117 cases of indirects portovenography through ecliac and supeior mesen- teric anterial approach by DSA mere analyed.This study displayed the anatomy and mor- phology of the portal vein including the controur,site and even hemodynamic.The arthurs gave a futuer discussion on the clinical application of these feature for the diagnosis,treat- ments and prognosis Of the abdominal diseases such as gastric cancer,colonic carcinoma, pancreatic head carcinoma,portovenal hypertension etc.

Objective To study the value of interventional therapy for chest diseases via internal mammary artery (IMA) and the features of internal mammary artery angiography. Methods 31 cases of different chest diseases were undertaken the angiography and interventional therapy through IMA. Results The lesions of 31 cases were supplied by internal mammary artery partly or totally. The good therapeutic effectiveness was achieved in 20 cases with pulmonary carcinoma. The masses and the enlarged lymph nodes were shrinked obviously in 4 cases of advanced breast carcinoma and one of them was cured with operation after internal mammary arterial infusion. One case of low invasive thymoma was cured by internal mammary arterial infusion combined with resection. The bleeding was stopped absolutely after IMA embolization in 6 cases of hemoptysis (bronchiectasis in 2 cases, pulmonary tuberculosis in 4 cases). Conclusions The interventional therapy via IMA is very important and necessary when the mass in the chest is supplied by IMA.

Objective To analyze implementation outcomes and obstacles of “treatment before payment” reform seen by medical institutions' managers,along with an optimal strategy proposed.Methods Quantitative survey and qualitative interviews were called into play,and the data so acquired are subject to evaluation of the radar chart and fishbone diagram analysis to learn the implementation outcomes and obstacles.Results The reform proves workable at hospitals of county and lower levels,achieving win-win for the people,hospitals and government.Obstacles found include poor allocation of designated funds for risk coverage,insufficient circulating funds in advance,poor risk aversion mechanism,and poor preparation for tertiary hospitals.Conclusion It is recommended to promote awareness of the reform,enhance inter-department cooperation,improve hospital information systems,clarify the screening standards of “purposely evasion offenders”,standardize the issuance and use of the NRCMS certificates,and better build the credit system of the society.

The paper analyzed legally the following predicaments of legitimization of rural doctors in China:no legitimacy protection for their practice,vague criteria for practicing medicine,conflicts between legal regulations for medical practice and rural realities,and lack of a liability insurance system.The authors,based on an exploration of the legislative framework for rural doctors,made four corresponding legislative proposals as follows:to clearly define the legal scope and identity of rural doctors,to establish a qualification and employment system for rural doctors,to develop practicing norms applicable for rural doctors,and to set standards for their income.

Objective To investigate the feasibility and the clinical effect of bronchial arterial chemoembolization with ADM-Lipiodol mixture in the treatment of brochogenic carcinoma. Methods Thirty-three cases of bronchogenic carcinoma undertaken bronchial arterial chemoembolization, including 20 cases of adenocarcinoma, 8 of squamous cell carcinoma, 1 of small cell carcinoma and 4 of undifferentiated carcinoma. The clinical staging consisted of 5 cases in II, 13 in III A, 11 in IIIB and 4 in IV. Using Seldinger's technique and selective bronchial arterial catheterization (5 cases of super-selective catheterization). After perfusion of 80 - 100 mg CDDP and 10 mg MMC, embolization with a mixture of 30 mg ADM and 2 - 10 mg Lipidol was performed. Another 3 cases were undergone surgery within 1 week after bronchial arterial chemoembolization. Results The 33 cases of bronchial arterial chemoembolization, showed 2 cases of complete response(CR), 21 of partial response (PR), 9 of stable (S) and 1 of processes (P). The pathology revealed massive necrosis of tumor cells after bronchial arterial chemoembolization. No severe complications such as spinal injury occurred. Conclusions Bronchial arterial chemoembolization with ADM-Lipiodol mixture for the treatment of brochogenic carcinoma is good short-term effectiveness. The procedure should be carried out carefully on the basis of fine digital subtraction angiography.

