Public-private partnership(PPP)serves as a useful attempt for an adjustment of existing number of public hospitals and incremental development of private hospitals in an effort to implement policies of the health reform and optimize the allocation of medical resources.Investment-OperationTurnover(IOT) is a way to introduce the PPP practice,regarded as an institutional innovation in reforming public hospitals.This paper traced back the IOT model in its development and analyzed its connotation and form,as well as its strengths and weaknesses in a feasibility study,and presented the existing IOT projects in China for reference and open discussion.

Objective To analysis the relationship between blood homocysteine concentration in diabetic retinopathy patients with vascular endothelial cell damage and platelet activation.Methods 80 type 2 diabetes mellitus(T2DM)patients,including 50 no diabetic retinopathy(NDR group)and 30 diabetic retinopathy(DR group)and 30 normal controls were selected to measure the concentration of Hcy as well as circulating endothelial cells(CEC),Endothelin(ET),Yon Willebrand(vWF)and platelet activation markers CD62p and CD63.Results The level of CEC,ET,vWF,CD62p,CD63 and Hcy in T2DM group were,distinctly higher than those of control(P＜0.01),furthermore,the level of these markers in DR group were also higher than that in NDR group(P＜0.01).Blood CEC level Was positively related with ET(r=0.839,P＜0.05),and the same relationship was found in Hcy and CEC(r=0.615,P＜0.05),ET(r=0.642,P＜0.05),CD62p(r=0.623,P＜0.05)and CD63(r=0.542,P＜0.05).Conclusions High blood Hcy,CEC,ET,vWF,CD62p and CD63 level were tighdy related with DR.High level of Hcy,vascular endMermis cell damage and platelet activation maybe play an important role in the pathogenesis of DR.

Microcirculation is closely related to occurrence and development of disease, so it is of significance in noninvasive imaging of microcirculatory structure and function in vivo.Photoacoustic imaging is one of the main techniques in microcirculation imaging, which has the characteristics of high contrast, high detection depth and high sensitivity to tissue function.A review of the literature showed that photoacoustic technique can noninvasively image and quantitatively measure microcirculatory structure, vasoconstriction and vasodilation, concentration of hemoglobin, oxygen saturation, blood velocity and direction, oxygen metabolism level in a certain depth of living tissue in real time.Research progress in photoacoustic imaging of microcirculation in subcutis, cerebral cortex, tumor, eye and other tissues is reviewed in this paper.

Objective To analyze the value of the serum BHMT for diagnosis of hepatic injury in patients with acute poisoning.Methods ELISA method was used to detect BHMT in serum samples,and the samples were detected in the sera of normal persons and patients with acute poisoning.Results 300 samples were detected in the sera of normal persons by ELISA method.The average level of human serum B HMT content in 300 samples was 9.02 ng/mL(6.19-12.84 ng/mL),and the 95 ％ medical reference value of BHMT content in healthy people ranges from 0.00 to 28.01 ng/mL.BHMT and ALT were detected in 43 samples from acute liver injury,the Spearman analysis indicating a good positive correlation between BHMT and ALT(rs =0.757 62,P＜0.001).The comparison of the content of BHMT was made between the serum samples from 20 renal damage patient and 20 normal human serum,there was no significant difference in the BHMT content between the serum of patients with renal injury and the normal human serum(P＞0.05).Conclusion The medical reference value range for of serum BHMT content in healthy population ranges from 0.00 to 28.01 ng/mL.There was a good positive correlation between BHMT and ALT.BHMT might not be closely related to kidney injury,while be more specific to liver injure.BHMT could be a better marker of acute poisoning liver injury.

Osteoarthritis (OA) is a bone and joint disease caused by multiple factors, which seriously threatens human health. It is mainly manifested as joint pain and dysfunction. In severe cases, it can cause deformity. The mechanism of OA is not very clear, and there is a lack of effective therapeutic drugs; the exploration of etiology, pathogenesis and preventive measures of OA has always been an important research direction in this field. Studies have found that the transforming growth factor-β (TGF-β)/Smad signaling pathway plays a key role in the occurrence and development of OA. This article reviews the research progress of TGF-β/Smad signaling pathway in OA in recent years at home and abroad.

