The compensation system of public hospitals in China failed to fully reflect the characteristics of the industry and the value orientation of knowledge.Based on the outside justice,inside justice and individual justice of the equity theory,from the perspective of the compensation system reform of public hospitals,it put forward specific policy recommendations,including rationally determine the salary level of public hospitals,optimize the salary structure of public hospitals,implement the autonomy of public hospitals and comprehensively promote the personnel system reform.

Stigma is demeaning,insulting social psychology mark.In A dream of red mansions,there are a lot of description about stigma and its psychological effects.Stigma effect not only influences many people's daily life,but also determines the fate of the key figures.The stigma effects also has obvious interference on the patients' psychology during the medical treatment.Moreover,stigma also influences the effects of clinical treatment.Therefore,hospitals should create an equal,united,tolerant medical environment and atmosphere of doctor-patient communication,and promote the government and the public health system to take corresponding policy measures to improve the living conditions of persons of stigma.

Objective To study the presentation,sensitivity of different diagnostic methods,snrgical modalities and pathological findings for patients of substemal goiter. Methods The clinical data of fifty nine cases of substernal goiter surgically treated were retrospectively analyzed. Results The main symptoms of substernal goiter patients were asymptomatic cervical mass(39/59),airway obstruction (13/59),hyperthyroidism(4/59),hoarseness(3/59)and choke(3/59).The sensitivity of chest X-ray,ultrasonography,CT and scintigraphy was 62.8%,15.8%,85.7%,and 50.0%respectively,and the specificity Was 99.4%,99.8%,99.5%and 99.0%,respectively.Standard cervical approach was successful for thyroidectomy operations in 57 cases.One patient underwent thyroidectomy by sternotomic approach,and another one by combined cervici-sternotomic approach.No major complications or perioperative deaths occurred.Pathology revealed nodular goiter in 48 cases.Grave's disease in one,thyroid adenoma in 2,and carcinoma in 8. Conclusions CT and chest X-ray are sensitive diagnostic techniques for substerual goiter.Cervical approach is appropriate for most substernal goiter.

Objective To invstigate the effect of high dose X-ray irradiation on the expression of multidrug resistance-1 (MDR1), Bcl-2, MMP7 genes. Methods A nasopharyngeal carcinoma cell line,CNE1, were irradiated with a total dose of 50 Gy. The resistance to the cisplatin of CNE1 cells and the irradiated CNE1 (CNE1 R) cells was detected by MTT. mRNAs expression of MDR1 , Bcl-2 and MMP7 was measured by quantitative RT-PCR. Results The expression of MDR1 increased in CNE1 R cells. The semiquantitative A value of MDR1 mRNA was 0.47 ±0.04, and the value of CNE1R cells (1st, 7th, 21st,28th, 35th, 42nd and 49th days after irradiation) were 0.67 ± 0. 06 (t = -5.44, P = 0. 003) ,0.70 ± 0. 01(t=-5.90,P=0. 002),0.73±0. 01(t= -6. 45,P=0. 001) ,0. 67 ± 0. 03 (t= -3.97,P=0.011),0.65 ±0.01(t = -4.43,P=0. 007),0. 62±0. 05(t= -2. 64,P=0.046) and 0.62 ±0.02(t = -3.34,P=0.021), respectively. Bcl-2 mRNA expression were 0.55 ±0.02 and 1.05 ±0.04(t = -9.93,P=0. 000) and MMP7 mRNA expression were 0.51 ±0.01 and 0.82 ±0.02(t = -8.51,P=0.000) in CNE1and CNE1 R cells. Conclusions The MDR1 expression was increased after a total dose of50 Gy irradiation,which may be related to the synchronous change of Bcl-2 and MMP7 genes.

Purpose To study NF-κB gene expression level in mouse hepatocellular carcinoma cell lines with differently lymphatic metastasis potentials and to discuss its roles in lymphatic metastasis.Methods Using real-time quantitative PCR, NF-κB gene expression level was detected in mouse hepatocellular carcinoma cell lines, including Hca-P with low lymphatic metastasis potential and Hca-F with high lymphatic metastasis potential.Results NF-κB mRNA expression in Hca-P and Hca-F cell lines were (1.41±0.48)×10~(-3),and (2.95±0.22)×10~(-3) (P<0.01),respectively.NF-κB mRNA expression levels were increased with metastasis potential.Conclusion NF-κB gene may play an important role in lymphatic metastasis of hepatocellular carcinoma.

Objective To develop a fluorescence signal activatable multifunctional molecular probe with theranostics function through combining ultrasmall gold nanorods(UGNRs) with fluorescein,and to evaluate its therapeutic effect on photothermal therapy (PTT) in breast cancer cells.Methods The UGNRs were synthesized by the one-pot seedless method,then the functionalized modification of UGNRs were conducted using cysteamine.Finally,the activatable ultrasmall gold nanorods (AUGNRs) were synthesized by amide condensation of —NH2 of cysteamine and —COOH of carboxylated fluorescein CyS.The cell uptake ability and GSH-mediated imaging ability of AUGNRs were studied using breast cancer 4T1 cells.4T1 cells co-cultured with AUGNRs were irradiated with 808 nm excitation light,and the PTT effects were assessed by MTT colorimetric staining and calcein-AM/PI staining.Results The AUGNRs were synthesized successfully,which could be uptaken by 4T1 cells quickly and efficiently,and could achieve intracellular glutathione (GSH) triggered fluorescence recovery.No obvious cytotoxicity of AUGNRs to 4T1 cells was observed in the co-cultivation.Moreover,obvious PTT effects could be induced by 808 nm laser,which could effectively kill 4T1 cancer cells.Conclusion The fluorescence signals of AUGNRs can be induced by intracellular GSH,and tumor cell destruction can be achieved by 808 laser-excitated PTT effects.

