This paper deals with the process of the reform and development of the social medical insurance scheme in urban China and the reasons for reform. At the same time, the paper presents the model of financing new urban employees' medical insurance in China.

Fundus autofluorescence (FAF) relies primarily on the presence of accumulated lipofuscin in the retinal pigment epithelium (PRE) cells. It has emerged as a valuable tool to detect and evaluate the viability and structural changes of the RPE in live. As a non-invasive, repeatable, simple and efficient means of detection. FAF imaging can provide information of RPE structure and function to assistant the diagnosis of many retinal diseases with other conventional fundus imaging technologies. With quantitative analysis and complementary analysis with other fundus imaging technologies, the FAF features of different retinal diseases will be further understood. This knowledge will not only extend the reasonable and unique clinical applications of FAF, but also will contribute to the understanding the pathogenesis and improving the treatment of many retinal diseases.

Objective To evaluate the quantity,category and the distribution of health resources of Traditional Chinese Medicine(TCM)in order to advise on optimizing TCM service system.Methods Based on the concept of agglomeration degree,this paper compared and analyzed the agglomeration of TCM resources in terms of medical institutions,their beds and medical workers.Results Currently the agglomeration degree of TCM health resources is found to be low,as TCM medical institutions tend to be small,with most of them being TCM clinics.Conclusions To rationalize the distribution of TCM medical resources,we must increase financial input and provide supportive policies,actively encourage healthy development of TCM medical institutions,strength TCM medical service system development in areas of poor TCM resources.

Objective To analyse the economies of scale in public hospitals in Zhejiang Province. Methods One hundred and twenty-five public hospitals in Zhejiang Province with qualification no less than class two level two were selected as sample hospitals. Douglas production function was employed to analyse the relationship between investment and output in sample hospitals between 2004 to 2006, with two types of production models established by medical service and incomes in hospitals as dependent variables. Results From 2004 to 2006, the medical service and incomes of sample hospitals were in line with economies of scale. The production increase rate was higher than investment increase rate. The medical service, incomes, total assets and number of staff in class three hospitals were higher than those in class two hospitals (P =0.000). Conclusion Economies of scale is the ultimate incentive to continuous outstretch for hospitals. Hospitals should rationally control the scale so as to avoid problems in medical service caused by overstretch.

Dysfunction of microRNA (miRNA) is associated with occurrence and development of tumor.MiRNA are very stable in blood serum,significantly tumor-related and tissue-specific.The detection of serum miRNA is convenient,little-invasive and fast,and then serum miRNA can be used as a new biomarker for tumor diagnosis.

Objective To analyze the inter-provincial utilization efficiency of health resources and master the differences between these regions so as to rationalize the allocation of such resources.Methods This paper called into play the data envelopment analysis to survey the efficiency of interprovincial health resourcas utilization,and the Malmquist productivity index method for further breakdown of the total factor productivity.Results Years 2003 to 2008 averaged an yearly growth of 6.8% for the total factor productivity of health resources in 31 provinces;the rate of technological progress was positive,while the annual rate averaged 5.2%;a slight growth of technical efficiency at the growth rate of 1.5%.Conclusion Years 2003 to 2008 saw an increase of varying extent in the total factor productivity,yet an insufficient utilization of health technology in the provinces in general.Compared to the efficiency of the central provinces,low efficiency was found in both the eastern and western regions in China.The westem regions made a faster progress in technology utilization,thus narrowing the gap of health resources among the provinces.

The balanced scorecard, a new performance management tool used by enterprises, transcends the traditional assessment method of measuring an enterprise only from the financial perspective and renders it possible to view an enterprise simultaneously from four perspectives: financial, customer, internal process, and learning and growth. The balanced scorecard, which can also be used in the medical and health field, enables the hospital to continuously improve performance so as to realize its vision and strategic goals. The paper gives an account of the concept, development steps and principles of the balanced scorecard and its application in hospital strategic management, thus identifying a new channel for hospital development.

The present study deals with the histochemistry of intramural plexus in stomach, duodenum, ileum, caecum, proximal colon, distal colon and rectum of normal adult guinea pig, including the reaction of Mg~(++)-ATPase, Ca~(++)-ATPase, CCO, SDH, G6PDH, carbohydrate, protein, nucleic acid and lipid in the enteric neurons. The reactions of all the enzymes mentioned above are observed under the light microscope and estimated semiquantitatively, among which, Mg~(++)-ATPase and Ca~(++)-ATPase are measured quantitatively with microphotometer (Leitz MPV II). Both results of light microscope, and microphotometer were analysed statistically. It was found that the above mentioned enzyme activities in the enteric neurons, suggesting that the neurons carry out active metabolism with these concerned enzymes. There were significant differences in some enzyme activities between myenteric plexus and submucous plexus, the former showed higher activity in SDH, while the latter in LDH, G6PDH, and two kinds of ATPase. It is suggested that there are some differences in. the major metabolic manner of carbohydrate, energy metabolism and functional activity between, two plexus. Besides, there were marked difference in enzyme activities among myenteric plexus of different part of digestive tract, the highest activity was showed in duodenum and proximal colon, the lowest was in caecum. These results indicate that enteric neurons differ greatly in functional state, but whether or not the variation of enzyme activities is related with the different types of neurons is unknown.

Objective To investigate the diagnosis and treatment of radiation pericarditis. Methods From 1982 to 1994, 3582 patients with esophageal carcinoma in the lower or midthoracic segment received radiotherapy. Twenty-five(0.69%) of them developed pericardial effusion in 1.5 - 9.0 years after radiation. One was carcinomatous effusion, whereas the other 24 patients were diagnosed as having radiation pericarditis and treated with pericardiocentesis,cortical hormone,anti-inflammatory drugs and hydragogue diuresis,and so on.Results With managment,pericardial effusion disappeared gradually in 24 patients. Up to now, 12 patients have died: four of constrictive pericarditis, four of metastasis and another four of unknown reasons.The other 12 patients are still alive.Conclusions Due to the possiblility of developing radiation pericarditis, though rare the area on the heart to be irradiated when giving radiotherapy to middle and lower segment esophageal cancer should be kept minimal. Malignant pericardial effusion should be ruled out by tapping and cytology. Pericardioocentesis,corticosteroids and other conservative management are effective. Pericardiolysis or percardiectomy is indicated when recessary.

Objective To study the operative method for severe duodenal trauma.Methods The clinical data of 38 cases of severe duodenal trauma complicated with pancreatic injury who underwent different operations between 1992—2006 year were reviewed.Results In 8 cases duodenal diverticulization was performed,of which 5 cases were cured,2 cases developed intestinal fistula,and one died.Of 9 cases who underwent panceaticoduodenectomy(PD),3 were cured but 6 had pancreatic leakage,and 3 of them died.Of 16 cases who had primary repair of ruptured duodenum with simple suture or patch suture,13 cases cured,2 cases developed intestinal fistula and one patient died.Five patients underwent duodenal repair and excision of head of pancreas plus pancreaticojejunostomy(PD with preserved duodenum),4 cases recovered and 1 had pancreatic leakage,but 3 with wrap-type pancreaticojejunostomy had no complications.Conclusions The repair of ruptured duodenum with simple suture plus duodenostomy and jejunostomy is preferential option for majority of cases of duodenal trauma.This procedure plus removal of head of pancreas and pancreaticojejunostomy(PD with preserved duodenum) can be used for severe pancreatic injury with excellent result,but duodenal diverticulization or panceaticoduodennectomy must not be undertaken lightly.