The paper described the significance of strategic planning and management for hospitals and analyzed the presence practice of such strategic planning and management in the country. It focused on the practices of 23 tertiary hospitals in Shanghai in making and implementing their development plan for the "12th Five-year Plan"; summarized their three characteristics in public benefic guidance, better operability and better services. In addition, it introduced the initial achievements made in enhancing service quality and patient satisfaction, tapping resource potentials, enhancing operation efficiency and sustainable development.

ObjectiveTo investigate the relationship between nephrogenic rests and the genetic steps occurring in the development of Wilms' tumor.MethodsThirteen Wilms' tumor with nephrogenic rests were microdissected from paraffin sections.Using polymerase chain reaction-based polymorphic markers,the loss of heterozygosity (LOH) or the putative tumor suppressor genes were studied at 11p13,11p15 and 16q LOH loci.ResultsLOH was detected in two cases at 11p13 and in three cases at 11p15,and in one of these cases LOH at both loci.All rests showing LOH also showed LOH in the tumor.Two cases showing LOH at 16q were identified only in the tumor but nor in the associated rest,and they had recurrence of the tumor.ConclusionsThis study suggests that LOH at 11p13 and 11p15 mutations are the early events whereas LOH at 16q occurs late in the pathogenesis of Wilms' tumor denoting a multistep model of Wilms' tumor pathogenesis.

Objective To study the effect and the mechanism of vitamin A deficiency (VAD) on neoplasia of nephroblastoma induced by dimethylhydrazine dihydrochloride (DMH). Methods A total of 90 Wistar rats weighing 40-50 g were divided into 3 groups:normal diet (ND) group (n=30),VAD group (n=30) and control group (n=30).In ND and VAD groups, 0.35% DMH was injected subcutaneously and the animals were fed with normal diet in ND group, and with vitamin A deficient diet in VAD group.In control group,the animals were fed with normal diet without DMH. The incidence of nephroblastomas and nephrogenic rests (NRs) in 3 groups were recorded. The renal tissues were prepared for detection of DNA index (DI) and S fraction of cell cycle by FCM,and for RAR? mRNA expression by RT-PCR.The incidence of nephroblastomas and NRs were determined according to Beckwith diagnostic criteria. Results No tumor developed in control group; the incidence of nephroblastoma in VAD group (36.7%) was significantly higher than that of ND group (13.3%,P

OBJECTIVE To make a new sterilizer to disinfect the instruments used for the root pulp treatment.METHODS After studying the SL sterilizer used in Japan,a new sterilizer was made.Studied how long the sterilizer could be used after putting through the electric.The effect of it was compared with the Eurouda sterilizer E6-18/24 by the method of culturing the bacteria.RESULTS 208.8 seconds after putting through the electric,the sterilizer could be used to sterilize the apparatus.And the effect of the new sterilizer was the same as the Eurouda sterilizer E6-18/24.CONCLUSIONS The effect of the sterilizer is testified,and the sterilizer could be used for the root pulp treatment instruments.

Objective To develop a set of indicators for measuring the performance of China's Healthcare Improvement Initiative.Methods Such methods as literature review,expert consultation and onsite preliminary experiment were used,to study and demonstrate the indicators,the evaluation framework,the weight,evaluation indicators,and evaluation standards.Results The final evaluation indicators for medical institutions included nine class-1 indicators,29 class-2 indicators,and 56 class-3 indicators;those for healthcare administrations included six class-1 indicators,nine class-2 indicators,and 13 class-3 indicators.Conclusions The system takes into full account the special nature of healthcare,and mission of the Initiative,as the well as the quality,safety,efficiency and equity of healthcare,to make the system scientific and operational.

Performance appraisal is an important means for keeping hospitals on correct tracks for their medical services and their public interest nature,in addition to its importance in enhancing internal performance management within public hospitals.Since 2006,Shanghai Shenkang Hospital Development conducted performance appraisal for directors of 23 public hospitals in Shanghai.This paper highlights the importance of performance appraisal for these directors,and its significance in keeping the correct director of hospital operation.

By means of joint research of new advanced technology project,joint development and application of appropriate health technology project,comprehensive prevention and control of chronic diseases between municipal hospitals and community clinics project and research supporting platform project,Shanghai Hospital Development Center has effectively improved the clinical science and technology innovation capability, promoted the development of medical disciplines and talents and improved the discipline influence of such hospitals.

This paper introduced the design ideas and general information of Shanghai in building theHospital-Link Project.Thanks to innovative information technology and service model,it achieved real-time connectivity and clinical information sharing between the 38 municipal hospitals,which enables the general reform of such hospitals citywide.

This study summarized the experiences of disease-specific performance appraisal at tertiary hospitals in Shanghai,which was launched since year 2013 by Shanghai Hospital Development Center (SHDC). 38 tertiary hospitals in Shanghai were included in the study. A disease-specific performance appraisal system centering on quality and performance, by means of case-mix model, classified surgery management and typical disease screening, and leveraging disease and surgery difficulties analysis, and inter-hospital performance appraisal of typical diseases. This reform has established appraisal criteria of disease difficulty management,coding criteria and data norms,guiding such hospitals to consolidate their functional positioning of focusing on difficult,urgent and complicated cases in the medical service delivery system.All these efforts have paved the way for the reforms to build a hierarchical medical service system, pricing per disease, payment per disease, and consolidate performance appraisal of medical workers.

This paper uses the data collected from 138,477 patient discharge records of 37 Shanghai tertiary public hospitals in December 2013 and classifies all the records into different groups by using a localized diagnosis re-lated group tool.The coefficient of variation index ( CV) of each group was used to analyze the dispersion of average hospital cost per inpatient day for each group, in order to evaluate the suitability of diagnosis related group systems and to set the coefficients of difficulty ( relative weights) for each disease.The study has found that severity-based di-agnosis related group systems are more suitable and consistent.However, future studies should collect more detailed information on health costs in order to reflect the value of health professionals and technologies and therefore further improve diagnosis related classification and develop new systems that can be adapted to local conditions by applying the weights of different groups.