The paper proposed a concept to build a management system for operating room hidden costs in an effort to better hospital management and alleviate patients' economic burden.The authors analyzed the root of such costs from the levels of operating room's design and construction,as well as management and operations,proposing a framework of such hidden costs.Based on diversified cost characteristics,they come up with a number of estimating methods,and control methods against different hidden costs by using management theories systematically.

BACKGROUND: An important initial step in developing a tissue engineering artificial salivary gland organoid is to find an ideal scaffold. To find other new biomaterials should to be further studied.OBJECTIVE: To obtain an acellular matrix from tracheae of rabbits and SD rats, and to investigate its biocompatibility as a primary step toward developing a tissue engineering artificial salivary gland organoid.DESIGN, TIME AND SETTING: A randomized controlled animal study, which was performed at the Key Laboratory of Transplantation Engineering and Immunology of Ministry of Health, West China Hospital of Sichuan University from February 2003 to May 2005.MATERIALS: A modified detergent and enzyme link extraction procedure was performed to remove cells from SD rats and rabbits tracheae. The histology, topography of inner-surface and biocompatibility were studied on both acellular tracheae.METHODS: Eighteen SD rats were randomly divided into 2 groups. One group was planted acellular trachea of SD rats. Other group consisted of acellular trachea of rabbits. On the third generations, submandibular gland cells were inoculated on two acellular tracheae and cultured on PGA membrane; while, cells in the control group were inoculated on 12-well culture plate, and cell/scaffold complex was cultured at the same time.MAIN OUTCOME MEASURES: The structure and topography of inner-surface of the acellular tracheae matrixes were observed both by light and scanning electron microscopy. The inflammatory response of the tissue around acellular tracheae implanted under the skin of cheek was evaluated at 1, 4, 12 weeks. The numbers of cells grown on the acellular tracheae and PGA film were counted at 1, 2, 3, 4, 5, 6, 7 days. At 1, 3, 5, 7 days, the mean values of metabolic activity test and the amylase activities of supernatants of the cells/scaffold complexes were examined.RESULTS: The cells were completely removed from both tracheae. No evident inflammatory response was found in tissues around two kinds of acellular tracheae implanted under the skin of cheek. The number of submandibular gland cells (SSG) grown on the two kinds of naturally derived biomaterials was much more than grown on PGA (P<0.05). The mean values of metabolic activity test and the amylase activities of supernatants containing cell/acellular matrixes were much higher than that of cell/PGA (P<0.05).CONCLUSION: The acelhilar tracheae matrixes made by our laboratory can be used as scaffold in the study of tissue engineering artificial salivary gland organoid.

BACKGROUND:Injection of isoproterenol is known to induce proliferation and hypertrophy of acinar cells in rodent salivary glands. However, the clonal proliferation ability of stem/progenitor cells of salivary glands by isoproterenol remains unclear.
OBJECTIVE:To study the proliferation and activation ability of stem/progenitor cells of submandibular gland with colony assay by intraperitoneal injection of isoproterenol.
METHODS:Sprague-Dawley rats were randomly divided into two groups, isoproterenol and control groups, respectively intraperitonal y injected with isoproterenol and normal saline for 5 consecutive days. The gland tissues were harvested, and the stem/progenitor cells of submandibular gland were obtained by enzyme digestion in vitro. The number of clonal colonies of each group was analyzed. The larger colony cells were col ected for immunohistochemistry staining with CD90.1, laminin andα6β1.
RESULTS AND CONCLUSION:The number of middle and low proliferative potential colony-forming cells was less but high proliferative potential colony forming cells were significantly more in isoproterenol group compared with control group (P<0.05). However, there was no significant difference in the total number of the colonies between two groups (P>0.05). The high proliferative potential colony forming cells were positive for CD90.1, laminin andα6β1. Results showed that isoproterenol treatment model cannot increase the cellnumber, but enhance the proliferation ability of stem/progenitor cells from the submandibular gland.

