The index weight has very significant role in the performance evaluation system for the public hospitals’ financial governance. This paper employed the analytic hierarchy process associated with the Delphi method to determine the index weight based on the previous studies. The index of maximum weight is non-profit (0. 35), fol-lowed closely by financial responsibility(0. 18), asset performance(0. 18), financial performance and risk (0. 18), and the index of minimum weight is society satisfaction ( 0 . 06 ) . The index weight guidance and the practical index system application were also interpreted in order to really play the significant role during the performance evaluation for the public hospitals’ financial governance.

Objective To study the therapeutic effects of conservation surgery of laryngeal function for larygeal carcinoma in patients aged 70 years and over. Methods 136 patients aged 70 years and over were collected. Among them, 34 cases underwent vocal cord resection, 28 vertical hemilaryngectomy, 24 horizontal supraglottic hemilaryngectomy, 15 horizontovertical (3/4)laryngectomy, 29 subtotal laryngectomy, 6 total laryngectomy with cricopharyngeal anastomosis.Tissue defects were repaired by use of cervical myocutaneous flap in patients of T3-4 tumor stage. After operation, a special pneumatoeeles was attached on the tracheal cannula when eating.Results All patients had their phonation restored in a week. 92 cases were decannulated. 45 cases had cough and then were improved after respiration training and one case was in failure. No death occurred in the perioperative period. The survival rates were 78.7% at 3 years and 68.5% at 5 years.Conclusions Laryngectomy with reservation of laryngeal function is feasible in senile patients aged 70 years and over under conditions of correct indication, right choice of operation and thoroughly care during perioperative.

To investigate whether the use of concentrate growth factors have a favorable impact on clinical outcome of immediate implant in periodontally infected sites.48 patients with 51 teeth with periodontitis and periapical periodontitis accepted immediate implantation in the maxillary esthetic zone.25 implants(test group) were placed simultaneously with guided bone regeneration (GBR) using CGF combined with Bio-oss, other 26 implants(control group) were treated with Bio-oss alone.The facial bone thickness at 0, 4 and 8mm apical to the implant platform were measured immediately after, 3 months after and 6 months after surgery;pain visual analogue scale (VAS) was used to assess the degreeof pain in the patient within 1 week after surgery.3 months after surgery,the change of horizontal resorption in labial was less in test group(P<0.05).In the first three days postsurgery, the test group reported significantly less pain with respect to the control group(P<0.05).The application of CGF produced beneficial impacts on clinical outcome of immediate implant in periodontally infected sites.

[Objective]To evaluate the mid-term and long-term clinical outcome of total hip replacement in patients with congerital acetabular dysplasia.[Method]Twenty-five hips in 23 patients diagnosed as congemtal acetabular dysplasia were treated with total hip replacement.According to the classification ofPemer,17 hips belonged to type Ⅰ,5 type Ⅱ,2 type Ⅲ,and 1 type Ⅳ.The fixation of the prosthetic components was as follows: 5 cups and 7 stems with cement,20 cups and 18 stems with un-cement.[Result]The complications included femur trochanter fracture in 1 case,deep vein thrombosis in 1 case,limb discrepancy in 3 cases,All patients were followed.up with the duration of 8.2 years(3 to 11 years).The preoperative Harris hip score ranged from 25 to 59(average 44.5).After the operation,the pain was completely relieved and the Harris hip score ranged from.63 to 97(average 85.6).[Conclusion]Total hip replacement in congenital acetabular dysplasia could be somewhat difficult,because of the liability to complications.The technical difficulties encountered during surgery included the correction of the length of bilateral lower extremity,the balance of the abductor muscles,the release of the soft tissue,the dealing of the superior seganental defect of acetabulum and selection of the components.

The clinical data of one case of laryngeal neuroendocrine carcinoma in our hospital were respectively analyzed. The patient was a 61-year-old male, and complained of progressive pain of right ear for 7-year, it was misdiagnosed as glossopharyngeal neuralgia and larynx hemangioma. This patient was achieved total laryngectomy and bilateral cervical lymph nodes dissection. As of 12 months after surgery, the patient remains under follow-up observation, and no findings indicating obvious recurrence or metastasis has been observed. This disease is a rare and highly malignant tumor that is lack of specific feature in clinical performances. Recognition at larynx is essential so that proper patient management can be initiated.
Carcinoma, Neuroendocrine ; diagnosis ; therapy ; Humans ; Laryngeal Neoplasms ; diagnosis ; therapy ; Male ; Middle Aged

OBJECTIVE To lower the incidence of postoperative pulmonary infection in abdominal major operation.METHODS We performed a retrospective trial analysis on pulmonary infection after major abdominal operation in 402 cases from Oct 2004 to Oct 2005,and in the meanwhile effective preventive procedures were conducted.RESULTS Thirty three cases with pulmonary infection went weel with active treatment and nursing.CONCLUSIONS The predisposing factors for postoperative infection include anesthetic method,incision pain,and environmental pollution.The better methods for prevention of pulmonory infection are good preoperative instruction,planned respiration training,keeping airway confluent postoperatively,effectively reducing incision pain,infection control,and preventing environmental and air pollution.

