China′s economy has moved into a new normal stage.It features slower GDP growth, relaxed macro-control,economic structure upgrading,new powerhouses for economic growth.In such a situation,it is imperative for the society to realize,comply with and encourage the new normal for all fields of work.As for the healthcare sector,reform of public hospitals as a top priority has entered a crucial period of system reconstruction and effective operation.In the perspective of auditing governance mechanism as a key role in public hospital′s supervision and management system,this article tried to explore how to enable public hospitals′auditing to comply with the economic new normal.This paper puts forwards that public hospital auditing should reconstruct its system as follows:Auditing entity framework should strengthen the development of functionality and linkage among national auditing,internal auditing and social auditing,and public hospitals should try to set up their auditing committee system when necessary;Auditing contents should emphasize the multiple development and innovation of public welfare auditing,economic responsibility auditing,governance performance auditing,policy implementation effect auditing and more innovative auditing services.

There are many defects in traditional clinical medical education,Socratic method has been used in law and commerce education,and we find it has the feasibility and operation to use the method in clinical medical education.

Objective To analyse clinical characteristics and preventive methods of pregnancy-induced hypertensive severe pre-eclampsia with ascites.Methods 184 cases of patients with severe pre-eclampsia complicated with ascite were divided into two groups and the clinical characteristics were compared(severe pre-eclampsia complicated with ascite group,n=36;Severe pre-eclampsia group,n=148 cases).Results The average time of the termination of pregnancy was (34±4) weeks in severe pre-eclampsia complicated with ascites group,and (36±3) weeks in severe pre-eclampsia group (t=2.71,P＜0.01).There were 6 cases of intrauterine stillborn (16.67%),14 cases of neonatal mortality (38.89%);22 cases of premature labor (61.11%) in severe pre-eclampsia complicated with aacites group;There were 4 cases of intrauterine stillborn (2.7%);16 cases of neonatal mortality (10.81%);and 35 cases of premature labor (23.65%) in severe pre-eclampsia group (X~2=10.99,16.73,19.01,P＜0.001).There were differences in the total protein,albumin,white/ball ratio,lactic acid dehydregenase,serum creatinine,24-hour urinary protein between the two groups [total protein:(51.68±6.08) g/L vs (59.34±8.28)g/L,albumin:(24.32±4.06) g/L vs (32.16±5.63) g/L,white/ball ratio:(0.92±0.26) vs (1.16±0.26),lactic acid dehydrogenase:(495.87±312.56) U/L vs (323.81±185.00) U /L,serum creatinine:(131.62±95.34) μmol/L vs (91.52±86.83) μmol/L,24 h urinary protein(4.21±3.51)g/24 h vs (2.38±2.57)g/24h,t=6.17,8.77,5.50,4.79,2.72,3.98,P＜0.05 or ＜0.01].Conclusion Tbe condition of severe pre-eclampsia with ascites is extremely serious,so pregnancy should be timely terminated.The aacites can be dissipated after delivery.Early,systematic and regular prenatal care can prevent severe pre-eclampsia and complications in time.

Objective To observe the TCM syndrome changes of lung cancer patients before and after chemotherapy and the effect of Shengxuetang on dealing with side and toxic effects caused by chemotherapy and patient’s immune function. Method Phase III and IV lung cancer patients were randomly divided into two groups, treatment group and control group. Patients in the treatment group were given the combination of chemotherapy and Shengxuetang, while those in the control group were given the combination of chemotherapy and berbamine. Peripheral WBC count, HGB level, platelet count, T-cell count, and NK cell activity were measured, and other toxic effects were observed before and after chemotherapy. Results Before chemotherapy, there were two syndrome types, one is the deficiency of Qi and Yin, and the other is phlegm-damp due to deficiency of Qi accompanied with blood stasis. During the treatment, these two syndrome gradually transformed to the deficiency of both Qi and Yin and coagulation of phlegm and blood stasis. The chance for patients to develop myelosuppression had no difference between two groups, however, most patients in the treatment group developed grade I myelosuppression, while in the control group, most patients developed grade II myelosuppression. G-CSF was prescribed more in the control group than in the treatment group (P

Objective To investigate the expression and the roles of Angiopoietin 1(ang-1) and Angiopoietin 2(ang-2) in the endometrium of women with abnormal bleeding after medical abortion. Methods Analyzing endometrial pathological change of 1087 patients with abnormal bleeding after medical abortion in early pregnancy,and the endometrial specimens from 40 patients were randomly chosen for the study. The endometrial specimens from 20 women without abnormal bleeding after medical abortion were used as control group.Immunohistochemistry was used to detect the levels of Ang-1 and Ang-2 proteins in endometria. Results The percentage of patients with both the residul decidua and villus was 80.5%; positive immunoreactive signals of Ang-1 and Ang-2 were found in the endometrial glandular epithelium, stromal cells and the endothelial cells of vessels; the expression rate of Ang-1 and Ang-2 in the patients with abnormal bleeding were higher than that in the control group(P

AIM: To understand the formation of portal hypertension through the change of portal hemodynamics on experiment cirrhosis. METHODS: Carbon tetrachloride was subcutaneously injected in the rat. The changes of the portal hemodynamics in the pathological process of liver tissue were observed. RESULTS: The liver underwent degeneration, necrosis of hepatocytes, and the normal architecture of the liver lobules was replaced by pseudolobule, which consist of regenerative hepatocytes and fibrous septa. The diameter, the blood flow velocity and the blood flow quantity of portal were significantly higher than that in former group (P0 05). CONCLUSION: The changes in hemodynamics of the portal are in accordance with the changes in pathology of liver in the formation of liver cirrhosis.

