Towards the problems after the medical reform of China,such as dramatic increase of healthcare expenditure and conflict between doctor and patient,this paper analyzes the tripartite relationships between hospital,insurance supplier and patient from the theoretical and practical aspects,concludes that the non-balanced development of the current relationships is an important reason of the problems,and gives the corresponding countermeasures for reference.

Objective To observe the effectiveness of botulinum toxin A (BTXA) in the treatment of small sample patients with acute acquired concomitant esotropia. Design Retrospective case series. Participants 6 patients (3 female and 3 male) with acute acquired concomitant esotropia aged 6 to 34 years. Methods All the patients were received 2.5 units of BTXA injected into the bilateral medial rectus muscles once under electromyographic control. They were performed alter prism-cover test,synoptophore and stereoscopic charts test. Main Outcome Measures The alignment of eyes and binocular vision. Results The follow-up of patients was 4 to 39 months. The pre-injection angle of deviation was 43.3?1.0△; the angle of deviation at the last follow-up was 3.3?8.2△,and 5 patients achieved alignment. In pre-injection,one patient had distance stereopsis,2 patients had near stereopsis with 600 seconds and 40 seconds; after injection,5 patients demonstrated distance and near stereeopsis (3 patients 40 seconds,1 patient 60 seconds,and 1 patient 200 seconds). Conclusion This small sample study shows that BTXA injection is effective alternative in treating acute acquired concomitant esotropia.

Objective To investigate the protective effects of recombinant human erythropoietin(rhEPO)treatment on histopathologic changes seen in hyperoxia induced lung injury.Methods Rat pups were randomly divided into four groups:Ⅰ:air-exposed control group,Ⅱ: air-exposed+rhEPO-treated group,Ⅲ:hyperoxia-exposed control group,Ⅳ:hyperoxia-exposed+rhEPO-treated group.GroupⅢ and Ⅳ rats were exposed to 85% oxygen.GroupⅡand Ⅳ rats were received rhEPO (1 200 U/kg) subcutaneously on postnatal 0 day and 2 day.On postnatal 14 day,survival curve,measurement of body weight and lung weight,radical alveolar counts(RAC),microvessel count were compared,CD_ 31 and vascular endothelial growth factor(VEGF) were performed by immunostaining to assess hyperoxia-induced changes in lung morphology.Results Treatment of hyperoxia-exposed rats with rhEPO prolonged the survival and resulted in a significant increase in the weight gain of body and lung[(25.88?2.59) vs(18.8?3.93) P

Composite Resins ; Dental Restoration, Permanent

Composite Resins ; Dental Cements ; Dental Restoration, Permanent ; Humans

According to the requirements of the ‘three guidance’ talent-cultivation model pro-posed by our university, humanistic spirit was permeated from multi angels during the process of phys-iology. Students'occupation quality was cultivated; physiology knowledge and clinical practice was combined for students; early contacting with clinical knowledge was conducted and teacher-student role reversal method was applied to train students' communication skills. Teaching practice showed that the reformed teaching model not only can ensure the quality of teaching but also can improve the comprehensive quality of students.

Objective To evaluate the value of 18F-FDG PET/CT in assessing radiosensitivity enhancement by irisquinone (IR) on rabbit xenografted VX2 lung tumor models.Methods Twenty-four tumor-beating rabbits were randomly divided into 3 groups (8 rabbits/group):group A with radiotherapy alone,group B with combined radiotherapy and IR,and group C without radiotherapy (the control group).18F-FDG PET/CT imaging was performed before radiotherapy and 24 h and one week after radiotherapy.The tumor SUVmax on delayed imaging was calculated in all rabbits.Two rabbits in each group were sacrificed after PET/CT imaging.HE staining was used to assess the differences in cancer cells among groups.Paired t test,one-way analysis of variance and Kaplan-Meier analysis were performed to analyze the data using SPSS 13.0.Results Before radiotherapy,the tumor SUVmax of all the 24 rabbits on standard and delayed imaging were 2.200 ± 0.761 and 3.162 ± 0.833 (t =-5.582,P ＜ 0.01).At 24 h post-radiotherapy,the delayed SUVmax of groups A,B and C were 2.614 ± 0.654,2.349 ± 0.869 and 5.663 ± 1.144,respectively.The differences between pre-radiotherapy and 24 h post-radiotherapy were statistically significant in all three groups (t =2.527,3.620,11.011,all P ＜0.05).One week after radiotherapy,the delayed SUVmax of groups A,B and C were 3.625 ± 1.064,3.058 ±0.850 and 7.424 ± 1.751,respectively.The differences among groups A,B and C were statistically significant (tA∶ B =2.652,tA∶C =3.799,tB∶C =4.366,all P ＜0.05).The cancer cells of group B were fewer than those of groups A and C by pathological findings,which was consistent with 18F-FDG PET/CT results.The survival times of groups A,B and C were (62.375 ±4.534),(69.000 ±4.660) and (54.125 ±5.276) d,respectively.Kaplan-Meier survival curves revealed better survival of group B as compared to groups A and C,respectively (Log-rank,x2 =7.355,16.943,both P ＜ 0.01).Conclusion 18 F-FDG PET/CT is able to evaluate the effect of irisquinone on tumor radiosensitivity enhancement.

