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.

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.

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.

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.

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 investigate the expression and clinical signification of tumor M2 pyruvate kinase in pa-tients with CRC, and to try to find a reliable and atraumatic method to predict the progress and pronosis in the CRC. Methods ELISA method was used to determine the serum levels of tM2-PK in 68 patients with CRC,40 pa-tients with colorectal polyps and 40 cases of normal subjects; immunohistochemistry ( IHC ) methods were respec-tively used to detect the expression of tM2-PK in tissues. Results ① The level of serum tM2-PK in patients with CRC was significantly higher than the group of patients with polyps and the normal subjects ( P<0.05 ) . The serum tM2-PK levels was closely correlated to tumor size and Duke stage.②The positive rate of tissue tM2-PK was signif-icantly higher in CRC than in colorectal polyps and normal subjects ( P<0.05 ) . Tissue tM2-PK levels was closely correlated to tumor size,Duke stage and differentiation grade. ③Serum tM2-PK levels was correlated to tissue tM2-PK levels (r=0.357,P=0.003). Conclusion Combined detection of expression of tM2-PK can provide the basis theory for the diagnosis and prognosis evaluation of CRC.

Objective Detected Her-2/neu, matrix metalloproteinases-2 (MMP-2) and Leptin in stomach cancer serum and tissue, discussed their roles in occurance and development of gastric cancer. Methods Detected the ex-pression of Her-2/neu, MMP-2 and Leptin in serum by ELISA, and detected the expression of Her-2/neu, MMP-2 and Leptin in stomach cancer tissue by IHC. Results The positive rates of Her-2/neu, MMP-2, Leptin in gas-tric cancer serum were higher than the positive rates in control group ( P<0.05 ) . The positive rates of Her-2/neu, MMP-2, Leptin in gastric cancer tissues were higher than the positive rates in adjacent tissues (P<0.05 ). The positive expressions of two tests had consistency. In tissues, the positive expression rates of Her-2/neu,MMP-2 and Leptin were correlated with the depth of invasion,lymph node metastasis, clinical stage(P<0.05). Their ex-pression was not correlated with sex, age, size, site of tumor and the degree of differentiation. In serum, the posi-tive expression of Her-2/neu was correlated with the depth of invasion, lymph node metastasis, clinical stage( P<0.05 ) . The positive expression of MMP-2 was correlated with lymph node metastasis ( P<0.05 ) . The positive ex-pression of Leptin had no significant correlation with pathological features. Conclusion Her-2/neu,MMP-2 and Leptin promote the occurrence, development and transfer process of gastric cancer. It can be used for clinical diag-nosis, guide the targeted therapy and provide scientific and reasonable reference for gastric cancer prognosis.

Status epilepticus (SE) is one of the common medical emergencies of the pediatric age group.It may lead to serious and even irreversible neurological abnormalities,even death,if not diagnosis and treatment properly.To recognise etiology,rise factors,seizure type,treatment,outcome and the correlation between each other of children with status epilepticus are significant for management.This paper aimed to review recent epidemiological studies on children with status epilepticus,in order to provide evidences for the current clinical practice and further research.

Objective To investigate the expression of ICAM-1 and VCAM-1 in colorectal carcinoma and the rela-tionship between ICAM-1, VCAM-1 and the occurrence, the metastasis of colorectal carcinoma, and to analyze the significance. Methods Immunohistochemistry staining(S-P method) was used to detect the expression of ICAM-1 and VCAM-1 on consecutive section in 78 cases of colorectal carcinoma and normal mucosa and 42 cases of colorec-tal adenomas. Plasma was obtained from 78 patients with colorectal carcinoma and 40 healthy volunteers prior sur-gery, by an enzyme-linked immunosorbent assay (ELISA). Results There was significant difference between the high expression of ICAM-1 and VCAM-1 in colorectal carcinoma and the low expression in normal mucosa and ade-noma(P < 0. 01). Serum ICAM-1 and VCAM-1 were significantly higher in patients with colorectal carcinoma than those in normal control group(P < 0. 01). The ICAM-1 and VCAM-1 levels were not related to sex, age, tumor lo-cation and histological grades(P > 0. 05),but had significantly statistical difference between lymph node metastasis and Dukes stage(P < 0. 01). Conclusion The increase expression of ICAM-1 and VCAM-1 in colorectal cancer suggests that the ICAM-1 and VCAM-1 may play an important role in evaluation of malignant degree and judging the progress as well as the mechanism of colorectal cancer.

BACKGROUND:Wtih hyaluronic acid and col agen by cellautocrine as endogenous scaffolds, cellsheet technology can eliminate the disadvantages of exogenous scaffolds. Human adipose-derived stem cells combined with cellsheet technology used in the study of ful-thickness skin defects have become the current hot spot.
OBJECTIVE:To summarize the research progress in adipose-derived stem cellsheet.
METHODS:Articles related to adipose-derived stem cells, cellsheet technology and tissue-engineered skin were retrieved in VIP information and PubMed database from January 1993 to April 2014. The key words were“adipose-derived stem cell, wound healing, tissue-engineered skin, cellsheet”in English and Chinese, respectively. Total y 27 relevant articles were analyzed.
RESULTS AND CONCLUSION:Adipose-derived stem cells derived from discarded human adipose tissue are immmunocompatible and multi-potent, rendering them ideal for regenerative medicine applications. cellsheet technology seemingly provides several advantages over traditional tissue reconstruction with biodegradeable scaffolds. Adipose-derived stem cells combined with cellsheet technology can enhance tissue vascularization, promote wound healing, the secreted extracellular matrix provides the microenvironment for the celldifferentiation and growth, so it is expected to build a real three-dimensional tissue-engineered skin.