To analyze the relationship between hospital non-price competition behavior and market structure, analyze the relationship between hospital market construction and health care costs gtowth. Methods:Using cross-province data(SCP) theory to establish the regression function of health cost expenditure, hospital market concentration ratio and the occupancy of public hospital market, process the empirical analysis based on the two-factor effectiveness model of panel data. Results: There is no medical arms race in hospital business under the current market concentration. Conclusion: The reinforcement of market competition played a more important role in the improvement of operational efficiency rather than the differences in the nature of property rights and the profit of hospitals.

Objective To study the effects of whole-body irradiation(WBI)with different doses of X-rays on apoptosis in mouse splenocytes and peritoneal macrophages.Methods The apoptosis percentages of mouse splenocytes and peritoneal macrophages were detected with flow cytometry(FCM)at different time after the whole-body X-irradiation using the staining of Annexin-V and PI.Results As compared with the control,the percentage of apoptosis in mouse splenocytes began to increase gradually 24 h after WBI with 2 Gy X-rays(P

Objective To investigate the effect of C4d deposition in peritubular capillary (PTC)in chronic allograft nephropathy (CAN) on prognosis and intervention of renal transplantation recipients. Methods All the cases who received the renal graft biopsy due to diagnosis of CAN from January 2000 to August 2008, and had the 2-year follow-up data were included in the study. The clinical data were analyzed according to the C4d deposition in PTC. Results Among 86 cases 39 cases were C4d positive (C4d+ group) and the remaining 47 cases were negative (C4d group). There was no significant difference in sex, age, donor source, transplant times, time after biopsy, the panel reactive antibodies (PRA) level between two groups (P＞0. 05). Before intervention, there was no significant difference in serum creatinine (Scr) and 24 h urinary protein between two groups (P＞0. 05). At the end of 2-year followed-up period, graft loss rate and urinary protein levels in C4d+group were significantly higher than in C4d- group (P＜0. 05). Before intervention, the incidence of blood lipid disorder and hypertension was higher in C4d- group (P ＜ 0. 05 ), but no significant difference was found in uric acid and blood sugar levels (P＞0. 05). At the end of 2-year followed-up period, there was no significant difference in blood glucose, uric acid, blood pressure and lipid profile (eliminating renal lost cases) between two groups (P＞0. 05). Conclusion The patients with CAN and C4d+ means the involvement of chronic humoral rejection and have poor clinical results. Effective intervention against humoral immune response can improve renal allograft survival.

Objective To explore treatment of bile duct variation in Laparoscopic Cholecystectom.Methods The author retrospectively analyzed the clinical data of 7 cases with bile duct variation in 2 000 patients performing Laparoscopic Cholecystectomy.Among the 7 cases,2 cases had small hepatic duct openings in the gallbladder bed;2 cases had cystic duct openings in the right hepatic duct;2 cases had accessory right hepatic duct;and one case had rare variation whose right hepatic bile duct and the jejunum connect together.2 cases of the first variation had no bile leakage,adopting the suture method in LC.Among 2 cases of the second variation(all found in LC),one case had bile spillage in the junction of the cystic duct and the right hepatic duct,so the operator converses to laparotomy,cuts the gallbladder,sutures the break,and the patient had no bile leakage at last;The other one case was anatomized clearly under the cavity mirror.Among 2 cases of the third variation,one had no bile leakage,whose accessory hepatic duct was ligated in LC.The other one case had bile leakage after LC,so the operator converses to laparotomy,clips the accessory hepatic duct,and extract the drainage tube until there was no bile drainage.The last case was mistaken and cut it,the next day biliary peritonitis appeared,so the bile leakage was sewed up under the laparoscope.Results The seven cases were followed 1 ~3 years,they had no jaundice and their liver function was normal.Conclusion Careful-ly dissect Calot's triangle in LC,observe bile leakage after LC;improve the level of understanding and dealing bile duct variation in LC,don't cut the duct which is known to us.We should treat differently according to particular case.

