Objective To investigate whether or not adaptive response of the 2BS and A549 cells induced by low dose irradiation.Moreover,to analyze the relationship between the adaptive response and cells cycle regulation. Methods 1.The dose-survival curves of A549 and 2BS cells were figured by colony formation and typan blue cell staining.2.Flow cytometry was used to analyze the cell cycle after the different doses irradiation. Results 1. The adaptive response induced in 2BS cells by low dose,while it was not induced in A549 cells.2.G2 phase arrest of 2BS cells after 75mGy X-ray plus 4Gy 60Co γ-ray irradiation appeared in 30 minutes,and cell cycle recovered in 24 hours. Conclusion The adaptive response of 2BS cell could be induced by low dose irradiation,and there was close relationship between the adaptive responses and the regulation of cell cycle.

BACKGROUND: Traditional anterior release followed by posterior correction and fusion is frequently used to treat severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve > 65° and flexibility < 34.5%; however, there are a great majority of complications. Whether isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may provide better effects on severe and rigid adolescent idiopathic scoliosis needs to be further studied.OBJECTIVE: To evaluate isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion for the treatment of severe and rigid adolescent idiopathic scoliosis. DESIGN: Case analysis.SETTING: Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiao Tong University.PARTICIPANTS: Twenty patients with severe and rigid adolescent idiopathic scoliosis, including 8 males and 12 females, were selected from Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiaotong University from June 1999 to August 2005. They were 12-18 years old, and the mean age was 14.6 years. All patients were finally diagnosed as X-ray of whole spine. According to King-Moe criteria, patients were classified into type Ⅰ(n =4), type Ⅱ(n =6), type Ⅲ (n =5), type Ⅳ(n =3) and type Ⅴ(n =2). Before surgery, mean Cobb angle of the major curve was 82° (75°-92°), mean flexibility was 30% (20%-40%), and mean shoulder height difference was 15 mm (5-35 mm). Moreover, according to Risser syndrome, patients were classified into degree 1 (n =3), degree 2 (n =5), degree 3 (n =6), degree 4 (n =5) and degree 5 (n =1). All patients and their relatives provided the informed consents, and the experiment was approved by the local ethical committee. Artificial bone was Osteoset provided by Wright Company, USA.METHODS: Patients underwent isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion, and spinous process, lamina of vertebra, zygapophysial joints and transverse process were exposed in a preconcerted fusion area. Pedicle screw was inserted into strategy vertebra using free hand technique according to the anatomic landmark of entry point. Six patients underwent fixation with TSRH system, and the other patients with CDH M8 system. Operative time and blood loss were evaluated after surgery. At 7 days after operation, Cobb angle was measured with X-ray, and correction rate of major curve was calculated. While shoulder height difference and admission duration were evaluated simultaneously. Complications and recovery states were followed up in the next 4 years.MAIN OUTCOME MEASURES: ① Operative time and blood loss; ② Cobb angle and correction rate of major curve; ③ shoulder height difference and admission duration; ④ follow-up results.RESULTS: All 20 patients were included in the final analysis. ① Operative time and blood loss: Operative time lasted from 3.2 to 4.3 hours, and the mean time was 3.5 hours. Blood loss ranged from 660 to 1 070 mL, and the mean loss was 865 mL. ② Cobb angle and correction rate of major curve: Cobb angle of the major curve ranged from 82° (75°-92°) before surgery to 31° (22°-37°) after surgery, and the mean correction rate was 62%. ③ Shoulder height difference and admission duration: Mean should height difference before surgery was 15 mm (5-35 mm). Postoperative lateral film of spine indicated that thoracic and lumbar vertebra generally suffered from normal posterior and anterior convexity, and mean shoulder height difference after surgery was 7.5 mm (0-11 mm). The admission duration lasted from 8 to 11 days, and the mean duration was 9 days. ④ Follow-up results: All patients were followed up in the next 4 years after surgery. The cobb angle correction of major curve remained unchanged, and the instrumented segments were completely fused without instrumentation failure.CONCLUSION: Isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may effectively cure severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve between 75° and 92° and flexibility ≥ 20%.