Objective To observe the effect of intravitreal lucentis injection combined with macular grid photocoagulation for diabetic macular edema (DME).Methods 42 DME patients(42 eyes) according to different treatment methods,were divided into the combined group 21cases(21 eyes) and photocoagulation group 21 cases (21 eyes).The combined group was treated with connaught suitable for intravitreal injection combined macular grid photocoagulation , and the photocoagulation group was treated with simple macular grid photocoagulation .After 1 weeks,2 weeks,4 weeks,8 weeks,12 weeks and best corrected visual acuity before treatment (BCVA) and macular foveal thickness ( CMT) changes were comparative analyzed between the two groups .Results The BCVA values of the photocoagulation group before surgery ,1 week,2 weeks,4 weeks,8 weeks,12 weeks,were (0.74 ±0.24), (0.56 ±0.22),(0.52 ±0.23),(0.51 ±0.21),(0.51 ±0.20),(0.53 ±0.21),and CMT values were (440.36 ±50.56)μm,(376.06 ±28.60)μm,(365.45 ±30.02)μm,(361.38 ±29.56)μm,(358.68 ±30.46)μm,(360.43 ±29.36)μm;The BCVA values of the combined with preoperative group before surgery ,1 week, 2 weeks,4 weeks,8 weeks,12 weeks,were (0.70 ±0.23),(0.55 ±0.19),(0.52 ±0.18),(0.50 ±0.20), (0.48 ±0.19),(0.47 ±0.20),and CMT values were (442.32 ±54.35)μm,(385.14 ±27.34)μm,(345.32 ± 28.12)μm,(336.24 ±28.17)μm,(326.45 ±27.65)μm,(315.36 ±28.23)μm.The differences of BCVA and CMT values of the two groups in each time period values before and after treatment were statistically significant ( all P<0.05),and after 8 weeks,12 weeks,the differences of BCVA and CMT values between the two groups were statisti-cally significant(all P<0.05).Conclusion The macular grid photocoagulation only or lucentis injection combined with macular grid photocoagulation for diabetic macular could increase BCVA and reduce macular edema instinctively , but the difference was not significant .Combined therapy could preserve the visual acuity and delay time to relapse .

Objective To investigate the expressions of VEGF and Ang-1 in neonatal rats with hyperoxia-induced BPD and its effects on lung development. Methods 48 SD neonatal rats (2 or 3 days old) were randomly divided into two group and raised under hyperoxia or air for 1, 3 and 7 days, respectively. Real-time RT-PCR and Western blot were used to determine the level VEGF and Ang-1 mRNAs and proteins in lung tissues of the two groups. HE staining was used to observe the changes of lung morphology. Results The levels of VEGF and Ang-1 mRNAs in the lung on the 7th day in the control group were 0.722 ± 0.372 and 0.828 ± 0.462, respectively, and those in hyperoxia group were 0.239 ± 0.293 and 0.327 ± 0.184 , respectively. The levels of VEGF and Ang-1 proteins on the 7th day in the control group were 0.632 ± 0.289 and 0.573 ± 0.436, respectively, and those in hyperoxia group were 0.358 ± 0.128 and 0.204 ± 0.068 , respectively. Comparing to the control group , the levels of VEGF and Ang-1 mRNAs and proteins on the 7th days significantly decreased in the hyperoxia groups (P<0.05). The lung tissues of the hyperoxia group display dysplastic features with , alveolar simplification , reduced alveolar numbers and retardation on microvascular development. Conclusion VEGF and Ang-1, functioning as an important regulators for pulmonary vascular development , are involved in the pathogenesis of BPD and the lung development.

[Objective]To appraise the clinical effect of acupoint application on cough-asthma.[Method] Choose clinic 144 cases,measure FEV1,PEF and FEV1% after treatment,make statistical analysis,compare the difference of the appraisal indexes between before and after treatment,study the relation among age,sex and TCM syndromes.[Conclusion] After treatment,the symptoms score and lung function were markedly improved.[Conclusion] After treated with Dog-days Paste,the patients’ clinical symptoms were obviously relieved,and the lung functional indexes improved too.