Objective] To study the impact of outpatient appointment supposed on the management of outpatient department and whole hospital. [Methods] Survey and research the average outpatient registration volume, patients' registration waiting time and the patients' satisfaction monthly during May 2011 to May 2014 when outpatient appointment was applied, and analyze the impact of outpatient appointment supposed on the management of outpatient department and whole hospital by comparing the results 3 years ago(during April 2008 to April 2011) when outpatient appointment was not applied. [Results] The number of patients with an appointment was on the rise, the total number of outpatients increased with the increase of outpatient appointment, and patients' registration waiting time was significantly shortened with higher satisfaction. The difference had statistical significance( P<0.05). [Conclusion] By outpatient appointment services, outpatient management has been optimized, with the increase of outpatients; the hospital benefits grow, and meanwhile the patients' satisfaction is improved.

[Objective]To obtain the normal linear parameters of different resection levels of normal proximal tibia in Chinese people, and discuss the influence of the gender and resection level on the design of the tibia prosthesis. [Methods]Thirty-six normal Chinese people (36 left knees, 18 males and 18 females), with an average age of 43 years (range 18～55 years) were enrolled in this study.Original CT image data were used to set up three-dimensional model of Chinese normal knees.The related linear parameters of different proximal tibia sections were measured and compared.[Results]Parameters of mediolateral (ML) ,medial and latera anteroposteriordimensions(MAP/ LAP) and the aspect ratio(AP/ML) of the resect proximal tibia surface were obtained. The parameters were confirmed by statistics analysis.[Conclusion]The geometry and anatomy of the knee in Chinese people have significant differences from the western people.The prosthesis designed by western people should be choosen carefully.Sex and resection levels should be taken into account in designing tibia prosthesis and or choosing the imported prosthesis in the total knee arthroplasty.

BACKGROUND: With the improvement of biomaterial and further recognition in aetabular revision, the main tendency is using biologic prosthesis for mild or moderate acetabular bone defect in total hip revision. OBJECTIVE: To observe the clinical effect of simple particulate bone grafting on mild or moderate acetabular bone defect in total hip revision. DESIGN, TIME AND SETTING: A retrospective case analysis. All cases were from Department of Orthopedics, Shanghai East Hospital Affiliated to Tongji University from June 2003 to June 2008. PARTICIPANTS: A total of 10 patients with mild or moderate acetabular bone defect who received total hip revision were from Department of Orthopedics, Shanghai East Hospital Affiliated to Tongji University. Among them, there were 5 male and 5 female, with an average of 58.8 years old from 43 to 77 years old. Their last replace time were 3-10 years, with an average of (7.0?0.5) years. Two of them in the last replacement used cement components, three used cementless, four used mixture, and one used dipolar artificial thigh bone. According to AAOS typing, there were 6 cases of type Ⅰ and 4 cases of type Ⅱ. The average preoperative Harris hip joint score was 40.6. METHODS: Simple particulate bone grafting combined with biologic prosthesis was used to treat the 10 patients with mild or moderate acetabular defects. All operations were at the posterolateral approach. The acetabular cup and screw fixation were performed after grafting. The postoperative effect should be evaluated by clinical and X-ray manifestations. MAIN OBJECTIVE INDEX: The bone grafting time, bleeding volume, Harris score and complications in the perioperative period were recorded. RESULTS: All patients were adopted simple particulate bone grafting combined with biologic prosthesis to reconstruct the acetabular bone defects. One acetalum cup was found loose after one month. The titanium plate combined with particulate bone grafting was used in the second revision. At 3 months after operation, the patient could walk without crutch. No complication was found in other patients. An average of 3 years following-up was obtained. The average Harris score was 87.0. Except one acetalum cup was found loose, the X-ray showed that the bed of acetabulum and particulate bone was good healing and there was no complete transparent zone. There was no patient with displacement of acetalum cup. No osteolysis in any patient. The particulate bone and host bone had a good healing. CONCLUSION: The simple particulate bone grafting is simple and effective for mild or moderate acetabular bone defects with the good follow-up result in early period.

Objective To understand the current situation about flexible position switch of non-licensed nurses in Chongqing, to discuss the cause of the flexible position switch, and to provide basic information for constructing scientific managerial measure. Methods Using the stratified clustering method to sample the nurses from 18 hospitals of different ranks in Chongqing and investigated them with self-designed questionnaire. Results Among the 1145 non- licensed nurses joining the investigation, 42.53%and 52.49% of them showed the will to switch their positions or occupations, 84.89% of them objected their children to occupy themselves with nursing service. 68.56% non-licensed nurses believed that flexible position switching had influence on themselves, while 74.50% of them believed that flexible position switching had impacts on hospitals. The main cause of the flexible position switching of non-licensed nurses included: feeling their work not beyond exceptions、 not enough respect in hospital 、lack of further development, and so on. Conclusions The high rate of will for flexible position switch cause great influences on the development of hospitals and non-licensed nurses themselves. Better treatment and raising respect should be given to them in order to stabilize nursing team.

