Objective To understand the present situation of city-level public hospital reform and to analyze the impacts on different clinical departments by analyzing the changes of hospitalization expenses of a third-level grade-A hospital from Anhui Province.Methods The inpatient data from April to September,2014 and 2015 of the third-level grade-A hospital were collected.Three typical diseases in Department of Internal Medicine,Surgery,Gynecology and Pediatrics respectively,were chosen to compare the changes of expenses and the structure before and after the reform.Results Overall,hospitalization expenses saw a declining trend after city-level public hospital reform.But,it was different in each department.The structure of hospitalization expenses became more reasonable after reform,however,the medical material expense remained a question.Conclusion The city-level public hospital reform reduces drug costs and inspection fees for inpatients effectively,thereby abating the overall cost of hospitalization,and the structure of hospitalization expenses becomes more reasonable.But the changes of hospitalization expenses in different departments reflect some problems.

The cholinergic anti-inflammatory pathway (CAP) is an important neuroimmunomodulatory mechanism that innervates the spleen through vagus nerve efferent and splenic nerve relay, and acts on macrophages by transforming adrenergic stimulation into cholinergic signal by spleen T cells, which plays an anti-inflammatory effect, and maintains the balance of inflammatory response. Due to the critical role of the imbalance of pro-inflammatory and anti-inflammatory responses in the physiological process of sepsis, regulating the activity of the CAP has become an important focus in the treatments of sepsis. Based on the understanding of the CAP, vagus nerve stimulation, drug agonists mimicking cholinergic signals, and acupuncture are currently applied in the research and exploration of sepsis treatment. This article summarizes the recent progress and prospects of the CAP mechanism, biological effects, and application in sepsis treatment.

This paper discussed the interference and noise of medical electronic device and their generation, hazard, depression and application, of which some ones are pointed out for the first time.

Objective To screen and identify the recombinants from the cDNA library of the adult Paragonimus west-ermani (PwA) for immunodiagnosis and immunoprophylaxis. Methods PwA cDNA library was screened with the PwA antigen immunized rabbit sera(IRS) pre-absorbed by the extract of E. coli XLl-Blue. The recombinants from positive clones were amplified by PCR, sequenced and cut off by KpnI/BarnHI and, then sub-cloned into pRESETB vector. The fusion protein was expressed,analysed by SDS-PAGE and identified by Western blotting with immune rabbit serum against worm antigen of Paragonimus westerrnani. Results The inserted cDNA fragment from the positive clone Pw-2 was about 800 bp, which contained an open reading frame(ORF) encoding Pw pre-procathepsin L belonging to cysteinase family. Expression product of Pw-2 was a fusion protein of 32 kDa, which can be recognized by immune rabbit serum against worm antigen of Paragonimus 晈esterrnani. Conclusion A recombinant plasmid Pw-2 encodes Pw pre-procathepsin L is constructed.

Objective To probe into the effect of sitagliptin on blood glucose fluctuation of the patients with type 2 diabetes mellitus(T2DM) and poor control by insulin aspart 30.Methods Ninety cases of T2DM and poor control by insulin aspart 30 in affiliated Zhongshan hospital from January 1,2014 to December 31,2014 were selected and randomly divided into three groups:simply continuous subcutaneous insulin injection(CSII),acarbose combined CSII group(CSII + Aca) and sitagliptincombined CSII group (CSII + Sig),30 cases in each group.Three groups received the intensive treatment for 2 weeks,and72-h continuous glucose monitoring was performed on last 3 d.The 24 h mean blood glucose(24 hMBG),largest amplitude of glycemic fluctuation(LAGE),mean amplitude of glycemic excursion(MAGE) within 1 d,postprandial blood glucose spike(PGS),postprandial glucose peak time(△t),postprandial glucose excursion(PPGE) and total T were observed within 24 h.The difference of insulin dose(△ insulin),hypoglycemia incidence,glucose-target rate,blood glucose profiles were compared at the end of treatment.Results After two-week treatment,intraday blood glucose variation indicators(24 hMBG,LAGE and MAGE) and postprandial blood glucose variation indicators (PGS,△t,PPGE and total T) in the CSII+Sig and CSII+-Aca groups were significantly lower than those in the CSII group(P＜ 0.05),while the differences in blood glucose variation indicators between the CSII+Sig group and CSII+-Aca group were not statistical significant(P＞ 0.05).In the comparison after treatment,△ insulin,hypoglycemia incidence and glucose-target rate in the CSI + Sig group were lower(P＜0.05).Conclusion The combined application of short-term CSII and sitagliptin will achieve a better effect than the combination with acarbose,can smoothly and steadily reduces the blood glucose level,relieves the whole day glucose fluctuations,effectively reduces △ insulin,and has lower hypoglycemia occurrence rate.

