This article respectively introduces famous doctor ZHANG Xi-chun’s original experience of using mineral drugs from four parts: taking suitable measures in accordance with the disease mechanism,syndrome,herbs,clinical experience,which hope to inspire and guide our clinical doctors.

BACKGROUND: Studies on substitute cells of bladder smooth muscle cells are in the early period at present. Mesenchymal stem cell transplantation is an ideal method. Human amniotic mesenchymal cells can differentiate into cardiomyocytes and nerve growth factor and promote local structure repair. OBJECTIVE: To investigate the differentiation of human amniotic mesenchymal cells into smooth muscle cells following transplantation, and the effects on bladder muscle layer. DESIGN, TIME AND SETTING: The cytology in vitro study was performed at the Japan Xinzhou University from October 2006 to April 2007. MATERIALS: Human amnion was obtained from healthy full-term puerperal. A total of 18 clean female Sprague Dawley rats were randomly and equally assigned into normal bladder cell transplantation group, frostbite bladder control group, and frostbite bladder cell transplantation group. METHODS: Amnion was cut and mixed in DMEM containing trypsin. Epithelial cells were removed prior to tissues were incubated in DMEM, supplemented with collagenase and DNA enzyme. Human amniotic mesenchymal cells were harvested for use. Posterior vertex of urinary bladder was frozen using a -70 ℃ iron rod in rats of the frostbite bladder control group and frostbite bladder cell transplantation group. Hematoma appeared at the frostbite region of the bladder three days later. 100 ?L DMEM was injected into the hematoma of the rats of the frostbite bladder control group, while an equal volume of human amniotic mesenchymal cell suspension (105 cells) was injected into the hematoma of the rats of the frostbite bladder cell transplantation group. Human amniotic mesenchymal cell suspension was implanted into the normal rat bladder in the normal bladder cell transplantation group. After three weeks, the bladder tissue including partial urethra was used for bladder sample preparation. MAIN OUTCOME MEASURES: Bladder smooth muscle repair was observed using hematoxylin-eosin staining. The differentiation of human amniotic mesenchymal cells in the wall of urinary bladder was detected using fluorescence immunohistochemistry. RESULTS: Compared with the normal bladder cell transplantation group, normal wall structure of urinary bladder, few fibrosis and good proliferation of smooth muscle cells were detected in the frostbite bladder cell transplantation group, while the wall of urinary bladder was slowly repaired, and disorder muscle structure, fibrosis, scar-like shape, and inflammatory cells were found in the frostbite bladder control group. Three weeks later, human amniotic mesenchymal cells were not seen in the normal bladder tissue. A large number of human amniotic mesenchymal cells was lived and some of them had differentiated into the smooth muscle cells in the frostbite bladder cell transplantation group. CONCLUSION: Human amniotic mesenchymal cells had the potential to differentiate into bladder smooth muscle cells and promoted self-repair of the wall of urinary bladder.

Based on a review of literature and the current reform of public hospital corporate governance,such corporate governance is divided intocombined regulation and operation,anddivided regulation and operationmodels.Then the principal-agent theory was called into play to analyze the main problems and causes of the existing models.From the perspectives of government supervision and assessment,professionalization of hospital directors,market competition mechanism,thoughts were made on how to improve such corporate governance.

OBJECTIVE:To investigate the incidence,clinical features and influential factor of adverse drug events appeared in Zhuhai area.METHODS:246 cases with adverse drug events reported in our hospital from Jan.to Sep.in 2007 were analyzed statistically.RESULTS:Of the total drugs inducing adverse drug events(246 cases),anti-infectives took the lead(43.24%),which was related to its great variety,high application frequency and application range;78.05% were induced by intravenous infusion;41.12% were manifested as lesion of skin and its appendants;119(48.37%)failed to follow the direction of package inserts,of which,113 cases involved the use of anti-infectives.CONCLUSION:Medical workers should attach great importance to the acquisition of medication knowledge as well as the medication safety at each steps.

