The paper proposed a concept to build a management system for operating room hidden costs in an effort to better hospital management and alleviate patients' economic burden.The authors analyzed the root of such costs from the levels of operating room's design and construction,as well as management and operations,proposing a framework of such hidden costs.Based on diversified cost characteristics,they come up with a number of estimating methods,and control methods against different hidden costs by using management theories systematically.

Objective To observe the effects of comprehensive rehabilitation program on severe traumatic brain injury young patients when the time from injury to admission was delayed. Methods Eleven severe traumatic brain injury young patients received comprehensive rehabilitation program, including the neurodevelopmental techniques. They were evaluated with Functional Independence Measure (FIM) and Berg Balance Scale. One Way ANOVA was used to assess the functional status of patients during the course of treatment. Results After 6 to 12 months' treatment, the motor, cognitive and total scores of FIM and the Berg scores of all patients increased significantly ( P

Objective Reengineering of existing facility capacity of the hospital operating department to tap the potential of the capacity, and development of scientific and quantitative basis for hospital decision-making. Methods Existing data of the hospital's operating department was called into play for a fit test of probability distribution, followed by an analysis of such capacity in the queuing theory, ending with a redesign based on the present service demand.Results The operating department in question was found with a low utilization, and with surplus capacity. When the utilization lies between 70% and 80% (7 operating rooms), the queuing system indexes are optimal.Conclusion It is rational and feasible to analyze and optimize operating department facility capacity in the queuing theory. This is conductive to increasing operating room utilization and enhancing hospital competitiveness.

An analysis of the development and present status of overseas hospital cost management pinpoints the setbacks found in China's hospital cost management, and brings forth the proposal to learn from advanced ideas and methods in overseas hospital industrial engineering and cost management. The goals are to build a nationwide total cost control system, explore new fields in cost management and introduce strategic cost management, in an effort to realize scientific cost management in China.

A growing body of evidence demonstrates that vascular factors have involved in the occurrence and development of Alzheimer's disease.This article reviews the research progress of the AD-associated vascular factors from the aspects of AD epidemiology,pathology,clinical research,imaging,and genetics,expecting to investigate the nature of AD from all aspects through vascular factors and finding a new entry point for prevention,diagnosis and treatment of AD.

Objective To make the management responsibility clear for guarding against the lacking of legal basis in patient lawsuits.Methods An implantable coding database for medical consumables was set.Barcode on packaging bag was scanned in 'information system'.'secondary management database for high-value consumables' was set in operation room.According to a warehouse-out list,the warehouse was checked monthly.Results The flow of all consumables was controlled.Conclusion Operational links are reduced and work efficiency is improved.Besides,the transparency of charges is increased.[Chinese Medical Equipment Journal,2008,29(2):64-65]

Objective To develop an information system for hospital material flow management.Methods The system,taking financial accounting and hard assets controlling as the primary purpose and making the flow rebuild as the masterstroke,mainly consisted of seven functions as follows: management of medical material and non-hygiene material,management of antisepsis providing department,management of hard assets,management of drug,management of storehouse materials economical using and support in peacetime and war time,management of biohazard waste and management of the budget of finical IC card department.Results The system formed the information chain of the whole hospital material flow process and effectively controlled the hospital medical costs and operational costs.Furthermore,the system firstly developed the storehouse material economical using and support management system both in peacetime and war time in our country.Conclusion The information system for hospital material flow management can resolve the problem of financial and material management divorce and promote the hospital holistic management level.

AIM and METHODS: The animal model of acute lung injury (ALI) caused by intratracheal instillation of lipopolysaccharides(LPS) in vivo and human peripheral blood polymorphonuclear neutrophil (PMN) in vitro were used to study the effects of sodium nitroprusside (SNP), nitric oxide (NO) donor, on LPS-induced PMN accumulation, microvascular permeability and PMN apoptosis. RESULTS: ① In vivo , PMN accumulation in lung, the protein content in bronchoalveolar lavage fluid (BALF) and the Evans blue dye and monastral blue dye extravasation in lung tissue of LPS group were markedly higher than those of both sham operation group and LPS+SNP group. ② In vitro, the apoptotic percentage of SNP group was much higher than that of control group, while compared with LPS group, SNP+LPS group has significantly higher apoptotic percentage. CONCLUSIONS: SNP intratracheal instillation attenuated LPS-induced microvascular permeability and alleviated ALI. PMN apoptosis induced by SNP may be one of the potential mechanisms underlying the decrease of PMN accumulation in lung tissue.

AIM: To study the role of polymorphonuclear neutrophile(PMN) in lipopolysaccharide (LPS)- induced acute lung injury (ALI) and the protective effect of interleukin - 10(IL - 10) on ALI. METHODS: LPS alone (100 ?g) or LPS+ IL-10 (l ug) was instilled intratracheally into rats. PMN numbers, protein content and malondialdehyde (MDA) content in bronchoalveolar lavage fluid (BALF) were measured. Histological change of lung was also observed. RESULTS: LPS increased significantly PMN numbers, protein content and MDA content in BALF. Histological finding shows PMN accumulation in lung. IL - 10+LPS reduced remarkably PMN numbers ,pro- tein content and MDA content in BALF than those caused by LPS. PMN decreasing was also identified by light microscopy. CONCLUSION: LPS instilled intratracheally causes PMN accumulation in lung and ALI, while IL - 10 could alleviate ALI through reducing PMN accumulation.

Objective To evaluate the efficacy of double filtration plasmapheresis (DFPP) in the treatment of patients with refractory rheumatoid arthritis (RA). Methods Eighty-two patients were randomly aesigned,42 to the DFPP group and 40 to the no-DFPP group. All patients previously experienced an incomplete response to 2-3 dis-ease-modifying antirheumatic drugs (DMARDs) and 1-2 nonsteroidal anti-inflammatory drugs (NSAIDs) or predni-sene. All patients received sulphasalazine (SASP,0.75 g three times daily) plus methotrexate (MTX, 10 mg orally once weekly). DFPP was performed once a week for 2-3 sessions. A total of 121 plasmapheresis procedures were per-formed in 42 patients. Control patients did not receive sham DFPP. The efficacy measures recorded one day after the final treatment and latest month in follow up for 12～24 months included the American College of Rheumatology 20% ,50% ,and 70% improvement criteria (ACR20, ACR50, and ACR70), the Health Assessment Questionnaire estimate of disability (HAQ); and the disease activity index. Results Patients in the DFPP group had ACR 20, ACR 50 and ACR 70 improvements of 100% ,92.9% and 81.0%,as compared with the patients in no-DFPP group 17.5% ,0,and 0 (P<0.001). Significant change from baseline was observed in HAQ scores in the DFPP group but not in the no-DFPP group (P<0.001). The changes from baseline in the disease activity scores were significantlygreater than in the no-DFPP group (P<0.001). Conclusion DFPP therapy significantly alters the signs and symp-toms of refractory RA. There are significant increases in physical function and improvement in quality of life.