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.

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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.

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 assess whether calcitonin exerts an chondroprotective action in unstable knees which induce experimental osteoarthritis.[Method]Twenty 6-month New Zealand rabbits were divided into two groups randomly.All rabbits underwent anterior cruciate ligament transection(ACLT) on the right knee.Rabbits of experimental group began to receive a daffy subcutaneous injection of salmon calcitonin at a dose of 5 IU per kg of body weight on day 7 postsurgery;in contrast,control group received normal saline(NS) at the same dose.All rabbits were killed on day 42 postsurgery.The knee joints were examined grossly and histologically and scored;the medial condyle sections were stained with Safranin O and immunohistochemistry of collagen II.We applied a computer graphic technology to assess the glycosaminoglycans(GAG) and collagen II of articular cartilage.[Result](1) In control group,compared uninjured knee joints with operative knee joints,the appearance of operative knee joints accorded with OA and histologic score of operative knee joints were higher than that of uninjured knee joints,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.