Combined Modality Therapy ; Congresses as Topic ; Head and Neck Neoplasms ; therapy ; Humans

OBJECTIVE:To provide reference for further implementation and improvement ofTwo Tax Billmedicines distri-bution reform. METHODS:Literature review and field investigation were used to systematically sort out,summarize and analyze the effect ofTwo Tax Billmedicines distribution reform and potential problems. Corresponding policy suggestions were proposed. RESULTS & CONCLUSIONS:TheTwo Tax Billmedicines distribution reform boosted the integration and re-combination of medicines distribution system,and effectively rectify the medicines distribution system. However,this study found no evidence of its effect on reducing the high medicines prices. We suggest that,the implementation ofTwo Tax Billmedicines distribution re-form should firstly ensure the stable supply of medicines,especially the availability of essential medicines in rural remote areas, and those medicines with high risk of shortage. It is also suggested to strengthen the audit of tax receipts;establish long-term mecha-nism to promote on-time payment to suppliers by hospitals;break down local protection;set up efficient multi-ministerial coordina-tion mechanism.

Objective: According to the medical system reform’s requirement of “strengthening supervision, increasing the public health investment, reforming the compensation mechanism of public hospital, establishing public hospital performance evaluation and incentive system”, public hospitals should continue to reform its management system optimization, performance appraisal is the core content of hospital internal reform performance appraisal method, which is an important guarantee for the results of hospital performance evaluation. Methods: The study on the assessment methods of hospital performance, use “public hospital”, “performance” and“performance evaluation” as the keywords to search the Chinese HowNet and Wanfang database retrieval and 142 articles; by reading the whole passage and the method of stratified sampling, the common performance appraisal method are used to collect and collate, eventually the assessment method of hospital performance of 32 Chinese literature references are included in the study. Results:Summarize the evaluation methods of hospital performance application condition advantages, disadvantages and present situation, and establish a set of performance evaluation methods with the management of public hospitals more perfect, scientific and detailed theoretical basis. Conclusion: In the process of the medical system reform, according to the characteristics of hospitals, to choose suitable and effective performance appraisal methods to help the performance management in hospital, and receive more economic benefits while maximize social benefits.

Objective To study the diagnostic value of cavernosography in the venous leakage impotence.Methods Cavernosography were performed for 25 patients with the venous leakage impotence who had been diagnosed by the clinic just after the contrast agent had been injected.The appearance of cavernosography were analysed.Results Different degree venous leakage had been shown in 25 cases.The diagnostic accordance rate of the cavernosography,clinic impotence for the venous leakage was 100%(25/25).The accordance rate of the degree of the venous leakage shown by the cavernosography and pointed out by the clinical impotence was 36%(9/25).Conclusion Cavernosography not only can show the venous leakage and its location,but also can know the degree of the venous leakage.

Objective To analyze features of clinical manifestation, laboratory tests, electrophysiology and imagol?ogy of Heidenhain’s variant of Creutzfelt-Jakob disease (CJD). Methods Clinical data, laboratory and electrophysiologi?cal results as well as medical images were collected from 3 patients with Heidenhain variant of CJD. Results Three pa?tients presented with rapid visual impairment at onset and refractory pruritus. Whole gene sequencing indicated that one patient had point mutation at E200K whereas the other two did not the mutation. All the cases had positive 14-3-3 pro?tein in CSF. Patients had three phases sharp waves burst at posterior part of cerebral cortices with slow waves back?ground in EEG, no evoked P100 in visual evoked potential test,‘cortical ribbon sign’at bilateral occipital lobe in DWI sequence of head MRI and hypometabolism of glucose from occipital cortex spreading to extensive cerebral cortices in PET/CT. Conclusion Head MRI and EEG should be conducted in old patients with visual disturbance as the onset symptom, followed by rapid cognitive impairment, ataxia and extrapyramidal symptom to rule out Heidenhain variant of CJD. Refractory pruritus indicates a high likelihood of CJD.

Objective　To study whether covering ice on head can abate headache produced by using nitroglycerin.Method　64 cases were collected from the patients who used nitroglycerin and were randomly divided into one contrasting group (group A) and one experimental group (group B).For the patients of group A,the state of headache produced by using nitroglycerin should be observed.For the patients of group B,covering ice on their head was adopted when they used nitroglycerin,and the state of headache should also be observed.Results　There were obvious difference between the two groups (P<0.001).Conclusion　Covering ice on head is a good method which can abate headache produced by using nitroglycerin.

