How to handle the relationship between doctors and patients is currently a hot spot of society. The author first expounds the fundamental propositions in the theories of the science of value. Then, using the theories of the science of value, he first describes the relationship between the object and subject of value, viz. who comes first, the patients or the staff, arguing that in the mind of the hospital director there should always be an unbiased balance of value benefiting both sides. Then he describes the realistic form in which value exists, viz. which is more important, the value of utility or the value of effectiveness, arguing that the hospital director should lay equal emphasis on the staffs value of utility and the patients value of utility, thus satisfying both sides. Thirdly, the author describes value accounting and the cost of value, viz. the dual unity of the values of effects and effectiveness, arguing that creating value while paying cost indicates the dual nature of the practice of hospital administration. Hence the need to lower cost as much as possible and create greater value.

To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods　Textual researches of materia medica were carried out and their history in clinical application were traced. Results　T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion　We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.

Objective To compare the safety and effectiveness of temporary occlusion techniques with different balloons in performing cesarean section for patients with pernicious placenta previa.Methods The clinical data of 15 patients with pernicious placenta previa,who received cesarean section during the period from March 2014 to April 2016,were retrospectively analyzed.In order to reduce bleeding during operation and to preserve the uterus as far as possible,temporary occlusion of abdominal aorta with balloon was adopted in 7 patients (group A),and temporary balloon occlusion of bilateral internal iliac arteries was employed in 8 patients (group B).The intraoperative radiation dose,the amount of blood loss and blood transfusion during cesarean section,the hysterectomy rate,the postoperative hospitalization days,and the intervention-related complications were documented,and the results were compared between the two groups.Results All the 15 patients were suffered from central type of placenta praevia complicated by extensive placenta accreta.With the help of temporary balloon occlusion technique,the cesarean section was successfully accomplished in all 15 patients.Subtotal hysterectomy had to be done in 7 patients,including 4 patients of group A and 3 patients of group B,and every one patient from each group developed arterial thrombosis of lower limb.The intraoperative radiation dose of group A was significantly lower than that of group B (P＜0.01),besides the amount of blood loss and blood transfusion during cesarean section,the hysterectomy rate,the postoperative hospitalization days,and the intervention-related complications of group A were all lower than those of group B,but because of the limited number of cases these differences were not statistically significant (P＞0.05).Conclusion For the treatment of pernicious placenta previa,temporary balloon occlusion technique-assisted cesarean section is safe and effective.The intraoperative radiation dose in the group using temporary balloon occlusion of abdominal aorta is remarkably lower than that in the group using temporary balloon occlusion of bilateral internal iliac arteries.

Object To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods Textual researches of materia medica were carried out and their history in clinical application were traced. Results T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.

Objective To observe the abnormalities of speech production when developmental stutterers reading four-character Chinese words aloud and to discuss its etiology mechanisms. Methods The speech production results between the developmental stutterers and normal speakers when reading four-character Chinese words under the voice reaction time paradigm and computerize program in acoustic data analysis were compared. Results The voice duration time (VDT) of developmental stuttering group (791±82) ms was longer than that of the control group (687±93) ms (t=3.42,P<0.01),but the differences of voice reaction time (VRT) and voice error rate (VER) were not significant between these two groups. Conclusion The speech fluency disorders of developmental stuttering maybe mainly exist in the stage of speech movement, and probably due to the speech production disturbed with language processing.

Objective To examine the performance of developmental stutterers in processing Chinese character to determine their basic cognitive abilities of Chinese language.Methods The reaction time and error rates of developmental stutterers and fluent speakers were compared when they performed orthographic,phonetic and semantic judging tasks in the manual reaction time paradigm.Results The differences of reaction time in orthographic,phonetic and semantic judgment and the error rates in orthographic and semantic judgment between both groups were not significant(P>0.05);however,the difference of error rate in phonetic judgment between the both groups were nearly significant(P=0.053).Conclusion The only disability existed in developmental stutterers seems to be the in phonetic abstracting or encoding processes,which is partly in accordance with the covert repair hypothesis.

Objective To evaluate cerebral autoregulation in cerebral vascular disease using transeranial Doppler(TCD)-CO_2 test and head-upright tilt test(HUTT).Methods Thirty-two patients with occlusive cerebral vascular disease (group A),28 cerebral infarction patients without stenosis (group B), and 26 controls were included.Cerebrovascular reactivity was calculated in terms of the breath-holding index (BHI) and vascular motor reactivity (VMR) by TCD-CO_2 test.Changes of cerebral blood flow velocity (CBFV),blood pressure (BP) and heart rate (HR) were detected during HUTT to assess the cerebral pressure-autoregulation.Results Compared with controls,VMR decreased in group A and B,being 0.18?0.02,0.26?0.04 respectively,and so did BHI,being 0.76?0.15,1.05?0.15 respectively with significance(P

[Objective]Through the clinical investigation of the conversative treatment of undisplaced femoral necks,to analyze the occurrence of secondary displacement and femoral head necrosis.[Method]The medical records of 216 patients with undisplaced femoral neck fractures who were primarily treated conservatively from January,2000 to January,2004 were analyzed.Among that,186 cases is in accordance with the selected standard,which were consisted of 82 men and 104 women.(the average age 67.5).One hundred and forty-one fractures were given to bed rest in rotation-proof shoes,and walking on the crutches was followed after four weeks.Forty-five patients began to get out of bed with double crutches on the third day.When displacement happened,the operation was carried out.Once X-rays showed the fracture line unclearly,it is considered as bone healing.The early stage of femoral head necrosis was defined by sclerotic region or cyst in the femoral head.[Result]Sixty-eight fractures(36.6%) united and secondary considered displacement occurred in 118 cases(63.4%); the average time was 16 days (2～68 d) after injury when the displacement is found.In all primary healing patients,femoral head necrosis rate was 25%.The discovery time of necrosis was between 4 and 18 months,the most was 36 cases in the interval of 6 to 12 months.As for patients of secondary displacement,92 for closed reduction and hollow screws fixation,and the head necrosis happened in 55 patients(59.8%).The discovery time was from 4 to 18 months,the most in 6 to 12 months was 36 cases.The operation of open reduction and internal fixation with hollow screws was in 26 cases,73% of necrosis rate for it.The time was range from 3 to 12 months,11 case was the most in the period of 3 to 6 months.[Conclusion]Undispalced femoral neck fractures treated conservatively bear higher risk of secondary displacement and femoral head necrosis.In addition with more mortality and general complications,we therefore recommend primary operative stabilization of undisplaced femoral neck fractures.

Objective To evaluate the effects of probiotics on experimental colitis of rats and to explore systemic and local changes of T regulatory cells(Tr) after the treatment. Methods The models of experimental colitis were established by enema with 2,4,6-trinitrobenzenesulphonic acid (TNBS). Live probiotics of combined bifidobacterium,lactobacillus and enterococcus (Bifico) were used. Four groups of rats were set up as negative group, TNBS alone group, probiotics group (high dosage and low dosage, with dose of 150 and 300 mg?kg-1?d-1, respectively), and combination group (probiotics plus prednisolone or sulfasalazine). Histologic scoring was used to evaluate the effect of medications; the proportions of CD4+CD25+ and CD8+CD28- Tr in peripheral blood, spleen mononuclear cells and intraepithelial lymphocytes of colon were detected by flow cytometry. Results Histopathology showed that high dosage of probiotics was effective in TNBS-induced colitis rats (2. 2?0.8 vs 3.5?0.7,P