Objective To evaluate the application effect of quality control circle on reducing the defect rate of health education in perioperative period of gynecologic surgery patients. Methods To carry out quality control circle activities, analysis of gynecological surgery patients in perioperative health education defect rate to the cause, the development of countermeasures, to achieve the purpose of continuous quality improvement. Results Before implementation health defects rate was 43.3%(303/700), after the implementation health education defect rate was 11.4%(223/1 950). The health defects rate before and after the implementation showed significant difference (χ2=8.387, P=0.004). The incidence of anxiety before and after the implementation was 11.8%(23/195) and 4.1%(8/195), the difference was significantly different (χ2=7.885, P =0.005). Conclusions To carry out the quality circle activity, can effectively reduce the perioperative health education defect rate and improve the quality of care and patient satisfaction, method is simple and easy to operate, it is worth clinical promotion.

The article explores the relationship of the hepatitis C virus infection with interferon treatment and thyroid diseases and reviews the subtypes of the thyroid diseases.Autoimmune and nonautoimmune cases of thyroiditis are often seen in patients with chronic hepatitis C while undergoing interferon treatment,especially in females with positive thyroid autoantibodies.Graves' disease is very rare.The thyroid function may be as a transient thyrotoxicosis,then followed by hypothyroidism.The thyroid function in patients with nonautoimmune thyroiditis is usually easy to recover.

The study was carried out on 52 patients with severe falciparum malaria: 26 cases were treated by quinine, SMP in combination with Thymogene (control group). The results showed that: There is a reduction on cellular immune response in severe malaria. Thymogen has contributed to increase the immune response in comparison with this before treatment. Thymogen has contributed shortening time to defervescence, clearance of parasitaemia and coma duration in 2-days after treatment in comparison to control group. Thymogen also has contributed reducing mortality in severe malaria
Malaria ; thymogen ; Malaria, Falciparum ; therapeutics ; Pharmaceutical Preparations ; Drug Resistance

Objective To explore the clinical effect of cassia twig tuckahoe capsule combined with mifepris-tone in the treatment of myoma of uterus,and to observe and analyze its influence on the quality of life,thus to provide basis for clinical treatment of uterine fibroids.Methods 138 patients with myoma of uterus were selected randomly. They were randomly divided into the control group and the observation group,69 cases in each group.The control group received mifepristone treatment,and the observation group received cassia twig tuckahoe capsule combined with mifepristone.The treatment effect of the two groups,tumor volume change were observed,follicle generate hormone (FSH),estradiol (E2 )and luteinizing hormone (LH)generated levels before and after treatment were detected,the quality of life and adverse reaction were assessed.Results The total effective rate of the observation group was 92.75% (64 /69),which was higher than the control group [82.61% (57 /69)],the difference was statistically significant (χ2 =10.16,P <0.05 ).The tumors volume of the observation group after treatment was (13.35 ± 1.17)cm3 ,which was lower than the control group after treatment (15.64 ±1.33)cm3 ,the difference was statistically significant (t =9.04,P <0.05).FSH and LH levels of the observation group after treatment were (30.55 ±6.14)U /L and (32.02 ±7.12)U /L,which were lower than the control group after treatment[(38.27 ±6.75)U /L and (36.91 ± 5.38)U /L],the differences were statistically significant (t =9.07,7.98,all P <0.05).E2 of the observation group after treatment was (53.41 ±5.13)pmol/L,which was higher than the control group after treatment[(47.82 ± 5.19)pmol/L],the difference was statistically significant (t =8.76,P <0.05).The period and menstrual volume of the observation group after treatment were (4.62 ±0.81)d and (52.36 ±6.21)mL,which were less than the control group after treatment[(6.71 ±0.86)d and (60.75 ±6.86)d],the differences were statistically significant (t =8.61,9.29,all P <0.05).The overall quality of life,physical function,emotional function and social function of the observation group after treatment were higher than the control group,the differences were statistically significant (t =10.26,9.69,10.13,10.27,all P <0.05).Conclusion Cassia twig tuckahoe capsule in combination with mifepris-tone in the treatment of myoma of uterus has better clinical curative effect,which can significantly improve sex hormone levels and menstrual status,and improve the quality of life.It has high security.

Performance agreements management plays an important role in transforming government functions, improving public management efficiency and quality of public services. The international experience shows that: performance agreements management, as a new tool, is also applicable to public hospital governance yet calling for basic policy environment,incentive mechanism and technical support.This paper analyzed the performance agreements managements'applicability in the governance of public hospitals,the implementation conditions and environment,the mechanism and so on,in order to provide a theoretical reference for the introduction of performance agreements for the pilot cities of the public hospital reform.