Maternity insurance is a policy support of China for women of child-bearing age.Given its good outcomes since it is enforced clinically,such insurance has been confronted with challenges as well.Doctors and nurses of Ob/Gyn departments serve as both protectors of parturient women's interests and practioners of the economic and social interests of the hospital.This paper summarized the experiences of maternity insurance of the Ob/Gyn department of the hiospital in rencent 6 years.The hospital has had 2026 inpationts covered by maternity insurance,without any medical disputes and harvesting a cash surplus of 657145 yuan.Such doctors and nurses are found to play a key role in ensuring a good doctor-patient relationship,and serve as clinival references for the single-disease management and teaching of the hospital.

Objective To investigate clinicopathological features of scalp angiosarcoma, and to analyze the relationship of tumor stage and treatment with prognosis. Methods Clinical and follow-up data were collected from 16 patients with non-metastatic primary scalp angiosarcoma treated in the Department of Plastic and Reconstructive Surgery of Zhongda Hospital, Southeast University from September 2002 to June 2013. According to the seventh edition American Joint Committee on Cancer (AJCC)TNM staging system for soft tissue sarcomas (2010), staging of scalp angiosarcoma was performed for the 16 patients. Statistical analysis was carried out by the Kaplan-Meier method for survival rates and by the Log-rank test for survival curve. The Cox regression model was used for multivariate regression analysis. Results Of the 16 patients, 4 had stageⅠangiosarcoma, 4 stage Ⅱangiosarcoma, and 8 stage Ⅲ angiosarcoma. The tumor usually began as ecchymosis-like lesions on the head or face in early stage, and progressed into dark red infiltrative plaques, nodules and ulcers which easily ruptured and bled in later stage. Histopathological examination showed generalized vascular proliferation and infiltration with high histological morphological diversity. Cytologic atypia was commonly seen. The median time to recurrence was 15 months, and local recurrence occurred in 7 patients. The median time to metastasis was 20.5 months, and distant metastasis was observed in 8 cases, including 4 cases of pulmonary metastasis, 2 lymph node metastasis, 1 liver metastasis and 1 bone metastasis. The survival time was 33.0 ± 4.4 months (median, 32 months)in 4 patients with stage Ⅰangiosarcoma, 24.0 ± 7.9 months(median, 15 months)in 4 patients with stage Ⅱangiosarcoma, and 23.9 ± 3.9 months (median, 24 months)in 8 patients with stage Ⅲ angiosarcoma. Additionally, the survival time was 23.4 ± 5.2 months(median, 21 months), 24.4 ± 5.7 months(median, 24 months)and 35.8 ± 9.7 months(median, 26 months) in 5 patients receiving surgical treatment alone, 7 patients receiving surgical treatment and radiotherapy, and 4 patients receiving surgical treatment, radiotherapy and immunotherapy, respectively. Conclusions Surgical treatment combined with radiotherapy and immunotherapy may serve as the first-choice treatment for scalp angiosarcoma. Tumor size and treatment regimens are main factors influencing prognosis of scalp angiosarcoma.

Objective To explore the role of MAPK and NF-?B in the increase of Toll-like receptor 4(TLR4) expression induced by lipopolysaccharide(LPS) in pulmonary micro-vascular endothelial cells(PMVECs) of mouse.Methods PMVECs were isolated,cultured and exposed to the different concentration LPS at(2 h),and(100 ?g/L) LPS in different time.The concentration of TNF-? in culture supernatant was detected using ELISA.(Using) PD98059 inhibitor for ERK,SB203580 inhibitor for P38 MAPK and PDTC inhibitor for NF-?B pretreated(PMVECs).RT-PCR was used to detect the levels of TLR4 and TNF-? mRNA.Western-blot was used to detect the protein expression of nuclear factor-kappa B(NF-?B) P65 subunit and ERK / P38 MAPK in nuclear extract after LPS exposure for 6 h respectively.Results With the treatment of 50～(500 ng /mL) LPS for(2 h) or(100 ?g /L)(LPS exposure) in different time,the concentration of TNF-?in culture supernatant of PMVECs was increased by a time and dosage dependent style(P

OBJECTIVE:To establish HPLC method for simultaneous determination of estazolam and diazepam in serum METHODS:The mobile phase consisted of methanol-water-triethylamine-acetic acid(55∶45∶0 5∶0 35)and the ?max was 254nm Phenytoin was adopted as the internal standard The drugs were extracted by diethyl ether under the alkaline condition RESULTS:The calibrating curves of estazolam and diazepam were linear in the ranges of 0 52～38 62?g/ml and 0 50～40 16?g/ml respectively CONCLUSION:The method was appropriate for determination of estazolam and diazepam qualitatively and quantitatively in intoxication accident