The effects of low-level radiation on cAMP in peasma, adrenal and testis and cGMP in adrenal of rats were studied. Adult male rats were given whole-body irradiation with x-rays at a dose rate of 15 mGy/min. They were irradiated with 50 and 100 mGy daffy for 30 days within 5 weeks with cumulative doses of 1.5 and 3.0 Gy respectively. One, two and four weeks after termination of irradiation, the levels of cAMP in plasma, the adrenal gland and testis, the level of cGMP in the adrenal gland and the weights of the body, testes and pitutary were examined. The weights of testes decreased within 4 weeks after irradiation as compared with the control and the level of cAMP in the testis was significantly increased at weeks 1 and 2 in the 3.0 Gy group. At week 4, it returned to near normal. In another experiment, animals were irradiated with ~(60)Co ?-ray at a dose rate of 45.3?Gy/min, 16.3 mGy/6h/day and 6 days per week. At 6, 10, 14, 18 and 22 weeks, with cumalative doses of 0.59, 0.98, 1.37, 1.76 and 2.15 Gy respectively, the levels of cAMP in the pitutary and testis and testicular weight were quantified. No significant changes were found. These results suggest that dose rate is an important factor In the determination of the degree of damage of the testis following low-level irradiation.

Objective To investigate the technique and feasibility of video-assisted thoracoscopic surgery (VATS) in the treatment of esophageal carcinoma. Methods Sixteen patients with esophageal carcinoma underwent esophagectomy by VATS between October 2002 and October 2003. The tumors were found in mid-segment in 13 patients and lower segment in 3 patients. Their TNM staging was: stage T 1 2 patients, stage T 2 5 patients and stage T 3 9 patients; stage Ⅰ 2 patients, stage Ⅱ 8 patients and stage Ⅲ 6 patients. Results No conversion to open surgery was required. The operation time of VATS was 90～150 min (mean, 110 min). The number of removed mediastinal lymph nodes was 6～14 (mean, 7.3). Drainage tube was taken out 2～3 days after operation and the drainage volume was 300～600 ml. No complications were seen. Conclusions VATS for esophageal carcinoma is feasible. Indications for VATS should be stage Ⅰ～Ⅱ and in addition no outward infiltration (≤stage T 3).

The paper discusses the basic contents, characteristics, and development trend of training programs abroad for high level hospital administrators as represented by MHA (Master of Hospital Administration) programs. Those programs establish curricula and training modes in light of the primary tasks and responsibilities of high level hospital administrators. They attach importance to the cultivation of concepts of macro health and ideas of modern management, provide training in methodologies of public health as represented by bio statistics and epidemiology, emphasize practical matters of operation and management such as hospital planning, quality control and financial accounting, and make wide use of case studies so as to enhance the abilities to solve practical problems. Hospital reform and development make it imperative to improve the training of high level hospital administrators, which must be properly oriented, and to develop domestic MHA programs with Chinese characteristics by utilizing existing resources of health administration education and integrate relevant courses.

Diabetic retinopathy (DR) is a common disease of ophthalmology,often causes irreversible decline of patients' vision,which has two features including macular oedema,diabetic retinal neovascularization.Diabetic retinal neovascularization is one of the most important reasons leading to blindness.Endostatin (ES) is one of the most effective agents inhibiting angiogenesis,whose biological function has a close relationship with its chemical construction.However,its mechanisms of treating diabetic retinal neovascularization are very complicated and remain unclear.Therefore,in this review we summarized several possible mechanisms,including regulating the expression of extracellular matrix,inhibiting the expression of pro-angiogenic factors,and regulating the signaling pathways,by which ES may inhibiting diabetic retinal neovascularization.

