Access of safe, effective, convenient and affordable medical and health care services to the people is set as the goal of public hospitals health services as stated in the "Guidelines for Public Hospitals Pilot Reform". Such a goal, however, can hardly be achieved by mechanism changes within the public hospitals. The input and output of public hospitals rely critically on such factors as the input mechanism, regional pattern of healthcare system, the economic and industrial conditions of the region,payment quota and payment approval procedures of medical insurance. This paper set off from the input compensation mechanism of public hospitals in China and analyzed the input and output characteristics of the hospitals. Furthermore, the paper proposed to establish an input compensation mechanism based on public welfare performance for such hospitals. This provided further reference for improving the management of public hospitals and building a public welfare-oriented operation mechanism of public hospitals.

ObjectiveDiabetes is an independent risk factor for coronary artery bypasss grafting(CABG). Off pump coronary artery bypasss (OPCAB) experience in 251 cases was reviewed to determine whether diabetes wou ld be applicable in OPCAB procedures.MethodsConsecutive 251 patients underwent OPCAB over 12 month period. This study included 71 diebetic patients (DM group) and 180 nondiabetic patients (NDM group). Preoperative v ariables were compared between the two groups by univariate analysis.R esultsNo differences were found regarding the length of stay in cardio intensive care unit [DM group(2.4?0.3)d; NDM group (2.4?0.3) d;P=0. 386], and sternal complication (DM group: 5.7%;NDM group: 3.9%;P=0.511) . In hospital complications were as follows: death rate(DM group: 2.8%; NDM gr oup: 1.1%; P=0.680); stroke (DM group: 2 8%; NDM group: 1 7%; P=0 623 ); hemofiltratioin renal failure (DM group: 2.8%; NDM group: 0.5%; P=0.194); myocardial infarction(DM group: 0%; NDM group: 0.5%;P=1.000); blood using were more frequent in DM group comparied with NDM group (P=0.111). ConclusionOPCAB in diabetic patients is as safe as in non diabetic patients.

BACKGROUND:In perioperative period of total knee replacement in elderly patients, it is crucial to maintain the normal function of blood coagulation. However, many factors may influence coagulation function of patients in perioperative period. Of them, anesthesia is an important factor. Different anesthesia methods wil produce different effects on blood coagulation. Appropriate anesthesia methods should be selected in the clinic to maintain the stability of coagulation function. OBJECTIVE:To explore the effect of application of general anesthesia and epidural anesthesia in elderly knee replacement and the effects on the function of blood coagulation. METHODS:A retrospective analysis was performed on clinical data of 135 elderly patients after total knee replacement in Dongying Hospital of Shandong Provincial Hospital Group from September 2012 to September 2013. Al patients were divided into control group (67 cases;general anesthesia) and observation group (68 cases;epidural anesthesia) according to the mode of anesthesia. Coagulation indexes and D-dimer levels were observed before anesthesia, 6 hours after anesthesia, and 1 day after replacement in both groups. The incidence of deep venous thrombosis was measured and compared between the two groups in 12-month fol ow-up.
RESULTS AND CONCLUSION:Through the statistics and comparison, no significant difference was detected in blood coagulation indexes at different time points in the two groups (al P>0.05). However, significant differences in D-dimer levels were detectable between the two groups at 6 hours after anesthesia and in the morning at 1 day after replacement. D-dimer levels were significantly lower in the observation group than in the control group (al P<0.05). The incidences of deep venous thrombosis were 3%and 21%in the observation and control groups, respectively, showing significant differences (P<0.05). These results suggest that epidural anesthesia during elderly totak knee replacement obtained good effects, and could maintain stable coagulation function.

〔Abstract〕 By use of the decision tree algorithm and diagnostic indexes , the paper sets up the discrimination rules to make differential diagnosis of Primary Hepatocelluar Carcinoma ( PHC) based on basic data of 95 patients with PHC and 190 patients with liver cirrhosis , in-cluding the CT diagnosis, testing results of imaging and serologic markers such as the HbsAg , AFP, CEA and AFU, sex and age, etc.As indicated by the results , the data mining technology represented by the decision tree can support the differential diagnosis of PHC .

