The research probed into studies at home and abroad on the correlation between hospital service capacity and quality of care,without finding definite correlation between the two.In view of such issue in China,the authors discussed the corelation between hospital service capacity and quality of care of China's hospitals,the relationship between hospital scale expansion and medical quality,and the evaluation of medical quality,providing references for researchers and policy-makers.

OBJECTIVETo evaluate the monitoring and early warning functions of the occupational disease reporting system right now in China, and to analyze their influencing factors.

METHODSAn improved audit tool (ODIT) was used to score the monitoring and early warning functions with a total score of 10. The nine indices were completeness of information on the reporting form, coverage of the reporting system, accessibility of criteria or guidelines for diagnosis, education and training for physicians, completeness of the reporting system, statistical methods, investigation of special cases, release of monitoring information, and release of early warning information.

RESULTSAccording to the evaluation, the occupational disease reporting system in China had a score of 5.5 in monitoring existing occupational diseases with a low score for release of monitoring information; the reporting system had a score of 6.5 in early warning of newly occurring occupational diseases with low scores for education and training for physicians as well as completeness of the reporting system.

CONCLUSIONThe occupational disease reporting system in China still does not have full function in monitoring and early warning. It is the education and participation of physicians from general hospitals in the diagnosis and treatment of occupational diseases and suspected occupational diseases that need to be enhanced. In addition, the problem of monitoring the incidence of occupational diseases needs to be solved as soon as possible.

OBJECTIVETo explore the quantitative relationship between the dust mass concentration and fiber number concentration of refractory ceramic fibres.

METHODSA typical refractory ceramic fiber plant was selected as the study site. Fifty-three paired samples of total dust mass concentration and fiber number concentration were collected using the long-time fixed site mode. The total dust mass concentration was measured according to the GBZ/T 192.1-2007 (Measurement of dust in the air of workplace, part 1: Total dust concentration). Membrane filter method/phase-contrast optical microscopy was used to determine the fiber number concentration. Univariate analysis was used to describe the distribution of the two concentrations and their ratio. Spearman rank correlation, as well as linear regression, logarithmic curve, polynomial, power function, and exponential curve model, were used to explore the relationship between the two concentrations. Results The range of the total dust mass concentration (x) was 0.45-13.82 mg/m3. The range of the fiber number concentration (y) was 0.01-1.04 f/ml. The range of the ratio (x/y) was 4-158. All of the three parameters did not follow normal distribution (P<0.000 1). The two concentrations showed a positive correlation (r,=0.705 22, P< 0.000 1). All the coefficients of determination (R2) of linear regression, logarithmic curve, polynomial, power function, and exponential curve model were relatively low. The trinomial curve model had the highest R2 (0.6848) and the fitted equation was y=-0.001, 1x+0.010 4x2+0.101 4x-0.055 1.

CONCLUSIONThere is a positive correlation between the total dust mass concentration and fiber number concentration of refractory ceramic fibers. However, there is no fixed regression relationship between the two concentrations, and neither is a definite coefficient which can be used to convert each other. The two concentrations cannot be replaced by each other.

Objective To prepare ?-CD(?-cyclodextrin) inclusion compounds and PEG- 4000[poly-(ethylene glycol) 4000] solid dispersions of mefenamic acid (MFA)in order to improve its dissolution. Methods The inclusion compounds of MFA were prepared using saturated ?-CD solution method by orthogonal test. The solid dispersions were prepared using melt-cool process with PEG- 4000 as a carrier. The inclusion compounds and solid dispersions were identified by differential scanning calorimetry (DSC) gram and their dissolution rates were tested in pH8.0 buffer solution. Results The suitable condition for preparing ?-CD inclusion compounds of MFA industrially was the weight ratio of 1∶4 between MFA and ?-CD, agitating for 4 h at 70 ℃. The suitable proportion for preparing solid dispersions of MFA was the weight ratio of 1∶4 between MFA and PEG- 4000. Conclusion Dissolution rates of MFA are apparently improved in inclusion compounds and PEG- 4000 solid dispersions, and the solubility of MFA is apparently increased by 2～3 times in inclusion compounds and PEG- 4000 solid dispersions.