Objective: This research is conducted to analyze the background, the main practices and the results of the synergistic service of health institutions in Changzhou city, as well as to provide references for promoting the construction of integrated medical and health service system.Methods: This paper uses qualitative interviews and questionnaires to collect information and analyzes the data based on synergetic management theory.Results:Changzhou city has tentatively achieved the synergy of its health institutions by introducing relevant policies, setting up healthcare unions at the municipal level, integrating internal resources among healthcare unions, establishing health information platform and feedback mechanism, etc.Conclusion: The regional synergistic service of health institutions can be effectively promoted by introducing policies at the municipal level, promoting the mutual sharing and communication on information, and integrating internal resources among healthcare unions.But, as there still exist problems such as the distribution of benefits is not perfect, the degree of synergy is not close, etc., thus, the government is suggested to expand the implementation scope of the close-type medical service synergy and further improve the distribution policy of benefits.

Oral and maxillofacial microsurgery has its own characteristics, including high precision, complicated operation, and long learning curve. It is important for young oral and maxillofacial surgeons to master the basic operation skills through standardized and systematic training.Department of Oral & Maxillofacial-Head & Neck Oncology of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine gives systemic teaching course for senior resident doctors or young attending surgeons. The teaching teams make an intensive course organization and focus on the practical training. They integrat theoretical teaching, basic skill training, gross anatomy training as well as operation observation into a systematic "four-stage ladder approach" , which make a better teaching effect in promoting the oral and maxillofacial surgeons to master the practical and correct microsurgery technique.

Oral and maxillofacial microsurgery has its own characteristics, including high precision, complicated operation, and long learning curve. It is important for young oral and maxillofacial surgeons to master the basic operation skills through standardized and systematic training.Department of Oral & Maxillofacial-Head & Neck Oncology of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine gives systemic teaching course for senior resident doctors or young attending surgeons. The teaching teams make an intensive course organization and focus on the practical training. They integrat theoretical teaching, basic skill training, gross anatomy training as well as operation observation into a systematic "four-stage ladder approach" , which make a better teaching effect in promoting the oral and maxillofacial surgeons to master the practical and correct microsurgery technique.

Oral and maxillofacial microsurgery has its own characteristics, including high precision, complicated operation, and long learning curve. It is important for young oral and maxillofacial surgeons to master the basic operation skills through standardized and systematic training.Department of Oral & Maxillofacial-Head & Neck Oncology of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine gives systemic teaching course for senior resident doctors or young attending surgeons. The teaching teams make an intensive course organization and focus on the practical training. They integrat theoretical teaching, basic skill training, gross anatomy training as well as operation observation into a systematic "four-stage ladder approach" , which make a better teaching effect in promoting the oral and maxillofacial surgeons to master the practical and correct microsurgery technique.

Oral and maxillofacial microsurgery has its own characteristics, including high precision, complicated operation, and long learning curve. It is important for young oral and maxillofacial surgeons to master the basic operation skills through standardized and systematic training.Department of Oral & Maxillofacial-Head & Neck Oncology of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine gives systemic teaching course for senior resident doctors or young attending surgeons. The teaching teams make an intensive course organization and focus on the practical training. They integrat theoretical teaching, basic skill training, gross anatomy training as well as operation observation into a systematic "four-stage ladder approach" , which make a better teaching effect in promoting the oral and maxillofacial surgeons to master the practical and correct microsurgery technique.