Cancelling drug price addition is one of public hospital reform content, under the condition of insufficient financial input, public hospitals should enhance the drug cost management, taking measures to reduce drug proportion, to deal with all kinds of hospital operation problems produced by hospital income decline due to the cancellation of drug addition. Through years of exploration and practice, Affiliated Hospital of Jining Medical University has controlled the rising of drug cost effectively and received better effect, which built a good foundation of public hospital reform.

ObjectiveTo explore the influence of gender,age and types of peer acceptance on the ability of theory of mind among rural parent-absent children.Methods 312 rural parent-absent children participated in the study (including 162 boys,150 girls; 102 members of 8 year-old,119 members of 9 year-old,and 91 members of 10 year-old).Their ability of theory of mind and types of peer acceptance were examined by the 2nd-order False-beliefs Tasks and Peer nomination.The date were analyzed by Multivariate analysis of variance (ANOVA),LSD checkout and Simple effect analysis.ResultsThere were statistically significant effects on ages in theory of mind,types of peer acceptance ( F=4.57,P=0.011 ; F =3.82,P =0.005 ) and the interaction among gender,ages and types of peer acceptance(F=3.20,P =0.042; F =2.50,P =0.043 ).The least significant different(LSD) assay of the ability of theory of mind age and types of peer acceptance shows:there were statistically significant lies in the divergence of age 8 and age 9 group,and also in age 9 and age 10 group,(I-J =-0.51,P =0.016;I-J =- 0.90,P =0.000 ).In the same way,there were also statistically significant lies in the divergence of the ability of theory of mind performance-popular and rejected ( I-J =1.05,P =0.001 ) ; popular and neglected ( I-J =0.84,P =0.003 ) ; popular and controversial( I-J =1.03,P =0.002) ; rejected and average ( I-J =- 0.66,P =0.02 ) ; controversial and average ( I-J =- 0.64,P=0.034).Results of simple effect shows:there were statistically significant lies in the gender divergence of the 9 age group (F =4.98,P =0.026),the age divergence of girls (F =7.50,P =0.001 ),the gender divergence of controversial groups (F=5.76,P =0.017 ),the peer acceptance divergence of boys(F=4.97,P =0.001),and also the peer acceptance divergence of girls(F =2.54,P =0.04).Conclusion There is substantial connection between the ability of theory of mind of rural parent-absent children and ages and types of peer acceptance.

Drug delivery system in tumor targeting research has always been a difficult problem.Apoptosis in vitro experiments and body pharmacokinetic experiments can not reflect the targeting of drug delivery system indirectly.Imaging techniques both in vivo and in vitro solve the problem,researchers can not only observe the drug delivery system in the target organ,the target tissue and target cell directly,but also analyze quantitatively and qualitatively.

Peripheral T-cell lymphoma (PTCL) is a kind of highly aggressive lymphoma which contains a collection of subgroups. The patients with PTCL have poor prognosis under current chemotherapy regimens, so the treatment of PTCL remains a big challenge. Brentuximab vedotin combined with CHP regimen, pralatrexate in combination with romidepsin and other regimens have set up more options for patients with PTCL. Novel agents, such as PI3K inhibitors, which entered into clinical trials, bring good news to PTCL patients.

To determine the relationship between Barrett's esophagus (BE) and features of gastroesophageal acid reflux, 24 h esophageal pH monitoring was performed in 90 patients. The patients were divided into 3 groups: 31 subjects with BE, 21 with mild esophagitis and 38 with severe esophagitis. The following parameters were evaluated: the percentage time of pH < 4; the number of reflux episodes over 5 min; the duration of longest episodes and DeMeester score over total period and the auterior three parameters in erect and supine position. All these parameters in BE were significantly different from those with mild esophagitis (P < 0.01) and not significantly different from those with severe esophagitis (P > 0.05). During supine position all the above parameters in BE were significantly different from those with reflux esophagitis (P < 0.05). It is concluded that the quantity of acid reflux is not an important factor in development of BE in gastroesophageal reflux (GER), and the acid reflux in supine position might be important in development of BE in GER.
Barrett Esophagus/etiology ; Barrett Esophagus/*physiopathology ; Esophagitis, Peptic/etiology ; Gastroesophageal Reflux/*complications ; Hydrogen-Ion Concentration ; Supine Position

[Objective]To summarize results of treating complex proximal tibia fractures with less invasive stabilization system(LISS),and to explore the concept and technology of LISS.[Method]From January 2004 to March 2006,39 cases of complex proximal tibia fractures were treated with less invasive stabilization system,including 26 male and 13 female.The mean age of the patients was 34.8 years(range 22 to 54 years).According to the AO/OTA fracture classification,there were 19 cases in type 41-A3,12 cases in type 41-C2,4 cases in type 41-C3,4 cases in proximal type 42.Seven cases were open fractures and were classified as 3 grade Ⅰ,4 grade Ⅱ open fracture according to the system of Gustilo.Eleven patients were multitraumatic patients.[Result]All the cases were followed up for averaging 15.6 months(10～21 months).The mean operation time was 75 min(60～130 min).All fractures healed,the averaging healing time was 13 weeks(11～16weeks).The averaging blood lost was 300 ml(170～500 ml).The postoperative alignment of 33 fractures was satisfactory,5 cases had 6?～ 8 ?valgus auglation,one case had 5?varus auglation in coronal plane.The mean time of weight bearing was 14.2 weeks(11～18 weeks).The range of movement was 100?～120?.All the cases had no infection,breakage of screws and plates,failed fixation and so on.According to HSS scores system,there were 26 excellent cases,7 good cases,5 fair cases,1 poor case,the excellent and good rate was 84.6%.[Conclusion]Less invasive stabilization system,providing stable fixation and optimizing early bone union and functional rehabilitation,is a realistic therapy in treatment of complex proximal tibia fractures.Exact comprehension of LISS concept and procedure,adjustment according to cases,are very important to assure satisfactory results.