Objective To analyze the factors related to glare occurred after the phakic intraocular lens (P-IOL) implantation,and to raise the standard for the P-IOL selection.Design Retrospective case series.Participants 104 patients with high myopia underwent P-IOL implantation in Beijing Tongren Hospital.Methods In 104 cases,22 cases (22 eyes) were implanted angle supported Phakic6 designed accord with corneal symmetry,54 cases (54 eyes) were implanted iris fixed Verisyse,and 28 cases (28 eyes) were implanted posterior chamber PRL.Selection of the diameter of P-IOL optics depended on P-IOL diopters.The pupil diameter,the P-IOL optic center position,the pupil and corneal center position were measured with anterior segment optical coherence tomography (OCT).The contrast sensitivity (CS) under different condition (day,day and glare,night,night and glare) and in different space frequency (1.5,3,6, 12,18c/d)were examined with Optec6500 system.Main Outcome Measures Glare incidence,CS,and the influence of pupil diameter and P-IOL location to glare.Results None of the 104 P-IOL eyes occurred glare in day time.59 eyes (56.73%) complained of glare in dime condition.The glare incidence was 63.18% (14/22) in Phakic6 eyes,55.56% (30/54) in Verisyse eyes,and 53.27% (15/28) in PRL eyes (P=0.691).CS of all surgical eyes were improved in day time with or without glare luminous environment (P=0.000).And the CS of halo-complaining eyes was lower than of no halo eyes in night time with or without glare luminous environment (P=0.000).Glare oc- curred more frequently in eyes with the pupil diameter larger than P-IOL diameter in clime condition after surgery (10 in Phakic6 eyes, 20 in Verisyse eyes,12 in PRL eyes,all P

Carcinoma ; diagnosis ; Carcinoma, Papillary ; Diagnostic Errors ; Female ; Humans ; Thyroglossal Cyst ; diagnosis ; Thyroid Neoplasms ; diagnosis ; Young Adult

Objective:To investigate the effects of extracts of aqueous joint during CIA development on the HUVEC proliferation in vitro and expression of VEGF Methods: 3H TaR incorporation was used to estimate the HUVEC proliferation by extracts of aqueous joint and VEGF, and was used cultured in an absolutely serum free medium Results:Extracts of aqueqous joint during CIA development stimulated proliferation of HUVEC and this proliferation was inhibited by the anti VEGF neutralizing antibody Conclusion:The expression of VEGF in the extracts of the aqueous joint during an early stage of CIA development increased and expressed biologically active

