The levels of C-reactive protein(CRP),adenosine deaminase(ADA),total cholesterol (TC),lactate dehydrogenase(LDH),carcinoembryonic antigen(CEA),ferritin(Fer),β2-microglobulin (β2-MG),alpha-fetoprotdn(AFP),carbohydrate anfigen12-5(CA125),carbohydrate antigen19-9(CAl99),carbohydrate antigen15-3(CA153),eyfra211(CY211)and neuron specific enolase(NSE)were detected by automatic chemistry analyzer or electrogenerated chemiluminescence analyzer in pleural and peritoneal exudates from 48 cases oftuberculosis and 82 cases of malignant tumors.The levels of CRP,ADA and β2-MG in tuberculotic exudates were higher than those in malignant exudates(P<0.01).However,the levels of TC,LDH,CEA,Fer,CA153,CY211,NSE,AFP,CA125 and CA199 in malignant exudates were higher than those in tuberculotic exudates(P<0.01).Combined determination of CRP,ADA,TC,LDH,CEA,Fer,and β2-MG in pleural and peritoneal exudates are of value in differentiation of tuberculosis from malignant exudates.Combined determination of CA153.CY211 and NSE in pleural effusions and AFP,CA125 and CA199 in peritoneal effusions can improve the semitivity and specificity of diagnosis for malignant exudates.

The study focused on tertiary public hospitals in Hangzhou,investigating the comments of both hospitals workers and foreigners in the city with questionnaires and literature search.The foilowing four problems were identified in the study in the foreigner medical services in Hangzhou:Communication barriers between doctors and foreign patients,insufficient communication of medical service information,poor service environment and service attitude,and payment mechanism for medical insurance and charges.On such basis,the authors recommended policy changes for the government to improve foreigner-oriented medical services,including building the regulations up to intemational customs for medical services,reforms in the payment system,medical insurance management,as well as planning and promotions of foreigner-related service institutions,and management strategies for key elements within the hospital

Seminar is an exploratory learning model with problem-based and project-or-ganized characteristics.The application practice of Seminar learning model in the process of teaching and training postgraduates of health management shows that the model has an important influence on improving the quality of postgraduates in our country.

The research capacity in post-graduate education process is an important content,also an important indicator of educational outcomes.School of Medicine and Health Management of Hangzhou Normal University has done a bold exploration at this area,making the integration and innovation,from the management system to the practical operation,from the school management to the society support.Considering the compound characteristics of Social Medicine and Health Service Management specialty,the school has designed the "ladder" training research capacity programs by playing the school system,teacher roles and social support,and many other forces,in order to ensure and enhance the research capability of post-graduates.

Objective To determine counts of T lymphocyte sub-populations in malignant and tuberculous pleural effusion or ascites and evaluate its significance in difierential diagnosis.Methods T lymphocyte sub-populations in pleural effusion or ascites and peripheral blood were determined in 30 patients with tuberculosis and 31 patients with cancer by flow cytometry.Concentrations of cytokines Th1 and Th2,γ-interferon(IFN-γ),interleukin-12(IL-12)and IL-4 in pleural effusion or ascites were measured by enzyme-linked immunosorbent assay(ELISA).Results Compared to that in peripheral blood,percentage of CD3+ and CD4+ T-celI counts were all higher in both malignant and tuberculous pleural effusion or ascites [(73±6)%and(67±20)%vs.(51±19)%and(48±14)%,P＜0.05].Although CD3+T-cells count was higher in tuberculous pleural effusions or ascites,no difference in ratio of CD3+ and CD4+/CD3+ and CD8+ T-cell counts was found between malignant and tuberculous pleural effusions or ascites.However,ratios of IFN-γ and IL-12 to IL-4 were higher in tuberculous pleural effusion or ascites(54±24 and 82±19vs.8±6 and 19±10,t=10.34 and 16.28,respectively,P＜0.01).Conclusions CD3+ and CD4+ Tcells can be aggregated in both malignant and tuberculous pleural effusions or ascites,80 nature (tuberculosis or malignancy)of pleural effusion or ascites can not be differentiated by CD4+ and/or CD8+ T-cell counts only,and determination of cytokines Th1 and Th2 can help their differentiation.