By means of comparative analysis and literature review,the paper identified differences of private non-profit hospitals at home and abroad in terms of their historical background,fund-raising,tax-free qualification,and governance structure.On such basis,an analysis was made on the development paths of such hospitals in China,for theoretical references and decision support for their development.

OBJECTIVE To discuss the possibility of HBV contaminating environment and transmission through the polluted surroundings. METHODS On the basis of that ascertain the contaminated environment by HBV marker(HBVM) and the relationship between HBVM and HBV infectivity in the blood,to discuss the probability of HBV contaminating and be spreading through the circumstance. RESULTS The positive rate of HBsAg and HBeAg was 26.39% and 11.11%,respectively in these specimens.While all of samples in control group were negative.The HBV DNA positive rate was 73.72% and 100.00%,respectively in the positive blood specimens of HBsAg and HBeAg.The infectivity was 0-10~9 and 10~2-10~9 ID/ml,respectively. CONCLUSIONS The blood worktable surface is contaminated by HBVM.The pollution is from patients′ blood.So the probability exists that HBV is transmitted through environment pollution.

NMDA-induced excitotoxicity cause severe neuronal damage including apoptosis and necrosis. The present study was aimed to evaluate the proportion of NMDA-induced apoptosis of rat cortical neurons and discover signal transduction mechanism. Caspase inhibitor and lactate dehydrogenase (LDH) assay were used to study the NMDA-induced apoptosis. To explore the involved signal pathways, the primary culture of rat cortical neurons were pretreated by the inhibitors of three MAPK pathways, extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 MAPK. With 2 h of NMDA treatment, cellular apoptosis was measured by caspase-3 activity, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) and Annexin V staining. The results showed that: (1) Caspase-dependent apoptosis accounted for 22.49% in NMDA-induced neuronal death; (2) Pretreatment with p38 MAPK inhibitor SB203580 (10 μmol/L) significantly decreased NMDA-mediated caspase-3 activity by 30.43% (P < 0.05). However, ERK inhibitor PD98059 (20 μmol/L) or JNK inhibitor SP600125 (20 μmol/L) did not influence caspase-3 activity; (3) Pretreatment with SB203580 significantly reduced the number of NMDA-induced TUNEL-positive cells by 33.10% (P < 0.05). PD98059 (20 μmol/L) or SP600125 (20 μmol/L) did not show obvious effect; (4) Pretreatment with SB203580 (10 μmol/L) significantly reduced the number of NMDA-induced early apoptotic neurons by 55.56% (P < 0.05). Also, SP600125 (20 μmol/L) significantly decreased the amount of late apoptotic/dead cells by 67.59% (P < 0.05). There was no effect of PD98059 (20 μmol/L). These results indicate that: (1) NMDA induces neuronal apoptosis besides necrosis; (2) p38 MAPK, but not JNK and ERK, is involved in NMDA-induced neuronal apoptosis, and inhibition of the apoptotic signaling pathway contributes to neuroprotection; (3) JNK activation might contribute to NMDA-induced neuronal necrosis rather than apoptosis.
Animals ; Anthracenes ; pharmacology ; Apoptosis ; Caspase 3 ; metabolism ; Cells, Cultured ; Extracellular Signal-Regulated MAP Kinases ; antagonists & inhibitors ; Imidazoles ; pharmacology ; JNK Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; MAP Kinase Signaling System ; N-Methylaspartate ; pharmacology ; Neurons ; cytology ; Primary Cell Culture ; Pyridines ; pharmacology ; Rats ; p38 Mitogen-Activated Protein Kinases ; antagonists & inhibitors

Objective To discuss the worthiness of real-time three-dimensional echocardiography in researching normal fetal heart ventricle growth and systolic function. Methods End-systolic volume(EDV),end-diastolic volume(ESV), struggle volume(SV) and ejection fraction(EF) of 54 normal fetal were acquired from 3-D data by Qlab software. The relation between ventricular growth with pregnant week was analysed and the difference of the volume and systolic function between left ventricle with right ventricle were compared. Results Ventricular volume of normal fetal heart (EDV,ESV,SV) were all increased with the gestational ages,there was linear relativity between them,while EF was not increased with pregnant weeks,there was no linear relativity between them. There was no statistics difference on EDV and ESV between left ventricle and right ventricle, while there was statistics difference on SV, EF between them. Conclusions The image of fetal endocarium could be derived clearly by real-time three-dimensional echocardiography, which help to get fetal heart ventricular volume and to study fetal heart growth and function.