This study reviewed the history and major issues of the reimbursement system reform on public hospitals in China,and analyzed the impact mechanism of specific reform approaches including price adjustment of health service and government special appropriation on the health care services provided by hospitals using qualitative analysis methods.This study has the following findings:if the public hospital is allowed to operate independently,the compensation by health service price adjustment will encourage hospitals to increase their service provision;the compensation method of government special appropriation will decrease the amount of service,and probably cut back the amount of drugs sold;with both reforms combined,hospitals will be encouraged to increase their medical service provision to make up for the revenue lost caused by canceling drug mark-ups.Finally,there were several policy suggestions.

Inborn errors of bile acid synthesis caused by enzyme defects are inherited metabolic rare diseases and mostly belong to the autosomal recessive hereditary diseases. They are clinically manifested as progressive cholestasis liver disease, neurological disorders, and fat-soluble vitamin malabsorption. The progressive cholestasis liver disease is characterized by conju-gated hyperbilirubinaemia with raised transaminase, but normal γ-glutamyl transpeptidase (γ-GT), and a biopsy specimen shows giant cell hepatitis. The neurological disorders usually present with childhood-onset or adult-onset spastic paraplegia. Early diag-nosis is important because oral administration of bile acids is effective for two disorders above. This article reviews pathophyso-logy, clinical features and various enzyme defects of inborn errors of bile acid synthesis.

Objective] To observe the clinical effect of blade needle step operation three Tongbi Decoction in the treatment of osteoarthritis of coracoid process.[Methods] The coracoid arthritis 80 patients were randomly divided into 2 groups, the treatment group of 40 cases using blade needle step-by-step operation three Tongbi Decoction treatment, 1 time a week; the control group 40 cases treated with acupoint injection therapy, 3 times a week. After 4 weeks of treatment, observe the clinical curative effect of the 2 groups.[Result] The treatment group and control group total effective rates were 97.7%and 80.0%respectively, the cure rates were 67.5%and 30%respectively, the recurrence rates were 2.6% and 25%, respectively. By contrast, two groups total effective rate and cure rate and recurrence rate difference were statistically significant( x2=11.257, P=11.257, x2=4.507, P=0.034, x2=4.505, P=0.033<0.05).[Conclusion] Effect of blade needle step-by-step operation three Tongbi Decoction in the treatment of arthritis of the coracoid process is obviously superior to the single point injection, is worthy of clinical application and promotion.

Objective To investigate the clinical effect and safety of fast track surgery in perioperative management in elderly patients with hepatic cancer.Methods 56 cases with hepatic cancer undergoing hepatic surgery were chosen,and randomly divided into observation group and control group (n=28 for each).Patients in observation group were treated with fast track surgery in perioperative management,and patients in control group were treated with conventional treatment.The C reactive protein level,liver function indexes,anal exhaust time,length of stay,adverse reactions and complications were compared between the two groups.Results The C reactive protein level had no difference between the observation group and control group 7 days after surgery [(8.6± 1.4) mg/L vs.(9.2± 2.1) mg/L,P＞0.05].There were significant differences in the levels of alanine aminotransferase,glutamic oxalacetic transaminase,total bilirubin and serum albumin between observation and control groups [(58.0±10.3)U/L vs.(100.3±25.7) U/L,(59.5±21.5) U/L vs.(99.1±29.7) U/L,(21.2±10.0) mmol/L vs.(35.9±8.6) mmol/L and (35.8±2.4) g/L vs.(32.1±2.1) g/L,all P＜0.001].The anal exhaust time and length of stay were less in observation group than in control group [(17.4±2.3) hours vs.(26.3±9.6) hours and (11.5±1.8) days vs.(14.8±3.4) days,both P＜0.001].There were 7 cases with nausea,4 cases with vomiting,8 cases with abdominal distention and 3 cases with abnormal liver function in observation group,and 9 cases with nausea,5 cases with vomiting,7 cases with abdominal distention and 4 cases with abnormal liver function in control group after surgery.There was no significant difference in the rate of adverse reactions between the two groups (P＞ 0.05).Conclusions Fast track surgery in perioperative management is safe for elderly patients with hepatic cancer,which can reduce the stress reaction,improve liver function,shorten anal exhaust time and length of stay,reduce complications and promote the rehabilitation,and it is worthy of clinical application.

In order to analyse the effects of flexion-extension motion of lumbar spine on the position and shape of lumbosacral dural sac, measurements were performed on 10 flexion/extension lateral myelograms of cadaver specimens of normal lumbar spine.It could be seen that from flexion to extension both sagittal diameter and length of the dural sac increased significantly, the dural sac moved caudally, and the sagittal diameter of the anterior epidural space decreased in the mid-vertebral level but increased in the inter vertebral level.The dynamic changes of the dural sac, the influence factors and the clinical relevances were discussed.