Objective: To rationally reduce the fees and improve the development of large public hospitals. Methods: Analyze the relationship among the fees, hospital economic activity and medical treatment price mechanism in large public hospitals based on resource dependence theory. Results: Price control can not effectively control the costs. Conclusion: Medical price mechanism reform should in the direction of medical system reform, avoid the “quantity success” in large public hospitals, strive for patients with basic medical health institutions; then it should adequately embodies the value of technical work value of medical project and stimulates the initiative of the doctor.

The present paper reviewed the recent researches on the toxicity and health effect of phthalate in the following four aspects: animal toxicology, population epidemiology, people exposure, and safety standard, moreover, some critical problems which should be studied as soon as possible were proposed.

ObjectiveTo introduce a rapid and stable rat model of middle cerebral artery occlusion (MCAO). Methods32 Wistar male rats were used to induce focal cerebral ischemia according to Longa's method. The main difference from Longa's was to introduce a nylon suture into the cervical internal carotid artery without ligation the pterygopalatine artery (PPA). Regional cerebral blood flow (rCBF), neurological deficit, brain water content, red tetrzolium (TTC) stain and pathology were evaluated in all rats.ResultsThe operation proceeded about 15 min after anaesthesia. Rats after operation presented severe neurological deficits companied with rCBF decreases. There were significant increases of brain water contents in ischemic brain regions. TTC staining showed infarct areas and histological examinations revealed remarkable astrocyte swelling and neuronal necrosis.ConclusionInducing rat MCAO without ligation of PPA could produce reliable ischemic changes,with the advantage of shortening operation time.

Objective To evaluate the significance of the treatment of intra- and extra- hepatic recurrent stones through the subcutaneous jejunal loop. Methods The authors respectively analyzed 24 cases of intra- or extra- hepatic recurrent stones and/or acute cholangitis treated through the subcutaneous jejunal loop from January 1989 to January 2003. Results Of the 24 cases, 10 cases (18 times) of acute cholangitis received drainage through the subcutaneous jejunal loop and their symptoms relieved (18/18); 14 cases (17 times) of recurrent intra- and extra- hepatic stones received selective drainage placement through the subcutaneous jejunal loop. The extra- or intra- hepatic stones were removed under choledochoscope through the subcutaneous jejunal loop, the stone clearance rate being 79.2% (19/24). Conclusions It is a convenient, minimally invasive, and effective method to treat intra- and extra- hepatic recurrent stones through the subcutaneous jejunal loop.

To study the determination method of cholesterol in human serum by Coulometric titration. METHODS: The titration was carried out in an electrolytic solution containing 1 mol.L-1 potassium bromide and glacial acetic acid (1∶3). Bromine was electrogenerated at the anode and cholesterol reacted with bromine with a value of reactional electrons (n) as 2. RESULTS: The ranges of recovery for 0.115 mg to 0.459 mg of cholesterol were from 93.9% to 105%, and the average recovery was 100.3%. The relative standard deviation in all applied analysis was less than 1.5%. The accuracy of the method was also assessed in comparison with the results obtained by the enzymatic method used clinically. CONCLUSION: The method proposed is simple, rapid and accurate, and is suitable for the determination of cholesterol in human serum samples.

The projections from the nuclei of the brain stem to the cerebellar nuclei were studied with the horse-radish peroxidase (HRP) retrograde transport method. The following nuclei in the brain stem were labelled with HRP;the inferior olivary nucleus, the lateral reticular nucleus, the nucleus reticularis tegmenti pontis, the pontine nuclei, the spinal trigeminal nucleus, the principal sensory trigeminal nucleus, the mesencephalic nucleus of trigeminal nerve, the spinal vestibular nucleus, the medial vestibular nucleus, the nucleus reticularis medullae .oblongatae pars ventralis, the nucleus reticularis gigantocellularis, the nucleus reticularis paramedianus, the raphe nucleus pontis, the raphe nucleus obscurus, the raphe nucleus magnus, the perihypoglossal nucleus, the locus caeruleus, the gracile nucleus, the cuneate nucleus, and the external cuneate nucleus.It was found that there are different patterns for the cerebellar nuclei to receive the afferent fibers from the brain stem. The number of the labelled nuclei of the brain stem projecting to the cerebellar lateral nucleus is similar to that projecting to the interpositate nucleus, while the number of the labelled brain stem nuclei projecting to the cerebellar fastigial nucleus is smaller than the above two. The topographic organization of the projections from the inferior olivary nucleus to the cerebellar nuclei was discussed.

Based on the study of cost accounting of several large public hospitals in Guangdong Province according to the New Hospital Financial Regulations, the paper presents a detailed operational and standardized cost accounting rules, including the specific processes and methods of cost accounting.It has laid a solid foundation for cost accounting, financial management and medical service pricing in hospitals.

Objective To study kidney transplantation in the aged and its perioperative management. Methods Scrutinized screening of heart,lung and liver were carried out before renal transplantation for 29 patients,aged 65～84.Color Doppler B type ultrasonic inspection was used to determine the status of arteriae iliaca externa and arteriae iliaca interna.Tissue match included HLA and PRA measurement.Warm ischemia time of donor kidney was within 5 minutes and cold ischemia time 10 hours.The dose of MP was under 2.0 g during the period of operation and the immunosuppressive regimen was CsA or FK506+MMF+Pred.The general condition,blood electrolytes,whole blood CsA or FK506 concentration and immune index were monitored. Results There were 4 cases of AR,1 cases of FK506 toxicity and 1 case of lung infection.All these 6 patients were cured.1 kidney graft was removed because of thrombogenesis of renal artery.Up to now,the other 28 have been surviving with the graft functioning well for 1 to 5 years. Conclusions Abide to the indications of kidney transplantation,donor kidney of good quality and well tissue match were important in the elderly patients.With comprehensive monitoring and adequate management,kidney transplant in old patients can achieve sa tisfying outcome.Rational application of immunosuppressants and effective long term follow up are major factors for long term allograft survival.

Objective To investigate the effect of different pharmacotherapy after lacrimal passage plastic laser operation. Methods Divided 90 patients (103 eyes) with nasolacrimal duct obstruction into group A (33 eyes), group B (36 eyes) and group C (34 eyes) randomly, each group consisted of 30 cases. Tetracycline cortisone ophthalmic ointment (TCO) was used to perfuse lacrimal duct in the end of the operation in group A, while TDO was used in group B and group C. In the first three postoperative irrigation, TDO was used only in group C, there are no no ointment during the course of irrigation in the other two groups. Followed-up survey for 3 months, evaluated the efficacy of the treatment in 3 groups. Results The therapeutic efficacy was significant better in group B than in group A (P

Objective To evaluate the best experimental technique with high-sensitivity and specificity for enhancing positive rate of syphilis screen test and preventing the blood dissemination of this disease.Methods Comparison of the results of TP-ELISA,TRUST and TPPA methods of syphilis examination was performed.Results Using three methods to exam 43,323 samples,299 samples were for positive syphilis.Among them, 294 positive samples with the ELISA method,the positive rate of syphilis test was 98.33%(294/299):92 positive samples with TRUST method,the positive rate only 30.77%(92/299);239 positive samples with TPPA method,the positive rate 79.93%(239/299).Conclusion TP-ELISA method with high sensitivity is suitable for the instrument standardization and data preservation,which is an ideal method for blood screen test of syphilis.For guarantee of blood safety and conventience and economic benefit of blood syphilis screen test, it is the best way to use both TP-ELISA and TRUST methods.The specificity of TPPA method is perfect, which is suitable for confirmation test of syphilis positive samples.