Objective: To analyze the regional differences of the health resource allocation in Guangdong Province from 2002 to 2011, and provide the scientific basis for regional health planning and health resource allocation optimizing. Methods: The Theil Index was used to analyze the regional differences of the health resource allocation in Guangdong Province. Results: The health resource per capital is consistent with the national level, while differences existed in different areas, and the gap of the differences has been broaden during this period. Conclusions: The differences are caused by the difference distribution of material resources, human resources, the faulty of system and mechanism. Therefore, the hygienic resources disposition should be balanced establish reasonable mechanism to improve the equity of health human resources, strengthen the community health service as a breakthrough during the health system reform, and promote the equal access to basic medical and health services to narrow the gap of the regional differences and promote the equity of health resource allocation.

Objective To analyze impact factors for resolving cases of medical disputes with people's mediation mechanism,for improvement of this mechanism.Methods This paper picked 273 cases mediated by Guangdong Medical Dispute People Meditation Committee from June 2010 to December 2011,for analysis from doctor-factors,patient-factors,mediator-factors and composite factors.Results Under such mechanism,doctor-factor has not significant difference on the mediation success ratio and mediation timeliness of the cases; the success rates of cases of death,disability,and no obvious impairment suffered by patients are 68.57％,55.81％ and 76.80％ respectively.Such results are found by chi-square test as P＜0.05,significant statistically.With cases reported via hospitals,the mediation timeliness is much better than other cases.Conclusion The mechanism is advantageous in effectively avoiding influences of case factors,yet emphasis should be placed on mediation of disability cases,and doctors should be encouraged to report the cases,contributing to higher success rate of mediation.

BACKGROUND:Extraction of a wel fixed cementless femoral stem or a cemented stem is difficult during revision of total hip arthroplasty. The extended trochanteric osteotomy provides excellent methods, and combining with long-stem cementless prosthesis can better reduce postoperative complications.
OBJECTIVE:To retrospectively analyze the recent clinical curative effect after extended trochanteric osteotomy combined with long-stem cementless prosthesis in hip revision.
METHODA total of 25 patients undergoing hip revision were selected from the Department of Osteoarthrosis, Pingdingshan First People’s Hospital, China from May 2008 to May 2013. Of them, 17 patients were subjected to the extended trochanteric osteotomy combined with single-incision and double-approaches. The femurs were reconstructed with long-stem cementless prosthesis. Al patients were fol owed-up for 12 to 60 months. Pre-operative and post-operative Harris hip scores, the post-operative complications, the bone cutting length, the length of stem in contact with cortical bone, the length of the end of bone cutting to the end of the prosthesis were recorded.
RESULTS AND CONCLUSION:17 patients were fol owed-up. The mean length of bone was 17 cm (15-23 cm). The mean length of stem in contact with cortical bone was 6.4 cm (4-11 cm). The mean length of the end of bone to the end of the prosthesis was 11.5 cm (8-18.5 cm). After fol ow-up, the mean Harris hip scores were improved from (39.0 ± 13.6) scores preoperatively to (75.0 ± 14.9) scores postoperatively (P<0.01). Subsidence occurred in two hips. The cutting sites of 17 cases of extended trochanteric osteotomy were fixed wel . These data suggested that the operation through single-incision and double-approach to the hip, while preserving the attachment of the external rotators and posterior capsule, wil strength rear hip stability and prevent postoperative dislocations. Recent effects were satisfactory, but the long-term outcomes should be further investigated.

Objective This paper aims to use components as the key factors to explore the feasibility of evaluation method about the learning effect of Web-based PBL.Methods We distributed a questionnaire to 101 students of clinical class of 2007 and 2008 grade in Guangzhou Medical University,and electronically distributed after 2 weeks.Cranach's α coefficient WaS used to evaluate intrinsic consistency reliability of the questionnaire.We applied principal axis factoring to extract components and to explain components which were orthogonally rotated by varimax.Multi-factor regression model Was simulated with key factors and the model's performance of fitting WaS tested.Results Multi-factor regression mode(WPBLSUM)=0.545 Collective collaboration capabilities+0.202 Self-learning and quest skills+0.137 linical reasoning and problem-solving capabilities+0.116 memorizing and understanding of medical knowledge.The coefficient of determination R2Was 0.998 and the corrected coefficient of determination R2Was 0.998.indicating that the model's fit results are obvious.Conclusion This paper demonstrates that using components as the key factors to simulate and assessing the Web-based PBL learning effect is feasible,which assesses the Web-based PBL learning effect well from four different aspects.

Due to the subjective and objective constraints of universities in China,PBL Teaching Mode failed to gain its popularity in China's medical education.In its teaching reform,Guangzhou Medical University put forward a new teaching model--Web-based PBL Teaching Mode(hereinafter referred to as WPBL).by integrating the classical concept of PBL education with the real situation of the university and carried it out among students in bilingual classes of Clinical Medicine.The resuIts showed that by effectively overcoming the difficulties during the implementation of classical PBL teaching,Web-based PBL Teaching Mode not only succeeded in achieving the teaching objectives,but also improved the learning efficiency and utilization of teaching resources greatly by means of network technology.

