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.

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 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.

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 determine the prevalence of vulvovaginal candidiasis(VVC) in pregnant women,to test its antifungal susceptibility to miconazole,clotrimazole,fluconazole, itrocona- zole,and nystatin and to treat VVC with miconazole in pregnancy. Methods Vaginal swabs were collected from unselected pregnant women in prenatal clinic. The antifungal susceptibility of 131 strains of Candidas to miconazole,clotrimazole,fluconazole,itroconazole,and nystatin were detected by Neo-Sensitabs susceptibility testing. 66 cases of VVC were treated with 6 day-course of miconazole(400 mg/d). Results The prevalence of VVC in pregnant women was 12.7%(127/1000). 37.4%(374/1000) had previous VVC. 0.6%(6/1000)of women were recurrent VVC(RVVC),which occupied 4.7%(6/127) of VVC. C. albicans was the most frequently(87.1%) isolated pathogen followed by C. glabrata (9.9%) ,C. tropicalis(1.5%),and C. krsei(1.5%). The resistant rate of C. albicans to miconazole,clotrimazole,fluconazole,itroconazole,and nystatin was 10.5%、2.6%、 6.1%、 7.9%,and 0. All 13 strains of C. glabrata was susceptible to miconazole,nystatin and susceptible or susceptible-dependent-upon-dose (SDD) to clotrimazole,fluconazole,and itroconazole. The mycological cure rate of miconazole on day 7～14 and day 28～42 was 84.8%(56/66 cases) and 80.3% (53/66 cases). Conclusions VVC is very common in pregnancy. C. albicans is the predominant Candida species in VVC and has some resistance to miconazole,clotrimazole,fluconazole,itroconazole,and nystatin. Miconazole therapy is effective on VVC treatment in pregnant women. Non-effective treatment might be associated with Candidas resistance.

Objective To evaluate the effects of different doses of epidural capsaicin on pain threshold, neurological function and spinal neurons.Methods Thirty-six male New Zealand white rabbits weighing 2.5-3.0 kg were randomly divided into 4 groups (n = 9 each): control group and 3 capsaicin groups (Cap 1, 2, 3). The animals were anesthetized with 10% chloral hydrate 50-75 mg?kg-1 i.v. . An intrathecal catheter was inserted at L6,7 interspace and correct placement was confirmed by outflow of CSF. 1 ml of 0.1 % ( Cap1) , 0.25 % ( Cap2 ) or 0.5% (Cap3 ) capsaicin was injected intrathecally 24 h after IT catheter was placed. Threshold to noxious thermal stimuli was measured and gait of the hind limbs were assessed using Johnson score (5 = normal, 0 = completely paralyzed), before and 1, 3, 7, 10, 15, 20, 25, 30 days after IT injection. On the 2nd day after IT injection 3 animals were killed in each group and the lumbar segment of spinal cord (L6,7) was immediately removed for light and electron microscopic examination. Results The threshold to noxious thermal stimuli was significantly higher in the 3 capsaicin groups than in control group ( P

Objective To understand the situation of indoor air fluoride and arsenic pollution caused by coal-burning and the impact of the pollution on children health in the rural area,southern Shaanxi Province.Method 77 fluoride samples and 186 arsenic samples were collected in 65 investigated villages of 5 counties in southern Shaanxi Province.13 120 children aged 8-12 years were selected for dental fluorosis examination,13 386 children aged 6-18 years for arsenism examination.Results Both of the average content of fluoride and arsenic in the indoor air exceeded the national standard limit.Fluorine content was 0.001-0.541 mg/m3 with an average of 0.038 4 mg/m3,arsenic content was 0.00-63.83 ?g/m3 with an average of 4.76 ?g/m3.The prevalence rates of dental fluorosis and arsenism were 45.50% and 1.86% respectively.Conclusion The indoor air fluoride and arsenic pollution caused by coal-burning in the investigated rural area is serious and the pollution has caused the prevalence of endemic fluorosis and endemic arsenism among the local children.

Objective To improve the therapeutic efficacy of cervical spondylotic myelopathy (CSM) and reduce the complications by anterior cervical locking plate system (ACLPs).Methods 78 patients with CSM were treated with ACLPs.Thoughtful preparation and careful observation were given before and after the operation.Result All the cases obtained excellent results postoperatively according to the JOA score system except one dead.Conclusion ACLPs is a promising method for the treatment of CSM;careful preoperative preparation and postoperative observation can improve the efficacy and reduce the complications.