An exploration was made on the content and methodology of supply chain management of a hospital in line with the fifth edition JCI standard.By means of enhanced management of supply chain procurement,tracking validation,risk management and indicators monitoring,the speed and certainty of relevant processes are improved,with hospital operation effectiveness and efficiency enhanced.

Objecfive To investigate the curative effect of Yunpi Zhengye decoction in the treatment of chronic functional constipation due to deficiency of both Qi and Yin.Methods 87 cases in line with the diagnostic criteria of functional constipation were randomly divided into a treatment group(46 cases)and a control group(41 cases).The treatment group was treated with Yunpi Zhengye decoction and the control group was treated with Maren Pills for a therapeutic course of 15 days.Results The cure rate,excellent cure rate and total effective rate in the treatment group Was 71.7%,23.9% and 97.8% respectively,and in the control group was 14.6%,14.6% and 87.8% respectively.The effective rate in the treatment group Was significant better than the control group(P＜0.05).Conclusion Yunpi Zhengye decoction has good result in treeing chronic functional constipation due to deficiency of both Qi and Yin.

Chipaozi, the dried mature fruit of Thladiantha dubia Bge. family Cucurbitaceae, hasbeen found to be used in mixture with Wanggua, the fruit of Trichosanthes cucumeroides (Ser. ) Maxim.of the same family.A comparative study on the morphological and characteristics of these two drugs were carried out and reported.

[Objective]To study the foot radiographs of rheumatoid arthritis(RA),evaluate the relationship between foot deformity and disease duration,the relationship between flat foot and forefoot deformities in RA,thus to improve understanding of the progression of deformity and provide more appropriate treatment. [Method]Anteroposterior and lateral weight-bearing radiographs were obtained for 112 feet of patients with RA and 104 feet of patients without RA.The hallux valgus angle,the first intermetatarsals angle,the top angle of the medial longitudinal arch,the anterior angle of the medial longitudinal arch,the relative height of the talus were measured.One-Way ANOVA were used to evaluate the difference between two groups,and partial correlations were used to analyze the relationship between the foot deformities and disease duration by control the age,the relationship between flat foot and forefoot deformity by control the age was also analyzed.[Result]The hallux valgus angle was 24.2?14.3 in RA group and 13.2?5.3 in control group,the first intermetatarsals angle was 9.6?5.9 in RA group and was 7.6?4.4 in control group,the top angle of the medial longitudinal arch was 129.4?6.6 in RA group and 124.4?5.2 in control group,the anterior angle of the medial longitudinal arch was14.5?3.0 in RA group and 16.2?4.5 in control group,the relative height of the talus was 0.184?0.024 in RA group and was 0.191?0.032 in control group,there was significant difference between two groups except the anterior angle of the medial longitudinal arch.With the increase of disease duration,the top angle of the medial longitudinal arch,increased in RA group(P

Objective To investigate a method for postmortem diagnosis of the sudden death from hypersensitivity by detection of serum tryptase and IgE.Methods Venous blood samples were collected from 9 cases of sudden death from hypersensitivity,19 cases of death from other causes and 10 health living adult individuals.The serum levels of the mast cell tryptase(MCT)and IgE were detected with immunofluorescent enzyme assay and enzyme linked immunosorbent assay(ELISA)respectively.MCT in the lungs was detected by immunohistochemistical method.Results The serum level of both MCT and IgE in cases of sudden death from hypersensitivity were higher than those in health living adults and cases of death from other causes(P﹤0.01).However,there was significant difference(P﹥0.05)in the serum level of IgE and MCT between the health living individuals and cases of death from other cause.More cells containing MCT-positive granules were detected in the lung in cases of sudden death from hypersensitivity than in cases of death from other causes(P

Objective To study the role of first metatarsal sesamoids s y stem in the pathogenesis of hallux valgus. Methods The sesamoids absolute and relative position (TSP) were measured in 245 normal feet and 141 hallux valgus ones, and the results were statistically analysed with hallux valgus angle(HVA), intermetatarsal angle(IMA) and metatarsal phalangeal joint subluxation. Results The absolute position of sesamoids had no difference in the normal feet and ha llux valgus ones. TSP was correlated with HVA,IMA. TSP≤3 was considered normal in 245 normal feet. 92 hallux valgus feet were surgically treated. 20 cases unde rgone Keller procedures which didnt correct TSP were excluded from this study. 19 cases treated with modified McBride procedures, 24 cases with metatarsal met aphyseal osteotomy, 29 cases with metatarsal basal osteotomy. All the cases were followed up for an average of 4 years(ranged 1－6 years). The postoperative HV A was 5?－10?(average 7?)，IMA was 5?－9?(average 7?)，TSP were all 3 or 4 . According to the evaluation standard made by SUN Junying et al, 60 cases(83％) were assessed as excellent， 8 cases(11％) as good， and 4 cases(6％) as worse ， giving an overall excellent and good rate of 94％. Conclusion TSP is an impo rtant parameter that should be routinely used for postoperative prognosis evalua tion and surgical procedures determination. Osteotomy is preferred to restore no rmal metatarsal-sesamoids system function when TSP is abnormal.