Objective To study the adsorption effect of activated charcoal suspension on paraquat (PQ) in gastrointestinal tract of beagles exposed to PQ.Methods Twenty healthy male beagles were randomly divided into experimental group and control group,with 6 beagles in each group.20％ PQ solution (a dose of 30 mg/kg) was prescribed through stomach for beagles in both groups.After exposure to PQ for 30 minutes,the beagles in experimental group were given activated charcoal suspension (1.0 g/kg of type Ⅰ activated charcoal powder mixed with 100 mL of normal saline) by gavage,while the control group was only given equal volume of normal saline.After exposure to PQ for 10 minutes,30 minutes,and 1,2,4,8,12,24,and 48 hours,blood was collected from hepatic portal veins and peripheral veins to detect the PQ concentration change in the plasma.The toxicokinetics software DAS 2.1.1 was applied to analyze PQ concentration and compare the change in toxicokinetics parameters between the both groups.The change in vital signs including heart rate (HR),respiratory rate (RR) and pulse oxygen saturation (SpO2) was dynamically monitored 10 minutes before exposure,4 hours and each day from the 1st to the 7th day after exposure.Results After exposure to PQ,the poison concentration in the plasma of hepatic portal veins and peripheral veins in the control group rose quickly and reached peak 4 hours later.It fell quickly at first,and fell slowly 8 hours later.But in the experimental group,the increase rate to the peak was significantly slow.Besides,PQ peak fell more obviously than that in the control group and it was about 50％ of the control group (μg/L:123.50 ± 11.67 vs.255.18 ± 12.29 in blood from hepatic portal veins,122.35± 11.72 vs.250.86± 11.15 in blood from peripheral veins).After 8 hours it fell much more quickly than that of the control group.After exposure to PQ for 48 hours,PQ concentration in the plasma was still lower than that of the control group (μg/L:0.53 ± 0.18 vs.15.98 ± 5.58 in blood from hepatic portal veins,0.31 ± 0.01 vs.15.03 ± 4.82 in blood from peripheral veins,both P ＜ 0.01).With the toxicokinetics analysis,compared with the control group,the maximum concentration (Cmax) and area under the curve (AUC) of PQ in the plasma of hepatic portal veins and peripheral veins in the experimental group were significantly decreased [Cmax (μg/L):125.07 ± 9.49 vs.255.18 ± 12.29 in blood from hepatic portal veins,123.38 ± 9.52 vs.250.86 ± 11.15 in blood from peripheral veins;AUC (mg· L-1· h-1):1.6±0.2vs.3.3 ± 0.4 in blood from hepatic portal veins,1.5 ± 0.2 vs.3.2 ± 0.3 in blood from peripheral veins],time to the peak (Tmax) of PQ was slowed (hours:5.3 ± 1.9 vs.4.0 ± 0.0 in blood from hepatic portal veins,4.7 ± 1.5 vs.4.0 ± 0.0 in blood from peripheral veins),and PQ plasma half-life (t1/2) and mean retention time (MRT) were significantly shortened [t1/2 (hours):3.8 ± 1.2 vs.15.4± 3.7 in blood from hepatic portal veins,3.5 ± 1.0 vs.15.5 ± 2.7 in blood from peripheral veins;MRT (hours):8.0± 1.5 vs.13.4± 1.2 in blood from hepatic portal veins,7.6± 1.3 vs.13.3± 1.2 in blood from peripheral veins;all P ＜ 0.01].After exposure to PQ,HR and RR in both the experimental group and the control group increased and reached to the peak about the 4th day and then the increase rate began to slow down gradually;SpO2slowed down gradually and reached to the valley about the 4th day and then it began to recover,but the change range of vital signs in the experimental group was smaller than that of the control group,and the parameters were significantly better than those of control group [4-day HR (bpm):134.50±3.00 vs.142.00±6.43,4-day RR (times/min):31.00±0.58 vs.34.33±0.94,4-day SpO2:0.900±0.006 vs.0.873±0.005,all P ＜ 0.05].Conclusion Activated charcoal administrated at 30 minutes after PQ poisoning can slow down the increase rate of PQ concentration in the plasma,decrease the peak concentration and has less influence on vital signs in beagles.

Objective To evaluate the application of M-mode echocardiography and Doppler echocardiography in diagnosing complete atrioventricular block (CAVB) in fetus. Methods M-mode and Doppler echocardiography were used to screen the fetuses and bradycadia was established as CAVB in 10 cases. Atrial and ventricular rhythm was measured by M-mode echocardiography. Flow of mitral valve, left ventricular in-flow and out-flow tract, venous duct was measured by Doppler echocardiography. The characteristics and prognoses of CAVB fetus were compared and analyzed. Results CAVB was established as independence in rhythm of atrium and ventricle. The rhythm of atrium could be in normal range, while the rhythm of ventricle should be slower than normal. Enlarged chambers were observed in 6 cases, cardiac dysfunction in 5 cases, and pericardial effusion in 7 cases. Tricuspid regurgitation and mitral regurgitation existed in 5 and 1 case, respectively. All of the CAVB fetus in this study underwent abortions. Conclusions Fetal echocardiography is proven to be a useful tool to diagnose CAVB, which greatly influenced the cardiac function in fetuses. Clear diagnosis as early as possible is crucial to the treatment of CAVB fetus.