Objective To evaluate the effect of deferoxamine on learning and memory ability in aged rats.Methods Forty-two healthy male Sprague-Dawley rats,aged 18 months,weighing 450-550 g,were randomly divided into 2 groups (n =21 each) using a random number table:normal saline group (group N) and deferoxamine group (group D).In group D,deferoxamine 150 mg/kg was injected intraperitoneally once a day for 6 consecutive days,while the equal volume of normal saline was given instead in group N.Morris water maze test was conducted at 2 h after each injection on that day,lasting for 6 days.The escape latency,swimming speed,time of staying at the original platform quadrant and time spent in the central region were recorded.Hippocampal ferritin expression was detected by Western blot before the first administration and at 2 h after 3rd and 2nd administration.Results Compared with group N,the escape latency was significantly shortened,and the percentage of the time of staying at the original platform quadrant and time spent in the central region was increased,the expression of hippocampal ferritin was down-regulated,and no significant change was found in the swimming speed in group D.Conclusion Deferoxamine can enhance the learning and memory ability in aged rats,and reduced iron deposition in hippocampi is involved in the mechanism.

Objective To evaluate the effectiveness of using anti‐cyclic citrullinated peptide (anti‐CCP) antibody or rheumatoid factor(RF) as the single laboratory parameter for rheumatoid arthritis(RA) diagnosis ,versus to using the two parameters in com‐bination .Methods A total of 56 cases of patients with RA were enrolled into RA group ,other 34 cases of patients with out RA were enrolled into non‐RA group .Levels of anti‐CCP antibody and RF were detected by using electro‐chemiluminescence immunoas‐say(ECLIA)and compared between the two groups .And the diagnostic efficacy of single and combined detection of anti‐CCP anti‐body and RF were evaluated .Results The levels of anti‐CCP antibody and RF in the RA group were higher than those in the non‐RA group ,had statistically significant differences(P<0 .05) .In diagnosis of RA ,the areas under receiver operating characteristic (ROC)curve of anti‐CCP antibody and RF were 0 .925 and 0 .822 respectively .The sensitivity and specificity of anti‐CCP antibody were both higher than those of RF .Compared with single detection of anti‐CCP antibody ,there was no significant increase of sensi‐tivity in using anti‐CCP antibody/RF ,whereas the specificity dropped significantly .Combined detection of anti‐CCP antibody and RF ,compared with single detection of anti‐CCP antibody ,had significantly lower sensitivity ,but no significant changes were found in specificity .Conclusion Single detection of anti‐CCP antibody is more effective than RF for diagnosing RA ,while combined detec‐tion of anti‐CCP antibody and RF could not significantly improve the specificity and sensitivity .It is suggested to only use anti‐CCP antibody for diagnosis of RA .

BACKGROUND: Traumatic osteoarthritis (OA) resulted from the injury of joints and postoperation of joints is commonly observed. Intra-articular injection of sodium hyaluronate (Na-HA) has been considered as effective method for OA. OBJECTIVE: To observe the influence of intra-articular injection of NaHA on mRNA expression of inducible nitric oxide synthase (iNOS) in cartilage of traumatic OA induced by transection of anterior cruciate ligament. DESIGN: Randomized controlled animal experiment. SETTING: Department of Orthopaedics, Renmin Hospital, Wuhan Uni ersity. MATERIALS: The experiment was performed in Laboratory of Depart ment of Orthopaedics, Renmin Hospital, Wuhan University from April to December 2003, in which, 16 clean healthy flat-eared white rabbits, aged 5-6 months were employed. The rabbits were randomly divided into Na- HA injection group and saline control group with 8 rabbits in each group. Na-HA (2000, No 366095) was provided by Shanghai Jiahua Fine Biologi- cal Products Co. METHODS: ①OA model was established in rabbits of the two groups. Each rabbit was anesthetized intravenously with 1.0 mg/kg ketamine hy- drochloride and underwent unilateral anterior cruciate ligament transection. ②5 weeks after transection, Na-HA injection group rabbits received 0.3 mL of intra-articular 10 g/L Na-HA injection, once a week for 5 weeks. Ani mals in saline controlled group were treated with saline of the same vol ume. ③The rabbits were killed at week 10 after operation, general morphology and histopathological changes of articular cartilage degeneration of medial femoral condyle were evaluated (0 points as smooth articular surface with normal color and luster; 1 point as minimal fibrillation or a slight crevice and dark grey color of the surface; 2 points as erosion extending into superficial or middle layers of cartilage; 3 points as ulceration and erosion extending into the deep layers, and 4 points as denudation of cartilage, erosion extending to the sub-chondral bone). The mRNA expression of iNOS in cartilages was examined with reverse transcription-polymerase chain reaction (RT-PCR). MAIN OUTCOME MEASURES: ①Observation of articular cartilage degeneration of medial femoral condyle, ②observation of articular cartilage degeneration of medial femoral condyle at light microscopic level, ③expression of iNOS in cartilages of each group. RESULTS: A total of 16 clean healthy rabbits entered the result analysis. ① Result of articular cartilage degeneration of medial femoral condyle: Pathological change of articular surface of femoral condyle was observed under anatomic microscope. Cartilage degradation in experimental group was significantly less severe than that in saline control group. ②Histological changes of articular cartilage degeneration of medial femoral condyle at light microscopic level: The Na-HA injection group showed cartilage changes: Membrane of cartilage presented denaturalization and abscission. Chondrocytes of superficial zone presented denaturalization, necrosis, turbulence and erosion. Animals treated with saline showed denaturalization, necrosis and disorder of chondrocytes, ulceration penetrating into the middle or deep zone of the cartilage. New hyperplasia of capillary vessels and fibroblasts were more obvious. Proliferation of fibrous tissue appeared at the bottom of ulcer. ③Expression of iNOS in cartilages of two group:The gene expression of iNOS in cartilage of Na-HA injection group was(1.09±0.18) and the expression of saline control group was (1.26±0.23). Nosignificant difference of iNOS expression was found between the two groups(P ＞ 0.05).CONCLUSION: Intra-articular injection of Na-HA has protective and repairing effect on cartilage with early OA and can significantly reduce the severity of cartilage degradation during early stage of traumatic OA. Intra-articular injection of Na-HA does not down-regulated iNOS expression in cartilage.

