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.

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.

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.

Humans ; Occupational Diseases ; prevention & control

Objective To observe the attachment,shape,function and activity of human umbilical cord mesenchymal stem cells cultured on silk fibroin porous scaffolds in vitro,and to provide experimental foundation for the choice of scaffold in the study of adipocyte tissue engineering.Methods These silk fibroin porous scaffolds were subsequently seeded with hUCMSCs and cultured in vitro.The growth and function of hUCMSCs were observed and measured with fluorescence inverted microscopy,scanning electronic microscopy and MTT methed. Results hUCMSCs were fixed on silk fibroin porous scaffolds 1 or 2 days later,and multiplicative growth was observed on the 5th to 7th day.After about 10 days,the microholes of the scaffolds were overlayed by hUCMSCs.Scanning electronic microscopy and fluorescence inverted microscopy showed that cells adhered to scafold well and there was a lot of extra cellular matrix surrounding cells. Conclusion Silk fibroin porous scaffolds are ideal for attachment,growth,function maintenance and activity of hUCMSCs.and the scaffolds can be used as natural scaffolds for hUCMSCs in 3D culture.

The S100 proteins are a multi-gene calcium-binding family,which are differently expressed in a variety of tumors.It is found to be associated with tumor invasion and metastasis.As a tumor-associated biomarkers,unraveling the relationship between S100 and prostate cancer progression as well as molecular mechanisms,would provide an important basis for the clinical diagnosis and therapeutic monitoring.

BACKGROUND:Cartilage is an avascular tissue and has a limited capacity for self-repair after injury. There are various methods for the treatment of articular cartilage injury ranging from conservation therapy to invasive surgery. With the development of tissue engineering technology, it provides a new way for treating articular cartilage injury. OBJECTIVE:To review the new development of tissue engineering technology for repairing articular cartilage injury. METHODS:The PubMed database and CNKI database were retrieved for articles from 2000 to 2013 by the first author with computer in May 2013. The key words were“cartilage tissue engineering, cartilage defect, stem cell, scaffold, growth factor”in English and Chinese. A total of 64 articles were included which related to cartilage regeneration and cartilage tissue engineering. For the articles in the same field, those published recently or in authorized journals were selected. RESULTS AND CONCLUSION:The three elements of cartilage tissue engineering, seed cells, scaffolds and cytokines, must be coordinated and mutual y beneficial development. At present, the research of tissue engineering for repairing articular cartilage injury has made a great progress. But the application in clinic has not enforced yet which is limited in experimental exploration stage. With the continuous development of new materials, the new tissue engineering cartilage repair materials should meet the requirement of material science and biological science, thus making the materials closely meet the biological characteristics of the self tissues. The animal studies wil turn to clinical experiments with the support of new technique, which make a breakthrough in the treatment of articular cartilage injury.

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.