Objective To approach a semi-quantitative diagnostic criteria of neonatal hypoxic-ischemic encephalopathy(HIE) by comprehensive scoring, including history, clinical manifestation and laboratory data,which can be used for early diagnosis,severity grading and the institution of therapy.Methods We analyzed history, clinical manifestation and some parameters of laboratory data,and established criteria for scoring and grading,and compared this grading with the grading determined by clinical data and follow-up,which brought forward a semi-quantitative diagnostic criteria, and applied this criteria to other 41 patients with HIE to test its reliability.Results The grading criteria were established as the following:if total score ≥20.0,the patient was graded as severe one;total score between 10.5-19.5, moderate one; between 5.5-10.0,mild one;≤5.0,non-HIE one. The scoring system was used in other 41 patients with HIE,the specificity and sensitivity were 100% and 96 .9%,97.2% and 100%,100% and 100%, respectively.Conclusions For severe HIE cases who are not permitted to receive compated tomography(CT) examination or no CT can be used, this scoring system can be used to diagnoze HIE and grade the severity. This method is simple and easy to perform.Both specificity and sensitivity are high for diagnosis and severity judgment of HIE.

Objective To describe the characteristics of the criss-cross heart with comprehensively segmental echocardiographic scanning in order to explore the diagnostic value of the echocardiography.Methods Ten cases of criss-cross heart were retrospectively reviewed with 2-dimensional,color Doppler echocardiography to summarize the main diagnostic methods.Results The right ventricle was located superiorly and the left ventricle inferiorly in 9 patients and paralleled alignment in 1.The solitus situs was observed in 9 patients and dextrocardia in 1;the atrioventricular connections were concordant in 8 patients and discordant in 2.Echocardiography revealed that 5 patients presented with transposition of great artery and 5 with double outlet of right ventricle as well as all with ventricular septum defect.Conclusions Clear visualization is available with echocardiography to show the crossing inflow streams at the level of atrial-ventricular valve,abnormal alignment of the ventricular septum as well as the associated abnormalities.

Objective To compare the efficacy of different analgesia regimens in elderly patients with femoral neck fracture undergoing posture changing during epidural anesthesia. Methods Ninety patients (35 males,55 females,aged 65-90 years,48-78 kg)with femoral neck fracture who would be treated with artificial femoral head replacement were randomly divided into 3 groups (n = 30 each):femoral nerve block group (group FNB),fascia iliaca compartment block group (group FIC)and intravenous group (group IV).Femoral nerve block or fascia iliaca compart-ment block was performed 30 min before epidural anesthesia (EA)in FNB group or FIC group re-spectively.Fentanyl 0.5 μg/kg was injected intravenously 3 min before EA.In the three groups,addi-tional 0.25 μg/kg fentanyl was administrated intravenously to keep the VAS scores <4 before posi-tioning.EA was performed between L1-2 in a position of troubled leg upper,and patients returned to supine position after epidural catheterization.The VAS scores at T0 (after entering the operation room),T1 (in supine posture before EA),T2 (before posture changing),T3 (while supine from lateral posture after EA),T4 (3 min after T3 ),the time for achieving EA,the fentanyl consumption, the cases of cardiovascular events and hypoxemia was recorded.Results Compared with group IV, VAS scores at T1 ,T2 ,the fentanyl consumption,time for achieving EA,and incidence of cardiovas-cular events and hypoxemia in group FNB and group FIC decreased significantly (P <0.05 or 0.01). There was no significant difference between group FNB and group FIC.Conclusion Preemptive anal-gesia regimens through both femoral nerve block and fascia iliaca compartment block during epidural anesthesia can reduce the fentanyl consumption,as well as decrease the incidence of cardiovascular e-vents and hypoxemia.

BACKGROUND:Fetal bovine serum as nutritional support is often used in the traditional cel culture. Consequently, a host of potential problems such as the spread of disease and immunological reactions exist. To find a suitable fetal bovine serum substitute and to establish a culture system of human bone marrow stromal stem cels in vitro which has been standardized, safe and efficient has just started. OBJECTIVE:To investigate the effects of different serums on proliferation of bone marrow stromal stem celsin vitro. METHODS:Bone marrow stromal stem cels were obtained from adult bone marrow, which were cultured in DMEM containing 10% AB serum, 10% autologous serum, or 10% fetal bovine serum. Cels at passage 3 were used in this study. RESULTS AND CONCLUSION:The cel confluence in the AB serum group was earlier than that in the fetal bovine serum group and autologous serum group. Human bone marrow stromal stem cels maintained the phenotypes of bone marrow stem cels in three serums detected by flow cytometry. AB serum group showed the highest fluorescence intensity and the most efficiency of cel proliferation which examined by the AlamarBlue assay. Apoptosis rate was < 5% in al the three groups, and cels grew wel in these serums. Alkaline phosphatase, calcium nodules and oil red O staining showed that the cels maintained the osteogenesis and adipogenesis capacity in the three groups. AB serum was found to have a better effect on proliferation capability of cels than fetal bovine serum and autologous serum. Taken together, AB serum is expected to be a substitute of fetal bovine serum to build anin vitro culture system of adult bone marrow stromal stem cels that accord with the clinical requirements of bone tissue engineering.