Objective To determine the expression of CD24 in colorectal carcinoma, and to explore the relationship between CD24 and the clinicopathological features of colorectal carcinoma.Methods The expression of CD24 in 62 cases of colorectal carcinoma, 47 cases of adenomas, 15 cases of colorectal polyps and 30 cases of the adjacent non-cancerous tissues were observed by immunohistochemical assay.The relationship between CD24 and the clinicopathological features was analyzed.Results The positive rates of CD24 in colorectal carcinoma 72.6％ and adenomas 63.8％ were significantly higher than those in colorectal hyperplastic polyps 13.3％ (x2 =17.83, P =0.00;x2 =11.61, P =0.00) and adjacent non-cancerous tissues 6.7％ (x2 =35.15, P =0.00;x2 =24.64, P =0.00).The expression of CD24 in colorectal carcinoma had a significant correlation with the tumor diameter (x2 =5.48, P =0.02), tumor differentiation (x2 =8.86, P =0.00), Duke staging (x2 =11.47, P =0.00) and lymph node metastasis (x2 =8.92, P =0.00).Conclusion The expression of CD24 is high in colorectal carcinoma, having a significant correlation with the size of tumor, degree of differentiation, Duke stage and lymph node metastasis.

Objective: To investigate the therapeutic effects of norcantharidin poloxamer 407(NCTD P407) slow released preparation on advanced primary liver cancer by local intratumoral injection. Methods: Fifty six advanced primary liver cancer patients with maximum diameter from 6 to 12 cm were randomly divided into test and control groups. Patients in test group (29 case) were treated by NCTD 407 intratumoral injection under ultrasonic and patients in control group (27 case) by PEI (percutaneous intratumoral absolute ethanol injection). Clinical therapeutic effects were observed respectively and compared. Results: Twelve months survival rates of patients in 2 groups were significantly different, being 31.0% in test group and 22.2% in control group ( P 0.05) in 2 groups. No evident poisonous and side effects were found in either test or control group. Conclusion: NTCD P407 administration exhibits therapeutic effects in relatively big advanced liver cancer because of the high concentration and prolonged action in the tumor foci, its comprehensive therapeutic effect is better than that of absolute ethanol administration. [

Objective To investigate dry chemical analysis of urine,automated quantitative anal-ysis of urine formed elements and urine living cells staining microscope extination combination of the three urine red blood cells for a variety of detection methods in the comprehensive analysis of renal dis-ease in the clinical application. Methods Gemany Miditron Junior Ⅱ of urine analyzer for chemical a-nalysis of urine. UF-1 00 automatic urine visible component analysis(referred to: UF-1 00)living cells (SM)staining, The difference in the imaging system under the microscope, in the urine of red blood cells to identify patterns observed. Results Urine dry chemical analysis,automated quantitative analy-sis of urine fomed elements and ,urlne staineg cells microscope examination of the three organic combi-nation of a variety of detection methods for urine analysis, Application of this paper, Detection of a va-riety of red blood cells urine analysis-urine flow chart of sources of identification laboratory, Improve the analysis of the urine test quality, efficiency and laboratory dinosis, made up of these expenmental methods of the deficiencies. Conclusion Kidney disease is extremely valuable to provide obj ective indi-cators, is in clinical methods.

