This paper reviews practices and features of health service system planning in some countries, and analyze its implications for China’s system planning. It is an international common practice to perform health service system planning to improve resource allocation efficiency, to meet multilevel demands of medical services, and to control dramatic growth of medical expenditures. Governments and their affiliated departments are the main body to formulate and implement the plans, and different levels of governments have different responsibilities in planning. During the procedure of formulating and implementing plans, collaborative governance network can be utilized to en-courage multi-party stakeholders to participate. The government should play an active role in planning to ensure the equity and accessibility of health services. The authority of planning can be achieved mainly through the comprehen-sive measures in legislation, political regulation, economic incentives, etc. Improved tools and methods based on multidisciplinary theories can be used to improve plan’s scientificity and delicacy. China can learn from international experience in formulating and implementing health service system plans.

Objective To distinguish malignant from osteoporotic acute vertebral collapses at the single location. Methods Fifteen osteoporotic and sixteen malignant vertebral collapses were studied in thirty-one patients with T1 WI,gadolinium enhanced T1 WI and T2 WI MRI. All the patients had the follow-up periods of 3 ～ 6 months or pathologic results from biopsy. Results Seven findings were suggestive of osteoporotic: 1. The compression of vertebral body was severe. 2. The lesion extended to the whole vertebral body was uncommon. 3. The location of the lesion was closed to the end plate of the vertebral body and the anterior and/or posterior of the vertebra was straight or concave.The posterior bone fragment can be seen. 4. Pedicles were normal. 5. No epidural soft tissue mass. 6. The vertebral vein was normal. 7. The bandilike or flakelike enhancement under the end plate. Another seven findings were suggestive of malignancy: 1. The compression of vertebral body was mild. 2. The lesion extended to the whole vertebral body was common. 3. The anterior and /or posterior of the vertebra cortex was convex. 4. Pedicles were involoved. 5.Epidural soft tissue mass was usually seen. 6. The vertebral vein was involved and disappeared. 7. The lesion was usually nodulus enhancement. Conclusion To distinguish malignant from osteoporotic acute vertebral collapses,the MRI findings of the morphology and the shape of the lesion postcontrast are useful in the differentiation of solitary acute vertebral collapses.

OBJECTIVE To explore the method to prevent 203 patients after liver transplantation from infection.METHODS According to infective reason after liver transpantation,the strict management in every step was performed,including establishing standard of infection control,strengthening the staff management,and separating the different area.RESULTS Multi-organs dysfunction sydrome was found in 4 patients after liver transplantation because of fungal infection,and the total mortality of patients after transplantation was 1.97%.CONCLUSIONS Strengthening the nursing management can take a significant effect for patients after transplantation to control infection and decrease mortality rate.

Objective To dynamically observe photodamage of subcellular sites by use of laser scanning confocal microscopy (LSCM). Methods The samples were divided into four groups. Murine lung endothelial cells were subcultured and incubated with HMME for 24 hours. Then the cells were stained with rhodamine-123 for demonstration of mitochondria. LSCM was applied and organelle-cell fluorescence intensity ratio analysis was adopted to study the intracellular distribution of HMME. Then dynamic fluorescence images sequence of rhodamine-123 was collected. Results Rhodamine-123′s fluorescence images of cell sample with HMME was changed gradually during irradiation: the typical characteristic of mitochondria disappeared gradually with decreasing fluorescence intensity. The fluorescence of rhodamine-123 was diffused and distributed in nuclear, while rhodamine-123′s fluorescence images of cell sample without HMME was not changed. Conclusion Mitochondria and nucleus are photodamage sites by HMME-PDT; LSCM can be applied in dynamic observation of photodamage of subcelluar sites.

Objective: To distinguish malignant from osteoporotic acute vertebral collapses at the single location. Methods Fifteen osteoporotic and sixteen malignant vertebral collapses were studied in thirty - one patients with T1 WI, gadolinium enhanced T1 WI and T2 WI MRI. All the patients had the follow - up periods of 3 - 6 months or pathologic results from biopsy. Results Seven findings were suggestive of osteoporotic: 1. The compression of vertebral body was severe. 2. The lesion extended to the whole vertebral body was uncommon. 3. The location of the lesion was closed to the end plate of the vertebral body and the anterior and /or posterior of the vertebra was straight or concave. The posterior bone fragment can be seen. 4. Pedicles were normal. 5. No epidural soft tissue mass. 6. The vertebral vein was normal. 7. The bandilike or flakelike enhancement under the end plate. Another seven findings were suggestive of malignancy: 1. The compression of vertebral body was mild. 2. The lesion extended to the whole vertebral body was common. 3. The anterior and /or posterior of the vertebra cortex was convex. 4. Pedicles were involoved. 5:Epidural soft tissue mass was usually seen. 6. The vertebral vein was involved and disappeared. 7. The lesion was usually nodulus enhancement. Conclusion To distinguish malignant from osteoporotic acute vertebral collapses,the MRI findings of the morphology and the shape of the lesion postcontrast are useful in the differentiation of solitary acute vertebral collapses.

