Objective: To build total cost allocation model based on Time Driven Activity-based Costing (TDABC) and explore how to use it to improve the hospital cost accounting system. Methods: Take an ultrasonic cardiogram department of public hospital as a cost object to estimate the cost of medical service, as well as the efficiency of service and operating benefit analysis by using TDABC method. Results: Parts of routine services of the ultrasonic cardiogram departments having policy loss in a public hospital, the department’ s capacity are not fully utilized in a certain period. Conclusion: TDABC not only plays positive role in raising the level of hospital cost management, but also provides useful references and scientific basis for the formulation and revision of medical service fee and carring out the DRGs payment.

Objective To study the efficacy of external dissection & internal ligation for beating mixed hemorrhoids, and compare with Milligan-Morgan. Methods One hundred and twenty-six patients with mixed hemorrhoids were divided into two groups: treatment group(66 cases)and controlled group(60cases).In treatment group used external dissection & internal ligation for treating mixed hemorrhoids, but in eontrolled group used Milligan-Morgan. Then the differences between both groups in healing time of wound surface, as well in the statuses of bleeding, pain, edema, anus stenosis, and anus overflow liquid were observed. Results Averaged healing time in treatment group was significantly shorter than that in controlled group, (8.2±2.6)days vs (17.4±3.8)days, P＜0.01.The anus stenosis and anus overflow liquid were significantly less in treatment group than those in controlled group, P＜0.01.Conclusion External dissection & internal ligation of hemorrhoids for treating mixed hemorrhoids decreases anal transitional zone(ATZ)disorganization, shorten healing time, and significantly decreases crissum scar,protectes anus function effectively.

Objective To investigate the indications and complications in the treatment of benign and malignant strictures using esophageal stents in order to avoid abusing effects in clinical practice. Methods A series of 20 patients, 12 men, 8 women, aged from 45～72, with esophageal stricutre. There were 3 cases had stricture at the anastomosis site. 4 cases with esophago bronchial fistula. 1 case with esophago mediastinal fistula after surgical operation ten cases used imported stents and another 10 with domestic Nickel Titanium stents. Results Successful stent placement was achieved in all cases. Dysphagia were relieved in most of 20 cases. The fistula vanished in 5 cases of complications with esophago bronchial and esophago mediastinal fistulas. Conclusions The esophageal stent placement is an effective treatment for benign and malignant esphageal strictures. The domestic Nickel Titanium stents is well effective as the imported ones.

[Objective]To analyze the relative factors of reoperation to lumbar disc herniation(LDH)and to discuss the three methods for reoperation.[Method]By retrospectively studying and analyzing etiopathogenisis in 102 cases,who were made at least one reoperation,and other(1 327) LDH patients underwent an initial standard discectomy in our department from 1999 to 2004.Then studied several relative factors,such as age,interval time between the initial operation to the first reoperation,was made stastistic analysises.Combined with the statistic results,the clinical outcomes of patients who underwent three different reoperative methods were evaluated.[Result]A total of 102 cases underwent at least one reoperadon,11 of them had multiple(two or more)reoperations.Among these patients 58 cases suffered from recurrent LDH,40 suferred from postoperative stenosis or instability and 4 had postoperative intervertebral-space-infection.Forty-eight cases(47.06%)were performed single discectomies again,20(19.61%)undergone decompressions by laminectomy and 34(33.33%)had decompressions,bone-grafting and fixed with spinal instrumentations.There were 16 patients in all interbody-fusion surgeries and the number increasd year by year.Higher reoperation rate was seen in patients with the initial operation taking place less than 1 year comparing,more than those with the initial operation performing more than 1 year ago(P

Objective To understand the risk factors of allergic rhinitis in adults. Methods Using 1:1 paired matching case-control study design, 100 pairs of adults allergic rhinitis patients and the relevant controls from the E.N.T. department of Renmin Hospital of Peking University were recruited. Cases and controls were interviewed face to face using a designed health questionnaire in which the general social demographic characters, disease history, smoking history, occupation, indoor environmental situation and family genetic history were included. The questionnaires were analyzed by signal and multiple regression model of SPSS software. Results Allergic rhinitis was associated with the pollen allergic history (OR=2.04,95%CI: 1.31-3.20), occupational exposure to dust was a risk factor of allergic rhinitis (OR=1.46, 95%CI:0.83-2.57), the mother allergic rhinitis history could increase the risk of their off-springs suffering from allergic rhinitis(OR=2.05, 95%CI:1.03-4.07) and keeping ventilation could significantly decrease the risk suffering from allergic rhinitis(OR=0.70, 95%CI:0.34-1.18). Conclusion The occupational dust exposure, pollen allergy and mother allergic rhinitis history are related to allergic rhinitis in adults. Keeping ventilation may be a protective factor of allergic rhinitis in adults.

[Objective]To approach clinical outcomes and experiences of low-grade spondylolistbesis patients treated with posterior lumbar interbody fusion(PLIF)and transpedicular instrumentation.[Method]Consecutive 53 cases suffered from low-grade spondylolisthesis were analyzed retrospectively.All patients were treated by posterior lumbar ioterbody fusion and transpedicular instrumentation.Pre-operative and post-operative Boxall index,angle of slipping,intervertebral height were oberserved in all patients.Curative effects,fusion fate,operation-methold and complications were analyzed in all patients.[Result]All patients were followed up from 9 to 21 months with an average of 16 months.Forty-nine(92.5%)patients were assessed to bony fusion postoperatively.Comparement about preoperative and postoperative Boxall index,angle of slipping and intervertebral height were observed in all patients.There were great changes in all these indexes(P

[Objective]To investigate the clinical curative effect and superiority of subtotal corpectomy through the pedicle,titanium rete support and pedicle screws system fixation in the treatment of burst fracture of thoracic vertebrae with paralysis.[Method]Twenty-three patients who suffered from the burst fracture of thoracic vertebrae with paralysis were treated with subtotal corpectomy through pedicle,titanium rete supporting bone autograft and pedicle screws system fixation.[Result]The patients were followed up for 8 months to 2 years.All had their bone grafts fused,and no incision infection,pneumothorax,hemothorax,pulmonary infection,internal fixation loosening or breakage occurred.The mean loss of Cobb's angle was 3.5?.According to Frankel grading,6 of grade A had no obvious recovery.In 5 of grade B,3 improved to C,1 to D,and the last one to E.In 7 of grade C,3 improved to D,4 to E.Five cases of grade D improved to E.[Conclusion]There had relatively less operation wound and good clinical curative effect with subtotal corpectomy through pedicle,titanium rete supporting bone autograft and pedicle screws system fixation.

Depending on the meaning and function of the liver in traditional Chinese medicine and modern medicine,this paper explores the important role of liver in the pathogenesis of DM (Diabetes Mellitus,DM).Combined with treatment based on syndrome differentiation and specific case report study,this paper has stressed the importance of treating DM from liver and so to set a sound basis for the systemic treatment based on syndrome differentiation from internal organs for DM.