Objective To sum up experience and lessons in the reform of the property rights of state-owned enterprises and explore policies and measures appropriate for reform in the property rights of the medical and health system. Methods Such methods as retrospective analysis, literature search and two-level data collection were used to gather relevant information and then comparisons were made of the major differences in the reform of the property rights of public hospitals and state-owned enterprises with regard to external environment, internal structure, reform progress, and changes in property rights. Results Due to the unique features of the medical and health industry, reform in the property rights of public hospitals proved to be different from that of state-owned enterprises, with the former displaying specific characteristics in the mainstay of competition, development of the elements market, and rules and manners of competition, all of which must be handled carefully. Conclusion Improvement of the external environment of competition ought to be the focus of reform in the property rights of public hospitals.

From the aspects of advantages, barriers, opportunities and challenges, this paper analyzed the environmental factors of Shanghai medical resources serving people in the Pan-Yangtze River Delta. As envisaged by the author, such services will provide medical resources information to patients from outside Shanghai, probe into feasible ways to medical insurance based on experiences drawn from serving such patients, help with the resources integration of medical systems in Shanghai, and probe into the potentials of telemedicine and distant medical e-learning, as well as improve hospital management levels and service functionality.

Objective To probe into the trust of residents on the health centers' service offered in their community in general for providing better family doctor services.Methods A custom-made trust scale for medical service (including 23 indicators) and random sampling were called into play.An imercept survey was made to 224 residents of different gender,age and education in a community in Beijing regarding their overall trust on medical service.Results The different satisfaction over their selection of the 23 indicators among residents of different gender is not significant statistically (P＞0.05); the seven differences of the residents of different ages regarding their trust of the general medical service are significant statistically; the 11 differences of the residents of different education regarding their trust on the community health centers in general are significant statistically.Conclusion The GP-based community health centers are expected to improve the trust of residents on them in general,by means of enhancing government responsibility,government investment and the improvement of services of general practitioners.

Liver ischemia reperfusion injury is a common pathophysiological process in hepatic surgery,which is the consequence of multiple mechanisms such as oxidative stress,inflammatory reaction,apoptosis,and autophagy and so on.However,the molecular mechanisms behind these processes have not been completely elucidated,the current treatment of liver I/R injury is merely supportive care,and thus new therapeutic strategies are needed.The recent studies indicate that the ischemic precondition and pharmacological precondition may protect the liver against hepatic ischemiareperfusion injury.It will be an important clinical significance of further studying its molecular mechanisms and protective strategies.

BACKGROUND: During conventional treatment for bone tuberculosis, there is a low effective concentration of anti-tuberculosis drugs, and the therapeutic effect is poor. OBJECTIVE:To develop a new biomaterial as a slow-release artificial carrier that can be directly implanted into the surrounding tissue of bone tuberculosis, maintain a certain anti-tuberculosis drug concentration for a long time, thereby playing an effective therapeutic action. METHODS:Rifampicin/polylactic acid/glycolic acid microspheres and isoniazid/polylactic acid/glycolic acid microspheres were prepared using the emulsion-solvent evaporation method. Usingα-cyanoacrylate, a biological adhesive, two kinds of microspheres were processed into a long-term slow-release bicomponent drug carrier. Then, in vitro release characteristics of the dual-drug sustained-release carrier were observed. After that, the dual-drug sustained-release carrier was implanted into rabbit intertrochanteric femur bone defects for observing drug release concentrations, histocompatibility and bone defect healing at different time points after drug delivery carrier implantation. RESULTS AND CONCLUSION:For rifampicin/polylactic acid/glycolic acid microspheres, the mean particle size was (240±13)μm, and the drug loading load rate was (26±1.5)%. For isoniazid/polylactic acid/glycolic acid microspheres, the mean particle size was (250±10)μm, and drug loading rate was (28±1.8)%. The in vitro cumulative release rate could reach 80%for rifampicin and 90%for isoniazid at day 90. The in vivo released concentration of rifampicin and isoniazid within 90 days was (0.5±0.4) and (0.6±0.3)μg/g, respectively. There were a smal amount of infiltrated neutrophils between the fascia and muscle fibers after the drug delivery carrier was implanted, and the amount of neutrophils in the muscle were reduced significantly at day 59. X-ray plain film showed that bone defects decreased obviously in size. These findings indicate that this dual-drug sustained-release carrier can maintain a certain anti-tuberculosis drug concentration in the surrounding tissues of bone tuberculosis, which is expected to provide a new type of dual-drug delivery carrier in the surgical treatment of bone tuberculosis.

Objective To explore the diagnosis of pediatric clinical hematuria disease. Methods The clinical data of one pediatric patient with IgA nephropathy combined with multiple bladder hemangioma were summarized and analyzed. Results For more than 6 years, 9-year-old female presented with repeated intermittent gross hematuria and persistent microscopic hematuria with the blood clot in urine after several respiratory tract infections. Routine urine test showed protein+++, RBC in full ifeld of vision/HP, and 0 . 54-1 . 02 g of 24 h urine protein quantitation. Early damage index of kidney is mainly based on microalbumin. The ultrasound showed no abnormal abdomen and urinary tract. Also there was no abnormality in enhanced urinary tract CT scan. Renal arteriography showed no ifstula or arteriovenous malformation. Pathological diagnosis of renal biopsy was focal proliferative IgA nephropathy. Cystoscopy examination suggested multiple hemangioma of bladder. Conclusion Bladder hemangioma is a rare condition in childhood. For children presented gross hematuria with blood clots, when the imaging ifnds no abnormalities or other diseases and the treatment of IgA nephropathy is unsatisfatry after diagnosis, the cystoscopy should be performed to exclude the possibility of bladder hemangioma.

