The paper proposed a concept to build a management system for operating room hidden costs in an effort to better hospital management and alleviate patients' economic burden.The authors analyzed the root of such costs from the levels of operating room's design and construction,as well as management and operations,proposing a framework of such hidden costs.Based on diversified cost characteristics,they come up with a number of estimating methods,and control methods against different hidden costs by using management theories systematically.

[ABSTRACT]AIM:Toinvestigatetheeffectofintracerebroventricular(icv)injectionofacidulatedartificialce-rebrospinal fluid ( aCSF ) on the respiratory reactions and the functions of acid sensing ion channels ( ASICs ) in this process.METHODS:Healthy adult SD rats (n=30) were divided into aCSF with pH 7.4 control group, aCSF with pH 6.5 group, amiloride control group, amiloride plus aCSF with pH 6.5 group, psalmotoxin 1 (PcTx1) control group and PcTx1 plus aCSF with pH 6.5 group.The electromyogram (EMG) of the diaphragm was monitored to observe the respirato-ry responses induced by icv injection of acidulated aCSF .The ASICs blockers were also injected into the lateral cerebral ventricle firstly and acidulated aCSF was injected following the ASICs blockers to observe the effect of ASICs on the respira -tory regulation by the central chemoreceptor .RESULTS:After icv injection of acidulated aCSF , the respiratory responses of the rats were excited (P<0.05).The respiratory excitation responses disappeared after icv injection of ASICs blocker amiloride.The degree of respiratory excitation was weakened after icv injection of ASIC 1a blockers-PcTx1.CONCLU-SION:ASICs play a key role in the respiratory regulation by the central chemoreceptor and ASIC 1a partly operates in this process.

0.05).Conclusion TP may have protective effects on chronical hypoxia induced polycythemia in rats.

Objective We discussed the optimal method for intestinal preparation before colonoscopy examination in order to increase the success rate of intestinal examination and reduce the incidence of adverse effect. Methods We divided 120 patients who were to undergo colonoscopy examination into group A, B and C with 40 cases in each group. Group A received oral magensium sulfate 100ml and 6000ml water after that on the morning of the examination. Group B received oral magensium sulfate 50ml and 2000ml in the evening before the examination, oral magensium sulfate 50ml and 400ml water on the morning of the examination. Group C was given oral magensium sulfate 100ml and 4000～5000 water at the same time. Group A and B took part in appropriate activity and were given health education. The effect of intestinal preparation was compared between the three groups. Results The cleaning degree of group B was better than those of the other two groups (P<0.05). The adverse effect of group B was less than that of group C (P<0.01). Conclusions Oral intake of magensium sulfate in the evening before and on the morning of the examination for intestinal preparation could increase the cleaning degree of intestine, facilitate the observation of disease part and lessen adverse effect. It gave satisfying examination results and made patients satisfied.

Objective To investigate the best dignostic cut-off point of non-typical ectopic pregnancy(EP) through the determination of vascular endothelial growth factor(VEGF)in 154 cases of suspected ectopic pregnancy patients.Methods The serum level of VEGF in 154 cases with suspected EP was determined by means of immunossay technique,and the results were made into ROC-Curve.Results The acreage behind the curve was 0.95,illustrating that the VEGF can be as a better marker for early diagnosis of EP.The serum VEGF level of 200pg/ml was the cut-off point for early diagnosis of EP throash ROC-Curve.Condusion The serum VEGF can be considered as an early diagnostic marker of EP,which cut-off point is benifical to reducing misdiagnosis of EP.

Objective To investigate and evaluate a novel fluorotyping procedure for HLA-DRB1 locus. Methods On the basis of low resolutation SSP technique,the fluorogenic probe was used to establish the fluorotyping procedure of HLA-DRB1 which was carried out for 46 samples. Results The fluorotyping has been successful for all the 46 samples and was completely coincident to the SSP results.As compared to the serological typing of DR locus,the coincidence rate was 66.3%(61/92) whereas the coincidence rate of both the 2 specific genes was 43.5%(20/46). Conclusions Fluorotyping is accurate,sensitive,reproducible,depends less on manual manipulation and eliminates the problems related to contamination.