AIM: To establish a determination for ephedrine hydrochloride and pseudoephedrine hydrochloride in Suxing Capsules(Herba Ephedrae, Semen Armeniacae Amarum, Fructus Perillal, etc.). METHODS:HPLC with Agilent ZORBAX Extend C_(18) (250 mm?4.6 mm, 5 ?m) column was used. Acetonitrile-0.2% H_3PO_4(5∶95) was used as a mobile phase. The flow rate was 1.0 mL?min~(-1). The detection wawelength was at 210 nm. RESULTS:The methodological evaluation showed that this method had a good repeatability and reproducibility; The average recovery of ephedrine hydrochloride was 99.65% and RSD was 1.6%. The average recovery of (pseudoephedr)ine hydrochloride was 98.90% and RSD was 2.3%. CONCLUSION: This method is simple, quick, accurate and with good reproducibility and can be used for the quality control of Suxing Capsules.

Objective To investigate the value of ultrasound in typing of epididymal tuberculosis on the clinical treatment . Methods The sonographic characteristics and treatment outcomes were analyzed in 125 patients with epididymal tuberculosis . Results In 125 patients with epididymal tuberculosis ,5 types were divided:( 1 ) Diffusive type ( 37 cases ) presented images of the epididymal diffuse enlargement , abnormal shape ,not smooth surface and inhomogeneous reduced in echogenicity ,13 cases were treated conservatively and 24 cases underwent surgical treatment after failure of conservative treatment . (2) Mass type (24 cases) showed images of hypoechoic mass lesion of caput epididymidis or cauda epididymidis ,4 cases were treated with surgical operation and 20 cases were treat with conservative therapy . (3) Abscess type ( 33 cases) manifested images of irregular liquid anechoic of caput epididymidis and cauda epididymidis , poor ultrasound penetration ,and unclear border . (4) Ulcer‐fistula type (9 cases) revealed images of liquid hypoechoic caput epididymidis or cauda epididymidis extend to the surface of the scrotum . ( 5) Testicular involvement type (22 cases) detected inhomogeneous hypoechoic mass lesion within the testicle and unclear border . The patients of abscess type ,ulcer‐fistula type and testicular involvement type were all treated surgically . Conclusions Ultrasonic diagnosis of epididymal tuberculosis provided a reliable basis for clinical treatment scheme and it was worth recommending .

Matrix metalloproteinases (MMPs) degrade extracellular matrix,participate in the atherosclerosis (As) formation and plaque rupture.They are associated with the stability of plaque.Tissue inhibitor of metalloproteinase (TIMP) is a specific natural MMP inhibitor.The disequilibrium between MMPs and TIMP is closely associated with the formation and development of AS.Therefore,it is a new approach for the prevention and treatment of cardiocerebrovascular diseases by regulating the equilibration between MMPs and TIMP, delaying the development of AS and preventing plaque rupture.

Objective To investigate the correlation between carotid intraplaque neovascularization and acute ischemic cerebrovascular disease. Methods The patients examined with contrast-enhanced ultrasound were enroled and divided into either a symptomatic group or an asymptomatic group according to their cerebral ischemic symptoms. The patients were also divided into a low-echo group, an equal-echo group, and an heterogeneous echo group according to the plaque echo characteristics on conventional ultrasound. The carotid intraplaque neovascularization was evaluated with contrast-enhanced ultrasound. Multivariate logistic regression analysis was used to identify the correlation between carotid intraplaque neovascularization and acute ischemic cerebrovascular disease. Results A total of 73 patients with acute ischemic cerebrovascular disease were enroled, 32 patients in the symptoms group (19 ischemic stroke, 13 transient ischemic attack), 41 patients in the asymptomatic group. Plaque echo characteristics: low-echo 15, equal-echo 41, and heterogeneous echo 17. The proportions of the patients with plaque enhancement (84. 4% vs. 61. 0% ; χ2 = 4. 802, P = 0. 028) and enhanced intensity (21. 78 ± 8. 50 dB vs. 15. 93 ± 8. 82 dB; t = 2. 440, P = 0. 018) in the symptomatic group were significantly higher than those in the asymptomatic group. The proportions of the patients with enhanced plaque in the low-echo, equal-echo and heterogeneous echo group were 93. 3% , 58. 5% , and 82. 4% , respectively (χ2 = 7. 826, P = 0. 020 ). The low-echo group and heterogeneous echo group were significantly higher than the equal-echo group (al P < 0. 05), but there was no significant difference between the low-echo group and the heterogeneous echo group (P > 0. 05). The intraplaque enhanced intensities in the low-echo group, equal-echo group, and heterogeneous echo group were 22. 62 ± 9. 33 dB, 14. 38 ± 8. 02 dB, and 18. 15 ± 9. 64 dB, respectively (F = 3. 877, P = 0. 027). The low-echo group was significantly higher than the equal-echo group (P = 0. 024 ). Multivariate logistic regression analysis showed that carotid intraplaque neovascularization (odds ratio 3. 456, 95% confidence interval 1. 103 - 10. 828; P = 0. 033) was independently associated with acute ischemic cerebrovascular disease. Conclusions Carotid intraplaque neovascularization is closely associated with acute ischemic cerebrovascular disease.

