Payment system reforms have become an important part of Chinese healthcare reforms, and global budget has been seen as a major trend. Based on the practice and data of four pilot hospitals in Beijing which have implemented the global budget, this paper focuses on analyzing the effects of implementation on the following aspects and provides references for policy improvements: medical services, average medical cost, total health expenditure, medical cost structure, average length of stay and out-of-pocket expense percentages.

Objective:To study the relationships between age,the state of genital tract and vaginitis,cervical erosion and vulvae leukoplakia in married women.Methods:Gynecologic inspection and laboratory examination were performed in 1 253 patients diagnosed vaginitis,cervicitis and vulvae leukoplakia in a women screen in a certain area in Chongqing in 2007.Statistics analysis was made by SAS8.1.Results:Of 1 253 patiens,45.89% had vaginitis,44.69%,cervical erosion,and 3.35%,vulvae leukoplakia,6.07%,the other conditions.Age,vaginal cleanness degree,candida infection were risk factors of vaginitis;Age,vaginal cleanness degree were related to cervical erosion and vulvae leukoplakia.Conclusion:Vaginitis,cervical erosion and vulvae leukoplakia should arouse more attention in the prevention and treatment of women genital tract disease in the future,and the standard etiology treatment should be performed to get microcosmic ecological balance.The perfect control and monitoring system for gynecologic disease should be established,and service quality of women health care should be improved.

Medical metrology work is the base of quality control for hospital medical equipment.It guarantees the accuracy of hospital medical instruments.It is important to set up a complete management system for hospital metrology institutions.

AIM: To investigate the clinical effect of phacoemulsification and intraocular lens ( IOL ) implantation for cataract patients after corneal refractive surgery, and to compare the accuracy of the different refractive IOL.
METHODS:The data of 120 myopia cases (160 eyes) in our hospital, who underwent cataract surgery and corneal refractive surgery were analyzed. Corneal curvature K value before corneal refractive surgery were obtained and calculated by using history method. Corneal curvature correction numerical method and corneal topography were used to record K value of patients with incomplete data before and after treatment. The K value was substituted into the formula. By comparing the actual cataract surgery and refractive state expected refractive status (-0. 50D), the accuracy of IOL refractive obtained from three methods was compared.
RESULTS: The average best corrected visual acuity before cataract surgery was 0. 25 ± 0. 05, and it was improved ( 0. 80 ± 0. 05 ) after surgery. The average spherical equivalent (SE) was -1. 98±1. 75 before surgery and +0.85±3.38 after surgery (P<0.05). The K values of 48 cases were calculated by clinical history method ( CHM ) and that of 73 cases was calculated with the adjusted keratometry method ( AKM) . The K values of 39 cases were calculated using the corneal topography method ( CTM) .
CONCLUSION: For patients with corneal refractive surgery, the appropriate method can be selected according to clinical symptoms, history, etc. and this may help to accurately calculate IOL. For patients with complete data, CHM can be used to provide corneal K values, while for those with incomplete data, AKM and CHM can be used.

Objectives To explore the effects of control measures and dynamic prevalence of drinking water endemic fluorosis in China, to provide basis and technique support for endemic fluorosis control in China. Methods The survey was carried out according to the national surveillance Scheme of Endemic Fuorosis. The fulfillment of control measures and the quality of water improving projects were surveyed. Household water sample and urine of children aged 8-12 years were collected and fluoride content was detected by iron selective electrode method. Check the teeth of children aged 8-12 years. Dental fluorosis was diagnosed by Dean's method. Results projects were build in 84 endemic villages in 2006, and the average water improving rate came to 73.98% fluoride contents of half the surveyed spots were over the standard, mainly between 1.0-2.0 mg/L, and the urine controlled just in only few spots and it was in moderate or severe status in some endemic areas for many years. Conclusions Little progress of control measures in drinking water endemic fluorosis counties surveyed has been made in these two years. Projects of running out of status and over standard of water fluorosis are frequently seen. Dental fluorosis in many spots is not controlled.

