Objective To compare the clinical effect of remifentanil and dexmedetomidine on controlled hypotension during endoscopic sinus surgery. Methods Forty patients undergoing endoscopic sinus surgery were randomly divided into group R and group D, 20 in each group. All patients received controlled hypotension when the surgeons began to sterilize the nasal cavity for the purpose of maintaining the MAP at 60 ~ 70 mmHg. Group R received remifentanil 1μg/kg over 1 minute, followed by 0.2 to 0.4μg/kg per minute infusion during maintenance, whereas group D received dexmedetomidine 1μg/kg over 10 minutes, followed by 0.2 to 0.7μg/kg per hour during maintenance. At the moment of pre-induction(T0), incision(T1), 30 min(T2) and 60 min(T3) after incision and 10 min(T4) after end of controlled hypotension, MAP and HR were measured. Quality of the surgical field, blood loss and extubation time were recorded. Sedation and postoperative pain were assessed on arrival at the PACU. Results The goals for the MAP level were achieved and the surgical field quality was ideal in both groups. The MAP and HR values at T1~ T3 were significantly lower than those at T0 in both groups (P < 0.05). There were no significant differences in the MAP or HR values between the groups at each time point (P>0.05). No significant difference was founded between the groups in the Fromme operative field score and blood loss (P > 0.05). The extubation time was significantly shorter in group R than in group D(P<0.05). The sedation score in the PACU was significantly lower in group R than in group D(P<0.05), while there were no significant differences in postoperative pain between the groups(P<0.05). Conclusion Both remifentanil and dexmedetomidine are safe agents for controlled hypotension and are effective in providing satisfactory surgical fields during endoscopic sinus surgery. However , remifentanil is advantageous in time for extubation and complete consciousness from anesthesia and therefore it may have the advantage of fast track anesthesia.

AIM: To compare the difference between medicinal and edible lilium brownii. METHODS: GC method was used for the determination of stigmasterol (the reference standard) in medicinal and edible Lilium brownii. And pharmacology experiment on stigmasterol was carried out. RESULTS: Stigmasterol had the antiinflammatory and anti-coughing effect. It represented the main effect of Lilium brownii. It was reasonable to be the reference standard. There were obvious differences in the stigmasterol content of medicinal and edible Lilium brownii. The stigmasterol content of medicinal Lilium brownii was much higher than that of the edible. CONCLUSION: Edible Lilium brownii can not be applied to clinical.

Objective To investigate the effect of nano carbon tracer for protecting parathyroid function in the surgery of thyroid cancer.Methods A total of 178 patients with thyroid cancer admitted in our hospital from Jun.2014 to Mar.2016 were collected and divided into the control group and the observation group according to the random number table method,89 cases in each group.The control group received routine surgery,while the observation group received nanocarbon suspension during surgery.The levels of serum parathyroid hormone and serum calcium in the 2 groups were measured at 3 days after surgery,and the patients with low parathyroid hormone,normal parathyroid hormone and low calcium were counted.Results The rate of ormal serum calcium in the observation group was 91.01％(81/89),significantly higher than 67.42％(60/89) in the control group (P＜ 0.05).The rate of normal parathyroid hormone in observation group was 94.38％ (84/89),significantly higher than 64.04％ (57/89) in the control group (P＜0.05).Conclusion The nano carbon tracer is helpful for protection of parathyroid function in the surgery of thyroid cancer.

The ongoing health reform is bringing reforms of public hospitals under spotlight in China, attracting growing attention onto its progress and roadblocks. Probing into the "three steps" of public hospital system reform in Wuxi, this article analyzed such a reform in the city. It described the measures and initial outcomes gained in such fields as the hospital trusteeship reform, the separation of hospital regulation from its administration, and the hospital board system. Citing the case of Wuxi No. 2 People's hospital as an example, the authors introduced the innovative efforts made in hospital internal mechanism, management innovation, medical service model, hospital connotation construction, and talents cultivation.