Objective To analyze risk factors for soft-tissue defects after surgery on leg trauma,to discuss methods for prevention of soft-tissue defects and its treatment.Methods A retrospective analysis was conducted on 217 cases of soft-tissue defects with bone exposure and / or internal fixation exposure after surgery on leg trauma from January,1999 to December,2012.Soft-tissue defects with various flaps were used in 201 cases,including neurocutaneous flap(89 cases),random flap(21 cases),free flap(75 cases),cross-leg flap(16 cases),and by skin grafting in 16 cases.For the 117 internal plate-fixated fractures,96 removed the plate and 21 cases did not remove the plate.For the 13 intramedullary nail fixations,4 cases of intramedullary nails were removed,9 cases were not removed.For the 56 cases of external fixation of the fractures,39 patients had unadjusted external fixation,17 cases re-adjusted external fixations.Results Of the 217 cases of soft-tissue defect after surgery on legs,201 cases were conducted flap surgery.The flap was completely necrosis in one case,and partial distal necrosis were in 14 cases,of which 6 cases healed after changing the dressing,5 underwent debridement and skin grafting,3 cases underwent flap surgery again.In cases of fracture patients,177 cases healed within 1 year,delayed union 23 cases,nonunion eight cases.Nonunion healing after bone grafting and re-fixation surgery.In 9 cases of uncontrollable osteomyelitis,6 patients underwent bone removal and bone transport surgery,3 patients underwent amputation.Conclusion Soft-tissue defects after surgery on leg trauma is a serious complication whose prevalence is associated,in a certain degree,with incorrect surgical time and methods.It is crucial for early repair of soft-tissue defects by using various kinds of proper flaps whenever soft-tissue complication occurs.In patients with early stage internal fixation,flap surgery without internal fixation removing is feasible if little soft-tissue defect,little exposed internal fixation and mild infection,otherwise it is necessary to remove internal fixation and re-fix by external fixation before flap surgery.

Objective　To distinguish benign from malignant multiple vertebral collapses.Methods　171 vertebral collapses (77 benign,94 malignancy) were studied in 58 patients with T1WI,T2/T2WI,contrast enhancement T1WI with fat saturation.Pathologic result was available in 16 vertebras,including 10 malignancy and 6 benign.The remaining patients were performed 3～6 months follow-up to confirm the final diagnosis.The following MR characteristics were reviewed:(1)The shape and distribution of abnormal signal intensity.(2)The shape of antero-or poster-border of compressive vertebral body.(3)Paravertebral soft tissue mass.(4)The change of lesions signal intensity on T1WI,T2WI and contrast enhanced MRI with fat saturation.(5)Signal intensity increasing ratio after contrast enhancement.Results　The malignant vertebral compression fractures showed as the punch or patchy low signal intensity on T1WI distributing anywhere in the compressive body and enhancement.It had the convex posterior cortex,pedicle involved,paravertebral soft tissue mass.The benign vertebral compression fractures showed as the band linear hypo-or-iso-intensity in end-plate,enhanced (acute fracture)or unenhanced(old fracture),retropulsion of posterior cortex,no pedicle involved and paravertebral soft tissue.Conclusion　The most important MR characteristics for differentiation of malignant or bengin vertebral compression are the shapes and distributions of the abnormal signal intensities of vertebral collapses.The contrast enhancement T1WI with fat saturation is helpful for imaging diagnosis.

Adult ; Giant Cells ; pathology ; Humans ; Lung Diseases, Interstitial ; pathology ; Male ; Pulmonary Fibrosis ; pathology

Objective To evaluate serum organochlorine pesticides and residues levels in breast cancer pa-tients between the seriously and lightly earthquake-striken areas of Tangshan. Methods 93 patients of breast cancer from seriously earthquake-striken areas and 65 patients from lightly earthquake-striken areas were selected as study subjects,which serum organochlorine pesticides (DDTs and HCHs) levels were detected and compared with gas chromatography/electron capture. Results Serum organochlorine pesticides and residues levels in 158 patients be-tween the seriously and lightly earthquake-striken areas of Tangshan were not normal distributed. The order of detec-tion rate of HCH isomer in breast cancer patients between the seriously and lightly earthquake-striken areas were β-HCH>δ-HCH >α-HCH >γ-HCH. The orders of detection rate of DDT isomer in breast cancer patients between two areas of Tangshan were PP'-DDE > PP'-DDT > OP'-DDT > PP'-DDD. The serum levels of α-HCH,β-HCH, PP'-DDE and PP'-DDD in breast cancer patients between the seriously and lightly earthquake-striken areas were statistically different. Conclusion The levels of organechlorine pesticides and residues in serum with high detection rate in seri-ously earthquake-striken area are higher than that in lightly earthquake-striken area. It is likely that there is an asso-ciation with a large number of organechlorine pesticides sprayed.

Objective To investigate the distribution of etiological agents in children with asthma exacerbation in Chongqing during 2013 .Methods Four hundred and forty seven cases of hospitalized children with asthma exacerbation in 2013 in Children′s Hospital of Chongqing Medical University were retrospectively analyzed in SPSS19 .0 software .Results Among the 447 children with asthma exacerbation ,the percentage of bacteria was 43 .8% ,streptococcus pneumonia(SP)(25 .5% ) was the most common bacteria .Among the 25 cases with bacteria culture of bronchoalveolar lavage ,the positive rate was 44 .0% ,and the difference to sputum culture was not significant (P>0 .05) .The positive rate of 7 common respiratory viruses was 27 .3% ,RSV accounted for 18 .8% ,and it was the most common virus .The virus infection rate was higher in the groups below one years old ,and compared each groups′virus detection rates ,the difference was significant (P< 0 .05) .The positive rate of mycoplasma pneumoniae was 23 .5% ,chlamydia pneumonia was not detected .Conclusion Asthma exacerbation in children is closely related to respiratory infec‐tion .Bacteria detection rate was high in all ages ,which suggests that bacterial infection is an important factor in asthma exacerbation that can′t be ignored .