This paper aims at evaluating the effectiveness of the “Medical and Pharmaceutical Separation” re-form in Beijing in three years , and put forward suggestions for the reform of public hospitals .Using data obtained from hospital database, we compared changes in the proportion of drug cost , the average drug expenditures per time, medical workload , quality , income and structure .The key findings of this study show that after the reform , the quali-ty of medical services has improved .Compared to one year before the reform , in the third year of reform the outpa-tient and inpatient medicine accounted for decreased to 16.98%and 13.3%, from 25.57%and 36%, respectively;and the outpatient and inpatient patients per capita medical expenses decreased by 21.39%and 34.8%respectively. The health care revenue increased by 68 .1%compared with before reform .Drug revenue fell 14.29%before the re-form.Medical service fee income reached 243,500,000 yuan.Income from medical examination and laboratory tests in-creased by 52.60%.Based on the findings of the present investigation , the Trial“Medical and Pharmaceutical Separa-tion” to control the cost of drugs achieved good results .Therefore ,it would be advantageous in adopting the reform of public hospitals in the next step toward the medical examination separated , adjust the price of medical services ,etc.

[Objective]To explore the outcome of treatment of traumatic talipes equinus with Ilizarov technique.[Method]From Dec 2004 to Feb 2006,Ilizarove technique was used for treatment of traumatic talipes equinus in 8 patients,5 male and 3 female,aged from 28 years to 52 years with an average of 34.6 years.The main reasons of the food deformity included rupture or defect of the anterolateral muscle group of the leg in 3 patient,compartment syndrome of the leg in 2 patients,peroneal nerve injury in 2 and supercondylar fracture of the femor combined with popliteal artery injury in a patient.Ankylosis of the ankle ranged from 50 to 65 degrees.During operation,Ilizarov fram was placed in relative position of the foot and leg,and cross Kirschner wires 2 mm in diameter were inserted and fixed the limb with the frame in different level rings.Form 3～5 days after operation,distraction 1～2 turns four times per day was conducted till the ankle was placed in neutral position and the deformity corrected satisfactorily,then,discontinued the distraction and maintained the external fiation for another 2～3 months.[Result]All of the patients were followed up for 10 months to 21 months with an average of 12.5 months. No severe complications,such as necrosis of skin,neurovascular injuries occurred in any patient of this group.All of the affected foot and ankle got neutral position with satisfactory ambulation function,and 3 of them had 10 degrees of active dorsal flexion.No recurrence of the deformity occurred in any patient at the latest follow up.[Conclusion]Ilizarov techinque for treatment of traumatic talipes enquinus has significant advantages over other methods,it is recommended extensive application in clinic.

The lumbar facet joints osteoarthritis can be a potentially important source of low back pain.The risk factors of lumbar facet joints osteoarthritis has been systematic reviewed.Recent research shows that risk factors for lumbar facet joints osteoarthritis include advanced age(older than 50 years old),male or post-menopause female,relatively more sagittal orientation of the facet joints,a background of intervertebral disk degeneration and L4、5 spinal levels.An up-to-date knowledge of this subject can be helpful in diagnosis and treatment of low back pain.

This paper describes an algorithm of extracting location information in 2D eyeball ultrasound slices. The relative position of eyeball slices is adjusted based on the correlation between the slices. Some middle slices are added with elastic matching-based interpolation algorithm. Then ray-casting algorithm for volume rendering is used to reconstruct 3D image of the eyeball.