An analysis of the fundamental concepts for public hospital reform further defined public hospitals and other hospitals,business and non-business in nature,public benefits and welfare,as well as public benefits and profit-oriented hospitals.These distinctions can help reformers of public hospitals clarify their concepts,make clear the purpose and direction of the public hospitals reform,so as to speed up the reform with theory support.

This paper studied the development stages in terms of the public nature of public hospitals in China and analyzed the causes for their weakened public benefits.It proposed the principle of government guidance,achieving government purchasing of healthcare services as the roadmap,as well as building and improving the service purchasing system,performance appraisal system,and payment review system along with supervision system.These measures are designed to make public hospitals in their public benefit nature with scientific system design,powerful institutional guarantee,and efficient execution strategies.

Object Through performing the service satisfaction survey,to learn their interest claim and discover the service defects ,so as to provide advice and countermeasures.Method Using field survey methods and statistics analysis to study.Result The satisfaction of relatives of pediatric patients at the level of "relatively good" and "good" is about 60% both in medical treatment environment and equipment ,over 70% in medical treatment effect,doctor capacity,nursing capacity and overall assessment,but only 5.1% in medical expenses.Conclusion Relatives of pediatric patients have high satisfaction in treatment capability of medical staff,medical treatment effect as well as overall assessment ,normal satisfaction in medical environment and equipment,but lowest satisfaction in medical expenses,and the satisfaction in tertiary hospital is not high.Relatives in some districts demand much in some aspects,such as improving hospital environment,attaching importance to ward hygiene ,improving service attitude,and providing single ward ect.

Objective To analyze the clinical features of patients with cholelithiasis treated in our hospital in the recent 10 years to explore the changing tendency of the spectrum of cholelithiasis in the Jiaodong region. Methods The clinical data of 2899 patients receiving operation for cholelithiasis in this hospital between January 1998 and January 2008 were retrospectively analyzed. The clinical parameters of sex, age and the lesion sites were reviewed. Compared with the clinical data of cholelithiasis patients in 1991, the data of the 2899 patients were statistically analyzed by SPSS 12.0 package.Results Significant differences existed in sex, e peak morbidity, and lesion sites. The ratio of male patients and female patients with cholelithiasis in differents site had obvious diversity. The constituent ratio of the female was manifestly higher than that of the male. The peak morbidity age range of cholecystolithiasis was 40 to 69. The peak age of gallbladder stones combined with common bile duct stones was 70 to 79, which was the same as that of common bile duct stones. The peak age of intrahepatic bile duct stones was 40 to 59. The constituent ratio of cholecystolithiasis was obviously higher than cholelithiasis in other sites. The incidence of cholecystolithiasis increased with age. Conclusion In the recent 10 years, female's ratio of gallbladder stones and intrahepatic stones was higher than male's.The morbidity of cholelithiasis significantly increased in aged patients. The spectrum of cholelithiasis has changed significantly.

For the purpose of resolving such current problems as low inclusion ratio and high exit ratio in the single-disease clinical pathway management,the paper proposed an idea of clinical pathways grouping management,in line with DRG management and based on traditional clinical pathway management practice and China' s conditions.Proposed in the paper are such measures for government service procurement,as quality control mechanism,price negotiation mechanism,performance-based payment mechanism,and supervision mechanism.These measures are designed to provide incentives for medical institutions and medical workers,control irrational rise of medical expense,optimize expense makeup,and improve both quality of care and patient satisfaction.Thanks to the China Rural Health Development Project in place in Henan province where DRG-based clinical pathway grouping management and government service procurement are in trials,the following outcomes are achieved.Namely,significant expansion of diseases coverage and population coverage,efficient control of per-patient/per-visit expenses,and a steady rise of surgery and treatment expenses which embody value of service of medical workers.Other benefits include 50％ to less than 30％drop of drugs proportion,gradual optimization of medical expenses makeup,obvious improvement of quality of care.These measures have made hospitals,insurance providers and patients satisfactory.