The aim of this research is to evaluate the effect of tetramethylpyrazine (TMP) and connective tissue growth factor (CTGF) miRNA plasmids on the expressive levels of CTGF, transforming growth factor-beta (TGFbeta) and type I collagen of rat hepatic stellate cells (HSC) which are stimulated by high glucose. The rat HSCs which were successfully transfected rat CTGF miRNA plasmids and the rat HSCs which were successfully transfected negative plasmids were cultured in vitro. After stimulus of the TMP and the high glucose, the protein levels and gene expressive levels of CTGF, TGF-beta and type I collagen were tested. The results indicated that high glucose increased the expression of CTGF mRNA, CTGF protein, TGF-beta mRNA,TGF-beta protein and type I collagen (P < 0.05). The expressive levels of CTGF mRNA, CTGF protein, TGF-beta mRNA, TGF-beta and type I collagen in TMP group were lower than those in high glucose group and showed statistically significant differences (P < 0.05). Compared with high glucose group, the expressive levels of CTGF mRNA, CTGF protein, TGF-beta mRNA, TGF-beta and type I collagen in rat CTGF miRNA plasmid interference group were significantly lower (P < 0.05). However, no statistically significant difference was found in CTGF mRNA and CTGF protein levels between TMP group and CTGF miRNA group (P > 0.05), while type I collagen levels showed statistically significant differences (P < 0.05). It is concluded that high glucose could promote the expressions of CTGF, TGF-beta and type I collagen, and TMP and rat CTGF miRNA plasmids could reduce the expressions of CTGF, TGF-beta, type I collagen.
Animals ; Cells, Cultured ; Collagen Type I ; metabolism ; Connective Tissue Growth Factor ; genetics ; Culture Media ; pharmacology ; Glucose ; pharmacology ; Hepatic Stellate Cells ; drug effects ; metabolism ; MicroRNAs ; genetics ; Plasmids ; Pyrazines ; pharmacology ; RNA, Messenger ; Rats ; Transfection ; Transforming Growth Factor beta ; metabolism

OBJECTIVE:To prepare Tacrolimus niosomes (Tac-NS) and evaluate their characteristics in vitro. METHODS:Tac-NS were prepared by a film hydration-ultrasonic method. Using the comprehensive score of encapsulation efficiency (EE%), drug-loading amount,mean particle size and PDI as the evaluation index,orthogonal design was used to optimize the concentration of sorbitan monostearate(Span-60),mole ratio of Span-60 to cholesterol,mole ratio of Span-60 to SDC. The morphology,mean particle size,PDI,Zeta-potential and EE%of Tac-NS were investigated. Accumulative percutaneous penetration(Q)and accumula-tive retention amount(Qs)of Tac-NS and physical mixture of Tac and NS were compared by percutaneous penetration test in vitro. RESULTS:The optimal formulation was as follows as Span-60 0.025 mol/L,mole ratio of Span-60 to cholesterol 10∶1,mole ratio of Span-60 to SDC 15∶1,drug-loading amount of 5%. Tac-NS was spherical and distributed evenly,but hardly congregated.The mean particle size,PDI,Zeta-potential and EE% were (233.0 ± 6.48) nm,0.266 ± 0.021,(-41.7 ± 0.32) mV and (76.83 ± 4.61)%,respectively. The results of in vitro permeability study showed that Qs of Tac-NS was 2.4 times of physical mixture;in ad-dition,Q of the two were similar. CONCLUSIONS:Tac-NS,owning high EE%,small particle size,uniform distribution and ide-al permeation effect,is prepared successfully.

OBJECTIVETo investigate the effects of anti-infection treatment on the expressions of antigen-presenting-related membrane-surface molecules HLA-DR and CD86 in dendritic cells (DCs) in rabbit buccal VX2 squamous cell carcinoma tissue complicated with local inflammation.

METHODSRabbit buccal VX2 squamous cell carcinoma with local inflammation models that were established by inflammation was induced by inoculation VX2 tumor, mechanical trauma, and drinking of milk with high sugar viscosity. The animals were divided into four groups. Group A (n=12): rabbit buccal VX2 squamous cell carcinoma with local inflammation, procaine penicillin was intramuscularly given, and tinidazole tablets were given by gavage for three consecutive days. Group B (n = 12): rabbit buccal VX2 squamous cell carcinoma with local inflammation, normal saline was intramuscularly given, and aspirin were given by gavage for three consecutive days. Group C (n = 12): rabbit buccal VX2 squamous cell carcinoma with local inflammation, normal saline was given intramuscularly and by gavage for three consecutive days. Group D (n = 10): rabbit buccal VX2 squamous cell carcinoma, normal saline was given intramuscularly and by gavage for three consecutive days. All the rabbits were sacrificed for collection of tumor specimens, and the expression levels of membrane-surface HLA-DR and CD86 in DCs of tumor specimens were detected viaflow cytometry.

RESULTSThe positive expression rate of HLA-DR and the double positive expression rate of HLA-DR and CD86 were group A > group D > group B > group C. The positive expression rate of CD86 were group A > group D > group B and group C (P < 0.05).

CONCLUSIONAnti-infection treatment significantly increased the expressions of HLA-DR and CD86 in DCs of rabbit buccal VX2 squamous cell carcinoma tissue complicated with local inflammation.

