females had an average age of 18 years (range 3-60 years).Seventeen patients received gross total resection (GTR) while fourteen received subtotal resection (STR).Median total radiation dose was 53.9 Gy (48.6-60 Gy).The three-year and five-year progress-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method.Univariate analysis was performed using eight clinical and dosimetric factors by Log-Rank testing.Cox proportional hazards model was used to identify the independent prognostic factors correlated to EPs.Results The median time of follow-up was 51 months.At the endpoint of the follow-up period,7 patients experienced tumor recurrence:5 had a local recurrence (LR) and 2 had both LR and distant recurrence.Six patients died,4 of which had cases of pediatric infratentorial anaplastic EPs.The three and five-year progress-free survival (PFS) were 80.6％ and 75.9％.Overall survival (OS) at three-year and five-year were 83.9％ and 76.2％,respectively.Univariate analysis showed a more favorable prognoses in terms of three-year PFS,five-year PFS and OS for GTR compared to STR (x2 =4.685,6.311,4.238,P ＜ 0.05).Besides,a more favourable univariate outcome in terms of five-year PFS was evident in patients when the total radiotherapy dose was ＞ 55 Gy compared to ≤55 Gy (x2 =4.210,P ＜ 0.05),and no severe radiotherapy complications occurred.Conclusions Surgery is the major treatment method,while adjuvant radiotherapy is important for subtotal resection and anaplastic EPs patients.Surgical resection and radiotherapy dose were relevant to prognosis.

objective:To investigate the clinical features and prognosis of pinealoblastoma in children. Methods:The clinical data of 10 patients with pinealoblastoma were retrospectively analyzed. These patients were admitted to the Department of Radiation Oncology, Beijing Shijitan Hospital, Capital Medical University from December 2011 to December 2015. Results:This study included 10 patients, with 8 males and 2 females, with a median age of 7 years. Of the 10 patients, 5 underwent gross total resection and 5 underwent sub-total resection. The 10 patients were exposed to craniospinal irradiation after surgery. The median doses of craniospinal irradiation and tumor bed were 30.6 (25.5-36) Gy and 55.8 (50.4-60) Gy, respectively. Of the 10 patients, 4 underwent chemotherapy 1 month af-ter radiotherapy. The median follow-up period was 16.5 (1.5-49) months. The 10 patients survived. No local and distant recurrences were observed. Conclusion:Pinealoblastomas are rare, malignant, and pineal regional lesions that can metastasize along the neuroax-is. Surgery combined with adjuvant radiotherapy and chemotherapy should be applied to patients with pinealoblastoma. Prognosis is also favorable.

Objective To assess systematically the effect of problem-based learning (PBL) versus traditional methods in nursing students.Methods Relative literature was searched by computer at home and abroad.according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software,and literature selection and repetition were used according to the Note Express software.Results A total of 9 studies of randomized controlled or not randomized controlled trial were brought into the study by random effects model.A total of 1 187 were collected into the study,574 in the experimental group and 613 in the control group.According to subgroup analysis showed by measurement scale,problem-based learning (PBL) can significantly improve the critical thinking ability of nursing students.The results had high stability and reliability.Conclusions PBL teaching method can significantly improve the critical thinking ability of nursing students,and provide a better learning method for clinical teachers and students,which is worthy of further promotion.

OBJECTIVE:To evaluate evidence situation and implementation of global national drug policies on rational pediatric drug use,and to provide decision-making reference for setting up national drug policies for rational pediatric drug use which adapt to the situation of China.METHODS:By retrieving domestic and foreign related database,scanning drug management websites of WHO,the European Union as well as many countries and regions.A pre-designed data extraction form was used to collect information of the policies of rational pediatric drug use.The information was summarized and analyzed.RESULTS:A total of 45 literatures were included,involving WHO and the European Union,the United States,Canada,Britain,Ireland,Holland,Germany,Spain,France,Australia,New Zealand,China,India,Korea,Japan,South Africa and many other countries and regions.The main points of concern for the national policies of rational pediatric drug use in all countries included promoting the development of clinical trials of children's drugs,formulating and promoting essential medicine list for children,formulating and promoting standard treatment guideline of national pediatric formulary,etc.,and promoting pediatric drug monitoring after the listing.The United States,the European Union and Japan had enacted national laws and regulations on pediatric drug clinical trials;WHO,South Africa and India had developed pediatric essential medicine list;WHO,Britain and China had established pediatric formulary.CONCLUSIONS:It is suggested that the relevant departments should refer to the experiences of the United States and the European Union and other countries and regions to establish national drug policies which adapt to pediatric disease burden and drug use in China

Objective To investigate the possible role of nerve growth factors (NGF) and its receptors in ovarian follicle development,and detect the difference between polycystic ovarian symdrome (PCOS) and normal control.Methods Immunohistochemisty was applied to detect the expression of NGF,p75NTR,TrkA in ovarian follicle granulosa cells.Results In 54 cases (including 9 cases of IVM-PCOS,16 cases of IVF-PCOS and 29 cases of IVF-Normal),49 cases showed NGF protein positive in granulose cells with significance difference between groups (P＜0.05),and especially NGF was the strongest expressed factor in IVF-PCOS group but there was no remarkable difference between the other two groups in the expression of NGF.41 were TrkA protein positive,almost all IVF cases were TrkA protein positive while only 2 in IVM and there was no remarkable difference in expression of TrkA between IVF PCOS and IVF Normal(P＞0.05).The cases with stronger expression of NGF or TrkA had higher estradiol level than that of lower expression group (P＜0.05).51 cases had positive expression of p75 NTR protein but there was no significant difference between groups (P＞0.05).Conclusions TrkA is expressed in mature ovarian follicle,and the interaction of NGF-TrkA may be involved in ovarian follicle development,and overexpression of NGF may be associated with PCOS development.

Premium healthcare is the key area of healthcare industry and private medical institutions. Howev-er, with the expansion of VIP services in public hospitals and policy barriers to private medical institutions, the de-velopment of premium healthcare in China is still in its early stage. The premium healthcare industry has in fact be-gun to take shape in some developed countries, accumulating rich experience in the aspects of developing bases, op-erating modes and security systems. Therefore, this paper introduces the experiences of premium healthcare develop-ment in several countries:the United Kingdom, the United States, Germany, Singapore, Australia, and India: the building of safety net hospitals;the setting of hierarchical pricing and differential financial assistance;the use of pub-lic-private partnership based on commercial health insurance to determine prioritization. Based on the actual situation in China, this paper provides some implications to develop premium healthcare, including the implementation of dif-ferential payment policies built on the provision of basic healthcare services, the promotion of commercial health in-surance and public-private partnerships, and the determination of preferential areas.