Objective To compare the ventilatory effects between three-way laryngeal mask airway (TLMA)and tracheal catheter (TC) on hemodynamics, respiratory function and stress responses on patients during bronchoalveolar lavage (BAL). Method Forty patients scheduled for BAL under general anesthesia were divided (stratified sampling) into either TLMA group (group T,n = 20) or TC group (group C, n = 20) according to the stratified sampling principle. SpO2, SBP, DBP and HR were measured in 5 min after entering the operating theater (To), just before inserting TLMA or TC(T1), immediately after inserting TLMA or TC(T2) ,3 min(T3), 5 min(T4), 10 min(T5)after mechanical ventilation, 10 min(T6),20 min(T7), 30 min(T8)during the course of BAL,immediately after extubating TLMA or TC (T9)and 3 min after extubating TLMA or TC (T10). The tidal volume (VT), peak inspiratory airway pressure (Ppeak) and end expiratory CO2 pressure(PETCO2)were recorded at T2,T4,T6,T7, T8, T10. The venous blood samples were taken at T0, T2, T3, T4, T6, T9, T10 for the measurements of epinephrine(AE), norepinephrine(NE)and dopamine (DA) levels with high performance liquid chromatography.Data were dealt with SPSS version 10.0 statistic software. The variables of hemodynamics and stress responses were analyzed with ANOVA of repeating test data. P ＜ 0.05 means the difference in statistical significance. Results In group C, SBP, DBP and HR were significantly higher than those in group T at T2 ,T3 ,T9 (P ＜ 0.05). In group C, the levels of Ppeak were significantly higher than those in group T at T6 ,T7 ,T8 (P ＜ 0.05), and the concentrations of AE, NE and DA were also significantly higher in group C than those in group T at T2, T3 and T9 (P ＜0.05). Conclusions Ventilation with TLMA in patients during BAL is better than TC in respects of keeping stable ventilation, stable hemodynamics and producing less stress responses.

The reasons why some medical treatment facilities (MTF) can not be repaired and returned on time in some medical therapy units are explained. Countermeasures are put forward: repairing and supervising mechanisms must be established between the medical therapy units and factories in time; professional maintainers can be asked to repair MTF or cooperate with technicians in hospital when necessary so as to keep MTF in good condition.

Three-way laryngeal mask airway (tLMA) was used in 31 patients aged 4-68 yr, weighing 10- 79 kg undergoing tracheal foreign body removal under general anesthesia. Anesthesia was induced with propofol 3 mg/kg, vecuronium 0.12 mg/kg and remifentanil 0.4 μg/kg. tLMA was inserted. The patients were mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 2 mg . Kg-1 ? H-1, vecuronium 0.08 mg·kg-1·h-1 and remifentanil 0.15 μg·kg-1 ·min-1 . Radial artery was cannulated for BP monitoring and blood sampling. The operation time was 6-34 min and mechanical ventilation time 19-45 min. There was no significant change in SP, DP, HR, VT, Ppeak and Ppeak CO, during operation as compared with the baseline values before anesthesia. SpO2 was significantly increased at T2-6. PCO2, PO2 and O2sat were obviously improved after tLMA was used. All the patients emerged bom anesthesia within 30 min after operation. No aspiration, obvious gastrointestinal inflation, and pharyngeal and laryngeal edema and injury occurred. Mild agitation occurred in a short time during the recovery period in one patient. No complication occurred.

OBJECTIVETo explore the efficacy of hyperthermal lipiodol embolization and thermocoagulation for the treatment of primary hepatocellular carcinoma.

METHODSOne hundred and thirty-one cases were randomized into two groups: the hyperthermal dilute lipiodol embolization group (63 cases) and the chemoembolization group (68 cases). With Seldinger's method, We first placed the catheter to the targeting vessel superselectively and then put the hyperthermal dilute lipiodol (110 degrees C) 10~30ml to the tumor vessels to IV degree for the former group; gave the lipiodol-epirubicin emulsion by the same way to the latter group.

RESULTSThe rate of tumor minification and AFP normalization in the hyperthermal lipiodol embolization group was higher than that in the lipiodol-epirubicin embolization group. The side effects and the liver damage were mild in the former group. The survival time of the patients in the former group was longer than that in the latter group.

CONCLUSIONSEmbolization of the tumor vessels with hyperthermal dilute lipiodol is more thorough due to its better fluidity. The thermocoagulation of the hyperthermal dilute lipiodol becomes stronger for its higher specific heat. It is therefore a good technique for the treatment of primary hepatocellular carcinoma.

Carcinoma, Hepatocellular ; therapy ; Contrast Media ; Electrocoagulation ; Embolization, Therapeutic ; Humans ; Iodized Oil ; Liver Function Tests ; Liver Neoplasms ; therapy ; Treatment Outcome

Objective To prepare gemcitabine hydrochloride thermosensitive gel injection and to stablish the determina‐tion methods of its contents .Methods Gemcitabine hydrochloride thermosensitive gel injection was prepared using PLGA‐PEG‐PLGA as thermosensitive viecle .The contents of gemcitabine hydrochloride were determined by HPLC .Results The formulation contained 40 mg/ml gemcitabine and 20% (wt) PLGA‐PEG‐PLGA with phase‐transition temperature of (37 ± 0 .15) ℃ ,showing the best viscosity around human body temperature .Gemcitabine hydrochloride presented a good linearity in the range of 5‐500 μg/ml(r=0 .999 8) ,which had good precision and reproducibility .The recovery rate of low ,middle and high concentrations of gemcitabine hydrochloride were (99 .5 ± 3 .2)% ,(100 .4 ± 2 .4)% ,(102 .1 ± 2 .4)% ,n=3 ,respectively . The average contents of gemcitabine hydrochloride in three batches of sample were (101 .87 ± 2 .95)% ,(99 .4 ± 2 .73)% , (98 .98 ± 0 .71)% ,n=3 ,respectively .Conclusion The quality of gemcitabine hydrochloride thermosensitive gel injection with PLGA‐PEG‐PLGA as matrix could be controlled .It is a promising new drug for pancreatic cancer .