Implementation of the clinical pathway is key to the ongoing health reform in China. However,the hospital is faced with such hurdles as low incentive among the medical workers,low utilization rate,high pathway-deviation rate among others.Therefore,this paper combined management practices of a tertiary military hospital,analyzed factors influencing its application,and discovered the key factors for the pathway system.Then the corresponding countermeasures were formulated and implemented with significant effects.

Objective To improve the material and personnel management in hospital by promoting construction of information system. Methods Based on the existent network system and RFID technology, the RFID-based system was developed to manage doctors, nurses, patients and material of hospital. Results The system could identify people and material automatically, thus realizing automatic management efficiently. Conclusion The combination of RFID technology and hospital information has good development prospects.

Concept-map can be seen as supplementary tool and strategy for teaching and learning of English writing,in addition,that can help the student open their mind,organize the article,inspire their creativity and cultivate the habit of English thinking,the purpose of that is improvement of writing level.

At present, China's medical service costs keep rising, and residents' out-of-pocket medical expen-ses are also increasing heavily. The prepayment reform of medical insurance is considered as an important starting point to solve the problem. It is of great significance to evaluate the effect of prepaid medical insurance reform on con-trolling medical expenses and reducing economic burden when sick. In order to achieve the objective of this study, a use of CHARLS data 2011 &2015 and DIDPSM theory, and a combination of the Interaction Item Model and PSM model, and make use of a natural experiment developed from experimental reform stage for the comprehensive promo-tion stage of new rural cooperative medical system (NCMS) in 2012, were very crucial. This paper finds that:(1) Prepayment system can control the rise in outpatient and inpatient expenses. Compared with those who did not partici-pate in NCMS in the initial stage of reform, after the universal reform, outpatient and inpatient expenses dropped by 6. 3％ and 41％, the average decrease was 1041yuan and 2895yuan, respectively. (2) After the universal reform, the insured patients' medical burden of outpatient and inpatient reduced by 17％ and 33％. Prepayment system has, to some extent, resisted the rise in medical expense, and alleviated the burden of medical treatment. (3) On the basis of PSM, the estimated value and significance of coefficients have not changed, the effect of PPS reform is good. The poli-cy implication is that accelerating the prepayment system reform is the key way to control the growing medical expenses.

Medical imaging is a medical discipline with strong practicality.Picture archiving and transmission system ( PACS ) provides a convenient and effective method for the clinical teaching of diagnostic imaging,especially for the students from the University of Traditional Chinese Medicine.Applying PACS is more convenient to gain and manage typical images,more effective to study and teach individually and easier to probe novel method for medical imaging.

Objective To compare of pathogenic bacteria characteristics between praecox and tardus ventilator-associated pneumonia (VAP) in the elderly with critical illness,and to provide the guildline and evidence of clinical prevention and treatment. Methods The clinical data of 276 VAP patients aged (69.3 ± 5.3) years in our hospital were retrospectively analyzed.There were 97cases (35.14％) with praecox VAP,179 cases (64.86％) with tardus VAP.Vitek 32 system was applied to identify pathogenic bacteria. Results In patients with praecox VAP,105 pathogenic bacteria were isolated,among which 72 cases(68.57％) suffered from G- bacterium,21 cases (20.00％) from G+ and 12 (11.43％) from fungus. The most widely distributed pathogens were hemophilus (22.86％),streptococcus pneumoniae(14.28％ ) and staphylococcus aureus(14.28％).In the patients with tardive VAP,186 pathogenic bacteria were isolated including 117(62.90％) G- bacterium,54 (29.04％)G+ bacterium and 15 (8.06％) fungus; the most widely distributed pathogens were staphylococcus aureus (24.19％), pseudomonas aeruginosa (22.58％) and klebsiella pneumoniae (14.52％).The death rate of tardus VAP(24.58％) was significantly higher than of praecox VAP (10.31％ ) (x2 =8.14,P＜0.05).The durations in ICU and mechanical ventilation were much longer in tardus VAP[(10.3±4.2)d and (7.8±2.7)d] than in praecox VAP[(7.8±3.1) d and (3.7±1.1)d] (t=5.15,14.32,P＜0.05). Conclusions There is differences in pathogenic bacteria distribution between praecox and tardus VAP,and the prognosis of tardus VAP may be worse.

Objective To explore the efficacy of borneol and Norfloxaein in treating patients with stage IV pressure sore. Methods 132 patients with pressure sore were randomly divided into the obser-vation group(applying borneol and Norfloxaein)and the control group(applying iodophors and gentamycin). The effect of the two methods was compared. Results The curative rate of the observation group was 98.5%,and 47.7% for the eantrol group. Total effective rate of the observation group was 100%,and 81.5% for the control group.The average curative time for the observation group was shorter than that of the control group. Conclusions Borneol and Norfloxaein is superior to iodophors and gentamycin in treating pa-tients with stage Ⅳ pressure sore.

Brain-derived neurotrophic factor(BDNF)belongs to the neurotrophin family and abundantly expressed in the nervous system.It plays an essential role in the survival,development,function,morphogenesis and plasticity of neurons by binding to the tyresine receptor kinase B(TrkB)and subsequent downstream activation of several signal transduction pathways in the nervous system. The PI3K/Akt and the MAPK/ERK DathWays ale two major intracellular signaling network activated by BDNF involved in survival of neurons.Becently.it is investigated that BDNF and TrkB are involved in the pathophysiology of hypoxic ischemic brain damage (HIBD)and in the mechanism of action of therapeutic agents.Therefore we image changing the internal or external condIitions can increase the expression of BDNF,thsu reduce the nervous system damage of HIBD.

Objective To study the clinical effect of trimetazidine on patients with unstable angina pectoris. Methods133 patients with unstable angina pectoris were randomly divided into regular group and trimetazidine group,the effects after two weeks' treatment were evaluated. ResultsThe therapeutic effect in trimetazidine group is much better than the regular group. ConclusionThe therapeutic effect of trimetazidine on unstable angina pectoris patients is definite.

Objective To explore the perioperative nutritional support and nursing countermeasures for laryngeal cancer patients. Methods 28 cases of hospitalized laryngeal surgery patients, in accordance with the working method of clinical pathway, finished product and homemade homogenate enteral nutrition was fed through nasogastric tube. Nutrition evaluation was finished by use of body mass index (BMI), blood biochemical indicators on 1d preoperation and 14 d postoperation, All indexes were compared between preoperation and postoperation. Results Nutrition assessment with BMI showed incidence of mild malnutrition as 10.7% and 14.3% on 1d preoperation and 14 d postoperation. Nutrition evaluation index such as HB, BUN was statistically significant, and BMI、 TLC、ALB、TP showed no statistical sisnificant difference between 1d preoperation and 14 d postoperation. Conclusions Clinical pathway in accordance with the working method, using the reasonable meal is laryngeal cancer patients homogenate perioperative enteral nutrition support a more scientific and deserves popularization of nursing countermeasures.