Objective To introduce a new purchase management model of hospital.Methods Through a narration and a deep analysis on current status of hospital purchase,some disadvantages were summed up and new suggestions and solutions were put forward so as to reform purchase model.According to the characteristics of military hospitals,commercial bribery in national medical industry was eliminated and medical costs were reduced.The broad masses of ordinary people could benefit from it.Results The facts of the new purchase management model of hospital were clarified and analyzed in an unique perspective,which were proved to be worthy of researching.Conclusion More detailed work should be done to implement the model.

Objective To introduce a new field-based operating astral lamp. Methods The operating astral lamp employs specially -designed LED as the main light source, and IC as the control circuit. All the components are arranged in a combinatorial structure. It uses no glass material and makes the most of light plastic materials instead of metal. Results By testing the use of it in field training, this astral lamp proves to possess the following traits that high efficiency of light-emitting and low heat and thermal radiation, small power consumption affording a long time of use, strong abilities for vibration and shock resistance, and light-weighted conformation and easy assembly providing a convenient portability. Conclusion It is very suitable for field patrolling and defending.

Hepatocyte growth factor participates in many gynecologic and obstetric diseases such as gynecological tumor,endometriosis and hypertensive disorder complicating pregnancy by combination with its receptor c-Met.This article reviews the expression and mechanism of HGF in these diseases.

Arthralgia ; diagnosis ; etiology ; therapy ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Tendon Injuries ; diagnosis ; therapy

In order to explore the dose-response patterns of Gancao (Radix Glycyrrhizae) in Shanghan Lun (Treatise on Febrile Diseases), all prescriptions containing Gancao in Shanghan Lun were analyzed by frequency and hierarchical clustering analysis. The doses of Gancao used in Shanghan Lun ranged from six zhu (Chinese unit, and one zhu is equal to 0.65 g) to four liang (Chinese unit, and one liang is equal to 15.625 g). Doses of one, two, three or four liang were commonly used. One liang Gancao as juvantia was usually matched with Mahuang (Herba Ephedrae), Xingren (Semen Armeniacae) and Guizhi (Ramulus Cinnamomi) for restricting the excessive diaphoresis of Mahuang. Two liang Gancao was often matched with some couple drugs, such as Guizhi and Shaoyao (Radix Paeoniae), Shigao (Gypsum Fibrosum) and Zhimu (Rhizoma Anemarrhenae), Fuzi (Radix Aconiti Lateralis) and Ganjiang (Rhizoma Zingiberis), for warming yang to supplement qi, nourishing yin, detoxifying Fuzi, and preventing qi impairment from heat evil. Three liang Gancao was mainly matched with Banxia (Rhizoma Pinelliae) or Renshen (Radix Ginseng) for treating middle energizer emesis. Four liang Gancao was matched with Ganjiang or tonifying herbs for invigorating vital qi and relieving spasm in deficiency syndromes with contraction, palpitation or diarrhea. Gancao is used for treating many syndromes in Shanghan Lun. It is frequently used to treat excess or heat syndromes with one or two liang in a dose and deficiency or cold syndromes with three or four liang in a dose.

Objective:To investigate the clinicopathological characteristics of lung cancer patients with axillary lymph node metastasis (ALNM). Methods:The clinical data of 91 lung cancer patients with ALNM who were treated in Zhejiang Cancer Hospital from January 1st, 2007 to December 31st, 2013 were retrospectively analyzed. The relevance of the sites of the tumor site, local lymph node, and ax-illary lymph node was checked by contingency table. Survival rates were calculated by the Kaplan-Meier method and compared by a log-rank test. Cox proportional hazards model was applied to analyze the prognostic factors. Results:The proportion of lung cancer pa-tients with ALNM was 0.63%, and the patients were often presented with adenocarcinoma, peripheral tumor type, pleura invasion with pleural effusion, or chest wall invasion. A relationship between tumor sites, local lymph node sites, and axillary lymph node sites was observed. The median survival time of lung cancer patients with ALNM was 19.02 months, and the two-year survival rate is 62.64%. Patients identified with ALNM at the initial diagnosis reported poor prognosis (P=0.002). Cox regression analysis showed that the relative risk of death in patients with ALNM at initial diagnosis was elevated 2.18 times (95%CI:1.330?3.572, P=0.003). Conclu-sion:ALNM in lung cancer is rare, and it may involve through direct chest wall invasion and spread from supraclavicular and mediasti-nal lymph node metastasis or systemic origin. Patients detected with ALNM at the initial diagnosis indicated poor prognosis.