Objective:To evaluate the advantages of function-preserving parotidectomy for benign tumors involving deep parotid lobe. Methods:17 patients with benign tumor involving deep parotid lobe were treated by limited partial parotidectomy.All of the tumors were not more than 3 cm of diameter,12 of them were in the deep lobe and 5 involving both superficial and deep lobes.In the operation fascia glandular flap was made,the tumor with the surrounding gland tissue was thoroughly dissected and the glandular parenchyma was preserved.Results:All the operations were successful and the wounds healed well with symmetrical facial contours.No patient experi-enced salivary fistula.Temporary facial palsy was observed in 2 cases(11.76%).No tumor recurrence was observed.Facial nerve function of all patients completely recovered after a median follow-up of 11 months.Conclusion:Function-preserving parotidectomy for benign tumor involving the parotid deep lobe may improve functional outcomes without compromising local tumor control.

Objective:To study the effect of paclitaxel liposome on the apoptosis of cancer cells in neck metastatic lymph node of rabbit tongue cancer.Methods:24 New Zealand rabbits with VX-2 tumor at tongue edge were divided into 6 groups randomly after neck lymph node metastasis.Paclitaxel liposome,free paclitaxel and 5％ glucose were injected into the lingual arterial and ear marginal vein,respectively.A week after chemotherapy metastasis lymph nodes were collected.The apoptosis of the cancer cells in the lymph nodes was examined by transmission electron microscope,flow cytometry,and SP immunohistochemical method for P53 protein expression of the cancer tissue.Results:The apoptosis rate of cancer cells in the intra-arterial chemotherapy group was higher than that in the intra-venous chemotherapy group,in the paclitaxel liposome injection group was higher than that in the free paclitaxel injection group(P ＜ 0.05).The positive rates of P53 protein expression in paclitaxel liposome group by intra-arterial injection was the lowest (P ＜ 0.05).Conclusion:Paclitaxel liposome is more effective than free paclitaxel,regional arterial infusion is more effective than intra-venous infusion in the apoptosis induction of lymph node metastasis cancer cells.

Objective To observe the effects of deep electroacupuncture on carlilage tissue in knee osteoarthritis (KOA) rabbits. Meth-ods 40 New Zealand rabbits were randomly divided into normal group (A, n=10) and model group (n=30). The model group was modeled KOA with Hulth-Telhag way, and identified with X-ray. Then they were divided into no-treated group (B, n=10), deep electroacupuncture group (C, n=10) and routine electroacupuncture group (D, n=10) randomly. The groups C and D accepted electroacupuncture since 6 weeks after modeling, for 4 weeks. They were measured with pH of joint fluid, observed structure and pathology of cartilage under transmission electron microscope, detected apoptosis index, and determined the expression of acid-sensing ion channel 1 (ASIC1), p38 mitogen-activated protein kinases (p38MAPK) and p53 with Western blotting, and distribution of ASIC1 with immunohistochemistry in cartilage tissue. Re-sults The pHs of joint fluid from high to low were ranged as the groups A=C>D>B (P<0.01). The cartilage structure was more complete in the groups A, C and D than in the group B. The apoptosis rates from less to more were ranged as the groups A=C

Objective To analyze the prevalence and clinical features of cytomegalovirus (CMV)infection in patients with systemic lupus erythematosus (SLE).Methods Patients with SLE in Peking University Third Hospital from 2013 to 2015 and age and sex matched healthy controls were enrolled.All patients were detected for CMV antibody,CMV DNA and CMV PP65 in the blood.The prevalence of CMV infection and the clinical characteristics were analyzed using Chi-square test.Results Altogether 349 SLE patients and 209 healthy controls were enrolled.In SLE group,the positive rate of CMV IgG was 90.3％ (315/349),which was similar to that of the control group,while the positive rate of CMV IgM was 8.0％ (28/349),which wassignificantly higher than controls 1.4％(3/209) (x2=10.811,P=0.001),and the active CMV infection rate was 69.1％(241/349).Those in the active phase of SLE were more likely to have active CMV infection when compared with those in remission [75.4％(93/256) vs 51.6％(48/93),x2=18.049,P＜0.01].The percentage [43.2％(104/241)] of severe patients in those with active CMV infection was much higher than that in those without CMV infection 9.2％(10/108) (x2=38.953,P＜0.01).Those SLE patients had active CMV infection were clinically more severe and the most common clinical manifestation were proteinuria/hemoturia,cytopenia and fever.Conclusion In SLE patients,the positive rate of CMV IgM is significantly higher than healthy control and the prevalence of active CMV infection is high,especially in those at active disease.Those with active CMV infection are clinically more severe but have no features of active CMV infection,which indicates that the CMV infection might be a trigger of SLE activity.