Objective To study the clinical significance of detection of infectivity index in patients before transfusion. Methods A total of 12 863 patients in hospital were examined for hepatitis B virus surface antigen(HBsAg),anti-hepatitis C virus(anti-HCV),anti-AIDS virus(anti-HIV)and treponemiasis test(TRUST)before operation and transfusion. Results The positive rates of HBsAg,anti-HCV,anti-HIV and TRUST were 12.59%,1.90%,0.02%and 0.80%respectively.Conclusion The detection of infectivity index before transfusion has a very,important role in the prevention of blood transmissible disease and reduction or medical treatment dispute caused by infection after transfusion.

One hundred forty-four residents registered at department of anesthesia of West China Hospital from 1999 to 2010.The duration of residency training is 5 years (3 + 2).The residents enrolled during 1999-2002 were on the staff.They were assigned to work at this hospital after graduation from medical school and became staff anesthesiologist of this hospital after 5 year training.The residents enrolled during 2003-2010 were trainees and not on the staff.They had to apply for a job as anesthesiologist somewhere after 5 year training.After 3 year training the residents are qualified to undergo subspecialty training.Thirty-nine of the 144 residents dropped out of the training program.The reasons for their withdrawing from the program included finding a regular job,failing the qualifying examination,changing profession studying abroad and death.In order to reduce dropout rate,correct public opinion on the importance of residency training,raising the quality of the residents and improving income of the residents are needed.

Objective To explore the effect of GAS MAN assisted instruction on theory learning of volatile anesthetics in anesthesiology residency training.Methods A total of 32 residents in the first stage of anesthesiology training were enrolled and randomly assigned to either study(S) or control (C) group.Theory-test l(Test-1) was conducted for all residents after the lecture-based learning (LBL).Next,reference book self-reading strategy was used in both groups while computer-based simulation(CBS) using GAS MAN was only developed in S group.Then,theory-test 2(Test-2)was conducted for residents in both groups and residents in S group completed the questionnaire smvey.In addition,thirty-four resident teachers observed the CBS courses and completed the questionnaire smvey.Results The mean scores of Test-1 did not differ significantly between the two groups(P=0.64).However,the mean Test-2 score of S group(81.3 ± 13.6) was significantly higher than that of C group(61.3 ± 15.4) (P=0.001).100％(16/16) residents believed that CBS was beneficial to the theoretical study of volatile anesthetics,93.8％(15/16) residents considered GAS MAN could help understand the concepts and improve efficiency during self-learning.97.1％ (33/34) and 91.2％ (31/34)resident teachers agreed that CBS was helpful for analyzing complex concepts and improving study effectiveness,respectively.Conclusions CBS using GAS MAN improves theory knowledge and study effectiveness for anesthesia residents.Both residents and resident teachers find GAS MAN highly ac ceptable.Therefore,GAS MAN has the potential to be the assistant teaching tool for LBL in anesthesiology residency-training program.

Objective To observe the effects of scalp acupuncture on cognitive impairments after traumatic brain injury (TBI). Methods 42 cases of TBI were randomized into experiment group (n=23) and control group (n=19). The control group accepted cognitive training and Donepezil, and the experiment group accepted scalp acupuncture in addition for 3 months. They were assessed with event related potential P300 and Montreal Cognitive Assessment (MoCA) before, 1 and 3 months after treatment. Results The results of P300 and MoCA improved significantly 3 months after treatment (P<0.001) in both groups, and improved more in the experiment group than in the control group (P<0.001). Conclusion Scalp acupuncture could improve outcomes of cognitive impairments after TBI.

This article provides an overview of the severe acute respiratory syndrome (SARS) epidemics in mainland China and of what we have learned since the outbreak.The epidemics spanned a large geographical extent but clustered in two regions:first in Guangdong Province,and about 3 months later in Beijing and its surrounding areas.The resulting case fatality ratio of 6.4％ was less than half of that in other SARS-affected countries and regions,partly due to younger-aged patients and a higher proportion of community-acquired infections.Strong political commitment and a centrally coordinated response were most important for controlling SARS.The long-term economic consequence of the epidemic was limited.Many recovered patients suffered from avascular osteonecrosis,as a consequence of corticosteroid usage during their infection.The SARS epidemic provided valuable experience and lessons relevant in controlling outbreaks of emerging infectious diseases,and has led to fundamental reforms of the Chinese health system.Additionally,the epidemic has substantially improved infrastructures,surveillance systems,and capacity to response to health emergencies.In particular,a comprehensive nationwide internet-based disease reporting system was established.

