For medical insurance systems, medical expense examination is a key measure to keep medical expenses under control. In 1948, Japan established an examination authority of legal person status to operate the medical expense examination. Based on years of modifications and improvement in the organizational system and operation mechanism, the system is running smoothly by now. Authors of this paper made a detailed introduction to the specific operations of such a system, and to China's local features as well. On such basis, the study proposed to build in China a third-party medical expense examination institution as a legal entity, and practice the reexamination system and information disclosure system, in an effort to safeguard legitimate rights of insurance organizations and medical institutions.

The Medical Care Act of Japan has undergone five major revisions since it went into effect in 1947. Each revision has been designed to target and tackle main problems found in the medical and health sector in the country. These problems range from the making of regional healthcare plans to the establishment of the hospital with specific functions, from the division of rehabilitation beds to the establishment of nursing insurance scheme, from the birth of medical corporations to the establishment of social medical corporations, and from strengthening of non-profit nature of medical institutions to the construction of medical information system. These efforts were made to provide a safe and convenient health service for the Japanese people. These revisions are closely related to hospital management, and its experiences prove useful for the health reform in China.

The clinician training system in Japan is different from that in China as their medical students are allowed to take medical doctor examination immediately following their graduation.But they must undergo at least two years of training in basic clinical knowledge and skills prior to taking any clinical practice.This training system is inspirational for us as follows:China should include standardized training of residents into the law of medical practitioners,and medical graduates must take two years of knowledge training in full medicine before they are qualified for clinical practice.On top of this training,they need to undergo at least three years of specialized doctor training,making them competent clinicians with comprehensive knowledge coverage and outstanding skills in specific areas following such staged training.

Adult ; Facial Nerve Injuries ; etiology ; Foreign Bodies ; complications ; Humans ; Male ; Neck ; Parotid Gland

Hemispatial neglect often occurs after brain injury, especially the higher incidence after stroke. The studies on cognition, attention, and perception have greater significance. However, the related domestic studies at present are rare. Being themed by line bisection, this article reviews the influencing factors and relevant mechanisms, brain location, and extensional study in the assessment of hemispatial neglect.

A total of 306 Malaysian university students and staff were surveyed to ascertain the physical and emotional effects of the polluted haze on them. All subjects completed self-reported questionnaires. Analysis of the results indicated that the majority of subjects reduced their outdoor activities and sports, and also reported an increase in emotional and physical health problems. The results indicated that there was a general increase in emotional problems such as feeling depressed, lacking in energy, not feeling like doing anything, feeling anxious and afraid, difficulty sleeping, feeling agitated and irritable, and having no appetite. There was also an increase in physical symptoms such as itchy or red eyes, itchy or running nose, dry throat/cough, headaches, nausea, and fever. This study indicated that emotional and behavioural problems are just as common during the haze, when compared with physical health problems. The study also suggests that there are a broad range of problems which health care and human resource departments need to be aware of and take precautions to minimize during a haze.

Objective: To study the minor triterpenoid saponins from the roots of Panax notoginseng, which provided basis for the systematic research, quality control and safety evaluation of P. notoginseng. Methods The compounds were isolated and purified by MCI resin, ODS, along with Preparative-HPLC, and the structures were identified by spectroscopic analysis, and comparing with the pubished literature values. Results: Twelve monomeric compounds isolated from the roots of P. notoginseng, were identified as notoginsenoside P1 (1), notoginsenoside T5 (2), ginsenoside Rk3 (3), ginsenoside Rh4 (4), notoginsenoside T3 (5), 20(S)-protopanaxatriol (6), dammar 20 (21),24-diene-3β,6α,12β-triol (7), ginsenoside Rg3 (8), gypenoside XIII (9), ginsenoside Rk1 (10), ginsenoside Rg5 (11), and 20 (S)-ginsenoside Rh2 (12). Conclusion: Compound 1 is a new dammarane-type triterpenoid saponin

Students(64)of two years in our department were divided into two groups in experimental teaching of forensic toxicology analysis:in one group,the methods of LBL was performed,while the methods of PBL was performed in the other group. By comparing effects between these two methods,we analyzed the function methods of PBL to improve students'experimental skills and capacity of analyzing and solving problems. It was concluded that the PBL methods was more suitable for the experiment teaching of forensic toxicology analysis than the LBL methods.

Objective:To develop a diagnostic analysis software for determining the type of acid-base balance disorder.Methods:Mathematical models were built based on Henderson-Hasselbalch equations and compensation formulas, to determine the important parameters of acid-base balance disorder, and to develope acid-base balance disorder analysis process. The software was compiled using the Visual Basic.NET programming language, and the installation package was generated after debugging. Acid-base balance disorder cases were searched by PubMed, Wanfang and CNKI databases from 1980 to 2015, and the blood gas parameters [pH, arterial partial pressure of carbon dioxide (PaCO 2), HCO 3- and anion gap (AG)] and the types of acid-base imbalance (literature results) were recorded. All cases were reanalyzed by software and the type of acid-base balance disorder was determined (software diagnostic type). Kappa-test and McNemar-test were performed for the two diagnostic results. Results:The "four parameters-four steps" analysis method was used as the analysis process to judge the types of acid-base balance disorder. "Four parameters" included pH, PaCO 2, HCO 3- and AG. "Four steps" were outlined by following aspects:①according to the pH, combined with PaCO 2 and HCO 3-, the primary types of acid-base balance disorder was determined; ② according to the compensation situation, double mixed acid-base balance disorder (DABD) was determined; ③according to AG value, three mixed acid-base disorders (TABD) were determined; ④ the ratio of ΔAG↑/ΔHCO 3-↓ was also calculated to determine whether there was normal AG metabolic acidosis or metabolic alkalosis. The software had the characteristics of simple interface, convenient operation, rapid judgment, and comprehensive analysis. It could judge all acid-base balance disorder types excepted "AG normal metabolic acidosis combined metabolic alkalosis". The software was used to reanalyze 112 cases of acid-base balance disorder reported in the literature, with a consistent rate of 87.50% and better consistency of the diagnostic results (Kappa test: κ = 0.84, P < 0.01; McNemar test: χ2 = 0.87, P = 0.65). Conclusion:The software can be used as an important tool to judge the type of acid-base balance disorder, and provide clinicians with diagnostic reference, which have practical value and application prospect.

Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation (rTMS) applied to the supplementary motor area (SMA) of children with Tourette's syndrome (TS). Methods Thirty TS subjects less than 16 years old were treated with 1 Hz rTMS to the SMA at 110％ of the resting motor threshold (RMT) in 20 daily sessions,receiving 1200 pulses/day.Clinical assessment and physiological measures of the left and right RMT were conducted at different time points during the treatment. ResultsAfter 4 weeks of treatment,statistically significant reductions were observed in assessments with the Yale global tic severity scale (YGTSS) and in terms of clinical global impression (CGI).Symptomatic improvement was correlated with dramatic increases in both right and left RMTs. ConclusionApplication of 1 Hz rTMS to the SMA can improve the clinical symptoms of TS children.