OBJECTIVE:To determinate the plasma concentration of ropivacaine in rabbits by HPLC,and study the secu?rity of ropivacaine in rabbits.METHODS:Nine rabbits were injected with ropivacaine drop by drop with a speed of1mg/(kg?min)until the rabbits died.RESULTS:The mean plasma concentration of ropivacaine in rabbits was224.54?107.45mg/L when the rabbits died.CONCLUSION:Ropivacaine has high security in rabbits.

BACKGROUND: Opiate drugs are widely used to control chronic cancer pain, which brings many adverse reactions. Transplantation of sodium alginate-polylysine-alginate microencapsulated bovine adrenal chromaffin cell (BCC) has reported to be used as chronic cancer pain controllers. However, the high price and poor strength of polylysine limited its clinical application. Chitosan is characterized by sufficient resource, low price and good biocompatibility, which is a substitute for polylysine.OBJECTIVE: To study the effect of xenotransplantation of sodium alginate-chitosan-alginate (ACA) microencapsulated BCC on patients with advanced cancer pain.DESIGN, TIME AND SETTING: A retrospective case analysis. All cases were obtained from Department of Oncology, Affiliated Zhongshan Hospital of Dalian University from January 2007 to December 2008.PARTICIPANTS: Totally 10 patients with advanced cancer, including 1 female and 9 males, aged 46-78 years. According to visual algetic mimic scale (VAS), 3 patients suffered moderate pain and 7 cases suffered severe pain.METHODS: Microencapsulation method was applied to encapsulate BCC with ACA membrane and transplant the microencapsulated BCC (5-7)×10~6 into the subarachnoids pace of 10 patients.MAIN OUTCOME MEASURES: The degree of pain release, duration of analgesic effect, as well as adverse reaction.RESULTS: All 10 patients had pain relief rapidly after transplantation in varying degrees. Complete pain relief was shown in 2 cases, medium relief in 1 case, slight relief in 4 cases. Slight irritation of cauda eguina was presented after transplantation, which could disappear within 3-5 days.CONCLUSION: Xenotransplantation of ACA microencapsulated BCC into the spinal subarachnoids pace of patients with cancer pain can produce analgesic effect promptly, significantly, and safely.

Objective To explore the clinical value of the thin-section CT scanning in all the steps of non-small cell lung cancer (NSCLC) therapy through 125I seed implantation. Methods In the 137 patients who were diagnosed with non-small cell cancer (NSCLC), the preoperative targets were delineated by CT scan, and the implantation plan was accom-plished according to treatment planning system (TPS); Intraoperative 125I seeds were implanted under the guidance of CT, then their positions were confirmed and corrected by CT scan layer-by-layer in real time;Post implantation dosimetry was validated also under the help of CT scan. If necessary, distribution and number of seeds should be adjusted to conform dose distribution under the principle of effectivity and micro-invasion;Follow-up and periodic evaluation should also be accom-plished by CT scan. Results Dose-volume histograms (DVHs) showed that the dose in line with the targets meet the re-quirement of prescription dose while the surrounding organs at risk were within the scope of their tolerance dose. Among 137 patients, implanted seeds number was the same with seeds number of TPS plan in 129 patients, and the coincidence rate was 94%. CT scan showed the local control efficient rate was 91.9%after 6 months. The 1-year and 2-year survival rates were 91.2%and 50.4%respectively. No serious operation-led complication was found during treatment. Conclusion The thin-section CT could be applied in all key steps of 125I seed implantation in NSCLC therapy, especially it is clinical significant and irreplaceable in quality assurance and control of seed implantation therapy.

Objective To evaluate the efficacy of lumbar discectomy,radiofrequency ablation and annuloplusty performed with Disc-FX system under the guidance of C-arm in treatment of discogenic low back pain.Methods Twenty-eight patients with discogenic low back pain,with VAS score greater than 7,aged 27-73 yr,underwent lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system under the guidance of C-arm.The patients were followed up for 2 months after surgery and pain was assessed using VAS score.VAS scores were recorded before surgery,and at 7 and 14 days and 1 and 2 months after surgery.The effective analgesia was recorded according to VAS scores.The therapeutic effect was evaluated according to Macnab standard 2 months after surgery.Results VAS scores were significantly lower at each time point after surgery than before surgery (P ＜ 0.05).The rate of effective analgesia was 93 % at 2 months after surgery.The excellent and good rate of the therapeutic effect evaluated was 93 %.One female patient developed injury to lumbar venous plexus,and no patients developed infection of intervertebral disk,nerve root injury or spinal cord injury.Conclusion The excellent and good rate is 93 % when lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system is used for treatment of discogenic low back pain under the guidance of C-arm,with fewer side effects.