Objective To study the impact of main source voltage fluctuation on dose rate and dose delivery accuracy of BJ-6B accelerator. Methods The accelerator was calibrated by a voltage regulator at an output voltage of 332 V. The main source voltage fluctuation was simulated by changing the output of voltage regulator within the range of 321 - 338 V. The change of dose rate was recorded. Using a water phantom, each absorption dose was measured five times and averaged along the central beam axis at the depth of 1.5 cm, 5 cm and 10 cm, respectively, with the conditions of monitor unit: 100 MU ,field: 10 cm× 10 cm and SSD = 100 cm. The impact of voltage fluctuation on dose rate and dose delivery of BJ-6B accelerator was analyzed. Results Voltage fluctuation had an significant effect on dose rate. In a certain range, dose rate and absorption dose at different depths increased as the output voltage increased. Conclusions It is essential to equip the BJ-6B accelerator with a high accurate voltage stabilizer, and the voltage stabilizer must be adjusted to its highest accuracy.

Objective To study the maintenance of BJ-6B accelerator. Methods Analyzed retrospectively the maintenance record of BJ-6B accelerator, including phenomena, causes and handle from 2002 to 2009. Results In 231 records, there were motion-controlling 64, hand-controlling-pendant 20.modulator 41, anti-peak overload 36, charging overload 5. Flatness 7, mechanical 21, digital-display 20,others lie in magnetron power, water-cooling system, light-indicator system, dose-monitor system and wedge system. Motion-controlling system is the highest among those, followed by high-voltage modulator and mechanical system. Conclusions The down time for BJ-6B accelerator is low because of its perfect technology. To keep its stability in clinic, the hospital authorities should emphasize training of engineer for improving their maintenance ability. The engineer must be familiar with the circuit diagram, check the electric wire and machine unit on time and prepare unit for maintenance. The temperature and humidity in machine house must be controlled on demand. The engineer must pay attention to machine parameters when beam is on for avoiding the spark's damage to magnetron and accelerating-tube

Objective To study the effect of CT scanning condition on the target position coordinate with WIMRT radiotherapy planning system using the" Z" form localizing frame. Methods The whole Head Phantom containing three metal targets was scanned under the following conditions: localizing frame transver-sally tilting, CT gantry tilting and localizing frame axially tilting. Then the three target coordinates were com-puted respectively and compared with those under the standard condition. Results The height and width of coordinate under the localizing frame transversally tilting condition deviated from those under the standard scanning condition,which was in an angle dependent manner. On the other hand ,a tendency was shown that the greater the absolute height value of the targets coordinate, the greater the width value deviation. And so was the relation between the absolute width value of the coordinate and height value deviation. If CT gantry angle was not zero degree or localizing frame axis is not in the same line with the CT bed moving direction, the calculated longititude value of the targets coordinate was mainly affected. Conclusions CT scanning must be performed strictly under the standard localizing scanning condition by a proficient physicist.

Objective To evaluate the left ventricular function and the synchrony of myocardial ischemic segments in patients with coronary heart disease (CHD) after PTCA and stent implantation by quantitative tissue velocity imaging (QTVI). Methods Thirty-six patients with isolated left anterior descending stenosis (≥75%) were examined by QTVI three days before, one week and one month after successful PTCA and stent implantation to measure the following items of 5 different left ventricular segments: peak systolic velocity( Vs), early diastolic velocity (Ve), late diastolic velocity (Va), time to peak systolic velocity(Ts). Then the coefficient of variation (SD/mean) of the 5 different Ts were calculated.Results The value of Vs,Ve and Va were decreased and the Ve/Va ratio was reverses three days before PTCA + stent. Compared with that before PTCA + stent,the value of Vs and Ve were increased significantly in one week ( P ＜0. 05) and one month( P ＜0.01 ) after PTCA + stent,respectively,the value of Va was not statistically significant. Ve/Va ratio was recovered in one week after PTCA treatment. Ts and Ts-SD were shorted dramatically in one week( P ＜0. 05) and one month( P ＜0.01 ) after PTCA + stent compared with that before PTCA + stent in which Ts were prolonged more than 33 ms. Conclusions QTVI can quantitatively assess the left ventricular function and the synchrony of myocardial ischemic segments, and can be used to real-time detect the changes of function and synchrony of left ventricle after PTCA and stent implantation.

Objective: To discuss the effects of acupuncture plus Tuina (Chinese therapeutic massage) in intervening the mental development, motor function, cerebral hemodynamics, and muscle tone in kids with spastic cerebral palsy (CP). Methods: A retrospective analysis was conducted on 87 kids with spastic CP. They were divided into a control group and an observation group based on their original treatment plan. Kids in the control group received symptomatic treatment, motor development therapy, and Tuina treatment. The observation group was additionally given acupuncture treatment. One month was taken as a treatment course. After six courses, the efficacy, change in muscle tone, mental development, gross motor function, fine motor function, and the systolic velocity (Vs), mean velocity (Vm), and pulsatility index (PI) of the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) were compared between the two groups. Results: After treatment, the muscle tone score dropped in both groups (P<0.05) and was significantly lower in the observation group than in the control group (P<0.05). The observation group achieved more significant efficacy than the control group (P<0.05). After the intervention, the mental development index (MDI), psychomotor development index (PDI), gross motor function measure (GMFM) score, and fine motor function measure (FMFM) score all increased in both groups (P<0.05) and were notably higher in the observation group than in the control group (P<0.05). After treatment, the Vs and Vm of the ACA, MCA, and PCA were markedly higher in the observation group than in the control group (P<0.05), and the observation group was significantly lower than the control group comparing the PI of the ACA, MCA, and PCA (P<0.05). Conclusion: Based on the symptomatic treatment and motor development therapy, Tuina and acupuncture treatment can effectively treat spastic CP children, manifesting as reducing muscle tone, boosting mental development, and improving motor function and cerebral hemodynamics.