OBJECTIVE: To explore the characteristics and general pattern of adverse drug events(ADE) in Zhuhai area.METHODS: 311 ADE cases collected from Aug.2005 to Dec.2006 by Zhuhai workstation of Guangdong ARD Monitoring Center were statistically analyzed in respect of patients' age and sex,route of administration,category of drugs involved,ADR-involving organs/systems and clinical manifestations etc.RESULTS: The antiinfective drugs showed highest incidence rate of ADE,which caused ADE in 213 cases(68.49%).The most common clinical manifestations of the ADE were the damage of skin and adnexa,accounting for 51.45%(160 cases),all recovered after receiving corrsponding treatment.CONCLUSION: Allergic history of patients and their family members should be inquired in detail before the use of drugs and high alert should be given to pharmaceutical incompatibility,and the patients should be given fully attention after medication to reduce the incidence of ADE.

Objective To summarize the diagnostic and therapeutic experiences of 18 patients with chronic expanding intracerebral hematoma.Methods Clinical data of 18 patients with chronic expanding intracerebral hematoma was analyzed retrospectively.Results Most of the lesions were misdiagnosed preoperatively as cerebral neoplasms.Among 18 cases, 15 cases were cured, 2 cases had severe disability, and one case died after operation.Conclusions Chronic expanding intracerebral hematoma must be considered when encapsulated mass lesion is present in the brain. The ultimate diagnosis is confirmed at surgery and by histological analysis.

Objective To investigate the heritability of Graves′ disease (GD) and to discuss its clinical significance. Methods The heritability of GD was calculated using Falconer′s formula and by investigating the GD numbers of 1968 first relatives of 526 established GD patients. Results The heritability of GD was 45%, appearantlymuchlowerthanthoseofprevious reports in China. Conclusion The onset of GD is affected by both inheritant and environmental factors, the latter seems to be predominant over the former.

Objective To investigate the new therapy for primary intraventricular hemorrhage (PIH).Methods 31 cases of PIH were treated by rigid neuroendoscopy.The cases were composed of 16 cases of single intraventricular hemorrhage,14 cases of double intraventricular hemorrhage and 1 case the third-fourth intraventricular hemorrhage.24 cases were accompanied with acute obstructive hydrocephalus.Results Duration of operation lasted from 30 minutes to 60 minutes, with an average time of 43.4 minutes.More than 90 percent of hemorrhage in 24 cases with single or double intraventricular hemorrhage were evacuated. 50 percent to 90 percent of hemorrhage were evacuated in other 7 cases. Neurological status was obviously improved and improved in 25 cases, no change in 4 cases and dead in 2 cases.Only one patient developed hydrocephalus.Conclusion Neuroendoscopic neurosurgy for PIH was characterized by visualized manipulation, shorten operative time,minimal invasion, effective hemorrhage evacuation and excellent post-operative outcomes.

Objective To discuss the surgical approaches t o treat the 3-and 4-part-fractures of the proximal humerus in young adults.Methods Open reduction,internal fixation with T-shaped steel plate or together with tension band wire,repair of rupture d rotator cuff and joint capsule were conducted.Early rehabilitation wa s performed after the operation.Results8cases were followed up for 1to 4years,with an average of 3years.The functional recovery of the injured shoulder joint had an excellent result of 87.5%.Conclusions Internal fixation with T-shaped steel plate or together with tension band wire to treat the 3-and4-part-fractures of the proximal hu merus in young adults can better the function al recovery of the shoulder joint,as long as used properly,because it is s table and eliminates the need of postoperativ e external fixation so that function al exercises can be done earlier.

AIM: To investigate the clinical efficacy of trimebutine maleate combined with Morita therapy in the treatment of patients with irritable bowel syndrome (IBS). METHODS: 108 patients were randomly assigned to two groups. Trimebutine maleate group (n=54) was given trimebutine maleate 200 mg, po, tid, combined with Mortia therapy. The patients were analyzed by self rating anxiety scale (SAS) and self rating depression scale (SDS) before and after the treatment. Control group (n=54) was only given trimebutine maleate 200 mg, po, tid. The course was 4 weeks. RESULTS: The total efficacy rates were 87.04 % and 72.22 % in trimebutine maleate group and in control group, respectively. The therapeutic effects in trimebutine maleate group were better than those in the control group (P