OBJECTIVE:To discuss the related measures for the reduction of medical expenses.METHODS:The related data concerning hospital drug revenues before and after the operation of’pharmaceuticals purchase by public bidding’were compared,and reasons for the high undescended hospital drug expenses were analyzed.RESULTS:Although the drug revenues kept increasing year by year,yet the profits gained by hospitals from which decreased year by year,which may resulted from many factors.CONCLUSIONS:The operation of the’pharmaceuticals purchase by public bidding’failed to bring down the high medical expenses.

Staphylococcus epidermidis(SE)is the main opportunistic pathogen in nosocomial infections.It usually enter the body along with biomedical materials and adheres to the surface of biomaterials to form bacterial bi06lm.SE bi06lm bears high organized multi.cell colony structure.Bacterial biofilm iS the key reason for refractoriness of biomaterial originated infection.This paper gives an overview of the research progresses in biomaterial related infection,including SE ica operon,formation of biofilm,biofilm treatment,and SO on.Our review shows that studies of SE biofilm were COnfined to the mutated strain from laboratory and growth pattern of plankton and thus the natural clinical pathogenic procedure of SE can't be fully described.Further study should be carried out on formation of SE biofilm and treatment of infections related to the clinical application of biomaterials.

Objective To investigate the therapeutic effects of orthotopic urinary diversion in women. Methods From September 1995 to December 2003,34 female patients (mean age,58 years;range,53-64 years) with bladder cancer were included.Of them,30 cases were of primary tumors and 4,of recurrent ones.Pathology showed transitional cell carcinoma in 30 cases,bladder adenocarcinoma in 3 and squamous cell carcinoma in 1.Radical cystectomy was performed in all the 34 cases;and the technique of cystectomy with nerve-sparing was performed in 24 of them. Intraoperative frozen section of the distal urethra surgical margin showed no evidence of tumor,and ileal neobladder was formed in all.The clinical therapeutic effects were analyzed retrospectively. Results The mean operative time was 360 min(range,280-420 min),and mean blood transfusion was 600 ml(range,300-1000 ml).Thirty cases were followed up for a mean of 61 months(range,6-108 months).At 6 months after surgery the continence rate was 90%(27/30) during the day and 86%(26/30) at night.Twenty-three cases could empty the neobladder one time and 2 needed intermittent catheterization due to hyper-continence; the other 5 needed pushing the abdomen to empty the neobladder. Twenty-three patients had good urodynamic findings;the vesical capacity ranged 300-520 ml and maximum intravesical pressure were

Objective To study the relationship between the expression of E-cadherin and the development, invasion and metastasis of esophageal carcinoma. Methods The expressions of E-cadherin in 58 cases with esophgeal carcinoma and 122 other cases with esophageal epithelial disease were examined by immunohistochemical technique. The relation between the expression of E-cadherin in esophageal carcinoma and the clinical pathological characteristics of esophageal carcinoma were analyzed. Results The expression rate of E-cadherin gene protein in esophageal squamous carcinoma and adenocarcinoma was 22.0%(11/50), 25.0%(2/8), respectively, compared with the normal group (100%, 20/20) and simple atypical hyperplastic group (92.9%, 26/28). The difference was significant (P

ObjectiveTo investigate the correlation between recent cardiac events and the score of myocardial infarction by delayed-enhancement MRI (DE-MRI).Methods DE-MRI was performed in 40 subjects with coronary artery disease.The score of myocardial infarction by DE-MRI,the ejection fraction (EF) by echocardiography,recent cardiac events (the number of weekly nitroglycerin,the number of weekly angina episodes and the onset number of heart failure in the last year),6-minute walking distance,as well as the Seattle angina questionnaire (SAQ) score were assessed.The Spearman correlation test and Kruskal-Wallis test,Mann-Whitney test were used for the statistics.ResultsThere were negative correlation between the myocardial infarction score by DE-MRI (median 12,inter-quartile range:6.0-19.8) and the 6-minute walking distance(378.93 ± 100.53 ),SAQ score (74.55 ± 11.40 ) (r was 0.66 and 0.54,P ＜0.05).The myocardial infarction score by DE-MRI was strongly correlated with the number of weekly nitroglycerin ( median 1 ; inter-quartile range:0-2.8),the number of weekly angina episodes ( median 3,inter-quartile range:1-6.5 ) and the onset number of heart failure in the last year ( median 0,inter-quartile range:0-2) (r was 0.87,0.85 and 0.89,P ＜0.05).EF [(49.2 ± 13.72)％] was negative correlation with the number of weekly nitroglycerin,the number of weekly angina episodes and the onset number of heart failure in the last year (r were 0.67,0.73 and 0.73,P ＜0.05).ConclusionDE-MRI can be used for evaluation and prediction of future cardiac events.

