Hologram is a theory to study the properties and laws of the world under a holographic interaction.Traditional Chinese Medicine(TCM) shares many common fi elds with hologram theory.Although some originally diagnostic folk methods such as Zhejiang.sixian pulse theory,Kunlun?tianyuan pulse theory have been rarely known and have not been widely recognized in modern time,the diagnostic methods of Jiugong pulse and hologram pulse based on the two pulses theories have shown its uniqueness and effectiveness through hundreds of years of clinic practices.Based on holographic principles and holism,a physician can make diagnoses noninvasive,simple and rapid,which is benefi t for inheritance and development of TCM pulse methods.

This paper analyzes the reform backgrounds, mechanisms and measures of financing and payment taken in the second-generation national health insurance (NHI) in Taiwan. The results indicate that in 2nd NHI, the rate was adjusted more flexibly, supplementary insurance premium was charged to enlarge the financial source by im-plicating additional subsidies and expanding the sources of financing, multiple payment methods and auxiliary assis-tive means were used to control the growth of medical expenses, social insurance payments are specified in terms of category or clear payment projects and standards, new health technology assessments are used as new basis for deci-sion making, etc. by greatly alleviating the financial deficit, which helped achieve the financial balance again. Many features of the 2nd NHI in Taiwan, especially like its diversified financial resources and financing methods, global budget of control fees and DRGs payment systems, making evaluation criteria for medical quality control and health insurance reimbursement project development and so on, are worth learning for the mainland China.

Objective:To evaluate the technique of reduction and rigid internal fixation of sagittal maxillary fracture. Methods:15 cases of sagittal maxillary fracture were reviewed. Occlusal guide plates were prepared preoperatively by model surgery analysis in 10 cases; Le Fort ? osteotomy and down-fracture were done in 8 cases; Pterygomaxillary junctions were also separated in the other cases. Internal fixation was applied along the anterior maxillary surface by using microplates in all 15 cases. Results:Anatomically reduction was achieved in all cases; Occlusion of 14 cases was corrected except one case of fracture re-displaced. Conclusion:Orthognathic technique is effective treatment of sagittal maxillary fracture; One microplate applied along anterior maxillary surface may be not enough to ensure the fixation of sagittal maxillary fracture.

Objective: To investigate the principle of diagnosis and treatment of orbital fracture. Methods:114 cases of orbital fractures were reviewed. The incidence of major clinical feature was estimated and the surgical procedures were analyzed. Results:Incidence rate of restricted ocular motility, diplopia and enophthalmos were 63.2%, 62.3% and 59.6% respectively; The incidence of optic nerve injury, lacrimal injury and rupture of the globe was 15.8%,15.8% and 12.3% respectively. 95.6% of the cases were undergone orbital wall reconstruction (artificial bone graft) and 72.8% were received fracture reduction and internal fixation. Conclusion:Restricted ocular motility, diplopia and enophthalmos are major symptoms of orbital fracture and optic nerve injury, lacrimal injury and rupture of the globe are important complications of orbital fracture; Orbital reconstruction is the most popular surgical procedure for orbital fracture and bone reduction and internal fixation is also need for impure orbital fracture.

Objective To explore the application value of mammary gland remodeling to one-stage repair local defects after partial excision.Methods The clinical data of 62 breast patients undergoing mammary gland remodeling to one-stage repair local defect after partial excision between January 2011 and December 2014 were reviewed.Results All patients recovery,the average operative time was 60 min,the average hospital stay was 7 days,the average cost was 5 216 yuan,1 case with postoperative concurrent incision infection,6 cases with postoperative hematoma.The cosmetic results were excellent or good rate was 87.1％ (54/62),and fair rate was 12.9％ (8/62).The breasts showed natural and symmetrical appearance during a follow-up of 12-36 months.Conclusions The application of mammary gland remodeling to one-stage repair local defect after partial excision is a safe and economical method.

Objective To investigate the clinicopathological features,the diagnosis and therapy of primary pulmonary perivascular epithelioid cell tumor (PEComa). Methods One case of primary pulmonary perivascular epithelioid cell tumor diagnosed and treated in April 2010 was presented. The clinical symptoms,imaging, pathology features, treatment and follow-up record of the patient were analyzed retrospectively,and relevant literatures were reviewed. Results The patient had not special clinical symptoms and was found through the medical checkup. The imaging methods could easily find the tumor but hard to diagnose it. The final diagnosis depended on the pathologic features and immunohistochemistry techniques. Among present literatures, scarce cases of pulmonary malignant PEComa were reported. Conclusion Primary pulmonary PEComa is a very rare tumor that arises from mesenchymal tissues, especially the malignant cases. The diagnosis of PEComa mainly depends on the pathological features. Because of the uncertain biologic behavior pulmonary PEComa should be followed up closely for a long term.