Objective To detect serum Vaspin level in subjects with normal glucose regulation(NGR)and newly-diagnosed type 2 diabetes mellitus (T2DM) ,and to investigate the association between serum Vaspin and body mass index (BMI), age, gender, glycometabolism and lipemetabolism and insulin sensitivity index. Methods The fasting serum levels of Vaspin were measured in 48 normal controls and 66 T2DM patients using enzyme linked immunosorbent assay ( ELISA ). BMI, waist-hip ratio (WHR) and % body fat were measured,as well as fasting blood glucose (FBG), HBA1C, lipids and insulin levels. Results The fast serum Vaspin concentrations in the obese T2DM patients was ( 1.13 ±0. 25 ) μg/L,which were significantly higher than that in the non-obese T2DM patients (0. 65 ± 0. 13 ) μg/L (P ＜ 0. 01 ). In the NGR group, the fast serum Vaspin concentrations in the obese was (0. 95 ± 0. 11 ) μg/L, which were significantly higher than that in the non-obese (0. 38 ± 0. 18) μg/L( P ＜ 0. 01 ). In the T2DM group, serum Vaspin concentration in females ( [0. 92 ± 0. 35]μg/L) was higher than in males ([0.76 ± 0. 22] μg/L) (P ＜ 0.01 ). In the NGR group, serum Vaspin concentration in females was also higher than that in males ( [1.05 ± 0. 21] μg/L vs [0. 48 ± 0. 14] μg/L) )(P＜0. 01 ). Serum Vaspin level was positively correlated with BMI,WHR,% Body Fat,fasting insulin(FINS)and insulin sensitivity index (ISI) (r = 0. 365,0. 214,0. 238,0. 183 and 0. 147, respectively, Ps ＜ 0. 05 ). The multiple stepwise regression analysis showed that gender( R2 = 0. 161, P ＜ 0. 01 ), ISI ( R2 = 0. 183, P ＜ 0. 01 )and WHR( R2 = 0. 216, P ＜ 0. 01 ) were independent variables associated with Vaspin. Conclusion Serum vaspin level significantly increases in subjects with obesity, and independently associated with gender, ISI,WHR. These findings suggest that serum Vaspin may be involved in the pathophysiology of insulin resistance syndrome.

The paper introduces and summarizes the teaching purpose and content project,implementation and effect of the optional course in Excel and medical data analysis.

OBJECTIVETo observe the clinical effect of float needle therapy combined with reperfusion activity for pain induced by cyclomastopathy.

METHODSThirty-five female patients with cyclomastopathy were randomly divided into a comprehensive group (18 cases) and a float needle group (17 cases). In the comprehensive group, float needle manipulation was used at the centre of the biceps brachii belly or the ligature between the affected nipple and breast nodule, about 4 cm beside the exterior margin of the breast, and the reperfusion activity of the affected upper limb and breast was combined. In the float needle group, simple float needle therapy was adopted. In the two groups, treatment was started 7 ± 3 days before menstruation, once every other day. After 3-time treatment, the changes of short form McGill Pain Questionnaire (SF-MPQ) scores before and after treatment, the time of pain relieved during the first treatment, recurrence in 3 months after treatment and the adverse reaction were observed. Also, the clinical effects of the two groups were compared.

RESULTSImmediately at the end of the first treatment,after 3-time treatment and while followed up for one month, each item score and the total score of SF-MPQ were decreased apparently than the scores before treatment (all P < 0.05), and all the scores mentioned above of the comprehensive group were declined more obviously than those of the float needle group (all P < 0.05). The time of pain relieved during the first treatment of the comprehensive group was much shorter than that of the float needle group [(94.72 ± 33.67) s vs (162.06 ± 29.16) s, P < 0.01]. The recurrence rate of the comprehensive group in 3 months after treatment was 5.9% (1/17), which was better than 20.0% (3/15) of the float needle group (P < 0.01).

CONCLUSIONFloat needle therapy combined with reperfusion activity and simple float needle therapy can both safely and effectively improve cyclomastopathy, and the combination therapy is better than simple float needle therapy in the aspects of pain relieving effect at once and the long term effect.

Acupuncture Therapy ; Adult ; Breast Diseases ; pathology ; therapy ; Female ; Humans ; Hyperplasia ; Mammary Glands, Human ; pathology ; Middle Aged ; Needles ; Pain Measurement