To address such challenges as the rapid rise in health care costs,insufficient constraints on supply-side behavior by medical insurance,and rising risk exposure of the insurance foundation,the Ministry of Human Resources and Social Security has proposed a payment mode reform featuring total reimbursement control.Such a total control policy will affect significantly the business operation of urban public hospitals.To adapt to the impacts so incurred,a three-level transformation strategy is recommended as follows.A development strategy calling for a new growth model,greater role of hospital-health alliances for greater service coverage; a business management strategy to ensure quality of care and safety,clinical pathways in place and optimize service processes; an administrative strategy to enhance cost control,strengthen information technology,and transform the management functions.

BACKGROUND: Nanohydroxyapatite reinforced polyamide 66 (n-HA/PA66) prepared using the novel process based on nanohydroxyapatite (n-HA) sol may promote the biocompatibility due to the well distribution of n-HA in the polyamide66 (PA66) matrix and chemical bond at organic-inorganic interface, n-HA/PA66 composite has been proposed as a premising bone repair biomaterial.OBJECTIVE: To investigate the biocompatibility of the novel material both in vitro and in vivo.METHODS: Primarily cultured osteoblasts were co-cultured with n-HA/PA66 and PA66. The cell attachment and morphology were studied using phase contrast light microscope (PCLM) and field-emission scanning electron microscope (FE-SEM).Moreover, n-HA/PA66 pins, with PA66 pins as control, were implanted into the right and left (control group) shinbone shafts of the rabbits, respectively. Materials were harvested at weeks 2, 8 and tissue sections were observed.RESULTS AND CONCLUSION- n-HA/PA66 and PA66 exhibited no cytotoxicity with osteoblasts, while the cellular morphology near the samples was better in the test group than in the control one. Moreover, the cell density attached on n-HA/PA66 was higher than that on PA66 and the cell number were especially different after co-culturing for 3 days (P < 0.01 ). The osteoblasts at the interface between the host bone and n-HA/PA66 also had a higher activity during the earlier period after implantation.Meanwhile the bone formation process was faster and effective in the experimental group. Results suggested that n-HA/PA66 prepared base on the n-HA sol has a better biocompatibility as compared with PA66.

Objective: To investigate the effects and mechanism of microscrew implant anchorage (MIA) in speeding up the closure of extraction space by one step and retraction of anterior teeth. Methods: Twenty-three patients with teeth extraction and required strong posterior anchorage were treated with MIA to close the extraction space. The extraction spaces were closed by two methods respectively. The extraction spaces were closed by the method of one step and retraction of anterior teeth(Ni-Ti spring from MIA to the hook on the wire combined with the elastic pull from MIA to cuspid) on the experiment sides and by the traditional one step method(Ni-Ti spring from MIA to the hook on the wire alone) on the control sides. Which side treated as trial side or control side was selected at random. The period of the space closing, the way and position of anterior teeth movement were observed on each side and the period of the space closing of two sides were tested by paired t test. Results: ①The average period of the spaces closing which was (6.69±1.07) months on the trial side and (9.56±1.19) months on the control side was significantly different (P<0.05).② After the closure of extraction spaces, the cuspid achived better position on the trial side than the contral side on which cuspid presented distal-lingual rotation. Conclusion: The extraction spaces can be closed in all cases by two methods respectively. Using MIA to close the extraction space by one step and retraction of anterior teeth can not only shorten the period of space closing but also achieve nice outcome by moving the cuspid in spongy bone.

Objective:To analyze the characteristics and differences of upper airway forms in the adults with class Ⅱ sagittal facial type of different vertical facial types and investigate the correlation between craniofacial structures and upper airway forms.Methods:Cephalograms of 135 adults with classⅡsagittal facial type of different vertical facial types were collected.60 cases were males and 75 cases were females.All the cephalograms were measured in sagittal upper airway depths.The differences were compared between genders,and also among different vertical facial type groups.Results:Among different vertical facial type groups,only the sagittal depths of nasopharynx(PNS-Ba、PNS-R)of the males and PNS-Ba of the females in high angle groups were smaller than that in average and low angle groups(P0.05),but the values of V-LPW of the males were larger than that of the famales in all vertical facial type groups(P