Purpose: To measure the distribution of radiation dose on neighboring tissue of the mandible metallic. Materials and Methods: The stainless steel and tantalum prothesis of mandible were inserted in the phantoms. The percent radiation dose distributions of 60 Co ?-ray were measured by Lithium fluoride thermo-luminsence method. Results: Using unidirectional beam, the radiation dose was increased in the front of metallic and decreased at the back of it in 3mm thickness. Stainless steel gave higher changes than tantalum. Using opposite beams irradiation, these changes were compensated each other. Conclusion: Tantalum prothesis is advised to mandible when 60 Co is used.

Objective To improve work efficiency and lower management cost. Methods Based on experiences from the 95th hospital in six years, PACS application benefits were analysed from such seven aspects as digital film management,economic benefit, efficiency and quality of diagnosis, evidence support for solving medical dispute,simplified treatment procedures, social effect, and remote disgnosis. Results Better economic benefits and social effect were obtained. Conclusion It is proved by practice that construction of PACS in small & midium-sized hospitals is necessary and feasible.

Objective To investigate the effects of sevoflurane preconditioning on autophagy after traumatic brain injury (TBI) in rats and the role of C-Jun N-terminal kinase (JNK) signaling pathway.Methods Sixty adult male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into 4 groups (n =15 each) using a random number table:sham operation group (group S),group TBI,TBI + sevoflurane preconditioning group (group TBI + Sevo) and TBI + sevoflurane preconditioning + JNK inhibitor SP600125 group (group TBI + Sev + SP).TBI models were established using Feeney' s method.In TBI + Sev and TBI + Sev + SP groups,the rats inhaled 2.4％ sevoflurane for 30 min once a day for 4 concecutive days,and TBI was produced at 24 h after the end of sevoflurane preconditioning.In TBI + Sev + SP group,SP600125 (6 mg/kg) was injected intrapetitoneally at 30 min after TBI.Five rats were chosen at day 1,3,and 7 after TBI,and neurological deficit score (NDS) was measured.The rats were then sacrificed and brains were removed to measure brain water content,expression of LC3 lⅡ and Beclin-1 mRNA (using PCR),and expression of LC3 Ⅱ,Beclin-1,JNK and phosphorylated JNK (p-JNK) (by Western blot).Results Compared with group S,brain water content and NDS were significantly increased,and the expression of LC3 Ⅱ and Beclin-1 protein and mRNA,JNK,and p-JNK was up-regulated in the other three groups.Brain water content and NDS were significantly decreased,and the expression of LC3 Ⅱ and Beclin-1 protein and mRNA,JNK,and p-JNK was down-regulated in TBI + Sev and TBI + Sev + SP groups as compared with group TBI,and in TBI + Sev + SP group as compared with TBI + Sev group.Conclusion The mechanism by which sevoflurane preconditioning mitigates TBI is related to inhibiton of activation of JNK signaling pathway and decreased autophagy in rats.

Objective To investigate the effects of mechanicl ventilation with lower tidal volume and positive end-expiratory pressure (PEEP) on pulmonary function during laparoscopic surgery in patients with chronic obstructive pulmonary disease (COPD).Methods Forty patients with COPD,aged 60-82 yr,with body mass index of 16-29 kg/m2,undergoing elective laparoscopic surgery,were randomly divided into 2 groups (n =20 each) using a random number table:conventional ventilation group (group Ⅰ) and mechanical ventilation with lower tidal volume and PEEP group (group Ⅱ).Anesthesia was induced with midazolam,sufentanil,cisatracurium and propofol and maintained with iv infusion of propofol,cisawacurium and remifentanil.The patients were endotracheally ventilated and mechanically ventilated.In group Ⅰ,fresh gas flow was set at 2 L/min,VT at 10 ml/kg,and I∶E at 1∶2 during ventilation.In group Ⅱ,fresh gas flow was set at 2 L/min,VT at 6 ml/kg,I∶E at 1∶2 and PEEP at 6 cm H2O during ventilation.PErCO2 was maintained at 35-45 mm Hg in both groups.Airway peak pressure (Pp~),airway plateau pressure (Pplat),airway resistance (Raw) and dynamic lung compliance (Cdyn) were measured at 5 min after intubation (T1),45 min of pneumoperitoneum (T2),and 15 min after the end of pneumoperitoneum (T3).Arterial blood samples were obtained at T1,T2 and T3 for blood gas analysis.Alveolar-arterial oxygen gradiant (A-aDO2),oxygenation index (PaO2/FiO2),respiratory index (RI) and physiologic dead space fraction (VD/VT) were calculated.The extubation time and development of complications were recorded within 48 h after operation.Results Compared with group Ⅰ,Ppeak and Plat at T2 and Raw at T1,2 were significantly decreased,Cdyn at T2 and PaO2/FiO2 at T1-3 were significantly increased,RI,VD/VT and A-aDO2 were significantly decreased at T1-3,and the incidence of hyoxemia,atelectasis and rales was decreased within 48 h after operation in group Ⅱ (P ＜ 0.05).There was no significant difference in the extubation time between the two groups (P ＞ 0.05).Conclusion Mechanical ventilation with lower tidal volume (6 nl/kg) and PEEP (6 cm H2O) can improve the pulmonary function during laparoscopic surgery in patients with COPD.