Objective To evaluate the medial longitudinal arch of the foot with and without hallux valgus in order to establish the relationship between hallux valgus and the arch. Methods 34 feet of 24 cases with hallux valgus and 34 normal feet of 18 cases were investigated by roentgenography. On the dorsal plantar view while weight-bearing standing, the hallux valgus angle (HVA), the first intermetatarsal angle, and the position of the tibial sesamoid relative to the first metatarsus were measured respectively. On the lateral view while weight-bearing standing, the top angle of the medial longitudinal arch, the anterior angle of the medial longitudinal arch (also named as the first metatarsal inclination angle) and the relative height of the talus, which are similar to measurement of the height of the medial longitudinal arch, were measured respectively. The characteristics of the medial longitudinal arch of the feet with and without hallux valgus were compared, and the correlation between the height of the medial longitudinal arch and the severity of the hallux valgus, which were manifested by the hallux valgus angle, first intermatatarsal angle, the relative position of the tibial sesamoid, was analyzed. Results The top angle of medial longitudinal arch was 136.9??7.6? in hallux valgus feet and 126.7??2.1? in normal feet; the anterior angle of medial longitudinal arch was 10.8??2.6? in hullux valgus feet and 16.6??1.6? in normal feet; the relative ratio of height of talus was 0.159?0.03 in hallux valgus feet and 0.199?0.01 in normal feet , there was significant difference between two groups. While with the increase of the lateral displacement of tibial sesamoid, the angle of hullxus valgus and the first intermetatarsal angle, the top angle of medial longitudinal arch became larger, the anterior angle of arch became smaller, and the relative height of talus became lower. The medial longitudinal arch of the foot with hallux valgus was collapsed, and there was moderate to high relationship between the height of the medial longitudinal arch and the severity of the hallux valgus. Conclusion Hallux valgus is a three dimensional deformity, which will disturb the normal biomechanics of the foot.

Objective To observe the clinical effect , blood glucose time , clearance time of ketone body , correction time of acidosis and influence on average daily dosage of insulin of supplementing Qi and nourishing Yin combined with insulin treatment of patients with diabetic ketoacidosis (DKA).Methods 67 cases of DKA were divided into 2 groups.Control group (n=32) was giv-en micro injection of pump continuous infusion of insulin and aggressive fluid resuscitation for potassium supplement , water and elec-trolyte maintaining and acid -base balance;the observation group ( n=35 ) was given oral Chinese medicine for supplementing Qi and nourishing Yin on the basis of control group .The clinical effect after treatment , blood glucose time , clearance time of ketone body, correction time of acidosis , average daily dosage of insulin and the average number of hypoglycemia per capita were compared and analyzed .Results Blood sugar could be controlled faster in observation group .Clearance time of urine ketone and correction time of acidosis were significantly shortened .The dosage of insulin and number of hypoglycemia per capita were greatly reduced .There were significant differences compared with the control group (p<0.01);in terms of clinical effect, 19 cases of observation group were markedly effective , 14 cases effective , and 2 cases ineffective with the efficiency rate of 94.29%; 13 cases of control group were markedly effective , 10 cases effective , and 9 cases ineffective with the efficiency rate of 71.88%.There were differences between the two groups (p<0.05).Conclusion Supplementing Qi and nourishing Yin can significantly improve the curative effect in the treat -ment of DKA .

Objective To evaluate the therapeutic effect of implanted drug delivery system (DDS) in patients with inoperable pancreatic carcinoma.Methods During 1998 to 2004,145 patients with no indication for operation were randomly divided into two groups.In 73 patients with regional interventional chemotherapy group (group A),percutaneous left subclavain artery port-catheter DDS implantation with the tip in common hepatic artery was performed, and regional chemotherapy infusion were done in every 1 to 2 month. In 72 patients with systemic chemotherapy group (group B), the chemotherapy were given via peripheral vein in every 1 to 2 month. The FAM(adriamycin 40 mg/m2+mitomycin 6 mg/m2+fluorouracil 375 mg/m2) were selected in two groups. Results In group A, after 2-10 (average 7.6) cycles of chemotherapy, 4 patients reached complete release (CR) and 49 patients reached partial release (PR). In group B, after 1-7 (average 3.8) cycles of chemotherapy, no patient reached CR and 25 patients reached PR. The effective ratio was 60.2% and 34.7% in group A and B, respectively. The survival time ranged from 3 to 34 months (median 13.5 months) in group A and 1 to 13 months (median 6.2 months) in group B. Among the 56 patients with obstinate pain in group A, 27 patients were free of pain and 22 patients got partially alleviation 2-3 weeks after chemotherapy. Among the 54 patients with obstinate pain in group B, 11 patients were free of pain and 14 patients got partially alleviation 2-3 weeks after chemotherapy. The pain-releasing ratio in group A and group B was 87.5% and 46.3%. There were no severe damage of liver, kidney, heart and bone marrow in group A. Twenty five patients in group A experienced mild digestive side-effect and decrease of white blood cells, all of them completed the chemotherapy. In group B, 3 patients experienced bone marrow arrest, one died of severe damage of liver and kidney, and 67 patients displayed digestive side-effect and decrease of white blood cells. The ratio of side-effect in group B was 90.3%. The differences of effective ratio, survival time and side-effect ratio between group A and B were statistically significant (P

0.05） . Strains of cemented groups were usually less than that of non-cemented ones for all zones except the stem tip zone. Normal group and osteoporosis group had different stress shielding and concentration(P