Objective To evaluate the outcomes of the payment reform at public hospitals in Sanming city.Methods Interrupted time series analysis was used to compare changes of the average days of stay,per capita hospitalization expense,outpatient expense per visit,proportion of medical expense and that of drugs during hospitalization at 21 public hospitals at or above county level before and after the DRGs reform.Results Comparisons before and after the reform found the average days of stay at the original momentum,poor control in curbing the proportion of medical expense and that of drugs during hospitalization,adropping followed by rising trend in the outpatient expense per visit,and minimal drop of the abovementioned proportions.Conclusions The rapid growth of outpatient and hospitalization costs at tertiary hospitals may be incurred by unreasonable cost transfer,structural trend of hospitalization expense makeup,and rationality pending scrutiny.

Tripartite-sector reform (a synergistic reform in public health services,medical insurance and medicine production-circulation) in Sanming city was described in the paper which centers on medical insurance.Tapping full potentials of the medical insurance,the city achieved efficient synergy among healthcare,medical insurance and medication systems.This reform has trimmed out inflated drug pricing to some extent for rooms of maneuver of medical service pricing changes,thus curbing excessive growth of medical costs successfully.The authors proposed areas of further improvements including the relationship between achieving such objective as curbing medical expenditure,and advancement of technical/medical service capacity;that between integrative control of medical insurance expenditure and protection of people's health;the equilibrium of interests between medical insurance,healthcare and medication.All these will contribute to the goal of healthy patients flow and a hierarchical medical system.

Objective: To explore the utilization and effects of informatization in perfecting the community health service mode. Method:Through purposive sampling, 12 community health service centers in Beijing, Shang-hai, Chengdu, and Zhengzhou were selected for site investigation. The heads of the health administrative department and community health service centers were interviewed, with a focus on the construction and utilization of the local community health informatization and a discussion of the role of informatization in perfecting the community health service mode. Results:The information systems can be divided into core systems, core auxiliary systems, and periph-eral support systems. Informatization provides strong support to perfecting the community health service mode in opti-mizing the service process, improving work efficiency, strengthening institutional cooperation, promoting quality regu-lation, optimizing performance appraisal, and strengthening doctor-patient interaction. Conclusion: Informatization plays a key role in perfecting the community health service mode. Recommendations were proposed to strengthen community health informatization construction and utilization:optimizing service processes, promoting the efficient co-ordination of safe health services, optimizing performance appraisals, and strengthening doctor-patient interaction.

Objective:To analyze the concerning guarantee mechanisms during the transformation of the com-munity health service mode. Method:Purposive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou, and Chengdu, where the transformation of the community health service mode was pi-loted earlier and representative, were selected as the field survey sites. The qualitative method was used to collect da-ta accompanied by the quantitative method. Results: The guarantee mechanisms related to the transformation of the community health service mode could be concluded into four main types:collaboration mechanism, health profession-al training mechanism, incentive mechanism, and policy guarantee mechanism. All of the four mechanisms contribu-ted to the improvement of general teamwork, dual referral systems, and the development of contract and appointment services. Conclusion:During the transformation of the community health service mode, priority strategies include top-down design, health professional training mechanisms, and performance-based incentive mechanism, all of which should be implemented in the future.

Objective:To analyze the structure modes of general practice teams in community health care cen-ters in order to provide empirical evidence for the transformation of the community health service mode. Method:Pur-posive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou and Cheng-du, where the transformation of the community health service mode was piloted earlier and representative, were se-lected as the field survey sites. The qualitative method was used to collect the data accompanied by the quantitative method. Results:The structure models of general practice teams could be divided into four types:1) general practi-tioner+nurse+nurse assistant+pharmacist, 2) physician (general practitioner, herbalist physician) +nurse+com-munity volunteers, 3 ) physician ( general practitioner/herbalist physician ) +nurse +assistant +community volun-teers, and 4) general practitioner+nurse+assisting team (professionals of public health and maternal care, etc) +supportive team ( pharmacists, health technician, etc) . Conclusion:The paper verified the common sense conclusion that general practitioners should play an essential role in general practice teamwork. The four general practice team models analyzed above positively contributed to the improvement of efficiency and quality, the relationship between health professionals and patients, the promotion of community participation, and the combination between preventive care and clinical care.