The objective of the medical students’ education cost control is to reasonably reduce the education cost differences caused by mismanagement and insufficient investment. The budget is an important tool for the control;the elabrate cost accounting is the essential information condition for the control. It is proposed that enhancing the control power must clear responsibility cost, the education quality cost is guaranteed through both increasing income and reducing expenditure.

Chinese meteria medica (CMM) chain is a long-span chain covering agriculture which mainly depends on the forces of nature as well as high-tech CMM industry, CMM expertise industry and fast developing CMM circulation industry. Imbalance among the development of these industries produces bottlenecks and hinders the operation of the entire production chain. After analyzing the structure of Chinese meteria medica industrial chain from the perspective of national economy industry, three industry classifications and differentiation of factor intensity, we conclude that the complex structure of CMM industry chain is attributable to these three aspects. And the complexity is mainly shown at complex industry, varied product types, different coordination of various industrial sections and different technical growth speed of varied industry. We propose that structural complexity is the natural property of the chain, which is the main reason of industry sector development imbalance and bottleneck. Results of this research could provide theoretical analysis for future research on the coordination of industrial chain and the efficiency of resource allocation.
China ; Drug Industry ; economics ; standards ; Medicine, Chinese Traditional ; economics ; standards ; Plants, Medicinal ; chemistry

Objective:To evaluate the efficacy and safety of continuous intrathecal morphine infusion system for patients with refracto-ry cancer pain. Methods:Seventeen patients with refractory cancer pain were implanted with intrathecal catheters and connected with a continuous external electronic patient-controlled analgesia (PCA) pump for intrathecal morphine analgesia. Visual analogue scales (VAS) score, the dose of routine opioids, and the score for quality of life before and after intrathecal analgesia were recorded. Adverse reactions were observed. Results:After the application of continuous intrathecal morphine analgesia, the VAS score of pain was 2.9±1.8, which is lower than 7.2±2.5 before intrathecal analgesia (P<0.001). Moreover, the dose of routine opioids (i.e., equianal-gesic dose of morphine) was 42.1 ± 7.5 mg/day, which is significantly lower than 282.9 ± 95.5 mg/day before intrathecal analgesia (P=0.004). The scores of general activity, mood, and sleep after intrathecal analgesia were significantly lower than those before intrathe-cal analgesia (P<0.05). However, the analgesic satisfaction of patients considerably increased after intrathecal analgesia (P<0.001). Ad-verse reactions included withdrawal syndrome, headache, urinary retention, and intrathecal infection. Conclusion:The continuous in-trathecal morphine infusion with PCA is effective and safe on analgesic treatment for patients with refractory cancer pain.

Objective To explore the application effect of weekly maintenance together for detection equipment by persons specifically designated.Methods Firstly carries on the preliminary training and the organization of the examination for all junior technicians and nurses,the appropriate persons were selected.Secondly,the recruited personnel were trained and as-sessed by the manufacturer or equipment engineers.After obtaining a certificate of conformity,weekly centralized mainte-nance for detection equipment officially began to implement in August 2014.Maintenance time was designated as every Wednesday afternoon or evening.Two months after the operation the test carried out by the head of clinical laboratory and the equipment department engineers in strict accordance with the week maintenance prcedures for each instrument and each item,and on-site questions.Other personnel also participated in the test as a control group.After half a year,the question-naire was sent to all the inspectors,and the satisfaction rate about the maintenance of the instrument was counted.Results Seven personnel selected to participate in the weekly maintenance,includings two senior technicians,three technicians and two nurses.Experimental personnel BC5390,UF-1000i,BH5100Plus and BH2100,C8000 and i2000,ADVIA2400 average score was significantly higher than the control group.Before and after the programme,the average number of failures of the instrument was reduced from 22 to 8 times and the average satisfaction rate of the inspection personnel was 83.0%±5.0%and 98.0%±2.0% respectively,and the difference was statistically significant.Conclusion Weekly centralized maintenance for detection equipment by persons specifically designated can truly implement instrument maintenance requirements,and at the same time with the implementation of the program,the failure times is greatly reduced,which is beneficial to improve the quality of inspection and to avoid the medical risks caused by TAT.

Due to therapeutic regimens for patients with malignant lymphoma (ML) is currently unsatisfactory, it is important to develop new complementary therapies for longer disease-free survival. Dendritic cells (DC) are specialized antigen-presenting cells of immune system and vaccination with tumor antigen-pulsed DC has been applied to treat patients for ML. In this review, we summarize various types of ML-associated antigens and clinical trials on DC-based immunotherapy in ML, and discuss the development of DC immunotherapy for ML patients in future.

