The function of hepatic stellate cell (HSC)in liver fibrosis has been well recognized.In recent years,the role of HSC in the liver tumor microenvironment have been paid increasing attention.Platelet derived growth factor (PDGF) is the most important mitogen of hepatic stellate cell,and plays an important role in the activation of hepatic stellate cell.Hepatic stellate cell is not only the target cells of PDGF,but also PDGF-secreting cells.Thus a bi-directional cycle mode of PDGF activating hepatic stellate cell has been established.The signaling pathways of HSC activation include MAPK,PI-3K,Ca2+ and JAK pathways.To explore PDGF activating hepatic stellate cell in liver tumor microenvironment and to find the new methods of targeting PDGF and hepatic stellate cell,may help us find a new direction for the treatment of hepatocellular carcinoma.

Objective To discuss the types,pathogenesis and treatment of early cardiac arrhyth-mias in infants after open heart surgery with congenital heart diseases. Methods 992 infants after open heart surgeries were divided into control group and arrhythmia group. Another junctionalectopictachycardia ( JET)group was separated from arrhythmia group. Various preoperative and postoperative data were com-pared. Results 197 infants suffered from cardiac arrhythmia within 3 days right after open heart surger-ies. After exactly the same surgery procedures,JET group was significantly different with control group in aortic cross-clamp time,cardiopulmonary bypass time and stay in CICU(p<0. 05). As for time of ventila-tion,no significant difference was found between the two groups. Conclusion Early diagnosis and treat-ment of cardiac arrhythmia can not only improve the success rate of open heart surgery,but also promote early recovery.

The paper introduced the multi-site physician practice operational in the modes of hospital departmental support,hospital trusteeship,and public-private hospital management,and summarized the merits of such a practice adopted in the background of cooperative hospital operations as follows.A cooperation of common interests enjoys supports of all stakeholders and minimum resistance;better policies and conditions mobilize physicians'incentives; better continuity of medical practice; better public benefits of the hospital.The paper also probed into such issues as setbacks of the practice in such a background,complicity of medical disputes definition and resolution,possible talent drain of public hospitals,and possible impacts on branding and core competence of public hospitals.

Uarthritis is a common inflammatory arthritis, which has been well known as the White Tiger arthritis in traditional Chinese medicine. This article discussed the pathogenesis of blood stasis and the related studies in hyperuricemia, acute and chronic phase of Uarthritis. It suggested that blood stasis is a crucial pathogeny of uarthritis. Thus, the chinese herb medicine of blood circulation drugs should beapplied in all the phases of Uarthritis.

Hospitals are currently confronted with many problems, including distribution according to the division of administrative areas and jurisdiction; construction with complete sets of facilities on the part of all hospitals,big or small; and worsening of the unbalanced allocation of health resources due to the to assumption by big hospitals of many tasks of bssic-level hospitals. Besides, the excessively speedy incresse of expenses for outpatient and inpatient services as a result of hospitals' introduction of high technologies has inhibited some people's demands for medical services and competition among hospitals will become particularly fierce. Thus, ways out for hospitals lie in clarifion of their respective functions and development according to regional planning; regrouping of health resources by the government through measures of shutting down,stopping down, sopping production, merging, changing products or moving to other sites; structural readjustment and implementation of the system of responsibility by hospital directors within hospitals;bringing into play the initiatives of middle-level cadres; establishment of a scientific mechanism for personnel employmennt and selection; giving priority to efficiency and consideration to fairness in distribution; improvement of service quality; and making a good job of rational charging.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Facial Injuries ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; therapy ; Retrospective Studies ; Wounds, Penetrating ; therapy ; Young Adult

The development of community-based rehabilitation (CBR) needs to improve to meet the change of environment during the period of 12th Five-year Plan. The problems of CBR development included 3 major contradictions: administration of CBR and marketization of medical services; professionals demand of CBR and their professional development; and the demand of CBR and capacity of services. It is necessary to establish some market-oriented CBR project, pay attention to professional development, and promote the capacity of the community rehabilitation agencies.

Objective To explore the effect of hyperoxia through mechanical ventilation induced lung injury(VILI) in newborn rabbit.Methods One hundred newborn rabbits aged 1-5 days were randomly divided into 4 groups: with 900 mL/L O2 and mechanical ventilation(MV),group A received high peak inspiratory pressure(HPIP),group B received moderate peak inspiratory pressure(MPIP),group C received low peak inspiratory pressure(LPIP),and group D with no mechanical ventilation with room air.There were 30 rabbits in group A,B,C,10 rabbits in D group.All rabbits were killed at 1,3,6 h after trial respectively.Wet-to-dry weight ratio(W/D) of left lung,and white blood cell(WBC)counts in broncho alveolar lavage fluid(BALF) were measured.The changes of lung histopathology were assessed by hematoxylin-eosin(HE) staining and observed under light microscope.Results Compared with group B and C,the group A demonstrated more pulmonary hemorrhage and pulmonary bullae formation,and the WBC and neutrophils counts in BALF increased and the W/D was higher compared with group B and group C.Meanwhile,alveolar epithelial cellⅡ(AECⅡ) hyperplasy transformed to AECⅠ.In group C,AECⅡswelled and lung tissue edema showed obviously,after 6 hours collagen fibers hyperplasia appeared.Part pulmonary atelectasis was obvious in group C.Conclusions HPIP ventilation can increase lung injury induced by hyperoxia in newborn rabbits,but has minimal effects on MPIP and LPIP ventilation.Pulmonary histopathologic changes participate in the newborn rabbit machine ventilation induced lung injury.