Objective To investigate the effect of treatment and restoration of residual dental root and crown in the elderly. Methods A total of 68 elderly patients with 202 residual roots and 47 residual crowns was treated.Radiography was taken to find out the length of residual roots and the status of treatment. A comprehensive treatment plan was made for each case, including restoration, extraction and endodontic treatment, etc. The restoration and the periodontal health of abutment teeth were followed up for 1 5 to 3 years consecutively. Results In endodontically treated teeth, the success rates of anterior 109, bicuspid 74, molar 26, were 92 3% 94 5%. In 87 post core crowns, 1 root cracked, 7 teeth mobility was 2 0 3 0 , all of which were the abutment teeth of removable dentures and single tooth. Maybe it was the impact of load heavy and occlusal trauma. In 64 post core fixed bridges, 6 ceramic broken was the impact of occlusal trauma. The function of restorations was good, with no root caries. Periodontitis was mainly in the abutment teeth and single tooth. Failure rate of restorative was 5 5% 7 7%. Conclusions Comprehensive treatments and restorations for residual root and crowns in the elderly would improve periodontal health and chewing function.

9 adults aged 23 to 43 years old were treated with bidimensional self-ligating lingual bracket technique for upper teeth and labial ceramic or aesthetic bracket for lower teeth.After treatment the labioclination of anterior teeth in Angle's II patients decreased from 28.12°± 10.05°to 19.25°±3.12°(P <0.05),in Angle's III patients from 32.14°±4.71°to 28.15°±3.26(P <0.05).

Objective To investigate the role of IL-28B gene on the antiviral curative effect in the patients with chronic hepatitis B.Methods 205 HBeAg-positive patients treated with the antiviral therapy of pegylation interferon(PEG-IFN)were detected the IL-28B rs12980275 and rs12979860 genotypes by TapManSNP genotyping assay and the relationship between the IL-28B genotypes and HbeAg seroconversion at end of treatment was analyzed.Results Among 205 cases,6 cases of genotype were uncertainty,the frequencies of IL-28B genotypes in other 199 cases were 77%,19%,5% for AA,AG,GG genotypes at rs12980275 and 76%,20%, 4%,for CC/CT/TT genotypes at rs12979860 respectively.The IL-28B polymorphisms were significantly correlated with the HbeAg seroconversion at the end of PEG-IFN treatment (P =0.001).In rs12979860 genotype,by the HBV genotyp,age,HBV lev-el,ALT and the combined therapy,the odds ratio (OR)of AA versus AG/GG was adjusted to 3.16 by HbeAg seroconversion.The similar result also obtained for the rs12980275 genotype.The IL-28B genotype was also associated with the HBsAg clearance.Con-clusion The IL-28B gene polymorphism is associated with the antiviral curative effect in the patients with HBeAg positive chronic hepatitis B.

Background:Resistance of Helicobacter pylori(Hp)to antibiotics is the primary reason for failure of Hp eradication therapies. It has been reported that there are regional differences in the resistance rate of Hp to commonly used antibiotics. Monitoring the regional Hp resistance status is helpful for improving the eradication rate in local area. Aims:To investigate the resistant spectrum of clinical Hp strains to commonly used antibiotics in Jiaxing Area,Zhejiang Province. Methods:A total of 17 402 patients who underwent gastroscopy from Jan. 2009 to Dec. 2013 at Jiaxing First Hospital were recruited for Hp culturing by using gastric antral biopsies. Then a drug sensitive test was performed for the Hp strains obtained from the culturing. Sensitivity of these Hp strains to metronidazole,amoxicillin,gentamicin,furazolidone,clarithromycin and levofloxacin was determined. Results:Among the 17 402 cases of gastric antral biopsies,5 898(33. 9% )were positive for Hp culturing. Drug sensitive test revealed that the resistance rate of metronidazole was extremely high in all year and age groups;the resistance rates of clarithromycin and levofloxacin were increasing by years;and the resistance rates of furazolidone,amoxicillin and gentamicin were considerably low in all year and age groups. When two antibiotics were combined,amoxicillin and gentamicin accounted for the lowest resistance rate,and the next were amoxicillin and furazolidone,and gentamicin and furazolidone,respectively. Conclusions:The clinical Hp strains isolated from all age groups in Jiaxing Area,Zhejiang Province are highly resistant to metronidazole,therefore it is not recommended to be used in first line eradication regimen. Amoxicillin combined with gentamicin/ furazolidone is an ideal antibiotic combination for patients with Hp infection in all age groups;and combination of gentamicin and furazolidone is recommended to patients who are allergic to penicillin.