Objective To investigate the changes of gut barrier function under glucocorticoid, so as to understand the reasons of gut-derived infection and bacteria infection.Methods Fifty-six Wistar rats were divided into control and methylprednisolone (Mep, 100 mg/kg, i.p., once every day) groups, and there were four time points in each group (0, 3, 5, 7 day). At each time point the rats were subjected to general anaesthesia and blood, mesenteric lymph nodes, enteric content and ileal tissue were obtained for determination of serum D-lactic, DAO, intestinal microecosystem, apoptosis index of mesenteric lymph nodes and bacterial culture. Results At the latter three time points, compared with control group, serum D-lactic and DAO, and apoptosis index of mesenteric lymph nodes in MeP group were significantly increased (P 0.05) from the day 3 after administration,the positive rate of organs bacterial culture in MeP groups at the No7 day is much higher than that in control group(P

Objective: To develop the norms of Chinese Words and Vocabulary Discerning Test (CWVDT). Methods: According to the principle of stratified proportional sampling,a total of 1605 adult subjects from 17 cities and their surrounding rural areas of China was measured by CWVDT. Results: ①There was significant difference in two dimensions scores and total score of CWVDT between city and countryside(P0.05). Conclusion: The nationwide norms of city and countryside with educated degrees on CWVDT have been developed and with a good representation.

Objective To establish a satisfactory method of isolating,culturing and determining gut neural crest stem cells,which may provide theoretical basis for clinical application.Methods The guts of embryonic mice removed and dissociated were plated into serum-free DMEM/F12 medium.The mitogen-free DMEM/F12 medium supplementd with 10% fetal bovine serum was used to induce differentiation of GNCSCs.Neurospheres and their derivations were determined with immunocytochemical and immunofluorescent staning.Results Neurospheres were generated in the simplified serum-free medium.The staining results showed that enteric neurospheres were GNCSCs and could differentiate into neurons,glial cells and smooth muscle cells by serum-induction.Conclusion GNCSCs have the capacity of self-renewal and proliferation,and give rise to neurons,glial cells and myofibroblasts.

Objective To observe the effect of different doses of propofol injection and propofol medium/long-chain fat emulsion injection in short time infusion on plasma ketone body ratio,to eva-lute its effecton hepatic energy metabolism.Methods Forty patients,aged 18-50 years old,ASA Ⅰ orⅡ undergoing selective surgery were randomly divided into 4 groups with 10 cases in each;propofol injection 4 mg·kg-1·h-1 maintain anesthesia (group L4 ),propofol injection 6 mg·kg-1·h-1 maintain anesthesia (group L6 ),propofol medium/long-chain fat emulsion injection 4 mg·kg-1·h-1 maintain anesthesia (group M4 ),propofol medium/long-chain fat emulsion injection 6 mg·kg-1·h-1 maintain anesthesia (group M6 ).MAP,HR,SpO2 and PET CO2 were recorded before anesthesia induction (T0 ),after tracheal intubation (T1 ),after 2 hours infusion of propofol (T2 )and operation completed (T3 ).The blood samples were collected at T1 and T2 to detect the level of acetoacetate,β-hydroxybu-tyrate and to calculate the blood ketone body ratio (the ratio of acetoacetate andβ-hydroxybutyrate). Results MAP,HR,SpO2 ,PET CO2 at T0-T3 and acetoacetate,β-hydroxybutyrate,blood ketone body ratio at T1 ,T2 showed no significant statistic difference.Conclusion Different doses of propofol and different doses of propofol medium/long-chain fat emulsion injection in short time continuous in-fusion has no obvious effect on hepatic energy metabolism;same dose of propofol injection and propo-fol medium/long-chain fat emulsion injection in short time continuous infusion has no obvious effect on hepatic energy metabolism.