OBJECTIVE:To explore effective pharmaceutical administration measures for the rational adjunctive drugs. METH-ODS:The effective pharmaceutical administration of adjunctive drugs in medical institutions of Sichuan province was introduced, including establishing key monitoring management system of adjunctive drugs (establishing and implementing prescription review system,rational drug use training,strict supervision and examination) and playing promotion effect of provincial pharmaceutical quality management control center on medical institutions,etc. The effects of pharmaceutical administration in 18 third-grade class-A medical institutions were evaluated through statistically analyzing rational utilization ratio,drug ratio,consumption sum of ad-junctive drugs. RESULTS:Up to May 2016,key monitoring management system of hospital adjunctive drugs had been established and improved in medical institutions over Sichuan province. The rational utilization ratio of adjunctive drugs in 18 medical institu-tions increased from 69.41% in Jan. 2016 to 79.05% in May 2016;drug ratio decreased from 29.22% to 27.93%. The monthly consumption sum of adjunctive drugs decreased from 22 970 000 yuan in Apr. 2015 to 17 380 000 yuan in Apr. 2016(decreasing by 20.49%). CONCLUSIONS:Medical institutions of Sichuan province conduct effective pharmaceutical administration of adjunc-tive drugs through establishing the key monitoring management system for medical institutions and playing the role of the provincial pharmaceutical quality management control center for the supervision.

OBJECTIVE: To seek approach for the protection of domestic pharmaceutical enterprises with immature creativity and to ensure drug accessibility. METHODS: An analysis was performed applying the theory of demand elasticity by comparing the attributes of health right and patent right etc based on TRIPS protocol and the related practice abroad. RESULTS & CONCLUSIONS: For a developing country, China should give top priority to the short-term urgent needs, such as to meet people's medication demands, followed by meeting the long-term demands, such as to encourage independent intellectual property rights. Hence, drug accessibility-related system in drug patent system should be evolved step by step.

Bone Marrow Mesenchymal Stem Cells (BMSCs) are ideal seed cells for cell therapy,which have been through many long-term studies of in vitro and animal disease model treatment and have been widely used in preventing and treating a variety of clinical diseases caused by aging and other damage,including bone injury and regeneration,neural degenerative and injury,myocardial injury,liver cirrhosis,diabetes,lung disease and so on.BMSCs application in the treatment of orthopaedic disease is the most common and effective.By retrospective literature review,we summarize the BMSCs transplantation application in Orthopaedic disease treatment.As an ideal cell source,BMSCs was first applied in bone tissue engineering,mainly used in the treatment of long bone defect and bone nonunion;Recently,the research trends of clinical BMSCs application turned to treat degenerative diseases and genetic disorders because of its great potential,including osteoarthrits,femoral head necrosis,disc degeneration,spinal cord injury,knee varus,osteogenesis hypoplasia,hypophosphatasia and so on.The safety and efficacy of BMSCs treatment are the key issues in clinical cell therapy.There is no side effects and complications after BMSCs treatment,prove its clinical application is safe.But due to type and degree of disease and individual differences,therapeutic methods including injection method,effective concentrations,treatment window selection,cycle and therapeatic effects have a bigger difference.There is still no uniform of recognized operation standards for the treatment of the same type of disease.So BMSCs transplantation requires effective control during whole medical process and its application in orthopedic diseases is still lack of large-scale multicenter clinical study.Therefore,this review focuses on induction,summary and analysis in the research status of BMSCs in bone disease treatment,and provide new ideas and methods for BMSCs transplantation in orthopaedic disease prevention and treatment.

The frequency and influence on prognosis of hemorrhagic transformation (HT) after acute ischemic stroke are still uncertain with mixed results in previous studies.Slight hemorrhage transformation may will not worsen stroke patients' short-and long-term prognosis,but some MRI studies suggest that HT may impede patients to get a dramatical improvement of neurological function.We aimed to determine the overall frequency of and risk factors for HT.More importantly,we discussed the mechanism,subtypes of HT and the influence of HT subtypes on prognosis.

Objective To investigate the effects of malnutrition,nephrosis itself and glucocorticoid therapy on serum thyroid hormone,illustrate the relationship between serum thyroid hormone and renal IGF-I/IGFBPs autocrine/paracrine in nephrotic rats.Methods Twenty-four male Sprague-Dawley(SD) rats were randomly divided into control,pair-fed,doxorubicin(5mg/kg)-induced nephrotic and dexamethasone treated nephrotic(des-treated) rats.Serum T 3,T 4 and GH were measured by RIA,renal GHR and IGF-I/IGFBPs mRNA were analyzed by radioreceptor assay and RT-PCR respectively.Results ⑴Serum thyroid hormone levels were decreased by degrees according normal rats,pair-fed rats,nephrotic rats and lowest in des-treated rats except for high serum T 4 in pair-fed rats showed increasing trendency.⑵Reduced serum thyroid hormone was parallel well with decreased renal GHR and IGFBP-2 mRNA,and correlated negatively with increased renal IGFBP-3 mRNA.⑶There was some significant correlation positively between nose-tail length or weight and serum thyroid hormone.Conclusions The hypothyroidism is a possible mechanism of IGFBPs autocrine/paracrine disorder and further growth retardation in nephrotic syndrome.