Objective To explore the role in the localization of vascular puncture points with dynamic contrast-enhanced magnetic resonance angiography (DCE-MRA) before transjugular intrahepatic portosystemic shunt (TIPS). Methods MRA images of 46 patients with portal hypertension were measured. The patients were then punctured according to the measurement Results The supero-inferior distant from the puncture point of hepatic vein to plane of right branch of portal vein (AA') was (22.63±10.21)mm, the anteroposterior distant from the puncture point of hepatic vein to plane of right branch of portal (A'A'') was (13.93±1.07)mm, the angle of sag was (31.64±9.23)°. The distant from puncture point of hepatic vein (AS) and right branch (BS) were (23.51±2.12)mm and (38.51±5.36)mm. The angle of cor was (33.57±8.93)°. Forty-five patients were successful punctured, and the time of puncture decreased. Conclusion The location of portal vein puncture point during TIPS are changeable, therefore individualized location of positioning is needed. DCE-MRA is a valuable non-invasive method of localization, playing an important role in localization of vascular puncture points of TIPS.

Objective To investigate the relationship between the different ambulatory arterial stiffness index and the markers of renal impairment in order to provide a scientific method for detecting the renal impairment of essential hypertension. Methods Three hundred essential hypertensive patients without overt proteinuria were enrolled. The ABPM was performed and the blood pressure parameters were analyzed in order to estimate the symmetrical ambulatory arterial stiffness index (S-AASI) and ambulatory arterial stiffness index (AASI) . Microproteinuria was measured by urine microalbumin to creatinine (mAlb/Cr)as well as n-acetyl-β-D-glucosaminidase (NAG)to creatinine rate (NAG/Cr). Creatinine clearance (Ccr) and Glomerular filtration rate (eGFR) were estimated from serum creatinine (sCr) . Linear correlations were performed to confirm the independent predictive power of S-AASI and AASI for renal lesion. Results Correlation test showed a significant positively relationship of S-AASI with urine mAlb/Cr (0.708, <0.001), urine NAG/Cr (0.700, <0.001) and sCr (0.229, <0.05) . Ccr (0.601, <0.001) and eGFR (0.309, <0.05) were negatively correlated with S-AASI. On the other hand, AASI was also correlated with urine mAlb/Cr (0.489, <0.001),urine NAG/Cr (0.470, <0.001) and Ccr (0.311, <0.05),but not with the sCr (0.064, >0.05) and eGFR (-0.135, >0.05) . S-AASI seems to get an independent relationship with all of the parameters of renal impairment which could not be detected with AASI. Conclusion This results suggested that S-AASI may be a better approach than AASI to estimate hypertensive renal impairment.

Objective To evaluate the effect of endovascular stent-graft exclusion used in of thoracic aortic dissection aneurysm. Methods by retrospectively study the clinical collections of 34 Stanford B aortic dissection cases which were treated by endovascular stent-graft exclusion in the condition of full anaesthesia from 2002 to 2005.Results 34 patients were successfully stened but one patient failed because the guide-wire could not get into the real vascular and no perioperative death.The range of postoperative follow-up was form 3 months to 29 months,the average of which was 15 months.24 of the patients accepted a reexamination of CT,9 of them were performed DSA at the same time.Conclusion Endovascular stent-graft exclusion is safe and efficient for Stanford B aortic dissection aneurysm.Further follow-up is necessary to evaluate its long-term effectives.

Objective To investigate the applied perineal anatomy of the pudendal nerve of female and its direction to perineal operation.Methods The gross anatomy were done on 20 female cadaver(ensuring the pelvic,the hip and the perineum were intact).In each cadaver,the dissection proceeded from intrapelvic,the pudendal canal(Alcock'canal) and the ischiorectal fossa.The composition,track,abut,ramus and domination area of female pudendal nerve were examined.Results The gross anatomy showed that the pudendal nerve was composed of the ventro-branches of sacral nerve 2~4(S_2~S_4).The pudendal nerve sends off anal branch at level of the ischial spine.And the trunk courses in the internal pudendal canal forwardly and inwardly send off the perineal nerves and dorsal nerve of clitoris.The perineal nerves sends off branches to back lunar labium,muscle and urethra.The dorsal nerve of clitoris sends off the nerve to skin of clitoris,and some to the urethra simultaneously.The pudendal nerve has different abut in different anatomical position.Conclusions The perineal anatomy of the pudendal nerve has the meaningful direction to the perineal operations.

With development of medical imaging,traditional picture has been replaced by digital information.To apply information-based education to medical imaging and enhance the teaching quality,the article explored the teaching methods of information-based education.