Objective To evaluate the effectiveness of transcatheter arterial embolization for congenital renal arteriovenous malformation.Methods Seven cases of congenital renal arteriovenous malformation causing gross hematuria were retrospectively studied.All of 7 cases were demonstrated by means of angiography and then the catheter was placed superselectively into the involved arterial end of the malformation undertaking embolization with gelfoam,dehydrated ethanol,coils,etc.Results All the malformations of the 7 cases were successfully embolized with stoppage of gross hematuria within 24 hours.No serious complications occurred except lumbago,fever,gastrointestinal reaction for one week.There was no recurrence of haematuria and the renal function was also normal in all cases during the follow-up for 36 to 98 months.Conclusions Transcatheter renal arterial angiography and embolization are the important and effective management for the diagnosis and treatment of congenital renal arteriovenous malformation.

Objective To analyze influencing factors of physicians' turnover intention at public county hospitals from career stage perspective.Methods Physicians career life was divided into three stages according to professional ranks and titles.The sample was drawn using stratified multistage random methods from public county hospitals in Shandong province and 677 questionnaires were completed,giving a 90.3％ valid response rate.Data were analyzed using multi-group stepwise linear regression.Results The percentage of responders with middle and high-level turnover intention was 23.0％and 6.5％ respectively,and there was no statistically significant difference in turnover intention across three stage subgroups.In physicians at stage 1,the most important factors to predict turnover intention were superiors ' appreciation (r =-0.22,P ＜ 0.05) and payment rationality (r =-0.21,P＜0.05),while in physicians at stage 2,the most important predicting factors were autonomy (r=-0.39,P＜0.05)and learning demand(r=-0.22,P＜0.05),and in physicians at stage 3 were career development(r=-0.31,P＜0.05)and autonomy(r=-0.21,P＜0.05).Conclusion Autonomy and workload are common factors of turnover intention with different predicting power across three career stages.Physicians adjust their career needs to self-actualization with development of career stage,so welltargeted incentives should be taken to stabilize the medical staff of public county hospitals.

Objective To analyze the policy support of rural doctors for the essential medicine system,and explore the main influence factors and mechanism affecting the support degree.Methods 621 rural doctors from five cities in Shandong province were subject to a stratified random sampling for a quantitative questionnaire,to build a hypothesis model of policy support of rural doctors,which is verified using factor analysis and path analysis.Results 59.1% of rural doctors support the essential drugs policy.It was found that the essential medicine factor,the factor to influence the practitioner,and the supporting policy factor had a direct impact on policy support of rural doctors,with the effect of 0.305, 0.1 59 and 0.135 respectively;Essential medicine factor and the supporting policy factor indirectly influence the policy support of rural doctors through the factor to influence practitioners,with the effect of 0.065 and 0.032 respectively.Conclusion The essential medicine system needs to emphasize such rationality as the quality,list and pricing of essential medicines;it is imperative for the government to better oversee the purchase and supply of essential drugs,to cater to the interests of rural doctors,to encourage the enforcement of the system,and promote the development of village clinics.

Recently, more systemic reviews and randomized controlled trials were published to prove the effectiveness of TCM,and some of those were included by Cochrane Library. But due to the potential selective reporting bias and publication bias, few trials were included in the meta analysis, which failed to prove the evidence for the TCM treatment. The difference of reported outcomes comes to the big problem of the comparison between interventions. Such problem of difference was gradually brought to the attention. Therefore, Core Outcome Sets(COS), which stands for that the minimum standardized outcome set that must be repoted, may be the solusion to that problem. In this research we've introduced the formation and development of core outcome sets in TCM.

Objective To discuss the characteristics of multiple blood supplies and the significance of multiple intra-arterial embolization in massive hemoptysis. Methods Forty-four patients with massive hemoptysis underwent digital subtraction angiography (DSA) and intra-arterial embolization after ineffective medical treatment. The characteristics of blood supply of lesions,the methods of intra-arterial embolization and the clinic efficacy were retrospectively analyzed. Results All the patients, one artery was embolized in 9 patients,2 arteries were embolized in 18,3 in 14 and 4 in 3. The hemoptysis decreased or ceased immediately after intra-arterial embolization in 43 patients and recurrence within lweek in 2,which were controlled with additional emblization. 1 patient died in surgery. Conclusion The lesions of massive hemoptysis had complicated blood supplies,and multiple intra-arterial embolization was very important.