The paper discusses the necessity and urgency of hospital ownership reform. and pinpoints the focal and difficult points of the task. It also identifies the goals of the reform, viz. establishment of a medical and health system that fits in with the development demands of a socialist market economy, which is of great significance. It can be seen both in theory and in practice that for a pretty long period of time in China, public hospitals, providing basic medical security for the broad masses of people will occupy a leading position whereas private hospitals known for their outstanding service and quality, will play a bigger role only when the living standards of the general population have reached a fairly high level.

Objective:To induce myeloma specific cytotoxic T cells response in vitro mediated by autologous dendritic cells generating from multiple myeloma(MM) patients.Methods:Monocytes isolated from the peripheral blood of MM patients were cultured in serum free medium with 800 U/ml GM CSF and 600 U/ml IFN? for 8 days to generate DCs.These DCs were pulsed by U 266 cells treated with mitomycin C and their lysates,and then incubated with autologus T lymphocytes for 5～7 days to induce antigen specific CTL.MTT assay was performed to examine the U 266 cell specific lysis.Results:DCs derived from MM patients carried a typical dendritic like morphology,they highly expressed CD86,CD54 and class II MHC molecule(HLA DR) on cell surface.Specific killing of U 266 cells mediated by DCs were tested with MTT assay.At an effector/target ratio of 20/1,specific cytotoxic activities against U 266 cells(28.0%?7.6% and 21.2%?5.4%,respectively),were observed,but without antigen stimulation,the killing rate was 11.7%?4.3%,without DC mediation,the killing rate was 15.6%?4.8% and 13.1%?5.5%(P

AIM:To conduct the relevance analysis of serum Dickkopf-1 (Dkk-1) and bone mineral density (BMD) in the different ages of female populations.METHODS: The women volunteers (n=100, 20~80 years old) were selected and divided into young group (20~39 years old), middle age group (40~59 years old) and elderly group (60~80 years old).The serum levels of Dkk-1 in the 3 groups of volunteers were detected by ELISA.In the middle age group, 25 people of 45~55 years old were selected and divided into postmenopausal group and premenopausal group to de-tect the serum level of Dkk-1 in the 2 groups of volunteers by ELISA.The BMD was measured by the method of dual energy X-ray absorptiometry.The differences of Dkk-1 expression levels among different ages of female populations, and the rele-vance with BMD were compared.RESULTS:With the increase in age, the serum Dkk-1 expression level increased ( P<0.05), and BMD were reduced (P<0.05).The blood level of Dkk-1 and BMD negatively correlated (P<0.05) in the 3 groups of volunteers.The serum levels of Dkk-1 and BMD had stronger negative correlation in postmenopausal women group than that in premenopausal women group.CONCLUSION:With the increase in age, the expression level of serum Dkk-1 increases and the BMD level decreases, which contribute to a risk of osteoporosis.In the same age range, the postmeno-pausal women express higher level of Dkk-1, and the decreased BMD is more obvious, which contribute to a greater risk of osteoporosis.The increased level of Dkk-1 also inhibits bone formation and promotes bone resorption.It may become a new target for preventing and treating osteoporosis.

Objectives To investigate the efficacy and toxicity of bortezomib based combination therapy for Chinese patients with relapsed or refractory multiple myeloma(MM),and to determine the combination regimen,dosage and cycles in application of bortezomib for MM therapy.Methods Forty-six patients with refractory or relapsed myeloma were treated with bortezomib(1.3 mg/m2)as an intravenous bolus twice weekly for 2 weeks on day 1,4,8,and 11 in a 3-4 week cycle,in combination with dexamethasone,dexamethasone plus thalidomide, CD(C-cytoxan,D-dexamethasone),MD(M- mitoxsnteone),DCEP(E-etoposide,P-platinol),and DT-PACE regimens(T-thalidomide,A-adriamycin). Response to bortezomib was evaluated according to the criteria of the International Myeloma Working Group (IMWG)before initiation of each cycle.Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0.Forty-nine matched patients with relapsed and refractory MM who received thalidomide based combination therapy were used as a historical control group.Results Among 43 of the 46 patients whom could be evaluated,the overall response rate was 72.1%(the control group was 51.0%,P＜0.05),including complete response in 5 patients(11.6%),very good partial response in 12 patients(27.9%),and partial response in 14 patients(32.6%).The overall response rate after one and two cycles was 30.2%and 58.1%(P＜0.05),respectively.The frequent adverse events were thromboeytopenia(62.8%),fatigue(55.8%),nausea(51.2%)and peripheral neuropathy (30.2%);all of the events could be tolerated.The most common adverse event in the control group was constipation(69.4%),followed by fatigue(59.2%)and dizziness(46.9%).Conclusions Bortezomib based combination therapy is a new effective therapy in relapsed or refractory myeloma patients with a higher response rate and difierent toxicities as compared with thalidomide based combinations.

OBJECTIVETo investigate the variation in movement traces of different condylar reference points.

METHODSIn 30 healthy subjects, mandibular movements were recorded during protrusion and open-closing of the jaw. The kinematic center and terminal hinge axis point of the condyle were used as reference points.

RESULTSThe kinematic center was located anteriorly and superiorly with respect to the terminal hinge axis point. The trace distance of the kinematic center was longer than that of the terminal hinge axis point of the condyle during opening. In contrast to differences in trace distances of the left and right condylar terminal hinge axis points, no such left-right differences were found for the kinematic centers. The ratio between the distance of opening trace and the distance of protrusion trace of the kinematic center was above 1.5.

CONCLUSIONSIn comparison to the terminal hinge axis, the kinematic center shows fewer variations in the movement traces.

Adult ; Biomechanical Phenomena ; Humans ; Jaw ; physiology ; Mandibular Condyle ; physiology ; Movement

[Objective]To investigate the efficacy of total hip arthroplasty(THA)on the treatment of traumatic arthritis that caused by internal fixation failures of intertrochanteric fractures.[Methods]During January 2009 and March 2016,35 cases of trau?matic arthritis(male:18 cases;female17 cases;49 ~ 86 years old,with an average age of 68.5 years)caused by internal fixation failures or malunion of intertrochanteric fractures,were undergo THA. Among 35 cases,13 cases were performed with the proximal femoral fixation stems,10 cases were with distal fixation stems,and 12 cases were with extended stems.[Results]With 3~65 months follow-up,the hip joint HSS score was elevated from 44.1(31 ~ 65)preoperative to 82.5(58 ~ 94)postoperative without obvious loosening. No postoperative deep infectionwas found. The femoral stems in 2 cases were found to sink 5 mm and 10 mm,respectively. No obvious prosthesis loosening was found. Taken together ,the satisfaction rate of THA on the joint function of traumatic arthritis was 91.4%.[Conclusion]Total hip arthroplasty is recommended as an effective approach for treating traumatic arthritis caused by internal fixation failures of intertrochanteric fractures. Distal fixed prosthesis was recommended due to bone sclerosis or defects of proximal femur. Coupled with emphasis on reconstruction of the greater trochanter ,good therapeutic effects could be achieved.

Objective To investigation the condition,expectation and support of quality of life in adult with intellectual disability.MethodsA total of 394 adult with intellectual disability,their parents and friends in Beijing were involved in the study.Their qualities of life were evaluated.ResultsAbout quality of life,the adult with intellectual disability had significant more expectation than they had gained actually;their parents and friends had significant more expectation than themselves and staff of primary rehabilitation did.ConclusionIt is necessary to provide support to improve the quality of life of adult with intellectual disability.