A description of the positioning of public hospitals in China, and an exploration of such issues as their compensation mechanism, management system, and operation mechanism. The authors hold that it is imperative to maintain a reasonable balance of the government, society and individuals in their share of healthcare expenditure, prioritize funding recipients, and encourage medical cost payment based on disease diagnosis groupings; to precisely distinguish the ownership, operation right, decision right, and supervision right of public hospitals, for building an effective incentive and supervision mechanism; to further consolidate the president responsibility system and target responsibility system, build a flexible talent use system and distribution mechanism, build a better quality control mechanism, a strict expenditure and cost control mechanism, and a scientific talent development mechanism as well.

The pulmonary surfactant protein D ( SP-D) plays an important role in host defense and innate immunity of the lung.It has increasing evidences that SP-D involves in the pathogenesis of respiratory syncytial virus (RSV)infection.Recent studies have demonstrated that SP-D can be used for treating infectious and inflammatory diseases of the lung .Here is to make a review on SP-D structure, function , relationship between RSV and pulmonary inflammatory disease treatment .aiming to provide some assistance for treatment of RSV infection .

The TV arthroscope signal is turned into digital video signal through a video capture card,and then the digital signal is recorded and stored through a computer.Edge detection and tracking algorithm for image are used to process and analyze the acquired digital image of arthrosis.Based on the image processing,the shape parameters of the position with pathological changes can be measured automatically.Results show that these methods are very effective.This study provides some valuable materials for the further autorecognition research of endoscopic image.

Objective To evaluate the curative effect of transurethral electrosection for the treatment of bladder neck sclerosis in senile patients. Methods Clinical data of 36 aged patients with bladder neck sclerosis treated by transurethral electrosection in this hospital from February to September, 2000, were reviewed. The curative effect was evaluated according to the improvement of dysuria, residual urine volume (RUV) and Qmax before and after the surgery. Results Follow-up for 3～18 months (mean, 7 months) in 30 patients showed an effective rate of 86.7% (26/30) and no severe complications. Conclusions Transurethral electrosection is an effective alternative for bladder neck sclerosis in senile men.

Because the rehabilitation process is too long and its effect is non-significant, stroke patients are prone to showing over-reliance on their families, being unconfident in their abilities, and they usually miscommunicate with medical staff, in fact, the reason why they have these problems is that they didn't manifest appropriate ego states, so they couldn't communicate with families and medical staff healthily,which is extremely unfavorable for stroke rehabilitation. So-called ego state is individual mentality and corresponding behavior patterns.This paper used ego state concept in transactional analysis theory to describe the change of stroke patients' ego states, and analyze the communication patterns among patients, medical staffs and families, in order to assist patients to be aware of their own ego states, and present them properly, develop healthy communication, and promote the rehabilitation of the disease in the end.

Actins ; metabolism ; Animals ; Antigens, CD ; metabolism ; Cadherins ; metabolism ; Carotid Artery Injuries ; metabolism ; pathology ; Endothelium, Vascular ; metabolism ; ultrastructure ; Fluorescent Antibody Technique ; Microscopy, Confocal ; Rats ; Troponin ; metabolism

To analyze the reasons for the formation of constipation,the causes,clinical manifestations,surgical indications and surgical treatment were analyzed,focusing on slow transit constipation,outlet obstruction constipation and mixed constipation.Grasping surgery indications is stressed in surgical treatment of constipation.Only appropriate procedure can obtain satisfactory results.

Widely accepted in other countries,DRG payment is also referred to in China now and then.The authors reviewed the status quo of medical payment in China,as well as the practices and studies of DRG payment overseas.Based on such studies,the paper probed into the feasibility of DRG application in China,in terms of policy environment,application demand,research basis and technical conditions.Proposed in the paper are ranges of application,possible roadblocks and countermeasures for the application in China,aiming to promote the research,application and use of the method in China.

