Objective To improve the recognition in clinical features,diagnosis and treatment of POEMS syndrome.Method Twenty-one cases of POEMS syndrome were analyzed retrospectively.Results The major clinical features were shown as follows: 21 cases of polyneuropathy, organomegaly, edema and skin changes, 13 cases of monoclonal plasma proliferative disorder, 19 cases of endocrinopathy, 1 case of sclerotic bone lesions, 1 case of Castleman disease,5 cases of papilledema.Conclusions POEMS syndrome is a rare multi-system damage disease.Screening for POEMS syndrome with serum protein electrophoresis, immunofixation electrophoresis,electromyogram and radionuclide bone scanning are essential for all patients with unexplained peripheral neuropathy or multi-system damage.If the index of suspicion is high enough, bone marrow cytomorphologic examination or biopsy with immunohistochemical staining may be required,in order to make an early diagnosis and try to avoid misdiagnosis and mistherapy.

目的探讨辽宁省机关干部肥胖的患病率及其危险因素以及肥胖与其他代谢异常的关系。方法对辽宁省1680名机关干部随机抽样进行体格检查,并进行肥胖患病率的流行病学调查。结果本组人群肥胖患病率为20.42%,其中男性27.8%,女性21.9%,男女性之间有显著性差异(P<0.05);不同年龄组间肥胖患病率亦有显著性差异,其中以40～50岁中青年干部肥胖患病率最高,为26.25%;肥胖与生活方式及其他代谢异常密切相关。结论中青年机关干部的肥胖患病率明显高于中老年组,且与不良生活方式有关,同时合并有其他代谢紊乱。

The information system of 301 Hospital One-Card service, was designed to enable outpatients to register online via mobile ends, pay in real-time, and hierarchical examination-diagnosis among other services. As the hospital HIS system cannot link to the Internet directly, the system could make use of the Internet application front end of China′s financial platform, and such means of 2D-barcodes and APP. This innovation could improve outpatient experience, keep confidential of medical information and patients′privacy, and change on-site registration to appointment in advance.

This paper described the practice of using the bank card as a medical card.This practice is designed to fully leverage the financial service system of major banks in China and premium medical resources,as it may optimize medical service flows of registration,doctors' visit and charging at the hospital.This reform aims at creating an information integrating bank cards and hospital cards featuring practicality,convenience,security and high-tech,so as to improve medical service and provide the patients with a better experience in seeing doctors.

The factors influencing cost accounting fall into such three categories as drivers and incentives,factors affecting authenticity and accuracy,and factors affecting application and selection.DRG payment,as it is getting more popular than before,is pushing forward cost accounting at an unprecedented pace.Thanks to the current payment system reform and the transition of public hospital reimbursement regime,such needs as exact payment,j ust compensation and cost/performance management of such hospitals are challenging the present cost accounting system,calling for the birth of a cost accounting system for these hospitals.To build such a system,micro-and macro-level goals need to be considered simultaneously,while needs of different levels should be designed,integrated and interacted with each other.Only in this way,goals can be reached for such a system.

Using the enterprise resource planning(ERP)management mode,the paper analyzed the present medical insurance payment audit accounts at public hospitals,and probed into the establishment of an information management platform for medical insurance payment audit accounts in the ERP environment.The purpose is to perfect the management of medical insurance payment audit accounts,increase the efficiency of hospital's working capital,strengthen the quality and efficiency of hospital management.

The overuse of injection exists more than 20 years since economic reform in China. It is a persistent problem and seems becoming a new challenge in the new health reform period. This study was designed to assess the effect of national essential medicines policy (NEMP) on injection use at primary health facilities in China by investigating their prescription information. Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011. The injection use was measured as the indicator as the percentage of prescriptions with one or more injections. The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82% (χ (2)=11.158, P=0.001) in the all survey areas during the NEMP reform. The difference in level of the injection use in 2011 was significant among the eastern, central and western regions (χ (2)=223.584, P=0.000); level of the injection use in western region was the lowest (27.73%), while that in the central region was the highest (43.10%). The level of the injection use in 2011 among different provinces was also of great difference (26.00%-58.25%, range: 32.25%). The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries (13.4%-24.1%). It was concluded that NEMP has improved injection use in China, but the injection abuse situation remains serious, indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs, especially the injection use.

Objective To evaluate the acute side effects and efficacy of three dimensional conformal radiotherapy(3DCRT)combined with chemotherapy(CT)for locally advance non-small cell lung cancer(NSCLC).Methods from May.2002 tO Dec 2004,36 patients with NSCLC were treated with three dimensional-conformal radiotherapy combined with chemotherapy navelbine+cisplafin(NP)Results The overall response rate(CR+PR)was 91.7% for the primary tumor,and 100%for metastases mediastinal lymph mode.The leucopenia mte was 94.4%(55.6%Grade 3.4)Acute radiation esophagitis occurred in 52.8%of patients(Grade 1.2)Acute radiation pneumonitis was observed in 11.1%of patients(Grade 1.2)Conclusion 3DCRT combined with CT is well tolerated in most patients with NSCLC.Its early responses are milder than the conventional radiotherapy combined with chemotherapy.Remote results awmt further follow-up

Objective To investigate the effects of low-dose X-ray radiation on pituitary gland area to treat benign prostatic hyperplasia.Methods Using the linear-accelerator 6mV X-ray to radiation on pituitary gland area,1.2Gy/f,2 times/week,total dose was 4.8～6.0Gy.The uro-flow rate and residual urine volume were measured.Results The immediate effect was 77.5%,the 1-year effect rate was 70%.After treatment,the uro-flow rate was significantly increased(P

[ ABSTRACT] AIM:To investigate whether the increase in PTEN expression is related to apoptosis, and whether it is regulated by reactive oxygen species( ROS) .METHODS: The rat islet cells were divided into constant low glucose group ( group L) , constant high glucose group ( group H) , glucose fluctuation group ( group F) , low glucose after high glucose group (group HL) and low glucose after fluctuation group (group FL).The ROS level, apoptotic rate, intracellu-lar calcium, insulin release and PTEN protein expression were analyzed.RESULTS:Compared with groups H and L, the insulin secretion decreased, and intracellular calcium, ROS level, PTEN protein expression and apoptotic rate increased in group F ( P<0.05) .Compared with group H, the intracellular calcium, ROS level, PTEN protein expression and apoptot-ic rate in group HL decreased, but were still higher than those in group L (P<0.05).Compared with group F, the intra-cellular calcium, ROS level, PTEN protein expression and apoptotic rate in group FL decreased, but were still higher than those in group L (P<0.05).CONCLUSION:Glucose fluctuation can cause the apoptosis of islet cells more easily than constant high glucose.This may be related to the change of intracellular calcium and increase in oxidative stress which pro-motes PTEN expression.The recovery of glucose level to some extent relieves oxidative stress, decrease PTEN expression and reduce cell damage.