Objective To evaluate the effect of training for therapists based on Kirkpatrick's Four-level Model. Methods Totally 39 ther-apists who completed 2014 Beijing Clinical Shortage of Manpower Training Programs (Therapist) were investigated with Kirkpatrick's Four-level Model, named reaction, learning, behavior and results. Results For reaction level, the total satisfaction was high, but different with the degree of education, especially in the items of Participate in Training, Type of Cases, Organizing on Practice Training, Organizing Case Discussions and Get A Lot of Benefits from the Training (F>4.59, P<0.05). For learning level, the test scores were significantly differ-ent before and after the training (t>9.53, P<0.001). For behavior level, the self-reports of the therapists, and the reports from their depart-ment directors and colleagues all agreed that their ability improved after training (t>4.44, P<0.001). For results level, eleven therapists passed the rehabilitation therapist test, two therapists participated in some researches, and one published an article. Conclusion The thera-pists satisfied in the training, that may improve the ability of therapists to contribute to their organization.

OBJECTIVE:To prepare Clopidogrel bisulfate tablets,and to optimize its formulation and technology. METHODS:The single factor test and compatibility test were used to optimize the fillers,disintegrating agents,adhesive,lubricants and prepa-ration technology;using sticking situation and disintegration time as indexes,the orthogonal test was used to optimize the amount of disintegrating agents [low substituted hydroxypropyl cellulose(L-HPC)],lubricants(hydrogenated vegetable oil and PEG6000), and the optimal technology was validated. The dissolution of prepared tablet and imported tablet(Plavix)in water,pH 2.0 hydro-chlorate buffer,pH 4.5 phosphate buffer(PBS)and pH 6.8 PBS were investigated,and influential factor test was conducted. RE-SULTS:Clopidogrel bisulfate tablets were prepared with dry granulating. The optimal formulation (1 000 tablets) was as follows as clopidogrel bisulfate 97.8 g,mannitol 84 g,amylum pregelatinisatum 36 g,L-HPC 8 g,hydrogenated vegetable oil 8 g, PEG6000 6 g;no tablet compressing sticking situation was found in prepared tablets and it owned medium disintegration time;ac-cumulative dissolution curves of prepared tablets in 4 kinds of medium were similar to those of Plavix;there were no significant dif-ference in results of influential factor test between prepared tablet and Plavix. CONCLUSIONS:Clopidogrel bisulfate tablets are prepared successfully,and the formulation is reasonable,practical,stable and controllable in quality.

Objective To compare the perioperative safety and curative effects oflaparoscopic adrenal sparing surgery (ASS) with laparoscopic total adrenalectomy (TA) for aldosterone producing adenoma (APA).Methods An online systematical retrieval was performed with Pubmed,ScienceDirect,Springerlink,the Cochrane library,CNKI and China Biology Medicine disc for clinical comparative studies published before May 2016,these studies reported the treatment of ASS/partial adrenalectomy (PA) versus TA for APA.The selected studies were applied to Revman 5.3 software for meta-analysis.The main contents were perioperative outcomes (operative time,intra-operative blood loss,and length of hospital stay) and postoperative efficacy (cure rate,partial response rate,inefficiency rate).Results A total of 9 clinical studies (3 English documents and 6 Chinese documents) with 1036 patients were included into the final analysis,among which 544 patients were assigned to ASS group and 492 in TA group.The analyzed results demonstrated no statistical significance between ASS group and TA group on operative time (WMD:-2.09min,95％CI:-9.86-5.67,P=0.60),length of hospital stay (WMD:-0.10d,95％CI:-0.32-0.12,P=0.36),intra-operative blood loss (WMD:1.13ml,95％CI:-8.86-11.12,P=0.82),cure rate (OR=l.07,95％CI:0.73-1.58,P=0.72),partial response rate (OR=0.85,95％CI:0.57-1.27,P=0.43) and inefficiency rate (OR=2.15,95％CI:0.32-14.34,P=0.43).Conclusion For surgical treatment of APA,ASS is technically safe,can achieve reliable postoperative efficacy and a similar therapeutic effect compared with TA,so deserves further application in clinical practice.