Based on a review of classical literature combined with modern anatomical and biomechanical research， this paper proposes the "four intersections" of channel sinew diseases from the perspective of structural interfaces， which involves sinew-bone， sinew-sinew， sinew-joint， and sinew-vessel intersections， and analyzes the corresponding pathological characteristics. It is believed that the dynamic evolution of channel sinew diseases can be summarized as "starting with mechanical imbalancew， with interface transmission as the pivot， compensation continuation as the variation， and neurological adaptation as the consolidation". Furthermore， the pathological changes at the "four intersections" structural interfaces correspond respectively to clinical manifestations of enthesial pain， referred pain， joint dysfunction and sensory abnormalities. Understanding channel sinew diseases based on the "four intersections" structural interface is conducive to deepening the understanding of the pathogenesis， thereby providing a reference for clinical identification and precise treatment.

Objective To investigate the clinical effect of facial dermabrasion by microcrystal combined with red blue light in the treatment of acne pitting scar.Methods Selected from June 2013 to April 2016 hospital dermatology outpatients,98 cases of facial acne pitting scar were retrospectively analyzed,in which 50 cases of patients with facial acne dermabrasion were treated with red and blue light treatment (combined group),48 patients only choose facial acne dermabrasion treatment (control group),then treatment effect was compared between the two groups.Results At 3 months after operation,the ECCA score and mean sag depth of the two groups were significantly lower than those of the preoperative (t=23.208 and 18.586,P＜0.001).The ECCA score of the combined group was significantly lower than that of the control group (t=7.039,P＜0.05);The healing rate was 80％,which was significantly higher than those in the control group (56.25％) (x2 =6.387,P＜0.05);after 1 months and 3 months;the subjective satisfaction scores of the patients in the combined group were significantly higher than those in the control group (t=3.318 and 3.776,P＜0.05);Patients in the combined group were significantly earlier than the control group (t =4.419,P＜0.05);the incidence of edema and erythema was significantly lower in the combined group than in the control group (x2 =5.096,P＜0.05).Conclusions Facial acne dermabrasion by microcrystal combined with red and blue light treatment is superior to the single use of dermabrasion.

Objective To investigate the clinical pathological characteristics and prognosis of primitive neuroectodermal tumor (PNET) of breast.Methods Patients with breast PNET were retrieved from CNKI,Pubmed,Europe PMC and other databases from Jan.1980 to Dec.2016.The clinical data of one patient with breast PNET in our hospital were analyzed retrospectively.Results 18 cases had painless,rapid growth mass as the main clinical features.The pathological morphology showed small round cell tumors,PAS staining positive.Immunohistochemistry CD99 and Fli-1 characteristic expression were the main indexes for the diagnosis of breast PNET.The positive expression of Vimentin,NSE,Syn and negative expression of CK,EMA,Desmin,CgA,LCA,S-100 also played an important role in the diagnosis of breast PNET.The positive expression of genetic marker EWSRI was the golden standard for diagnosis of breast PNET.The size of the tumor,surgical treatment,lymph node metastasis,distant metastasis and chemotherapy were the important factors that affect the prognosis of the PNET.The survival rates of 1 and 3 years were 71.4％ and 33.3％ respectively.Conclusions Breast PNET is a rare tumor with poor prognosis,and its diagnosis is highly dependent on pathology.Surgery can significantly improve the prognosis of the patients.Surgery should be the main treatment,combined with radiotherapy and chemotherapy.The current study does not show evidence of effectiveness in terms of endocrine or targeted drug therapy for breast PNET patients.

RANKL/RANK/OPG axis is important in bone metabolism regulation, and becomes a popular research area in bone diseases. RANKL is a critical part of RANKL/RANK/OPG axis, and widely required in bone metabolism research. However, the yield of recombinant soluble human RANKL (hRANKL) in Escherichia coli is much lower than mouse RANKL (mRANKL). In this study, by adjusting and stabilizing the pH value of LB medium at 7.5, lowering the inducing temperature to 16 ℃ and optimizing the lysis program, the yield of soluble hRANKL increased by approximately 5 to 12-fold over the non-adjusted group. Our experiment effectively enhanced soluble hRANKL expression in E. coli and might constitute a meaningful attempt to obtain soluble expression of recombinant protein in E. coli.

Based on the experience of Public-Private Partnership (PPPs) model in domestic and foreign medical field, this study innovatively explored and designed the Build-Transfer-Operate-Transfer (BTOT) operational structure taking the second phase project of ZP Hospital in Pudong New District as a case study.The exploration results showed that the model established the social capital of private non-profit medical institutions by setting up the project company, and used the asset rental and operating management fees in the form of return path.In view of this, the study put forward some relevant countermeasures and suggestions from the aspects of the institution nature and national treatment, property right ownership and risk mitigation, balancing of interests and the cooperation period and solving the core staff etc.All of these measures were taken in order to explore the replicable PPP model in the field of public hospital reform and development.

Objective To learn the acceptance of rural community health workers (CHWs ) following the reform of rural health workers′team building in Pudong New Area.Methods 3 295 CHWs were surveyed with questionnaire for their acceptance of the incentive policies,and chisquare test analysis was used to analyze the differences among CHWs in individual areas.Results Over 80.0% of the CHWs reported that they were motivated by the incentive policies to improve their professional competence, medical service and organizational commitment;40.9% of them reported that the policies improved their social status;and 47.3% of them believed the policies could promote the rural areas to attract and retain talents.When a comparison was made of CHWs′feedbacks on different aspects,significant differences indicated that the proportion of CHWs′positive attitudes was the highest at remote rural communities. Conclusions The rural health workers′team building reform could promote incentive on the CHWs,yet with obvious regional differences.