Objective To evaluate the changes of serum tumor markers of carbohydrate antigen 125 (CA125),carbohydrate antigen 199 (CA199),carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC) during anti-tuberculosis treatment in patients with active pulmonary tuberculosis and tuberculous pleurisy.Methods This research was a prospective study.Sixty-three patients with active pulmonary tuberculosis and 24 patients with tuberculous pleurisy underwent blood samplings before treatment,2 and 6 months after treatment.Centaur XP chemiluminescent immunoassay was used to test serum levels of CA125,CA199,CEA and SCC.Thirty healthy subjects were included as controls.Student t-test was used to compare continuous variables,and chi-square test or Fisher exact test was used to compare categorical variables.Serial changes of serum tumor markers levels pre-and post-treatment were analyzed by repeated measures analysis of variance.Binary Logistic regression model was used for multivariate analysis.Results The mean serum CA125 level of the 63 patients with active pulmonary tuberculosis pre-treatment was (64.4± 30.4) U/mL,which was significantly higher than that of healthy controls ([12.7±5.5] U/mL,t=11.98,P＜0.01).The mean serum CA125 level decreased to (16.9±6.1) U/mL after 6 months standardized treatment,which was significantly lower than that before treatment (t=12.74,P＜0.01).While compared with healthy controls,the serum level of CA125 in patients who had completed the standardized treatment was not significantly different (t =0.94,P =0.348).When compared with the healthy controls,serum CA199,CEA,SCC levels in patients with active pulmonary tuberculosis before and after treatment showed no statistically significant difference (P＞ 0.05).Univariate analysis and multivariate analysis by Logistic regression analysis showed that bilateral pulmonary tuberculosis (x2 =7.746,P=0.006; OR=6.99,95％CI:1.73-28.22) and cavity pulmonary tuberculosis (x2 =6.254,P=0.012; OR=7.64,95％CI:1.64-35.35) were associated with increased serum CA125 level.The mean serum CA125 level of 24 cases of tuberculous pleurisy pre-treatment was (81.2 ± 37.6) U/mL,which was both significantly higher than that of patients with active pulmonary tuberculosis (t=2.153,P=0.034) and that of healthy controls (t=12.05,P＜0.01).Similarly,CA125 levels sharply decreased to (15.5 ± 7.3) U/mL after 6 months standardized treatment,which was not statistically significant compared with the control group (t=0.450,P=0.652).However,CA199,CEA and SCC levels in tuberculous pleurisy pre-and post-treatment were all not statistically different from those of healthy controls (all P＞0.05).Conclusion Serum CA125 can be used as a marker for assessing the disease progression and therapeutic efficacy for patients with active pulmonary tuberculosis and tuberculous pleurisy.

Objective To identify the correlation factors associated with cerebral intragenic ischemia after temporary parent arterial occlusion in intracranial aneurysm surgery. Methods One hundred and eighteen patients who underwent temporary arterial occlusion in the 120 aneurysms (from a group of 324 consecutive aneurysm patients treated from 1996 to 2002) were reviewed retrospectively. These variables included sex, age, presence of preoperative subarachnoid hemorrhage (SAH), neurological clinical grade, operational timing, duration of arterial occlusion, numbers of temporary occlusion, mode of arterial occlusion, intraoperative aneurysm rupture, hypertension, the location of temporary occlusion, aneurysm size, hyperglycemia, atheromatous mass. Univariate and multivariate were used to investigate the relationship between the variates and postoperative ischemic changes. Results The total times of temporary occlusion were 156, with an average of 1.30. The duration of arterial occlusion ranged from 1 to 45 min (9.75?7.75). Seventeen patients (14.4%) demonstrated evidence of new infarction in the vascular territory subjected to temporary arterial occlusion. Conclusion In the univariate analysis, age, presence of preoperative SAH, duration of arterial occlusion, atheromatous mass are all significantly correlated with postoperative ischemic injuries. Multivariate logistic regression revealed that the age, older more than 60 (P= 0.010 3 , relative risk=4.335), and the duration of arterial occlusion, lasting more than 20 min (P= 0.032 9 , relative risk=4.177), have significant correlation with the injuries. Based on these findings, temporary occlusion is safe and useful in aneurysm surgery and the postoperative cerebral ischemia is less likely to occur when the duration of clipping is shorter than 20 min.