Objective To observe the effect of radiotherapy and chemoradiotherapy in patients with esophageal cancer and analyze the associated factors of surviving with esophageal patients.Methods 60 cases were retrospectively analyzed in the study.They were divided into two groups according to the treatment methods,radiotherapy(RT)group and chemoraidiotherapy(CRT)group.The group CRT was divided into concurrent chemoraidiotherapy(CCRT)group and sequence chemoraidiotherapy(SCRT)group.The group RT and group CRT all use 6mvX line conventional therapy,common fraction 200 Gy/f,DT 60 to 70 Gy,Group CRT combine the chemotherapy concurrent or after radiotherapy.Results The 1,2,3 year survival rate of the group CRT and the group RT are 73.30%,46.70%,16.67%and 60.30%,16.67%,6.67% respectively,2 year survival of group CRT is beaer than group RT(P＜0.05).(2)The 1,2,3 year survival rate of the group SCRT and CCRT are 88.89%,55.55%,22.22% and 84.21%,47.37%,15.79% respectively.The short-term side-effect is more serious,the patients could bear.The prognosis of the esophageal carcinoma is closely associated with treatment methods and clinical stage.Conclusion Chemotherapy combined with radiotherapy for advanced esophageal cancer improved the survival.Chemoradiotherapy is an effective treatment for advanced esophageal carcinoma,diagnosis and treatments in early stage are especially important.

OBJECTIVETo investigate the clinical features and genetic characteristics of patients with 3-hydroxy-isobutyryl-CoA hydrolase (HIBCH) gene mutations.

METHODThe clinical data of a patient with novel HIBCH mutations were collected, the related literature was searched from China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, National Center for Biotechnology Information and PubMed (up to December 2014) by using search terms" HIBCH", "3-hydroxy-isobutyryl-CoA hydrolase" or "beta-Hydroxyisobutyryl CoA Deacylase Deficiency". The clinical features, neuroimage and treatment of the patients with HIBCH gene mutations were studied.

RESULTThe patient was a girl who was born at term after an uneventful pregnancy to non-consanguineous healthy parents, she was hospitalized at 5 years and 5 months of age because of development delay for 5 years and 5 months and abnormal posture on the left of body for more than 10 days. The family history was unremarkable. Her psychomotor development was significantly delayed. Three times brain MRI between 2. 5 years and 5 years of age revealed bilateral symmetrical lesions in basal ganglia. At the age of 5 years and 5 months, she presented with acute encephalopathy and severe extrapyramidal symptoms preceded by fever. At that time, her brain MRI revealed aggravated lesions in bilateral basal ganglia, new lesions in the midbrain cerebral peduncle and pons, and cerebellar atrophy. The results of biochemical tests were normal. A novel compound heterozygous mutation of HIBCH gene, c. 1027C > G, p. H343D and c. 79-1G > T, splicing, were found in the parent. Further study showed that c. 1027 C > G mutation was inherited from her father and c. 79-1 G > T from her mother. Her symptoms were mitigated after "cocktail" therapy and symptomatic treatment. Repeated brain MRI revealed that the lesion in basal ganglia got better, the lesions in brain stem disappeared. Literature relevant to HIBCH published all around the world was reviewed, no Chinese cases with HIBCH gene mutations had been reported, 6 foreign cases with HIBCH gene mutations were reported. Among them, 5 patients were diagnosed as Leigh-like syndrome, with progressive neurodegenerative course, and symmetrical basal ganglia lesions on brain MRI. Another case was reported in 1982, with developmental delay and various physical malformations without data on his brain MRI. HIBCH gene mutational analysis showed that 4 cases had homozygous mutations, which were c. 950G > A (p. G317E) in two brothers, c. 219 _220insTTGAATAG (p. K73fsX86) and c. 1128_1129insT (p. K377X) respectively. Three of them died before 3 years old. Two cases had compound heterozygous mutations: c. 365A > G (p. Y122C) and IVS2-3C > G (p. R27fsX50); c. 517 + 1G > A and c. 410C > T (p. A137V). They were alive at the time of the report.

CONCLUSIONPatients with HIBCH gene mutation mainly presented as Leigh-like syndrome both in clinical manifestation and in neuroimage. HIBCH gene mutational analysis should be performed on children with Leigh-like syndrome, if the mutations of known genes of Leigh syndrome were negative.

Abnormalities, Multiple ; diagnosis ; genetics ; Amino Acid Metabolism, Inborn Errors ; diagnosis ; genetics ; Child ; Child, Preschool ; China ; DNA Mutational Analysis ; Female ; Heterozygote ; Homozygote ; Humans ; Infant ; Leigh Disease ; diagnosis ; genetics ; Magnetic Resonance Imaging ; Male ; Mutation ; Siblings ; Thiolester Hydrolases ; deficiency ; genetics