Aim To determine the effective compo-nents of Semen Ziziphi Spinosae for sedative-hypnotic and its mechanism. Methods The extraction of Se-men Ziziphi Spinosae and the rat brain homogenates were prepared. High concentrations of Diazepam com-petitively replaced the ligand compounds of Semen Ziz-iphi Spinosae combining BDZ receptor in brain tissue, and all the compounds with sedative and hypnotic effects were collected and identified by HPLC and LC-MS technique, as the compounds extracted from the brain tissue were administered with Semen Ziziphi Spi-nosae. The brain tissue was administered with Diaze-pam, and with Semen Ziziphi Spinosae and Diazepam. Results The HPLC chromatograms show that the peak time of BDZ receptor ligand compounds was 2. 71 min and 46. 87min, when compared with Diazepam. And the LC-MS chromatograms display the relative molecu-lar weight of the ligand compounds was 274. 28 m/z, 453. 34 m/z,496. 34 m/z and 608. 38 m/z respective-ly. According to the fingerprint of Semen Ziziphi Spi-nosae, these compounds may be fatty acid substances and lupine pill triterpene compounds. Conclusions On the basis of the principle of receptor ligand bind-ing, we established a way to quickly analyze and iden-tify the role of natural products in the same drug target compounds. The method not only can clearly define the effective components of natural products, but also clar-ify the mechanism of action of the compounds. The ac-tive ingredient of calm hypnosis in Semen Ziziphi Spi-nosae may be fatty acid substances Palmitic acid ( C16 H32 O2 ) and lupine pill triterpene compounds Alphitolic acid( C30 H48 O4 ) and Spinosin( C28 H32 O15 ) . They exert their sedative and hypnotic effects by combining with BDZ receptor, and the research has laid a theoretical foundation for the further study about mechanism of Se-men Ziziphi Spinosae.

On the basis of analysis of the current status and future tendency of development of the health services industry in Shanghai,the authors identified key problems and bottlenecks.Thus they made clear the target positioning and principles of the industry,and proposed the basic ideas and pattern of the industry in the 13 th five-year plan period,focusing on such fields as private and high-end healthcare services,traditional Chinese medicine services,public health services,commercial health insurance,and other related industries.In the end,corresponding supporting polices were proposed.

Objective To compare and analyze MRI characteristics of medical patellofemoral ligament(MPFL) injury patterns in adolescents and adults after acute lateral patellar dislocation.Methods MR images of 42 adolescents and 45 adults after acute lateral patellar dislocation were retrospectively reviewed.Routine MR scanning was performed in axial,sagittal and coronal planes,including T1 WI,T2 WI and fat saturation sequence.The x2-tests were performed to analyze the MPFL injury patterns between adolescent group and adult group.Results The prevalence rate of MPFL injury was 97.6％ (41/42) in adolescent group after acute lateral patellar dislocation,including 57.1％ (24/42) of complete tear and 40.5％ (17/42) of partial tear.The prevalence rate of MPFL injury was 100.0％ (45/45) in adult group,including 64.4％ (29/45) of complete tear and 35.6％ (16/45) of partial tear.There were no statistical difference between adolescents and adults in prevalence rate of MPFL injury,complete MPFL tear,partial MPFL tear (x2 =1.084,0.486,0.223 ; P ＞ 0.05).The prevalence rate of MPFL injury at femoral attachment,patellar attachment and midsubstance were 31.0％ (13/42),78.6％ (33/42) and 26.2％ (11/42) respectively in adolescent group,whereas they were 64.4％ (29/45),40.0％ (18/45) and 15.6％ (7/45) respectively in adult group.It occurred at multiple sites in 33.3％ (14/42) of adolescents,and in 15.6％ (7/45) of adults.There were significant differences between adolescents and adults in the prevalence rate of MPFL tear at femoral attachments and patellar attachments (x2 =9.759,13.324 ; P ＜ 0.05),but there was no statistical difference at its midsubstance (x2 =1.497,P ＞ 0.05).Although not statistically significant (x2 =3.749,P ＞ 0.05),MPFL tear at multiple locations were seen more in adolescents than in adults (33.3％ vs.15.6％).Conclusion The injury degree and distribution of MPFL are similar in adolescents and adults after acute lateral patellar dislocation,but there is significant difference in the site of MPFL injury distribution between adolescents and adults.MPFL is most easily injured at femoral attachment,secondly at patellar attachment in adults,while MPFL is most easily injured at patellar attachment,secondly at femoral attachment in adolescents.Adolescents are more likely to have multiple-site MPFL injury than adults.

The digital operating-room, with highly integrated clinical information, is very important for rescuing lives of patients and improving quality of operations. Since equipments in domestic operating-rooms have diversified interface and nonstandard communication protocols, designing and implementing an integrated data sharing program for different kinds of diagnosing, monitoring, and treatment equipments become a key point in construction of digital operating room. This paper addresses interface interconnection and data integration for commonly used clinical equipments from aspects of hardware interface, interface connection and communication protocol, and offers a solution for interconnection and integration of clinical equipments in heterogeneous environment. Based on the solution, a case of an optimal digital operating-room is presented in this paper. Comparing with the international solution for digital operating-room, the solution proposed in this paper is more economical and effective. And finally, this paper provides a proposal for the platform construction of digital perating-room as well as a viewpoint for standardization of domestic clinical equipments.
Data Collection ; Humans ; Monitoring, Intraoperative ; economics ; instrumentation ; methods ; Operating Room Information Systems ; economics ; standards ; Operating Rooms ; organization & administration ; Systems Integration ; Video Recording ; economics ; instrumentation ; methods