Objective To evaluate the safety of compound Qinghuang powder for myelodysplastic syndromes(MDS). Methods A total of108 patients with MDSwere collected, 60 patients were treated with Qinghuang powder(Qinghuang powder group)and 48 with compound Qinghuang powder(compound Qinghuang group). The treatment time of 3 months was as one course, and all the patients were treated for more than one course. The patients who developed adverse reactions in the Qinghuang powder group changed to receive compound Qinghuang powder. The adverse reactions were recorded during the treatment. Results The overall incidence of adverse reactions in the compound Qinghuang powder group was significantly lower than that in the Qinghuang powder group(18.75% vs. 41.7%; χ2=6.492, P<0.05). None in the compound Qinghuang powder group and 3 patients in the compound Qinghuang powder group developed moderate to severe adverse reactions. The incidences of various adverse reactions in the compound Qinghuang powder group were lower than those in the Qinghuang powder group, especially, lower limb swelling (4.17%vs. 25%;χ2=9.205, P<0.05) epigastric discomfort(18.75% vs. 41.67%; χ2=6.492, P<0.05). Twenty patients who developed adverse reactions in the Qinghuang powder group changed to receive compound Qinghuang powder. Among them, 5 patients (25%) maintained adverse reactions. The various adverse reactions after changing to compound Qinghuang powder were decreased, especially, facial swelling (10% vs. 30%; χ2=2.50, P<0.05), leg swelling (5%vs. 45%;χ2=8.533, P<0.05), and abdominal pain and diarrhea(10%vs. 30%;χ2=2.50, P<0.05). No patient developed liver or kidney dysfunction after the treatment with Qinghuang powder or Compound Qinghuang powder. Conclusion Compound Qinghuang powder is safer than Qinghuang powder in the treatment of MDS.

In response to such setbacks as inefficient medical service,costly human resources and low rate of return on capital,due to the pursuit ofMega hospitalsand extensive management of hospitals,Wuxi No.2 People's Hospital introduced the delicacy management chain to improve its management and service.This article studied its practice of delicacy management chain as follows.By means of the six gears of organization,clinic,outpatients,medical technicians,nursing,and logistics,the management chain pursues such management goals as flat management,attending-focused clinical medicine,centralized outpatient service,integrated medical examinations,vertical nursing management,and logistics outsourcing.These efforts are designed for the optimization of both scale and construction efficiency.

Objective To research the pharmacodynamics of lilium brownii Polysaccharide.Methods Five tests,including hypoxia tolerance test,serum content determination of SOD and MDA in mice,carbon clearance and weight determination of immune organ,content determination of serum hemolysin,and delayed-type hypersensitivity test were carried out to evaluate the main pharmacological indexes of lilium brownii Polysaccharide.Results Lilium brownii Polysaccharide can increase the hypoxia tolerance,anti-oxidation action and immuno-enhancing activity in mice.Conclusion Lilium browni Polysaccharide is one of the main active constituents of lilium brownii.

The authors probed systematically into the delicacy management measures adopted by the hospital in its internal mechanism reform, innovative medical service model, human resource optimization, and its performance appraisal system reform. Discussions in the paper include such topics as flat management for hospitals,intensification,centralization and integration in diagnose and treatment, as well as vertical nursing management, and the outsourced logistic services. The methods and paths to achieve these goals are summarized as “preciseness, accuracy, carefulness, and strictness”.

The reform of performance appraisal and salary system is key to public hospitals reform.This paper introduced practices of the factor performance and salary system reform based on the Balance Scorecard in hospitals.It established a four-dimension performance appraisal structure,a motive salary allocation model covering all members of a hospital.This would help build the performance appraisal and salary allocation system meeting present needs of public hospitals in China.

Talents are core competitiveness of a hospital.In view of the nature of long and slow development cycle of medical talents,Wuxi No.2 People' s Hospital has innovated aTalent-tree program.This program develops talents by categories and stages,in the model oftree root-tree trunk-tree crownto fit different stage needs of these people.The program features a categorized education mode to establish hierarchical individualized plan for the whole career.The hospital has explored a special pathway for talents development,for the purpose of providing talents to ensure sustainable and innovative growth of the hospital.