Objective To establish the telemedicine system for making the best of the resources of health-care and medical treatment. Methods Three different functional layers was included in the system with the service managing center, the general rural-clinic nodes, and the standard urban-hospital nodes by which the instrumental resources are inter-connected. Results By using the system, the medical records and expensive medical instruments are shared; the costs are decreased; the quality of medical treatment is ameliorated; and the lives of more patients are saved. Conclusion The medical specialists in different hospitals can cooperate to provide helpful and the high quality health services, especially to the patients and medical level in rural area.

BACKGROUND: At present, there are different strategies for treating unsteable osteochondritis dissecans of the knee joint in adolescents, but their therapeutic effects are not ideal. OBJECTIVE: To assess the therapeutic effect of bioabsorbable pin fixation on functional recovery and fracture healing in juvenile unstable osteochondritis dissecans through Lysholm, IKDC, Hughston scoring and imaging examination. METHODS: Eighteen patients with unstable osteochondritis dissecans were enrol ed. Under arthroscopy, a smal incision was localized and cut fol owed by bioabsorbable pin fixation. The average fol ow-up period was 2.7 years. Functional recovery of the affected limbs after fixation was assessed by using Lysholm, IKDC and Hughston scoring. X-ray examination was used to observe fracture healing. RESULTS AND CONCLUSION: At 6 months after fixation, the Lysholm and IKDC scores were improved significantly as compared with those before operation and maintained til the last fol owing up. There were 15 patients scored as excel ent, 2 as good and 1 as poor. X-ray films also showed that there were 17 cases of fracture healing (94% healing rate). The average fracture healing time was 2.9 months. These findings indicate that the bioabsorbable pins can improve the bone healing in juvenile unstable osteochondritis dissecans.

Objective To evaluate the prognostic factors for survival in patients with renal pel-vic and ureteral carcinoma. Methods The clinical data of 220 patients with renal pelvic and/or ure-teral carcinoma were retrospectively analyzed. One hundred and forty-six cases were males and 74 ca-ses were females. Age ranged from 38 to 84 years. One hundred and three cases were renal pelvic car-cinoma, 84 cases were carcinoma of ureter, 13 cases were renal pelvic carcinoma with carcinoma of u-reter, 5 cases were renal pelvic carcinoma with bladder cancer, 11 cases were carcinoma of ureter withbladder carcinoma, and 4 cases were renal pelvic carcinoma with carcinoma of ureter and bladder carci-noma. For TNM stage, there were 2 cases in T., 116 cases in T1, 48 cases in T2,37 cases in Ta and 17 cases in T,. For WHO grade, there were 5 cases with grade Ⅰ tumor, 87 cases with grade Ⅱ tumor and 128 cases with grade Ⅲ. Multivariate analyses were done using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method, Log-rank test and Gehan test, re-spectively. Results The 5-year survival rates of Ta--T1,T2,T3,T4cases were 80.5%(95/118), 70.8%(34/48), 45.9%(17/37) and 17.6%(3/17), respectively. Survival rates were significantly different in patients with tumor stage Ta-T1,T2and patients with tumor stage T3-T4 (u=9.429, P=0.002). There was no significant difference between survival o{ ureterorenoscopic surgery group and other operation group(x2=0.217,P=0.641). The factors affected survival were age (RR= 1.639,P=0.027), time of initial symptoms to operation (RR=1.279, P=0.019) and clinical stage of the tumor (RR=1.373,P=0.011). Logistic regression analysis showed that the factors influencing the recurrence of bladder carcinoma ineluded multi-site growth(RR=11.292,P=0.003)and coexisting bladder careinoma (RR=8.780,P=0.001). Conclusions Age, time of initial symptoms to opera-tion and the stage of the tumor are the important predictors affecting the prognosis of the renal pelvic and ureteral carcinoma. Multi-site growth and coexisting bladder carcinoma are important risk factors having impact on the recurrence of bladder carcinoma.

10 mm)were showed by DSA.On nonenhanced CT,there were 3-4 low density nodules and 4 isodensity nodules.Thirty-two nodules was high density and 8 nodules was low density in arterial phase,33 and 7 nodules were low density and isodensity respectively in portal venous phase,39 and 1 nodule were low density and isodensity respectively in delayed phase.Conclusion The MSCT is excelled DSA in detection satellite nodule of HCC,especially smaller than 10 mm nodule.