Aged ; Aged, 80 and over ; Anthracosis ; blood ; C-Reactive Protein ; analysis ; metabolism ; Cross Infection ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Pneumonia ; blood ; Serum ; chemistry

AIM: To study the effect of caffeine on the large conductance calcium activated potassium (K_(Ca)) channels by patch-clamp technique on smooth muscle cells enzymatically isolated from the porcine coronary artery (PCASMC),and to investigate the effect of ryanodine on K_(Ca) being activated by caffeine.METHODS: Using the single channel patch-clamp technique,single PCASMC was isolated by collagenase,the activity of single K_(Ca) channel was recorded in porcine coronary artery smooth muscle cells.RESULTS: Caffeine (0.1-10 mmol/L) enhanced the open probability (Po) of K_(Ca) channels in a dose-dependent manner in the intracellular side of inside-out patches and its effect was almost completely abolished by washout. Caffeine decreased the mean close time markedly,but had no effect on the amplitude of K_(Ca) channels. However,ryanodine (10-40 μmol/L) decreased Po of K_(Ca) channels activated by caffeine in a dose-dependent manner in cell-attached patches. The mean open time also decreased.CONCLUSION: Caffeine directly activates K_(Ca) channels of porcine coronary artery smooth muscle cells in inside-out patches,the activity of single K_(Ca) channel is inhibited by ryanodine indirectly in cell-attached patches.

Objective:We probe more direct operation pathways in sphenoidal sinus and saddle area, and take proper measures for correlated diseases which surpass scope of sphenoidal sinus by combining image data, which could prevent serious complication.Method:Under nasal endoscope, the operation approaches we adopted included trans-anterior ethmoid sinus-posterior ethmoid sinus-sphenoidal sinus pathway, trans-meatus nasi superior-posterior ethmoid sinus-sphenoidal sinus pathway, trans nasal septum-sphenoidal sinus pathway and trans-natural opening of sphenoid sinus anterior into sphenoid sinus pathway by taking upper edge of posterior naris as a consistent surgical landmark. Forty-six cases who had sphenoidal sinus mass with bone erosion recieved surgical treatment.Result:Twenty-one cases with cyst and pus cyst of sphenoidal sinus had been healed by trans-meatus nasi superior pathway;1 case with hematoma and organization in sphenoidal sinus had been cleared by trans-meatus nasi superior pathway;3 cases had hematoma and organization in sphenoidal sinus and pseudoaneurysm in internal carotid artery,one of them suffered fatal hemorrhage in surgical exploration, and cured by endovascular embolization, the other two only underwent nasal endoscopic examination,the diagnosis was established by DSA and they received interventional therapy;4 cases with papilloma in sphenoidal sinus had been treated by trans-natural opening of sphenoid sinus approach,and 3 cases were cured,1 case had only partial mass resection as the papilloma offended the outer wall of sphenoidal sinus diffusely;2 cases with cholesteatoma of sphenoid sinus have been removed completely by trans-meatus nasi superior approach;1 case with encephalomeningocele of sphenoidal sinus underwent sphenoidotomy by trans-natural opening of anterior of sphenoidal sinus, and intraoperative puncture showed characteristic cerebrospinal fluid,the exposed meninges were then repaird surgically;1 case with mycosis of sphenoidal sinus had been cured by thorough clearing of the leision in sphenoidal sinus combined with antifungal therapy;3 cases with malignancy of sphenoidal sinus had received major mass resection of sphenoidal sinus by trans-anterior ethmoid sinus-posterior ethmoid sinus approach, and followed with radio therapy and chemotheraphy;5 cases with NPC in-volving sphenoidal sinus had been treated by radio therapy and chemotherapy after pathological examinacation;5 cases with post-operative cerebrospinal rhinorrhea and granulation hyperplasia of sphenoidal sinus had been repaired successfully by trans-meatus nasi superior approach or tans-nasal septum approach.Conclusion:There are various surgical pathways to deal with sphenoidal sinus and correlated diseases under nasal endoscope.The operation will be direct, safe and minimal invasive if we choose the pathway properly. Thin slice CT scan and 3D reconstruction of sella, and DSA or angiography of brain before operation is one of effective means to prevent surgical complications for leisions beyond scope of sphenoidal sinus.

Objective To establish a suitable index system for typhoon disaster relief training of nurses.Methods Based on literature review and semi-structure expert interview,an index system frame work of typhoon disaster relief training of nurses was developed.Indexes were determined by adopting Delphi method and inquiring 21 experts with questionnaire.The weight of every index had been set up.Results The index system for typhoon disaster relief training of nurses was composed of 6 flintlevel indicators,28 second-level indicators and 37 third-level indicators.Conclusions The index system for typhoon disaster relief training of nurses is reliable and valid,which can provide objective and quantitative standards for the employment,training and evaluation of emergency specialized nurses.