Objective To observe the effects and the functions of valsartan and simvastatin in early diabetic nephropathy. Methods A total of 80 patients with early diabetic nephropahy were randomly divided into two groups.The patients in control group(n=40)received valsartan at a dose of 80rag/day ,while in treated group(n=40)on the base of the same treatment as control group, added simvastatin 20 mg/everyrfight. To compare the differences of lipids,urine albumin excretion rate(UAER) and C-reactive protein(CRP) before or after treatments through 12 weeks. Re-sults The UAER of two groups decreased obviously after therapy,especially the treated group(P<0.01) ;the lipids and CRP also decreased evidently in the treated group (P<0.05). Conclusion The lipids, UAER, CRP of patients in early diabetic nephropathy could be down-regulated,with combined medication of the simvastatin and valsartan, and the injury of renal alleviated.

Dating of injury and the discrimination in trauma and disease is always an important hot topic in the field of forensic medicine. Lumbar disc herniation is a kind of physiological degeneration. To seek a method for deducing the occurrence time of traumatic LDH exactly, this article reviewed the correlation between humoral, celllur immunity and the occurrence time of LDH. It is suggested that some characteristic changes of the expression of IgG,IgM,macrophages may be a helpful method for the occurrence time deduction of traumatic LDH.

Objective To master the running conditions of water project and the defluoridation results in monitoring sites of drink-water type fluorosis in Shaanxi Province,to provide a scientific basis of preventing and controlling endemic fluoroisis. Methods Every April and September 1998—2005 children aged 8～12 at school from the two monitoring sites of Wupo and Bayi village received the dental fluorosis examination by using the Deans method.The urine samples of 50 children from 5 age groups who were selected randomly and were grouped in 5 with 10 children each were collected,measured in accordance with WS/T 89—1996 Determination of Fluoride in Urinlon Selective Electrode Method,evaluated by Manual of Endemic Fluorosis Control(1991). At least 5 water samples were collected randomly from five directions(east,west,north,south,center).The fluoride contents in urine and drinking water were determined with FSIE,in accordance with GB/T 5750--2006 Standard Examination Methods for Drinking Water,evaluated by GB 5749—2006 Standards for Drinking Water Quality.Results After changing water,morbidity rate of children dental fluorosis fell from 66.67%in 1998 to 31.79%in 2005 and the dental fluorosis index also fell form 1.49 to 0.65 of Wupo village,morbidity rate of children dental fluorosis fell from 33.15%in 1998 to 13.10%in 2005 and the dental fluorosis index also fell from 0.50 to 0.24 of Bayi village.The fluoride contents in urine of children and the fluoride contents in drinking water were maintained stability.Conclusion After water improvement,the fluorosis has been effectively controlled in a certain degree in the investigated area.

Objective: To intimately assess the internal stress distribution in ceramic veneer bonding layer. Methods:Six buccolingual cross section models of the incisor restored with IPS-Empress ceramic veneer were built with the MSC/NASTRAN software. 2D-finite element method was used to analyze the stress distribution regularity of the bonding layer on the models under different functional load. Results: Stress concentration areas of ceramic veneer bonding layer were regularly located on the incisal margin and cervical margin. Under the same condition, incisal load caused highest stresse on the adhesive layer. Following the load shift from incisal to gingival area, the stress was gradually decreased.When the functional load acted on the palate margin of the restoration, the compressive stress on the bonding layer was significantly increased. Different load angle generated stress change in the bonding layer. The shear stress on adhesive layer increased following the horizontal load angle increasing close to the debonding level. Among the different incisal reduction designs there was no significant Von Mises stress variation under the same load condition. However, when the incisal edge was reduced by more than 4 mm, the tensile stresses in the bonding layer greatly increased. Conclusion: Restoration margin should be kept away from the tooth contact area, be exposed to minimal occlusion contact. The functional load should be induced to follow the tooth long axis. Edge to edge occlusion should be avoided. When incisal areas need to be altered, the incisal overlap or butt margin design will not cause any stress problem in the bonding layer. When restoring the incisal defect for more than 4 mm, the bonding agents must be selected carefully.

Objective To investigate the effects of intravesical therapy with elemene in preventing postoperative recurrence of superficial bladder cancer and its toxic and side effects. Methods This series included 123 patients with superficial bladder cancer (T 1),consisting of transitional cell carcinoma GⅠ in 37 cases,GⅡ in 73 and GⅢ in 13.They all underwent surgical treatment. Postoperatively, they were randomly assigned to 2 groups:63 patients in elemene group received instillation of elemene (400 mg,once a week) 2 weeks after operation and 60 patients in mitomycin C (MMC) group received instillation of MMC(40 mg,once a week) 2 weeks after operation. The instillations were repeated for 6 weeks and thereafter monthly for 1 year.The recurrence rates,side effects,and NK cell activity before and after treatment were evaluated. Results The recurrence rate of elemene group (mean follow-up of 19.7 months) was 7.9% (5 cases),which was significantly lower than that (25.0%,15 cases) of MMC group (mean follow-up of 19.4 months;P