Background There is no effective preventing way for the posterior capsular opacification(PCO) after cataract surgery.Objective The aim of this study was to investigate the preventing effect of adenovirus-mediated herpes simplex virus thymidine kinase/ganciclovir(HSV-tk/GCV) system on PCO.Methods Twelve New Zealand white rabbits were divided into BSS+BSS group,BSS+GCV group,HSV-tk+BSS group and HSV-tk+GCV group at random.Phacoemulsification was performed in bilateral eyes of rabbits,and 0.1ml of BSS or adenovirus vector with HSV-tk gene were injected into lens capsular bag during the operation based on the grouping.In 12 hours after operation,0.1ml BSS was injected into the anterior chamber daily for 3 times in BSS+BSS group and HSV-tk+BSS group,and 0.1ml GCV was used in the same way in BSS+GCV group and HSV-tk+GCV group.The situations of the anterior segment and the posterior capsule were examined under the slit lamp postoperatively.All the wet weight of capsular bags was assessed using electronic balance.The capsular membrane was histopathologically examined in the 4th week after injection.PCO was graded according to the method of Couderc.Results Mild corneal edema and aqueous humor opacity were observed in all the eyes within 3 days and returned to normal level gradually within 2 weeks postoperatively.PCO scores were higher in BSS+BSS group,BSS+GCV group,HSV-tk+BSS group than the HSV-tk+GCV group,showing the significant differences between them(H=2.647,P=0.008;H=2.939,P=0.003;H=2.884,P=0.004).No obvious difference was seen in PCO score among BSS+BSS group,BSS+GCV group,HSV-tk+BSS group(P＞0.05).The wet weight of the capsular bags in HSV-tk+GCV group was reduced in comparison with BSS+BSS group,BSS+GCV group,HSV-tk+BSS group with the statistically significant difference between them(q=9.93,q=10.15,q=10.07,P＜0.05).Histopathological examination revealed that mild proliferation of lens epithelial cells(LECs) at the capsular equator and migration toward the posterior capsule to form a thin soemmering ring in the periphery of the capsular bags and thin fibromembrane at the center of the capsular bags without cells or cortices in HSV-tk+GCV group.However,in BSS+BSS group,BSS+GCV group and HSV-tk+BSS group,the proliferation and migration of LECs were more obvious to form a dense soemmering ring in the periphery of the capsular bags and thick fibromembrane in the center of capsular bags.Conclusion Adenovirus-mediated HSV-tk/GCV system can effectively prevent PCO.

Background It is widely appreciated that many animal cells rely on the mechanism of regulatory volume decrease (RVD) after swell under the hypotonic environment,which involved in some processes of cellular physiology.But the RVD of lens epithelial cells(LECs) still is being further researched.Objective Present study was to clarify the possible mechanisms and influencing factors in the RVD of LECs.Methods Human LECs line (HLE B-3)were cultured and passaged in DMEM/F12 containing 10％ fetal bovine serum(FBS),and before volume measurement,cells were stuck to the base of a perfusion chamber,Ringer solution osmolality was decreased from 15％Hypo to 45％ Hypo,and the cells stimulated by 45％ Hypo Ringer solution were used as the control group.Some experiments were performed in the presence of high extracellular K+ concentration,chloride or potassium channel inhibitor,experiments were also carried out in the nominal absence of Ca2+,Cl-or HCO-3 to test the effect of a decrease in intracellular concentration of these ions on the cell volume response.The volume changes of living cells were measured by lag-time microphotograph acquisition and analysis system (IPP6.0).Results Time course of cell volume change after hypotonic shock in HLE B-3 cells was observed.The cell swelling was followed by a gradual volume recovery,indicating the presence of RVD was influenced by the hypotonic stress.Under the stimulation of 45 ％Hypo Ringer solution,the rates of RVD were (59.1 ±7.8)％.RVD was correlated positively to the maximum cell volume (r =0.99,P＜0.05)in S shape,and RVD changes were sensitive to alter maximum cell volume in the range of 115％-135％.RVD reduced to (16.5 ± 1.6) ％,(14.7 ± 2.3) ％,respectively after acted by potassium channel inhibitor,TEA(10 mmol/L)and BaCl2(5 mmol/L)as well as chloride channel inhibitor,NPPB(100 μmol/L)and DIDS(100 μmol/L),with significant differences in comparison with the control group(all P＜0.01).RVD decreased by(5.8±1.6)％ and(2.7±0.8)％ in high concentration of K+ in extracellular fluid and the absence of Cl-(P＜0.01).RVD was significantly inhibited under the absence of Ca2+.When the 45％ Ringer solution was pH6.8,the process of RVD delayed.The rate of RVD in the first ten minutes was (0.86±0.24)％/min,showing a significant decline in comparison with (3.24±0.84) ％ / min of pH 7.4 (P ＜0.05).Conclusions HLE B-3 have RVD ability under the hypotonic stress stimulation.A certain intracellular Ca2+ concentration is the premise of RVD activation,and Cl efflux and K+ efflux are the key mechanism of RVD of HLE B-3.Acidic environment of hypotonic solution delays the occurrence of RVD.