Background: Although there are some Chinese herbal medicines in treatment of constipation, but no multi-center randomized controlled trials have been carried out to prove their effectiveness. Objective: To evaluate the safety and efficacy of Yunchang Capsule in treatment of functional constipation with deficiency of both qi and yin and internal accumulation of poisonous pathogenic factors syndrome, and to explore the clinical dosage. Design, setting, participants and interventions: A randomized, double-blinded controlled, multicenter trial was conducted. A total of 240 patients with functional constipation from West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, the First Affiliated Hospital of Tianjing University of Traditional Chinese Medicine and Fujian Academy of Traditional Chinese Medicine were randomly divided into three groups: low dose group (80 cases), high dose group (80 cases) and control group (80 cases). Patients in the low dose group were treated with two pills (0.35 g/pill) of Yunchang Capsule and one pill of Yunchang Capsule simulant for three times daily; patients in the high dose group were treated with three pills (0.35 g/pill) of Yunchang Capsule for three times daily; and patients in the control group were treated with three pills (0.35 g/pill) of Biantong Capsule for three times daily. The therapeutic course was 14 days. Main outcome measures: Clinical symptoms, syndromes, and adverse effects were observed before and after the treatment, and blood, urine and stool tests, hepatorenal function and electrocardiogram were also examined. Results: Two cases were excluded, eleven cases were lost to follow-up, and there were 234 patients entered to intention-to-treat (ITT) analysis. After the treatment, the therapeutic effects were calculated by full analysis set (FAS) and per-protocol population set (PPS) analysis respectively. The effects on functional constipation in FAS showed the response rates in the low dose, high dose and control groups were 86.25% (69/80), 82.90% (63/76), and 70.52% (55/78) respectively, and PPS analysis showed the response rates were 85.71% (66/77), 83.56% (61/73), and 70.13% (54/77) respectively. There were no significant differences among the three groups (P>0.05). The effects on traditional Chinese medicine syndrome in FAS showed the response rates in the low dose, high dose and control groups were 78.75% (63/80), 69.74% (53/76), and 67.95% (53/78) respectively, and PPS analysis showed the response rates were 77.92% (60/77), 69.87%(51/73), and 67.53% (52/77) respectively. There were also no significant differences among the three groups (P>0.05). No severe adverse events were observed. Conclusion: Both low dose and high dose of Yunchang Capsule are effective and safe in treatment of functional constipation with deficiency of both qi and yin and internal accumulation of poisonous pathogenic factors syndrome.

Objective To study the clinical significance of diffusion weighted imaging (DWI) positive lesions in transient ischemic attacks (TIA) patients,TIA patients with fully reversible lesions were compared with the other patients for investigating the predictive value of apparent diffusion coefficient(ADC) for distinguishing between TIA and stroke.Methods Fifty-seven patients hospitalized with TIA at Department of Neurology,Central Hospital of Baotou August 2009 to June 2011 were identified.All patients had brain magnetic resonance imaging within 24 h after onset,then they were divided into DWI positive group and negative group.A follow-up MR imaging or CT was available in patients of DWI positive group.According to MRI or CT,patients were divided into TIA group and cerebral infarction (CI) group.Clinical features and DWI Imaging were compared between the two groups.For each lesion,the quantitative parameters on initial DWI (ADC) were recorded,and comparisons between reversible and irreversible lesions were performed.Results The ADC values were (630.4 ±25.9) × 10-3 mm2/s in lesions with TIA and (495.2 ±60.0) x 10-3 mm2/s with brain infaction (t =6.669,P =0.000).The relative ADC ratio values were lower (62.6％ ±7.4％ vs 82.1％ ±5.6％,t =7.013,P =0.000) in lesions with subsequent infarct than in those that were fully reversible.Conclusions ADC values are moderately decreased in DWI lesions from TIA patients,while ADC values are significantly decreased in CI group.It is useful to early distinguish TIA from CI by comparing ADC and rADC values.