Better governance of private hospitals is key to deepening the health reform.In view of the present development of private hospitals in Hubei province,this paper expounded the characteristics development of private hospitals and the governance of specific measures in the province and analyzed the defects found in the legal system and mechanism.The authors also raised such recommendations as perfecting the legal system and improving the mechanism of information disclosure and evaluation.

Objective To assess the effect of a noninvasive equipment (the human biological stimulation feedback instrument) for the screening of metabolic syndrome (MS). Methods The samples were selected from the International Health Care Center of the Second Affiliated Hospital of Zhejiang University College of Medicine. From January to December 2012, according to the inclusion criteria, a total of 5674 consecutive participants (3 437 men, 2 237 women) without medical history of diabetes mellitus underwent general health screening in this hospital, which included questionnaire investigation, all MS components and the risk assessment of the human biological stimulation feedback instrument. MS was defined according to 2004 the Chinese Diabetes Society (CDS) criteria. Results The 5 674 subjects were divided into three groups in accordance with the human biological stimulation feedback instrument risk score: the normal group, metabolic abnormalities low risk group, metabolic abnormalities high risk group. The detection rate of MS corresponding to the three groups was 8.73% (251/2 876), 29.32% (612/2 087), 32.77% (233/711), respectively (trend χ2=372.14,P<0.001). With the increase of risk score, the detection rate of MS increased. A total of 1 096 (male 879, female 217) were diagnosed MS by CDS criteria. The area under the curve (AUC) of the test was 0.674 (95%CI 0.658-0.691, P<0.000 1)for predicting MS. The corresponding cutoff value was 25.00%, the sensitivity, specificity, positive predictive value and negative predictive value of diagnosis of MS was 77.80%, 56.00%, 30.20%and 91.30%, respectively;409 subjects who had no history of MS and diabetes mellitus follow up for two years, the AUC of the test was 0.719 (95%CI 0.644-0.794)for predicting MS. The corresponding cutoff value was 25.00%, too. And the sensitivity and specificity of diagnosis of MS was 78.00%and 59.80%, respectively. The detection rate of MS was positively correlated with the risk score. Conclusion We found that the human biological stimulation feedback instrument is a potential screening approach for early predicting MS in health checkup with simple and noninvasive procedure and high negative predictive value, although its diagnostic efficiency is not so good. And it might have a warning effect on the progress of MS.

Objective:To investigate the use of proton pump inhibitors ( PPIs) in the patients with cirrhosis or hepatitis in one hospital and evaluate the use rationality .Methods:A retrospective study was carried out on 211 patients with the diagnosis of hepatitis or cirrhosis in the infectious disease ward between 2013 and 2014 , and the use rationality of PPIs was evaluated .Results: A total of 211 cases were inspected, and among them, 192 ones were treated with PPIs (91%) with 62 ones treated with PPIs irrationally, which accounted for 29.3%of the total cases.The main irrational use of PPIs was long treatment course (24.5%), inadequate prophylaxis indications (5.7%) and purposeless use (2.6%).Conclusion: Irrational use of PPI is common in hepatitis or cirrhosis patients . Clinical pharmacists should strengthen pharmaceutical care to improve the rational drug use .

Objective To evaluate the efficacy of interventional therapy for advanced pancreatic carcinoma. Methods 33 cases of advanced pancreatic carcinoma accepted interventional therapy from April 2005 were retrospectively analyzed. All patients were unoperable and accepted one or more times of celiac and superior mesenteric arterial chemotheraputics perfusion with dosage of 2:1. The embolization was further introduced with the addition of liver invasion. The repetition interval was kept at 6 weeks with no severe complications. Results The one with follow-up CT imagings showed obvious decrease of the lesion size, together with release or disappearance of the sensation of abdominal pain and abdominal distention. The life span prolonged with average survival of 13 months, including the longest of 22 months and the life quality improved. Conclusions The interventional therapy could be the first method of choice in the management of advanced pancreatic carcinoma.

OBJECTIVE: To explore the neuroprotective effect of electroacupuncture therapy on damaged cholinergic neurons in hippocampus in aged rats with Alzheimer's disease (AD). METHODS: Thirty six aged male rats were randomly divided into normal control group, sham-operated group, untreated group and electroacupuncture group. Animal model of AD was established with fimbria-fornix transection. The rats in the electroacupuncture group received electroacupuncture on Baihui (DU 20), Yongquan (KI 1), Taixi (KI 3) and Xuehai (SP10). The activity of choline acetyltransferase (ChAT) in septal area of brain was detected by radioimmunoassay, and the protein expressions of nerve growth factor (NGF) and c-fos in CA3 region of hippocampus were detected by immunohistochemical assay. RESULTS: The ChAT activity and the expression levels of NGF and c-fos proteins in the electroacupuncture group were significantly higher than those in the untreated group. CONCLUSION: Electroacupuncture therapy can protect cholinergic neurons in hippocampus in aged rats with AD by means of promoting synthesis of c-fos protein and increasing the expression level of NGF.