Objective To study the quality of outpatient prescriptions for patients of different age groups at both township and village level,for the purpose of evaluating the outcomes and problems of the ongoing healthcare reform at primary levels.Methods 100 outpatient prescriptions of April 2015 were mechanically sampled randomly from two township hospitals and 8 village clinics in counties A and B in Hubei province.These prescriptions were analyzed for the drug count per prescription,percentage of intravenous prescriptions,that of antibiotics,that of hormones and average cost per prescription.Results At the township hospitals,the drug count per prescription(2.02)of county A was less than that of county B(3.26),while the percentage of intravenous prescriptions(30.30%),that of antibiotics(47.98%)and hormones(6.57%)of county A were significantly less than those of county B(50.65%,69.08% and 15.13% respectively).At village clinic level,the percentage of intravenous prescriptions(31.05%)of county A was higher than that of county B(20.34%),the average prescription costs(￥29.28)of county A was less than county B(￥31.45);while in terms of children′s prescriptions,average drug count of county A(2.50)was higher than county B(2.09),and its proportion of antibiotics(65.91%)was higher than county B(45.56%).Conclusions General primary care reform is faced with challenges of poor control of intravenous injection and use of antibiotics,particularly at village clinics and pediatric drug use in terms of prescription quality control.Both township and village levels should strengthen the supervision over the drug suppliers,guide the demand side to rationally use drugs and focus on the reasonableness of the medication of village clinics and children.

For advanced pulmonary metastases or melanoma, radiotherapy combined with immune checkpoint inhibitor can block the immunosuppression pathway, enhance the antitumor immune response, and significantly improve survival. Stereotactic body radiation therapy ( SBRT ) delivers a large dose of radiation to the tumor target with high precision while sparing irradiation of the surrounding normal tissues. It is suggested that SBRT could be the most appropriate radiotherapy modality to be combined with immunotherapy since it induces the expression of a series of cytokines and immune molecules and is more likely to cause intense immune response and exert an abscopal effect than conventional radiotherapy. Previous studies have explored that total dose and fractionation seem to be important parameters for determining the immune response;the timing of radiation with immunotherapy significantly influences the outcome, and tumor infiltrating lymphocytes, the expression level of programmed death-ligand 1, and mismatch repair defect may be important predicators of the outcome. With appropriate radiotherapy dose and fractionation, the optimal timing of radiation with immunotherapy, and effective predictive markers, a combination of SBRT and immunotherapy may eliminate advanced malignancies while activating the systemic immune response to exert an abscopal effect.

The massive water and steam are consumed in the production of cellulose ethanol, which correspondingly results in the significant increase of energy cost, waster water discharge and production cost as well. In this study, the process strategy under extremely low water usage and high solids loading of corn stover was investigated experimentally and computationally. The novel pretreatment technology with zero waste water discharge was developed; in which a unique biodetoxification method using a kerosene fungus strain Amorphotheca resinae ZN1 to degrade the lignocellulose derived inhibitors was applied. With high solids loading of pretreated corn stover, high ethanol titer was achieved in the simultaneous saccharification and fermentation process, and the scale-up principles were studied. Furthermore, the flowsheet simulation of the whole process was carried out with the Aspen plus based physical database, and the integrated process developed was tested in the biorefinery mini-plant. Finally, the core technologies were applied in the cellulose ethanol demonstration plant, which paved a way for the establishment of an energy saving and environment friendly technology of lignocellulose biotransformation with industry application potential.
Bioelectric Energy Sources ; economics ; Biofuels ; analysis ; Biotransformation ; Ethanol ; analysis ; metabolism ; Fungi ; metabolism ; Industrial Microbiology ; methods ; Lignin ; metabolism ; Steam ; Water ; analysis