This paper clarifies the internal connection of hospital management and medical ethics,and points out that hospital management should be based on medical ethics management,for their combination could be the future trend of modern hospital management.It is of particular importance to clarify and further strengthen the significance of medical ethics management during hospital management,thus reasonably combine hospital management and medical ethics management,in order to promote a healthy development of hospitals.

Objective To compare tacrolumus (FK506) with cyclosporine A (CsA) in clinical application to organ transplantation.Methods The literature in recent years has been reviewed and compared. Results FK506 was a powerful immunosuppression with a mechanism of action similar to that of CsA, but significantly superiori to CsA in terms of prophylaxis and treatment of allograft acute rejection, delay of chronic rejection, and withdrawal of steroid in early period. The cardiovascular mortality and chronic graft nephropathy (CGN),such as hypertension and hyperlipidemia were less frequently seen in FK506-treated patients and FK506 also had an acceptable safety profile, including a low incidence of hypertrichosis,gingival hyperplasia and infections.However, CsA had been showed a better result in prevention of posttransplantation diabetes mellitus (PTDM ) and more economic agent than FK506. Pharmacokinetic studies showed CsA in the form of Sandimmun Neoral showed less inter- an intrapatient variability than FK506.Meanwhile, the combination of MMF and FK506 or CsA has been proved effectively with excellent graft and patients survival. Conclusion FK506 and CsA are safe and effective long term maintenance immunosuppressive agents in organ transplantation with wonderful prospect.

Insulin autoimmune syndrome (IAS) is rare.A patient with IAS was herewith reported and 50domestic cases reported in the last two decades were reviewed to discuss the approach to this syndrome.In hypoglycemic patients with high insulin level and with Graves' disease and taking tapazole,insulin autoantibody detection is mandatory to avoid misdiagnosis and unnecessary surgery.

Objective To evaluate the job burnout of the nurses in sterile laminar flow wards and offer proposals for improvements.Methods Forty nurses in sterile laminar flow wards were surveyed with MBI-GS.Results The scores of emotional exhaustion,cynicism,job inefficiency were higher after working in sterile laminar flow wards for 3 months than those working in general wards for 3 months.Conclusions The nurses in laminar flow wards are prone to have job burnout.Standardized training,humanized management and positive psvchological intervention can improve the job burnout of the nurses in laminar flow wards.

Objective,To evaluate the value of magnetic resonance imaging(MRI) in clinical diagnosis of tuberculous meningitis.Methods,Forty-six patients (29 men,17 women,age ranged 11-72,mean age 41.5) with tuberculous meningitis were examined with MRI.The MRI findings of tuberculous meningitis were analyzed retrospectively.Results,On pre-contrast T1WI and T2WI,meningeal lesions in the basal cistern region were detected in twenty cases.Abnormal meningeal thickening and enhancement were found in 38 patients.Meningeal and cerebral miliary tuberculous foci were demonstrated in 21 cases.Ependymal involvement was found in six patients and cranial nerves were affected in other two patients.No abnormal meningeal enhancement was detected in eight mild cases.On the follow-up images in nine patients,the abnormal findings alleviated in varied degree or,remained unchanged.Conclusion,The pathological changes in tuberculous meningitis could be demonstrated effectively by specific findings on MRI.MRI,especially the post-contrast MRI,proved a reliable modality in clinical diagnosis and assessment of tuberculous meningitis.

Objective To study the diagnosis and treatment of iatrogenic bile duct injury(IBDI).Methods The clinical data of 92 patients with IBDI who had been admitted to our hospital from January 1994 to December 2007 were retrospectively analyzed.Results The diagnosis of IBDI was based on the clinical findings,diagnostic abdominocentesis and imaging examination.Sixteen patients gave up treatment because of economic reasons,and 2 patients who were complicated with sepsis and multiple organ dysfunction syndrome died shortly after being transferred to our hospital.Forty-eight patients were treated by Roux-en-Y choledochojejunostomy,14 by endoscopic treatment.2 by bile duet repair+T tube drainage,3 by percutaneous catheter drainage,1 by choledochoduodenostomy,4 by percutaneous transhepatic cholangiodrainage,and 2 by ultrasound guided percutaneous puncture drainage.Sixty-two patients were followed up for 4 month to 10 years(mean,3.6 years),and satisfactory results were obtained.Conclusions Detection of IBDI during operation and prompt repair yield favorable outcome.Roux-en-Y choledochojejunostomy is the best choice for bile duct injury complicated with biliary stricture.Endoscopic and interventional treatments are important auxiliary measures in the treatment of bile duct injury.

Objective To study the treatment effect of self-made huoxue tincture for treating skin injury and phlebitis caused by extravasation of chemotherapeutic drugs.Methods Patients(30 cases)with skin injury and phlebitis caused by extravasation of chemotherapeutic drugs were divided into the observation group(20 cases)and the control group(10 eases).The observation group underwent treatment with huoxue tincture,while the control group adopted local hydropathic compress with 50%magnesium sulfate.Results The effective rate of the observation group was higher than that of the control group,P<0.05.Conclusions Hydropathic compress with huoxue tincture was effective in the treatment of skin injury and phlebitis caused by extravasation of chemotherapeutic drugs.It may be widely applied in clinic.

The study was based on the maths model of waves which were reflected by a reflecting ellipsoid and whose distributing of energy in the ellipsoid. We developed an equipment by ellipsoidal focus to substitute for energy based on the research. The equipment has the characteristics of revolving therapy as the X-knife and the γ-knife which can be used in 3D therapy. We call the system ″Ultrasonic-knife″ which were used in 3D hyperthermia. The equipment simulates an source of energy by the ellipsoidal focus. The source can be put in the tumor in deep organ． It also avoids some shortcomings, just as heat is in limit area and temperature is too high in the focus. We could do an ideal conformal therapy by a reasonable treatment planning.

Mental Health Law has specify the mental disorder patients’ informed consent right,but in practice, the problems,the mental health status of patients, namely the families’ right of subrogation exercise,“loss of self-control or deny having mental disorder”, have prevented the exercising of informed consent right. Therefore,it is necessary to effectively solve this plight of rebuilding a harmonious relationship between doctors and patients,estab-lishing mentally disordered patients’ right to advance directives, especially choosing the instrument of assessing the individual’ s capacity to consent.

Objective To explore the effect of Chitosan gel (Ⅲ) on the complications from Milligan-Morgan hemorrhoidectomy for treatment of severe mixed hemorrhoids.Methods Seventy-six patients with severe mixed hemorrhoids were randomly divided into treatment group and control group with 38 cases in each group. All patients from the two groups were treated with Milligan-Morgan hemorrhoidectomy. Then Chitosan gel (Ⅲ) was used in the treatment group. The two groups were compared in terms of curative effect, pain level, complications and hospital stay.Results There was no significant difference in the curative effect (P>0.05). But the scores on pain level, hemtochezia, infection and edema of the treatment group were all significantly lower than those of the control group (allP<0.05) and the hospital stay was significantly shorter than that of the control group (P<0.05).Conclusions In the treatment of severe mixed hemorrhoids by Milligan-Morgan hemorrhoidectomy, Chitosan gel (Ⅲ) is effective in relieving pains, reducing hemorrhage, edema and preventing infections and therefore shortens the hospital stay. In view of nursing, it is critical to perform mental care as well as close observations on complications.