Objective To compare the clinical effects of 2 common installation positions of the helical blade in the treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA).Methods From January 2010 to December 2012,166 old patients with intertrochanteric fracture were treated by PFNA.According to the installation position of the helical blade in the femoral head on the postoperative X-ray films,they were divided into a C/C group (87 cases) where the helical blade was at the center of the femoral head in both anteroposterior and lateral views and an I/C group (79 cases) where the helical blade was at the inferior one-third of the femoral head in anteroposterior view and at the center in lateral view.There were no significant differences between the 2 groups in general data preoperation (P ＞ 0.05).The 2 groups were compared in terms of reduction quality,tip-apex distance (TAD),full weight bearing time,fracture healing time,and Harris Hip Score(HHS) at the last follow-up.Results C/C group had 83 patients followed for an average of 13.6 months and I/C group had 76 patients followed for an average of 13.3 months.There were no significant differences between the 2 groups regarding the good-to-excellent reduction rate [94.0％ (78/83) versus 94.7％ (72/76)],full weight bearing time (9.4 ± 1.5 weeks versus 9.3 ± 1.3 weeks),fracture healing time (17.8 ±2.3 weeks versus 17.2 ±2.3 weeks),or HHS (89.6 ±4.6 points versus 89.3 ±4.7 points) (P ＞ 0.05).There was a significant difference in TAD (21.14 ± 3.17 mm versus 24.96 ± 3.48 mm) between the 2 groups(t =-7.242,P =0.000).No infection or cut-out or other related complications of the helical blade occurred in either group.Conclusion The helical blade may lead to satisfactory clinical effects in the treatment of senile intertrochanteric fractures with PFNA no matter at which of the 2 positions it is installed.

Astroglia is the first cell type in the central nervous system to encounter insult after brain ischemia. Then ischemia stimulates hypertrophic and proliferative changes in astroglia and induces it produce inflammatory factors involved in the initiation of immunologic cascade. The expression of these cytokines which interact in the central nervous system can both damage and protect the brain tissue. Therefore, it is important to study astroglia and cytokines in order to find a new way to reduce inflammation insults after brain ischemia.

Accidents, Occupational ; Humans ; Hydrogen Sulfide ; poisoning

To analyze the compatibility regularity of compound traditional Chinese medicine (TCM) patents for treating dyslipidemia, and provide basis for the clinical development and research of new TCM for treating dyslipidemia. Totally 243 compound traditional Chinese medicine patents for treating dyslipidemia were collected from the national patent database from September 1985 to March 2014 and analyzed by using drug frequency, association rules, complex network and entropy method of Traditional Chinese Medicine Inheritance System (V1.1). The commonest single medicine in the treatment of dyslipidemia is Crataegi Fructus 109 (44.86%). The commonest pair medicine is Crataegi Fructus-Salviae Miltiorrhizae Radix et Rhizoma 53 (21.81%). The commonest corner drug is Crataegi Fructus-Cassiae Semen-Polygoni Multiflori Radix 25 (10.29%). The common prescriptions on basis of association rules are Prunellae Spica-->Salviae Miltiorrhizae Radix et Rhizoma (0.833), Rhei Radix et Rhizoma, Alismatis Rhizoma-->Polygoni Multiflori Radix (1.00), Salviae Miltiorrhizae Radix et Rhizoma, Cassiae Semen, Alismatis Rhizoma-->Polygoni Multiflori Radix (0.929). The core drugs based on complex networks are Salviae Miltiorrhizae Radix et Rhizoma and Crataegi Fructus. The new prescriptions extracted by entropy method are Atractylodis Macrocephalae Rhizoma-Glycyrrhizae Radix et Rhizoma-Platycladi Semen-Stephaniae Tetrandrae Radix; Citri Reticulatae Pericarpium-Poria-Coicis Semen-Pinelliae Rhizoma. This study shows the regularity in the compatibility of compound TCM patents treating dyslipidemia, suggesting that future studies on new traditional Chinese medicines treating dyslipidemia should focus on the following six aspects: (1) Single medicine should be preferred: e. g. Crataegi Fructus; (2) Pair medicines should be preferred: e. g. Crataegi Fructus-Salviae Miltiorrhizae Radix et Rhizoma; (3) Corner drugs should be preferred: e. g. Crataegi Fructus, Cassiae Semen, Polygoni Multiflori Radix; (4) The compatibility among drugs shall be given attention, and highly correlated drugs should be preferred: e. g. Prunellae Spica, Salviae Miltiorrhizae Radix et Rhizoma; Rhei Radix et Rhizoma, Alismatis Rhizoma, Polygoni Multiflori Radix; Salviae Miltiorrhizae Radix et Rhizoma, Cassiae Semen, Alismatis Rhizoma, Polygoni Multiflori Radix; (5) Core drugs should be dominant and compatible, e. g. in the digestion catharsis method, the core drugs is Crataegi Fructus and compatible with Salviae Miltiorrhizae Radix et Rhizoma; (6) Application of new prescriptions: Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Platycladi Semen, Stephaniae Tetrandrae Radix; Citri Reticulatae Pericarpium, Poria, Coicis Semen, Pinelliae Rhizoma.
Dyslipidemias ; drug therapy ; Entropy ; Humans ; Medicine, Chinese Traditional ; Patents as Topic

