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 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.

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 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.

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

China ; Environmental Monitoring ; legislation & jurisprudence ; Environmental Pollutants ; Organic Chemicals

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

Objective To investigate the effect of matrix metalloproteinase(MMP-2) in the attack of exprimental autoimmune myositis(EAM) rats, and the effects of methylprednisolone on expressions of gene mRNA and protein of MMP-2. Methods The expression levels of MMP-2 in the peripheral blood, spleen lymphocytes and muscles were detected by using RT-PCR and immunohistochemistry techniques and was compared among EAM group,EAM with methylprednisolone treatment group (EAMM) and control group. Results ⑴ The degree of episode in EAMM group was lower than that of EAM group , and the infiltration of the inflammatory cells and the necrosis of the muscles were also mild in EAMM group. ⑵There was significant upregulation of the expression of the MMP-2 gene mRNA in the lymphocytes of peripheral bood and spleen of EAM rats as compared with that of the control,Elevation of the expression of MMP-2 protein in rats muscles tissues of EAMM group was observed obviously. However, the expression of the mRNA and the protein of MMP-2 was suppressed significantly in EAM group compared with control group. Conclusions The upregulation of the expression of MMP-2 may be correlated with the onset of EAM. Methylprednisolone may relieve the degree of the pathology of EAM by the downregulation of MMP-2 .

Objective: To observe the clinical effects of tuina therapy for cervicogenic headache. Methods: Fifty-four cases were randomized allocated into tuina group and medicine group, 27 cases in each group. The patients in the tuina group treated with tuina therapy, and the patients in the medicine group take ibuprofen orally. The headache degree (Visual Analogue Scale, VAS), frequency of headache occurrence and the neck disability index (NDI) were compared 2 weeks pre-treatment and 2 weeks post-treatment. Results: Before treatment, there were no significant differences in the headache VAS, frequency and NDI between the two groups. After treatment, headache VAS, frequency and NDI were significantly decreased, and there were statistical differences between the tuina group and the medicine group (P<0.01). Conclusion: Tuina therapy is more effective for treating cervicogenic headache than routine dose of ibuprofen.