BACKGROUND:Due to the puncture and difficult reduction, severe vertebral compressive fracture is considered to be the relative contraindication of vertebroplasty and kyphoplasty. OBJECTIVE:To investigate the vertebra reduction after the treatment of severe vertebral compressive fractures with percutaneous kyphoplasty. METHODS:Thirty patients (42 vertebral bodies) with severe compressive fractures were included. The compressive rate of the affected vertebral bodies was 75%-83%. The direction of percutaneous puncture was guided under digital subtraction angiography, and then postural reduction and local kyphoplasty were performed. After satisfactory reduction, bone cement was injected. RESULTS AND CONCLUSION:Al the 30 patients tolerated procedure wel . The mean height of the anterior, mid and posterior vertebral body was improved from (0.48±0.17) cm, (0.83±0.23) cm and (2.44±0.33) cm preoperatively to (0.71±0.22) cm, (1.21±0.25) cm and (2.44±0.33) cm respectively after operation. The postoperative height of the anterior, mid and posterior vertebral body was significantly higher than that before operation. The visual analogue scale score after treatment was significantly lower than that before operation. The results indicate that percutaneous kyphoplasty can ease pain, restore vertebral body height and improve quality of life of the patients with severe vertebral compressive fractures.

Objective:To determine the relationship between injury risk and alcohol drinking. Methods:Totally 531 patients (age≥18 years) who were treated for the ifrst time and came to the emergency room within 6 h atfer the injury were included. hTe American National Institute of Health questionnaire was used to investigate the trauma type, intentional injury, drinking before the injury, drinking volume, and drinking history in the past years and so on. hTe case-crossover method was used to analyze the data and relationship between alcohol drinking and injury.Results:Compared with the non-drinkers, subjects who drank alcohol 6 h before the injury had a higher risk of intentional injury (OR=2.79, 95%CI: 1.61–4.84). Male, drunken, patients with positive alcohol test results were more likely to suffer from intentional injury. Compared with the non-drinkers, victims who drank alcohol 6 h before injury had a higher risk of injury in traffc accidents (OR=2.41, 95%CI: 1.29–4.51). Compared with the non-drinkers, subjects who drank alcohol 6 h before injury had a higher risk of injury (OR=11.86, 95%CI: 5.48–25.65). Subjects who drank more than 6 standard drinks of alcohol 6 h before injury had much higher risks than non-drinkers (OR=24.52, 95%CI: 5.84–102.86). Conclusion:Alcohol drinking before injury is associated with increased the risk of trauma, intentional injury and injury related to traffc accidents.

Objective To investigate the efficacy of endoscopic intranasal structure reconstruction surgery for rhinogenous headache. Methods 82 cases of rhinogenous headache were given endoscopic intranasal structure reconstruction. Compared VAS scores before and 6 months after treatment, counted the effective rate. Results Among the 82 patients, 69 patients(84. 1%) were cured, 8 cases (9. 8%) were of obvious effect, 5 cases (6. 1%) were invalid, and the total efficiency was 93. 9%. VAS scores of the mucosal contact headache group before treatment were greater than that of the sinus headache group (P<0. 05). Compared with VAS scores before treatment, both of the two groups had lower VAS scores after treatment (P<0. 05), but there was no significant difference between the two groups after treat-ment (P>0. 05). Conclusion Endoscopic surgical operation can remove the extrusion of the nasal cavity and paranasal sinuses and factors of nasal congestion, and then reconstruct normal anatomical structure of nasal cavity, thus restoring normal function of paranasal sinuses. It has good therapeutic effect on rhinogenic headache.