Child ; Child, Preschool ; Humans ; Leukemia ; immunology ; prevention & control ; Vaccination

Firstly the paper expounds the fact that letting patients pick their doctors goes with the tide of social development: ①the connotation of medical quality determines the necessity of patients involvement; ②evaluation of medical quality has extended from self appraisal to social assessment; and ③the mechanism of letting patients pick their doctors conforms to the medical quality requirements of the times. Then the paper discusses the positive impact of letting patients pick their doctors on medical quality, including the choice of doctors by outpatients and the impossibility of doing so in medico technical and emergency departments or by inpatients. The paper also gives an account of the measures taken for safeguarding medical quality when adopting the practice of letting patients pick their doctors. Lastly the paper explains the boosting role of the practice and the difference between letting patients pick their doctors and letting them name particular surgeons for their operations.

After an account of the background to the practice of letting patients pick their doctors in the Third Central Hospital of Tianjin, the paper points out the positive impact of the practice, comments on the specific measures, and narrates the results that have been achieved. These include: ①enhanced awareness of self management on the part of the staff; ②increased cohesion of the hospital; ③higher efficiency; ④greater initiative on the part of the scientific and technical personnel as a result of the reform; ⑤social recognition of the reform; and ⑥a higher level of professional ethics building. Lastly the paper discusses the hospitals experience in adopting the practice of letting patients pick their doctors.

Objective To evaluate the diagnosis and treatment of aortic dissection combined with chronic renal failure.Methods Ten cases were retrospectively analyzed who were diagnosed as aortic dissection combined with chronic renal failure between January 2012 and December 2014.The history of chronic renal failure was 1-6 years.According to Standford classification,one case was type A dissection and the other nine were type B.Results Seven type B dissection had endovascular stent implantation.Perioperative renal function monitor and hemodialysis was given.The other two patients with type B dissection had conservative treatment.One patient with type A dissection died in the day of diagnosis.Follow-up data showed seven patients with stent implantation were in good condition and two others with conservative treatment died due to dissection rupture three and eight months after diagnosis respectively.Conclusions The mortality of aortic dissection combined with chronic renal failure is high.For Standford B dissection,endovascular stent implantation is a reliable treatment method.

Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for metastatic bone tumours. Methods Eighty patients with metastatic bone tumour by meta were randomly derided into two groups study group(n=40), and the eantrol group (n=40). The study group received 4 mg zoledronic acid infusion for 15 minutes combined with radiotherapy (DT 30Gy/10f/2w) ,control group was only treated with radiotherapy. The primary effective parameters were pain scores, quality of life, KPS scores and pain relief rates. The vital signs, bi-ochemical and hematological parameters were determined. Results The overall response rates of study group and control group were 97.5% and 72.5% ,respectively(P<0.05). The overall response rate of movement capacity im-provement was 87.5 % in the study group and 65.0% in the control group(P<0.05). There was statistical signifi-cance of QOL and KPS in two groups (P<0.01). An adverse event of mild systemic skeletal pain was recorded after pamidronate infusion and completely reversed after 8 hours. Conclusion Zoledronic acid combined with radiothera-py is effective and safe for treating malignant tumour with mestastatic bone tumours. It is a better way to treat meta-static bone tumors at present.

[Objective]A new limited contact femoral supracondylar interlocking intramedullary nail(LCFSIIN) was made,which was part of a new custom-made hemi-knee joint,to improve the results of childrens' limb salvage.[Method]A new LCFSIIN was performed and the stress of bolts,intramedullary nails and bone were analyzed by finite dement analysis(FEA) while the bolts were implanted in different angulafions-0?,15?,30?,45?and 60?.[Result]The results of FEA show that the stress of bolts,bone and nails with 15? insertion angles of bolt was the tiniest and well distributed.Stress of bone with 0? insertion angles was more obvious than that with 15?,30?and 45?.The more the angles,the stress of proximal bolt became more obvious and the stress of distal bolt decreasing.[Conclusion]This new LCFSIIN can reduce destruction of biological environment of bone and is easy in use in limb salvage surgery of allograft.

Objective To evaluate total laparoscopic splenectomy combined with pericardial devascularization. Methods In this study,40 patients with portal hypertension and hypersplenism underwent total laparoscopic splenectomy combined with pericardial devascularization,in which 26 cases had a history of up-GI bleeding. Results Procedures were successful in 36 patients.There was four conversions to open surgery.The operations were completed in a mean time of (224 ± 54) min,with a mean estimated blood loss of (296 ± 209) ml and with no serious complication. Conclusion Total laparoscopic splenectomy combined with pericardial devascularization is a safe and effective available minimally invasive procedure in patients with portal hypertension and hypersplenism.

Objective To investigate the association between prodromal headache and the propensity of rebleeding after aneurysmal subarachnoid hemorrhage.Method Prodromal headache was defined as a sudden attack of severe headache lasting at least one hour with or without accompanying symptoms,not leading to a diagnosis of SAH 4 weeks before the confirmation of subarachnoid hemorrhage.Two hundred and nine patients with aneurymal subarachnoid hemorrhage were enrolled in this research.Age,gender,Hunt-Hess grade,D-dimer, (FBG),site and number of aneurysms and prodromal headache were recorded.Patients were divided into rebleeding group and non-rebleeding group.Comparing the above survey components between two groups was carried out by using case control study method.Age,aneurysm number,D-dimer and fibrinogen of the two groups were analyzed by t test.Prodromal headache,gender,site of aneurysms were analyzed by chi square test.Hunt- Hess grade was analyzed by rank test.Results Twenty-two(10.5%)patients had rebleeding.In the rebleeding group,10 patients(45.5%)had prodromal headache,while in the non-rebleeding group(n=187),21 patients (11.2%)had prodromal headache.Patients with prodromal headache had greater propensity of rebleeding compared with those without prodromal headache(P

Objective To investigate the effects of Compound Zhe Bei granule (CZBG) combined with doxorubicin on the expression of GST and Topo - Ⅱ in K562/A02 cell line multidrug resistance tumor xenografts in mice. Methods Tumor xenografts model was established by injecting the multidrug resistance cell line K562/A02 in the axillary flank of BALB/c - nu - nu mice. Drug - comgbination of CZBG intragastric administration and doxorubicin intraperitoneal injection ( i. p. ) was given to the BALB/c - nu nude mice. The tumor xenografts were made into slice after the dissection, and the expression of GST and Topo - Ⅱ in K562/A02 tumor xenografts in mice was investigated by immunohistochemical technique. The integral optical density (IOD) of GST and Topo- lⅡ in K562/A02 tumor xenografts was measured by Image ProPlus 6.0. Results Compared with the single treatment of doxorubicin i. p group,the combination of the doxorubicin and CZBG with dosage classified by three types( high, middle, low) can decrease IOD of GSH and Topo - Ⅱ in K562/A02 tumor xenografts with statistical significance( P

Adult ; Humans ; Imaging, Three-Dimensional ; Jaw Fixation Techniques ; Joint Dislocations ; diagnostic imaging ; etiology ; surgery ; Male ; Mandible ; surgery ; Mandibular Condyle ; diagnostic imaging ; injuries ; surgery ; Mandibular Fractures ; complications ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed