OBJECTIVE:To promote the implementation of drug“zero profit”,and ensure the interests of both doctor and pa-tient. METHODS:Through introducing the related information of drug management and compensation mechanism of drug“zero profit”,the advices were put forward for the heavy financial burden,shortage of hospital income and medical accessibility,etc. RESULTS&CONCLUSIONS:Drug“zero profit”could promote the reform of public hospital. If both doctor and patient could ob-tain benefits,it is very important to strictly enforce compensation mechanism and increase the government investment. Meanwhile, medical service price should be appropriately adjusted to reflect technical value,knowledge value and risk value of medical staff;preparyment of the total amount should be propeled by project,disease,head and other payment methods to control unreasonable medical expenses growth;mechanical of the hospital operating service should be improved to consciously reduce the dependence on drug profits.

Background and purpose:Radical surgery remains the main treatment for patients with resectable gastric cancer.However,the majority of patients have advanced gastric cancer with either extensive invasion of tumor into the adjacent organs,lymph nodes or metastases when diagnosed.The advantage of neoadjuvant chemotherapy prior to surgery includes the shrinking of the cancer so that surgery becomes feasible for the patients with inoperable cancer and ultimately improve their long-term outcome.We conducted a clinical trial to evaluate the efficacy and toxicity of docetaxel(TAX),cisplatin(CDDP) and fluorouracil(5-FU) plus leucovorin(CF)as the neoadjuvant chemotherapy in the treatment of non-resectable advanced gastric cancer.Methods:From June 2003 to June 2005,12 patients with non-resectable advanced gastric cancer were treated with docetaxel/cisplatin/5-FU/CF before operation.Neoadjuvant chemotherapy regimens consisted of docetaxel(D),75mg/m~(2)(days 1),cisplatin(C),75mg/m~(2)(days 1),fluorouracil(F),500mg/m~(2)(days 1 to 5) plus leucovorin(CF),200mg/m~(2)(days 1 to 5) and were administered every 3 weeks for 2～3 cycles before operation.The immediate response and toxicity were documented for each patient.Results:9 of the 12 patients were downstaged and 8 were radically operated 4-6 weeks after the end of the neoadjuvant chemotherapy.The overall response rate was 75% with 8.3% CR and 66.7% PR,25% NC,and the ascites disappeared in 63.6%(7/11).Pathological complete response was found in 1 case.Histopathogical responses were scaled as mild,moderate and marked in 3,4 and 1 cases,respectively.The most common toxicities were bone marrow suppression,nausea,vomiting,alopecia and heptoses.The toxicities were recoverable after symptomatic treatment.Conclusions:The combination of docetaxel,cisplatin,fluorouracil plus leucovorin(CF) is a very effective and well-tolerated regimen as neoadjvant chemotherapy for the patients with non-resectable advanced gastric cancer.

ObjectiveTo investigate the early diagnosis and treatment of pleuropulmonary blastoma in children. Meth-ods The progress of pleuropulmonary blastoma from type 1 to type 3 was retrospectively analyzed.Results The male infant had no obvious abnormality in chest X-ray at 18 days. At one year old, X-ray iflm of the chest showed cystic lesions near hilum of the left lung (about 5 cm × 4 cm × 4 cm). The congenital cystic adenomatoid malformation was considered and an operation resection was suggested. However, it had been rejected by his parents. At 3 years and 2 months old, chest X-ray and CT showed left lung had a solid cystic lesion, the volume was signiifcantly enlarged, the back side was solid and the upper part had a large gas cavity. Two months later, the patient had asthmatic suffocation. The chest CT showed the tumor was completely solid. Pleuropulmonary blastoma type 3 was considered. The patient received the conventional chemotherapy after operation excision, and was followed up for 1 year. No recurrence was observed after the treatment.Conclusions Type 1 pleuropulmonary blastoma and congenital cystic adenomatoid malformation are hard to be differentially diagnosed. Early diagnosis and treatment of type 1 pleuropulmo-nary blastoma can improve the prognosis.

Newborn screening of inherited metabolic diseases by tandem mass spectrometry is flourishing in our country.With expansion of the coverage and spectrum of diseases, it is important to strengthen the quality management, optimize the performance and reduce the false rate currently, such as quality assurance of the specimens, quality control of the process, quality verification of the test procedure, quality evaluation of the laboratory and quality optimization of the interpretation method. Along with development of the equipment, software and project, promotion of regional collaboration by data and experience sharing will be more critical in the future, and national neonatal screening by tandem mass spectrometry will step into a new stage.