Objective To investigate condition of single drug or multiple drug resistance and sensitivities of different combinations of antibiotics in Helicobacter pylori (H.pylori) infected patients of different ages in Jiaxing City,Zhejiang Province.Methods From January 2007 to December 2011,a total of 6280 patients underwent gastroendoscopy examination were enrolled,the average age of them was 50.8 years old.Among them,129 cases were less than 20 years old,1802 cases were between 20 and 40,3016 cases were between 40 and 60,and 1333 cases were over 60.The mucosa of gastric antrum was collected for H.pylori culture.Drug sensitivity of isolated H.pylori strains was tested with metronidazole,amoxicillin and gentamycin,furazolidone,clarithromycin and levofloxacin.x2 test was performed for the comparison of drug resistance among different age groups.Results Among 6280 specimens,H.pylori culture of 2311 cases was positive (positive rate 36.80％).The positive rate of patients aged between 40 and 60 was the highest (38.43％,1159/3016),and that of patients over 60 was the lowest (33.76％,450/1333).The drug resistance rate of metronidazole in patients between 20 and 40 years reached 98.02％ (644/657) and was the highest.The drug resistance rate of clarithromycin in patents over 60 years old was the highest,which was 22.67％(102/450).The drug resistance rates of the levofloxacin,furazolidone,amoxicillin and gentamicin were low of all ages.Mixed resistance of two antibiotic appeared in 586 strains,mixed resistance rate of metronidazole and clarithromycin was the highest (259 strains,15.23 ％).Mixed resistance of three drugs appeared in 49 strains,mixed resistance rate of metronidazole,clarithromycin and levofloxacin was the highest (32 strains,12.88％).A total of 1691 strains were sensitive to the combination of amoxicillin and gentamycin,the sensitive was rate 99.41％.The sensitive rate of the combination of amoxicillin and furazolidone,gentamycin and furazolidone was both 94.24％.Conclusions Metronidazole presented high drug resistance of all ages,and should not be chosen.The combination use of amoxicillin and gentamicin is the ideal antibiotic combination for different ages.The combination of gentamycin and furazolidone is recommended for patients who are allergic to penicillin.

OBJECTIVETo develop a hydroponic Nicotiana cultivation system for rapid and high-yield transient expression of recombinant proteins under laboratory conditions.

METHODSTo establish the hydroponic cultivation system, several parameters were examined to define the optimal conditions for the expression of recombinant proteins in plants. We used the green fluorescent protein (GFP) and the geminiviral plant transient expression vector as the model protein/expression vector. We examined the impact of Nicotiana species, the density and time of Agrobacterium infiltration, and the post-infiltration growth period on the accumulation of GFP. The expression levels of GFP in Nicotiana leaves were then examined by Western blotting and ELISA.

RESULTSOur data indicated that a hydroponic Nicotiana cultivation system with a light intensity of 9000 LX/layer, a light cycle of 16 h day/8 h night, a temperature regime of 28 degrees celsius; day/21 degrees celsius; night, and a relative humidity of 80% could support the optimal plant growth and protein expression. After agroinfiltration with pBYGFPDsRed.R/LBA4404, high levels of GFP expression were observed in both N. benthamiana and N. tobaccum (cv. Yuyan No.5) plants cultured with this hydroponic cultivation system. An optimal GFP expression was achieved in both Nicotiana species leaves 4 days after infiltration by Agrobacterium with an OD(600) of 0.8. At a given time point, the average biomass of N. tobaccum (cv. Yuyan No.5) was significantly higher than that of N. benthamiana. The leaves from 6-week-old N. benthamiana plants and 5-week-old N. tobaccum (cv. Yuyan No.5) plants could be the optimal material for agroinfiltration.

CONCLUSIONWe have established a hydroponic cultivation system that allows robust growth of N. benthamiana and N. tobaccum (cv. Yuyan No.5) plants and the optimal GFP expression in the artificial climate box.

Gene Expression Regulation, Plant ; Genetic Vectors ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Hydroponics ; methods ; Plants, Genetically Modified ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Tobacco ; genetics ; growth & development