Objective To investigate the impact of gantry angles on the position accuracy of buildin multi-leaf collimator (MLC) during static (step & shoot) intensity modulated radiotherapy (IMRT).Methods The position accuracy of MillenniumTM 60 pairs multi-leaf collimator (MLC) in Varian 23EX medical linear accelerator during 10 fractions of treatments with static intensity modulated radiotherapy (IMRT) was retrospectively analyzed by resolving dynamic therapy log files and MLC planning files.The single leaf position deviation and gap deviation of each MLC pairs were compared between expected values and actual outcomes.The impact of gantry angle on MLC position accuracy was also investigated with paired t-test between vertical and horizontal beams.Results All the MLC position deviations ranged within ± 1.0 mm,while the gap deviations were at the range of ± 1.5 mm.The statistical standard deviation of MLC position deviations among fractions was less than 0.06 mm.After all the 60 pairs of MLC leaves were taken into account,the M LC position deviation in the field of 103° was smaller than in the field of 0° (t =58.74,P ＜ 0.01),but there was no significant difference between 257° and 0°,while only the moving leaves were put into consideration,the MLC position deviation in the field of 103° was still smaller than in the field of 0°,but the MLC position deviation in the field of 257° was slightly higher than in thefield of 0° (t =41.95、-4.47,P ＜ 0.01).Conclusions The MillenniumTM 60 pairs MLC in Varian 23EX medical linear accelerator meets the mechanical quality assurance requirement during static IMRT treatments.The MLC positioning showed stable repeatability among treatment fractions.Although the MLC position accuracy is slightly affected by gravity from different gantry angles,but still meets the mechanical QA requirements for medical linear accelerator.This dynamic analysis method is expected to be a novel strategy which may improve the existing QA protocols.

Objective To observe the mutifocal electroretinogram (mfERG) characteristics of rod and cone cells in patients with retinitis pigmentosa (RP) and to evaluate the function of photosensory cell.Methods The mfERG recording technique for rod cell in eight normal subjects (eight eyes) were established and the influence of different brightness lightstimulus in P1 wave amplitude were analyzed.The cone and rod cells mfERG of 38 eyes in 19 patients were recorded and then calculated positive ratio from local signal-noise ratio.The average visual acuity and P1 wave amplitude density of cone mtERG in different types were compared and statistically analyzed.Meanwhile,the changes in P1 wave amplitude of cone and rod mfERG in four quadrants also compared and analyzed.Results Rod cell mfERG in normal subjects can be recorded stably by using blue flashes with low light intensity as 0.04 cd/m~2.In patients with RP,the cone and rod cells mfERG can he detectd 65.790./00 and 10.51% respectively.P1 wave amplitude density in type I of cone cell mfERG was significantly higher than that in type Ⅱ (t=5.21,P=0.000).There were no differences in average visual acuity (t=1.15,P=0.612).P1 wave amplitude density in type Ⅰ was negatively related to IogMAR visual acuity (r=-0.48,P=0.04 ).The comparison of rod and cone cells mfERG in local wave characteristics showed that P_1 wave amplitude densities had spatial relationship in each area.Conclusions The results suggested highly variable central responses in cone cell in RP patients,higher positive recorded ratio in cone cell than rod cell and spatial correspondence between the function of reserved cone and rod cells.