BACKGROUND: Transplantation of the human umbilical cord blood mononuclear cells (HUCBCs) have received increasing attention, as a promising candidate for the cellular transplantation, but the majority of the existing studies are basic research.OBJECTIVE: To report a patient of extensive anterior-wall acute myocardial infarction with cardiogenic shock and severe heart failure, after treatment of HUCBCs transplantation. METHODS: A 73-year-old female patient with cardiogenic shock and severe heart failure after extensive anterior-wall acute myocardial infarction was treated with percutaneous coronary intervention (three scaffolds implantation) and medications, and she still appeared the symptoms of congestive heart failure, such as severe recurrent dyspnea. 2.4 × 108 HUCBCs (50 mL cell suspension) was injected into the infarcted myocardium through the left anterior descending artery by using coronary micro-guide catheter.RESULTS AND CONCLUSION: The patient reported profound clinical benefit including improvement of heart-failure-associated symptoms after the transplantation. Notably the patient did not experience the cell transplant-related side effects during 4 months of follow-up. The ejection fraction increased from 22% before the transplantation to 53% at 21 days after the transplantation. The B-type natriuretic peptide decreased from 1 730 ng/L before the transplantation, 854 ng/L after the transplantation to 264 ng/L at 21 days after the transplantation. The patient did not appear the symptoms of congestive heart failure, including dyspnea, chest distress and hypodynamia, she returned to daily activity at 4 months of follow-ups. Experimental findings indicate that the HUCBCs transplantation is an effective and safe means for patients cardiogenic shock and severe heart failure after acute myocardial infarction.

Commercialization of the doctors sector and lawyers sector, and that of medical services, sharp rise of medical disputes and its impact on healthcare services have grown into major challenges for the healthcare system in the United States where litigation is the legal way out of medical disputes at large.Anglo-American law system depends heavily on precedence as the criteria and the majority of such disputes trials are held in state courts, there is also a complete system of laws and decrees on medical disputes on the federation level.In an effort to handle medical disputes that are rising sharply in a piling-up amount, American lawyers, social organizations of arbitration and medicine, and many state courts are seeking alternative dispute resolution as a better way out for medical dispute mediation and resolution.Given the gaps between China and USA in social systems, legal systems, ,economic development, cultural background, healthcare systems and heahhcare security systems, these experiences will prove their value of reference for medical disputes resolution in China.

Carotid Arteries ; diagnostic imaging ; surgery ; Feasibility Studies ; Head and Neck Neoplasms ; blood supply ; diagnostic imaging ; surgery ; Humans ; Radionuclide Imaging

Arteriovenous Shunt, Surgical ; Blood Vessel Prosthesis ; Blood Vessels ; pathology ; Humans ; Neoplasms ; blood supply ; pathology ; surgery ; Vascular Surgical Procedures ; instrumentation ; methods ; Vena Cava Filters

Objective To investigate theeffect of the one-lung ventilation (OLV) on open heart surgery with right subaxillary minimally invasive small incision in infants. Methods We conducted a retrospective analysis of 316 infants undergoing open heart surgery through right axillary straight mini-thoracotomy in ourhospital from Jan-uary 2014 to December 2014. Ordinary tracheal tube was inserted into left bronchus during OVL in all patients. OLV with pressure-control mode was performed with FiO2 100% and I:E 1:1 ~ 1.5 and their respiratory rate and the pressure ventilation were adjusted to maintain SpO2 and ETCO2 in the normal range. Conventional ultrafiltration was performed after CPB and fluid restrictions were intraoperatively maintained. Blood samples were obtained for deter-mination of PaO2 and PaCO2 after induction of anesthesia (T1), at the time points: OLV 10 min (T2), OLV 30 min (T3), OLV10 min after CPB (T4) and the recovery TVL (T5). The HR, MAP, incidence of pneumothorax and me-chanical ventilation time were recorded and monitored as well. Result All patients lived through perioperative pe-riod, without pneumothorax. There were no significant differences in PaCO2, HR and MAP between time points. But PaO2 at the time point of T1 significantly lowerthan those at other time points of T2, T3, T4 and T5, but its indexes at all time points were in normal range. Conclusion The appropriate skills ofintubation, rational strategy of ventila-tion and intensive prevention of the lung may be good for the safe application of OVL in open heart surgery through right subaxillary minimally invasive small incision in infants.