Objective To investigate the influence of proprioceptive training of hemiplegic stroke patients on their visually compensatory dependence.Methods Twenty stroke patients without vestibular abnormalities were recruited.They were able to walk for 10 meters.All the patients underwent 4 weeks of rehabilitation training including proprioceptive training,treadmill exercises and isometric muscle strengthening.Static standing balance test was performed before and after 4 weeks of treatment.The parameters such as the anteroposterior and mediolateral sway of the center of gravity,center of gravity distribution were analyzed before and after the treatment,taking into consideration of visual feedback (eyes open or closed) by using t-test and multiple linear regression analysis.Results Visual feedback had significant no influence on the anteroposterior sway of center of gravity before and after training (P ＞ 0.05) ; Visual feedback had significant influence on mediolateral sway of center of gravity.Rehabilitation training significantly improved the mediolateral sway in opened-eye standing (P ＜ 0.05) but not closedeye standing (P ＞ 0.05).Visual feedback played significant role in center of gravity distribution after training (P ＜ 0.05).Conclusions Visual compensation is of significant influence on the mediolateral sway.Proprioceptive training can help decrease the patient's dependence on visual feedback and enhance the patient's balance ability.

Cystic liver metastasis, which lacks specific clinical manifestations and standardized treatment, rarely occurs after radical gastrectomy. This study presented two gastric cancer cases with cystic liver metastasis treated in Wuxi People's Hospital from September 2008 to November 2012. The two female patients were 66 and 65 years old, respectively. Poorly differentiated ulcerated adenocarcinoma classified as stage III B [Tumor, Node, and Metastasis Classification (T4aN2M0)] and clinical manifestations of abdominal distension and ascites were detected in both patients. Cyst fluids were subjected to cytological analysis. Results confirmed the presence of liver metastasis of gastric cancer. The two patients benefited from local intracavitary chemotherapy or systemic intravenous chemotherapy.

Objective To evaluate the efficacy of fluoroscopy-guided intercostal nerve radiofrequency coagulation in treating postherpetic neuralgia. Methods A total of 40 patients with postherpetic neuralgia (VAS ≥ 4.0) were randomly and equally divided into two groups. Patients in group A (control group) were treated with gabapentin, amitriptyline and oxycodone, while patients in group B (study group) were treated with intercostal nerve radiofrequency coagulation together with the same medicines used in group A. VAS score and oxycodone dosage were determined before the treatment and one, 7, 30, 90 and 180 days after the treatment. The side effects and complications during the treatment were recorded. The results were analyzed and compared between the two groups. Results The VAS scores of patients in group A and group B before the treatment and one, 7, 30, 90 and 180 days after the treatment were (8.2 ± 1.6) vs (8.1 ± 1.1), (6.1 ± 1.7) vs (4.5 ± 1.2), (4.2 ± 1.4) vs (2.7 ± 1.4), (3.6 ± 1.1) vs (2.3 ± 1.3), (3.3 ± 1.3) vs (1.6 ± 0.9), and (2.7 ± 1.2) vs (1.3 ± 1.0), respectively (P<0.05 in all), while the oxycodone dosages in group A and group B were (28.5 ± 5.4) mg vs (28.7 ± 5.8) mg, (35.2 ± 8.5) mg vs (17.3 ± 5.4) mg, (1.6 ± 8.5) mg vs (12.3 ± 3.8) mg, (18.6 ± 4.4) mg vs (5.1 ± 1.7) mg, (10.4 ± 2.3) mg vs (5.6 ± 1.1) mg, and (8.4 ± 1.6)mg vs (4.0 ± 1.1)mg, respectively (P < 0.05 in all). The drug side effects in group B were obviously very mild, and no serious complications occurred. Conclusion Fluoroscopy-guided intercostal nerve radiofrequency coagulation can rapidly relieve the pain in patients with postherpetic neuralgia, and reduce the oxycodone dosage and the occurrence of drug-related side effects as well. Therefore this technique is a safe and effective method for postherpetic neuralgia.

Objective To assess the therapeutic effect of imaging-guided pulsed-radiofrequency stimulation of medial branch of lumbar spinal nerve in treating lumbar facet joint syndrome. Methods A total of 48 patients with clinically-diagnosed lumbar facet syndrome were randomly divided into group A (anti-inflammatory and analgesic group, n=26) and group B (pulsed-radiofrequency group, n=22). The patients of group A received oral meloxicam dispersible tablets , while the patients of group B were treated with DSA-guided pulsed-radiofrequency stimulation of dorsal medial branch of lumbar spinal nerve corresponding to the diseased lumbar facet. Using visual analogue scale (VSA) the severity of pain at the time of admission, discharge and 6 month after discharge was separately evaluated , and the therapeutic effect was assessed based on the improvement of VSA score. Results The VAS scores of group A and group B at the time of discharge and 6 months after discharge were significantly lower than those determined at the time of admission (P<0.01). At the time of discharge, the VSA score of group B was significantly lower than that of group A (P<0.05). Six months after discharge, the VAS score of group B was significantly lower than that of group A (P<0.05). The total effective rates at 6 months after di scharge of group A and group B were 46.5% and 87.6% respectively;the excellent effect rates of group A and group B were 26.4% and 76.2% respectively. Both the total effective rate and excellent effect rate of group B were significantly higher than those of group A (P<0.01). Conclusion Imaging-guided pulsed-radiofrequency stimulation of dorsal medial branch of lumbar spinal nerve can effectively relieve chronic lower back pain caused by lumbar facet joint syndrome , and its therapeutic effect is superior to oral anti-inflammatory and analgesic medication.