The right internal quality control rules are really important for improving the quality of patient results report in clinical laboratory.In order to look for faster and simpler tools that will help laboratories select the right internal quality con-trol rules for their own applications,recently Westgard introduced a newer tool “Westgard Sigma Rules”which is quicker and easier to use than previous tools.And it is very easy to figure out the right internal quality control rules by using West-gard Sigma Rules.This article introduced the characteristics and usage of original Westgard Rules and sigma metrics graph, and focusing on the application methods and practices of Westgard Sigma Rules which is the combination of original West-gard Rules and sigma metrics graph.Once the sigma quality of the tests and methods in laboratories are calculated,the West-gard Sigma Rules diagram can make it easy to select the right control rules and the right number of control measurements.

Objective To investigate the efficacy and safety of compound kushen injection (CKI)in the treatment for patients with advanced liver cancers.Methods Relevantly randomized controlled trials from China National Knowledge Infrastructure (CNKI),Chinese Science and Technology Journal Database (VIP),Wanfang Data,and Pubmed were searched until November,2014.Randomized controlled trials (RCTs) of supportive care compared with combined therapy of CKI in the treatment for patients with advanced liver cancers were included.The methodological quality of RCTs was assessed independently with bias risk according to the Cochrane collaboration.All data were analyzed with the Review Manager 5.3.Results Eight RCTs involving 472 patients were included.The meta-analysis results suggested that the shortterm efficacy of the treatment group be higher (P =0.008) and that the pain relief be a significant benefit in the treatment group (P ＜0.01).Adverse reactions were not observed.Conclusions CKI is an effective and safe adjuvant drug for advanced liver cancers.

Dens invaginatus is a relatively rare tooth malformations,this paper reports a case of lateral incisor with typeⅢdens invaginatus with periradicular pathosis and without pulp involvement.The tooth was treated by root canal therapy and followed up for one year,the prog-nosis was good.

Although the key role of External Quality Assessment schemes ( EQAS ) in the standardization/harmonization process has been clear from the start, it has never been totally implemented, mainly due to the lack of commutable materials, the difficulty target values and acceptable range.EQAS may also improve standardization/harmonization by proposing rules for the post-examination phase.Improvements in standardization and harmonization will really be able to work under the joint efforts of stakeholders.

Quality indicators (QIs)in laboratory medicine can measure how well a clinical laboratory meets the needs and re-quirements of users and the quality of all operational processes.The identification of reliable QIs is a crucial step in enabling users to quantify the quality of laboratory services.Different QIs and terminologies are currently used and,therefore,there is the need to harmonize proposed QIs.A model of quality indicators has been consensually developed by a group of clinical la-boratories according to a project launched by a working group of the International Federation of Clinical Chemistry and La-boratory Medicine.The model includes 57 QIs related to key processes (35 pre-,7 intra-and 15 post-examination phases)and 3 to support processes.The developed a model of quality indicators and the data collected provide evidence of the feasibility of the project to harmonize currently available QIs,but further efforts should be done to involve more clinical laboratories and to collect a more consistent amount of data.

Objective To study the relationship among the area of transverse section of radial artery, the major axis length of the ellipse with same centroid as transverse section, the maximum centroid displacement in the direction parallel with skin surface in a cardiac cycle and width of pulse tracing. Methods ECG, pressure phygmograms and ultrasound images of transverse section of radial artery of 40 patients with different width of pulse tracing and 20 healthy persons were collected synchronously with a new-type sphymograph. On the basis of images analysis with MATLAB 7.0.1, image characteristics of transverse section of radial artery and centroid motion locus of pulse tracings with different width in a cardiac cycle were observed and analyzed. Results Between pulse tracings with different width, there were significant differences in the area of transverse section of radial artery, the major axis length of the ellipse with same centroid as transverse section and the maximum centroid displacement in the direction parallel with skin surface in a cardiac cycle. Conclusions The mean, maximum and minimum value of the area of transverse section and the major axis length of ellipse and the maximum centroid displacement can be used to discriminate width of pulse tracing.