Objective To observe the influencing factors of recurrence and metastasis for postoperative breast cancer high-risk population, and TCM regimen of syndrome differentiation and treatment was used to validate its significance for the prevention of recurrence and metastasis. Methods The influencing factors of recurrence and metastasis of 178 postoperative breast cancer high-risk cases with positive hormone receptor were studied. The recurrence and metastasis, disease-free survival and accumulative points of TCM symptoms of integrated group (with TCM syndrome differentiation and endocrine therapy) and western medicine group (with endocrine therapy) were compared. Results Lymph node metastasis, cancer staging and TCM therapy had influence on the disease-free survival rate of postoperative breast cancer high-risk patients. TCM therapy was the independent prognostic factor for disease-free survival. 3-year recurrence and metastasis rate was lower in integrated group than that in western medicine group, with statistical difference (P=0.03). The total accumulative points of TCM symptoms in both two groups decreased after treated for 3 and 6 months, integrated group showed greater significance. TCM therapy was better for the treatment of irritability, hot flash and perspiration, good for spontaneous perspiration and insomnia, but poor in dry mouth, bitter taste in mouth and fatigue. Conclusion Lymph node metastasis, cancer staging and TCM therapy are main influencing factors for recurrence and metastasis. TCM therapy with regimen of syndrome differentiation and treatment can reduce 3-year recurrence and metastasis rate, improve TCM symptoms, especially is significant for the improvement of irritability, hot flash and perspiration.

Objective To investigate the patients with postoperative skin damage around the stoma after Miles operation,take measures according to the influencing factors,and explore an effective way to reduce the incidence of skin damage around the stoma patients.Methods There were 62 cases of skin damage around the stoma in 110 cases of patients with permanent colostomy in out-patient follow-up.Each patient with skin damage occurring around the stoma were retrospectively analyzed the reasons,and the related factors that might affect Miles postoperative stoma skin damage were analyzed.Results The incidence rate of Miles postoperative skin damage around the stoma was 56.36％,through the multi-factor Logistic regression analysis,there were six related factors with the Miles postoperative skin damage around the stoma,patients' excrement stimulation,ostomy bag allergies,improper operation of the replacement of the ostomy bag,the potential skin disease,excessive scrub / rub the skin,unfamiliar with ostomy care knowledge were the influencing factors of patients with skin damage around the stoma.Conclusions Appropriate stoma care products and paste methods,detailed guiding of patients and their families about ostomy care knowledge and skills can significantly reduce the incidence rate of Miles postoperative skin damage around the stoma.

Objective To study the preventive effects of vitamin K2 on tumor recurrence in patients with hepatocellalar carcinoma (HCC) after radical resection. Methods The clinical data of 50 patients with HCC who received radical resection from March 2006 to March 2007 in No. 181 Hospital of PLA were analyzed retrospec-tively. All the patients were divided into 2 groups according to the random number table. Twenty-six patients in vitamin K2 group were administered with menatetrenone (45 mg per day), and the rest 24 pateints were in the control group. The accumulative and tumor-free survival rates, differences between the 2 groups, multivariate factors for prognosis were analyzed by Kaplan-Meier curve, Log-rank test and Cox regression model, respectively. Results During a period of 36 month follow-up, 10 patients died and 28 had tunor recurrence. The 1-, 2-, 3-year accumulative survival rates were 96%, 92% and 83% in vitamin K2 group, and 96%, 82% and 63% in control group (χ2 = 3.61, P > 0.05). The 1-, 2-, 3-year tumor-free survival rates were 92%, 60% and 38% in vitamin K2 group, and 75%, 42% and 12% in control group, with significant difference between the 2 groups (χ2 =5.61, P <0.05). Univariate and multivariate Cox proportional hazard analysis showed that without taking menate-trenone, the preoperative level of alpha fetoprotein (AFP) ≥800 μg/L and vascular invasion were the indepen-dent risk factors for tumor recurrence. Conclusions Vitamin K2 has a suppressive effect on tumor recurrence of HCC, while patients with AFP≥800 μg/L before operation or with vascular invasion have poor prognosis.

Objective To study the effects of flavone compound α-NF on CYP1B1 gene in transplanted nude mice tumor with human paclitaxel resistance ovarian cancer cell. Methods Using 24 nude models of orthotopic transplantation of human ovarian cancer, they were divided randomly into four groups: control group, α-NF group, paclitaxel group and combined group. RT-PCR and Western blotting method were used to detect CYP1B1 mRNA and protein expression. Results There was no significant difference in CYP1B1 mRNA expression between α-NF group, combined group and control group(P >0.05). Compared with control group, CYP1B1 protein expression was distinctly lower in α-NF and combined group (P<0.01). Conclusion α-NF has no effect on CYPIB1 gene in mRNA level, whereas α-NF down-regnlate, CYP1B1 expression of transplanted A2780TS nude mice tumor in protein level, thus α-NF has the effect on reversing paclitaxel resistance of A2780TS cell.