Objective:To observe the clinical effect of electroacupuncture (EA) plus self-made Jiawei Jinhuanggao (Supplemented Golden Yellow Paste) for gouty arthritis.Methods:A total of 80 cases with gouty arthritis were randomly allocated into an observation group (n=40) and a Western medication group (n=40). Cases in the observation group received EA and external application of self-madeJiawei Jinhuanggao(Supplemented Golden Yellow Paste), whereas cases in the Western medication group took Colchicine and Allopurinol tablets orally. After 10 d of treatment, the pain, joint swelling and uric acid in blood were observed. In addition, the follow-up was conducted 6 months after end of the treatment to evaluate the long-term effect.Results:After treatment, there were no between-group statistical differences in pain and uric acid in blood (P>0.05); and there were between-group statistical differences in joint swelling and relapse rate (P<0.05). The total effective rate was 97.5% in the observation group, versus 95.0% in the Western medication group, showing no statistical difference (P>0.05).Conclusion:EA plus Jiawei Jinhuanggao (Supplemented Golden Yellow Paste) has safe and long-term efficacy for gouty arthritis efficacy.

Our hospital started from 1998 the reform of the personnel system, adopting respectively the system of appointing each level of cadres by cadres at an immediately higher level, the system of hiring the entire staff on contract, the system of separating post appraisal and appointment, the system of eliminating the worst post holder, and the system of linking performance with distribution. In the course of the reform, our hospital has focused on developing reform plans which conform to reality, setting up posts in a rational manner, standardizing the procedures of operation, making appropriate arrangements for peopld waiting for post assignments and strengthening ideological and educational work. As a result of the reform, the staff have enhanced their sense of crisis and responsibility, further efforts have been made to ensure that work in the hospital is done around the goal of achieving the greatest satisfaction of the patients, the benefit of the hospital has been enhanced and its level of management and technology has been raised.

Today the problem of Abusing Medicine is more and more serious. In this paper,according to the authors' understading of life quality, they analysed the direct and indirect, the near and long future harmfulness which is produced by the Abusing Medicine. By demonstrating, the authors come to the conclusion that the Abusing Medicine will make the human life quality degenerate. This idea can arouse people to pay much attention to the problem of Abusing Medicine. The authors also promote some ideas about the aims of medicine and the control methods for Abusing Medicine in this paper.

Objective: To explore the effect of trimetazidine (TMZ) on T-peak (Tp) to T-end (Te) interval of resting ECG in patients with unstable angina pectoris (UAP) after percutaneous coronary intervention (PCI). Methods: We investigated 94 UAP patients with PCI and 76 of them ifnished the study as 2 groups. Control group,n=42, the patients received conventional treatment, and TMZ group,n=34, in addition to conventional treatment, the patients received TMZ 60 mg at 0.5 to 1 hour before PCI. The changes of Tp to Te interval before and after PCI were calculated, serum levels of creatine kinase (CK), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) at before and at 6, 24 hours after PCI were compared between 2 groups. Ventricular arrhythmia was recorded during PCI. Results: Both groups had shortened Tp to Te intervals after PCI, and TMZ group had more shortened Tp to Te interval, bothP<0.05, while the Tp to Te intervals were similar between 2 group before PCI,P>0.05. The occurrence rate of ventricular arrhythmia in Control group was higher than that in TMZ group (12.52% vs 5.16%) during PCI,P<0.05. Compared with Control group, TMZ group had lower levels of CK, CK-MB and cTnI at 6, 24 hours after PCI, allP<0.05. Conclusion: TMZ could decrease Tp to Te interval of resting ECG, prevent ventricular arrhythmia and reduce the relevant myocardial injury in UAP patients after PCI.

Objective To observe the expression of induced nitricoxide synthase(iNOS)in ligustrazine against cisplatin-induced ototoxicity.Methods Fifty white guinea pigs with normal hearing were randomly divided into the control group,ligustrazine group and traditional Chinese drug(TCD)group.The alternations of hearing function were evaluated by the examination of auditory brainstem response(ABR).Some specimens were perfused by AgNO3 and observed the damage of bristle cell.And some were sent for immunohistochemistry to detect the expression of iNOS.Results Compared with the control group,the threshold of ABR in ligustrazine group and TCD group were significantly different.There was a significant difference between the ligustrazine group and TCD group.There was no expression of iNOS in Cortis',spiral ganglion cell and stria vascularis in normal cochlear(control group).In the ligustrazine group,the expression became stronger in spiral ganglion cell,stria vascularis,spiral ligament and Cortis'.INOS also expressed in TCD group.Conclusion Ligustrazine can antagonize cisplatin-induced ototoxicity by inhibiting the expression of iNOS.

This paper reports 32 patients with primary esophageal small cell undifferentiated carcinoma confirmed by histologic examination from April 1972 to January 1989 in our hospital. The 1-, and 3-, 5-year survival rates were 53.1%, 18.8% and 6.3%. 93.7% patients died of local un-control, recurrence or metastasis. The age, sex, tumor size, stenosis, position and the type in X-films did not influence the treatment results. Patients with primary esophageal small cell undifferentiated carcinoma should receive a multimodal treatment instead of surgery alone.