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.

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 2008 World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (4th edition) has greatly advanced the diagnosis, treatment, academic exchange, and research of lymphoma worldwide. A new revised edition will be published soon, in which the diagnosis and management of lesions at the very early stages of lymphomagenesis, the diagnostic criteria for several entities, and the genetic/molecular landscape of numerous lymphoid neoplasms and their clinical correlates have been clarified, refined, detailed, and expanded. Furthermore, several new concepts have been suggested in the upcoming revised edition, although the framework of classification remains the same. These updates will lead to development of more targeted therapeutic strategies and increase our confidence in the era of precision medicine. This manuscript will review the major advances and updates that are helpful for our un-derstanding and improvement in tumor diagnosis.

Objective:To put forward some suggestions by comparing the current situation in both private and public hospitals. Methods:Comparing the basic information, scale, human resource and medical service management situation between the private and public hospitals by analyzing the 2014 Beijing health authorities report. Results:There are 355 private hospitals, 76. 1% of them are not rated and 59. 7% are not appointed for the medical insur-ance, and 82. 8% need to rent the land. Although the number of private hospitals is more than that of the public ones, their actual beds and health resources respectively account for only 20. 2% and 16. 4%. Besides, their in-come, assets and services also account for only about 10%. Conclusions:There is a big gap between the private and public hospitals in terms of scale, human resources and service ability. The Government should implement the policy about the ratings, medical insurance and the use of land which is given to support the private hospitals, and speed up the diversified medical model.

)0.05). However, the index of source memory (I) was (0.73?)0.13 in adult group and (0.87?)0.08 in children group, the difference between the two groups was obvious ((P

Objective To explore the effects of aerobic exercise training on the circulating miRNAs and their roles in cardio‐vascular adaption induced by aerobic exercise training .Methods Ten freshmen were enrolled .All subjects performed an 8 weeks swimming training .VO2 max and cardiovascular function were measured in acute exhaustive before and after the aerobic endurance training .The key circulating miRNs (miR‐133a ,miR‐21 ,miR‐146a ,miR‐199a ,miR‐15a and miR‐222) were measured at rest and im‐mediately following acute exhaustive exercise in competitive male freshmen before and after the aerobic training .Results Distinct patterns of c‐miRNA response to exercise were observed and adhere to 4 major profiles :after aerobic exercise training ,the levels of miR‐146a ,miR‐222 ,miR‐21 ,miR‐15a and miR‐199a at rest were significant higer than before training (P<0 .05) .The levels of miR‐146a and miR‐222 were up‐regulated by acute exercise before and after aerobic exercise training (P<0 .05) .Before the aerobic train‐ing ,acute exhaustive exercise increased miR‐21 and miR‐15a significantly(P<0 .05) ,however ,there was no difference between the miR‐21 and miR‐15a levels in acute exhaustive exercise and resting state after aerobic exercise training (P>0 .05) .There was no difference in the level of miR‐133a between resting state and acute exhaustive exercise before and after training (P>0 .05) .Further linear correlation analysis showed that the miR‐146a expression in plasma was significantly positively correlated with VO 2 max level (r=0 .842 ,P<0 .01) ,the change of miR‐222 expression in plasma before and after training was significantly positively correlated with EF (r=0 .920 ,P<0 .01) .Conclusion MiRNAs can be used as a marker to reflect the effect of training ,miR‐146a and miR‐222 play a role in physiological regulation of the cardiovascular function of aerobic exercise training in the body .

Objective:To study the neuropsychological features and explore possible mechanisms in pure word deafness.Methods:A case of a 55 year-old right-handed woman was analysed,who presented with a long lasting pure word deafness following subcortical and cortical hemorrhage in right temporal and parietal lobe.Results:There was no sign of aphasia. The auditory deficit was sepecific for language, while recognition of music and environmental sounds was normal. CT examinations showed that the lesion was due to right cerebral hemisphere hemorrhage, mainly the white matter of temporal and parietal lobe. Conclusion:It is proposed that pure word deafness was consequent to the isolation of Wernicke's area from incoming auditory information due to the interruption both of the association fibers from the right auditory area traveling across the corpus callosum and of the left auditory radiations.

OBJECTIVE:To strengthen the clinical rational use of drug and to ensure safety of drug use.METHODS:The irrational medication orders of PIVAS in our hospital from Mar.to Aug.in 2009 were analyzed statistically.RESULTS:Of total 859 339 medication orders,771 irrational medication orders accounted for 0.94‰,including excessive dosage,irrational compatibility and improper solvent selection,etc.CONCLUSIONS:Pharmacists can correct irrational medication order to improve rational use of drug by PIVAS.Moreover,PIVAS plays an important role in training clinical pharmacists.

Objective To summarize the clinical experience of laparoacopic cholecystectomy(LC) for acute cholecystitis. Methods LC was performed in 68 cases of acute cholecystifis for 2004 to 2007. The operation was completed under CO2 pneumoperitoneum by using 4-port technique. Results The LC was successfuUy accomplished in 64 cases, while a conversion to open surgery was required in 4 cases. A drainage tube at the foramen of Winslow was placed in 1 cases. Conclusion Strict adhesion to surgical indications of LC, standard performance of the proce-dure, timely conversion to open surgery, and proper placement of drainage tube are key factors to ensure a successful operation.