·AIM: To evaluate the recurrence rate and safety of amniotic membrane transplantation (AMT) augmented with mitomycin C (MMC) compared with amniotic membrane transplantation alone during the pterygium excision.·METHODS: We took a meta-analysis on this program.Pertinentstudieswereselectedthroughextensive searches of the Cochrane Library, MEDLINE, EMBASE,CBMdisc, CNKI. Pooled estimates were carried out in RevMan software V4.2.·RESULTS: Six trials reported postoperative recurrence rate of pterygium, included 882 eyes, three trials reported the complications. The results of meta-analysis showed that recurrence rate of AMT plus MMC group was 5.41％,AMT alone group was 16.89％, relative risk (RR) was 0.32, 95％CI ranged from 0.19 to 0.56, Zwas 4.06, P< 0.001. Two trials reported early complication as punctata keratitis, the incidence rate of AMT plus MMC group and AMT alone group were 17.14％ and 0.00％, RR was 12.11,95％CI ranged from 1.62 to 90.76.·CONCLUSION: Amniotic membrane transplantation with MMC is associated with lower recurrence rate compared with amniotic membrane transplantation alone in pterygium excision,whether accompanied a higher risk with adverse events need more investigation.

Objective: The inhibition on the proliferation of colorectal carcinoma cell strain with different proliferative potential by ATRA was investigated in present study, which would benefit for the therapy of ATRA on colorectal carcinoma. Methods: The proliferation of LS174T and CW-2 colorectal carcinoma cell strain inhibited by ATRA was determined using cell observation, FACS and MTT methods. Results: The growth speed of LS174T cell strain was faster than that of CW-2. ATRA played a significant role on inhibiting the proliferation of LS174T and CW-2 cell strain and inducting the cell differetiation in vitro. Conclusions: ATRA could inhibit the growth of LS174T and CW-2 cell strain. ATRA could inhibit the proliferation of colorectal carcinoma cell and induce cell differentiation to some extent, which was correlated with the concentration of ATRA.

· Application of capsular tension ring ( CTR ) in phacoemulsification has become a common method to increase the stability of the capsular bag. CTR can effectively reduce the posterior capsular opacification ( PCO) , prevent intraocular lens ( lOL ) decentration and tilt, not cause lOL degree deviation and aberration increase.ln this review, we summarized the development overview of CTR in phacoemulsification.

Objective To analyze serum levels of C1q in children with nephrotic syndrome (NS),and investigate the clinical significance and the relationship among the altered serum C1q levels and other lipid/lipoprotein and renal function parametersin children with NS inacute and remission phases.Methods Serum levels of C1q were measured in 78 NS children with acute phase,in 64NS children with remission and in 77 healthy control children.The other lipid/lipoprotein and renal function parameters were also analyzed in these children,including TP,ALB,TC,TG,LDL-C,HDL-C,Urea,Cr and Uric.Results Compared with the healthy control children [173.00(161.00～185.00)mg/L],children with NS inacute [203.50(183.75 ～ 223.75) mg/L] and remission phases [185.00 (161.00 ～ 202.00) mg/L] all had a significantly increasedserum levels of C1q.Compared with NS children in remission,those in acute phase showed a significantly increased C1q (P＜0.001).In all the NS children,the serum levels of C1q were positively correlated with the levels of TC (r=0.483,P＜0.001),TG (r=0.423,P＜0.001) and LDL-C (r=0.450,P＜0.001),while negatively correlated with the levels of TP (r=-0.276,P=0.001 ＜0.01) and ALB (r=-0.410,P＜0.001).Multiple linear regression analyses showed that serum levels of C1q were independently associated with serum TG levels (β=9.235,P＜0.001;adjusted R2 =0.215) after adjustment of other related factors.Conclusion Serum levels of C1q were significantly increased in NS children in association with their conditions and the levels of lipid/lipoprotein parameters,and may be function as anovel parameter for assessing the development of NS.

OBJECTIVETo analyze the related factors of the infection after operation of open tibiofibula fractures.

METHODSThe clinical data of 141 patients with open tibiofibula fractures underwent surgical treatment from June 2009 to December 2012 were retrospectively analyzed. All the patients were male and aged from 18 to 61 years old with an average of 39.2 years; all the fractures were unilateral. According to Gustilo typing of fracure, 5 cases were type I, 44 cases were type II, 27 cases were type III a, 56 cases were type III b and 9 cases were type III c. These clinical data included patients' age, gender, body mass index (BMI), underlying diseases, time of operation, fracture site, fracture type, fixation method, postoperative drainage, debridement condition and so on. The postoperative infection conditions were recorded, and the correlation between above factors and infections were analyzed. Finally, the significant related variables were introduced into a Logistic regression model to evaluated their risk.

RESULTSAmong the 141 patients, 22 cases developed with infection (15.6%). The significant relative factors with infection contained fixation method, debridement condition, underlying diseases and postoperative drainage (P < 0.05). The correlativities were stepped up in order, their odds ratios value was 2.451, 3.164, 3.414, 5.117, respectively.

CONCLUSIONActive treatment for underlying diseases before operation, thorough debridement for open wound, suitable fixation method for fracture and thorough draining are effective measures in preventing postoperative infection.

Adolescent ; Adult ; Debridement ; Fibula ; injuries ; Fractures, Open ; surgery ; Humans ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; etiology ; Tibial Fractures ; surgery