Objective To investigate the influence of infasound therapy on Raji cells. Methods The Raji cell line was cultivated routinely and grouped as an infrasound and a control groups.Infrasound 8TM was used as a therapeutic infrasound generator which worked in 3 modes(frequency range 4～20 Hz,infrasound energy less than 90 dB).The applicator of the infasound generator was put on 1.5～2.0 cm fom the surface of liquid in the dish containing Raji ceil.Raji cells would be treated for 15,30,60,and 90 minutes,then tested with trypan blue assay,MTT assay,flow cytometry anatysis,and scanning electron microscope(SEM)after 0,24,and 48 h cultivations,respectively. Results Trypan blue assay showed that there were no significant differences between the 2 groups(P>0.05).MTT assay showed that although optical density value of the infrasound groups seemed to be lower than that of the control group.the differences were not significant(P>0.05).Flow cytometry analysis showed that the rate of necrotic cells and apoptosis cells in all groups was less than 10%;and that the differences between all groups were not significant(P>0.05).The scanning electron microscopy showed that the cells treated by infasound exposure for 120 minutes and then cuhivated for 24 h showed that the prominent or micro-floss of the membrane become shorten and decreased.The surface of the membrane became smooth. Conclusion Infrasound(less than 90 dB)treatment in the experiment had no obvious influence on multiplication and apoptosis of Raji cells.But the membrane of Raji cell Would be affected directly by the infrasound,and the penetration of the membrane could be changed.

Objective To investigate the correlation between the expression of the activating and inhibitory receptors on periph-eral natural killer (NK) cells with the liver injury in the patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) .Methods The peripheral blood samples were collected from 20 patients with HBV-ACLF and 20 patients with HBV-chro-nic hepatitis B(CHB) .The expressions of the activating receptors (NKP30 ,NKP46 ,NKG2D) and the inhibitory receptor (CD158a) on peripheral NK cells were detected by the multicolor flow cytometry .Results Compared with the HBV-CHB patients ,the ex-pression of the activating receptors NKP30 and NKP46 in the HBV-ACLF were remarkably unregulated(P<0 .05) ,but the expres-sion of the inhibitory receptor CD158a was markedly downregulated(P<0 .05) .Conclusion The enhanced expression of the activa-ting receptors NKP30 and NKP46 and the weakened expression of inhibitory receptor CD158a may be the important factor of the NK cells activation and the subsequent HBV-ACLF immune-mediated hepatocyte injury .

Objective To observe the effect of power-assisted functional electrical stimulation (PAFES)therapy on ankle joint function recovery in stroke patients.Methods Ninety hemiplegic stroke patients were randomly and evenly divided into a control group,a PAFES group,and a neuromuscular electrical stimulation (NMES)group.All groups received conventional rehabilitation training.PAFES group adopted PAFES treatment on affected lower extremities and NMES group was given the NMES therapy on the tibialis anterior of the affected lower limbs,in addition to conventional rehabilitation training.The active range of motion (AROM) of ankle dorsiflexion,FuglMeyer motor assessment (FMA),Barthel index (BI) and Ankle flexion and extension movement (AFEM) in 10 seconds were evaluated before the trial and after 4 weeks treatment.Results After treatment,there were significant differences in the AROM of ankle dorsiflexion,FMA,BI and AFEM (P ＜ 0.05) compared with before treatment within each group.The improvement of AROM of ankle dorsiflexion in PAFES group (8.19 ± 3.39) ° and the values in NMES group (8.96 ± 3.68) ° were to a significantly greater extend than control group (3.88 ± 4.10) ° (P ＜0.05) ; the improvement of FMA and BI in PAFES group was also superior to those in NMES group and control group (P ＜ 0.05).Conclusion The intelligent PAFES therapy could help improve AROM of ankle dorsiflexion,the motor function of the affected lower extremity and the ability of the activities of daily living in stroke patients.

Objective To compare effectiveness,performance,onset time and complications between ultrasound-guided cervical transverse process block and interscalene brachial plexus block in patients undergoing proximal humeral surgeries.Methods Sixty patients,27 males and 33 females, aged 18-70 years,scheduled for proximal humeral surgeries were randomly divided into two groups. They were given either cervical transverse process block (group T,n =30)or ultrasound-guided in-terscalene brachial plexus block (group I,n =30).All patients received a total of 8 ml of 0.5% ropiv-acaine.The performance, anesthetic onset time, the side effects and block success rate were evaluated.Results Block procedure was quicker in group T than in group I [(8.73 ±3.1 7)min vs. (14.40±8.21)min,P <0.01].The severity of diaphragmatic paralysis in group T was significantly lower than in group I (P <0.01).The ultrasound-guided cervical transverse process block was more effective than the interscalene brachial plexus block in patients undergoing proximal humeral surgeries (100% vs.80%,P <0.05).Conclusion The ultrasound-guided cervical transverse process block has a higher success rate and fewer incidence of diaphragmatic paralysis than the interscalene brachial plexus block in patients undergoing proximal humeral surgeries.