Through a comparison of the differences between China and Australia in the models of hospital management and the roles of hospital managers, the paper expounds the specific features of the model of “decentralized powers” and “professional presidents” and the model of “centralized powers” and “expert-turned presidents”. It argues that under the pressures of both internal and external changes, including rapid socioeconomic development, the deepening of the health care reform, the effect of China's accession to the WTO on the medical and health industry, the development of a contingent of professional health care managers in China has become an inevitable trend.

Objective This article aimed to describe an interactive segmenting method for serial anatomical cross-sectional image of Chinese Digital Human(CDH) using commercially available software,Photoshop CS(Adobe;San Jose,CA,Corel KnockOut 2.0 plug-in) and Matlab 7.0(Math Works;Worcester,MA). Methods First,the interesting region was segmented from the image interactively utilizing the Knochout menu of Adobe Photoshop which had a powerful masking function.And then smooth contour was acquired precisely by morphological operation function and edge detection operator(the Sobel method) in Matlab. Results The segmentation and classification of bone,muscle and main vascular nerve were fulfilled successfully and the smooth contour lines were acquired with precise details and accurate localization.Conclusion This local clustering segmenting method might segment and classify the colored image of Chinese Digital Human quickly and precisely.

Objective: To investigate the therapeutic effect of oat β-glucans on serum lipid levels of rats with experimental hyperlipemia. Methods: Rats were fed on high fat forage for 3 weeks to establish hyperlipemia models, then the model rats were orally given oat β-glucans at doses of 133, 266 and 533 mg/(kg · d) separately. At the same time, there were 3 control groups including chitosan ligosaccharide[200 mg/(kg · d)], normal, and high blood lipid (model rats fed with distilled water). Serum levels of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were assayed in rats of all groups and the results were compared. Results: β-glucans obviously decreased the levels of TC and LDL-C and increased HDL-C in rat hyperlipemia models. The reduction of serum lipid level in 4-week β-glucans treatment rats was more obvious than that in 3-week β-glucans treatment rats. Besides, β-glucans showed an obvious dosage dependent effect in reducing serum lipid level without adverse effect. Oat β-glucans had a better lipid-reducing effect than ligosaccharide did. Conclusion: Oat β-glucans can obviously decrease serum lipid in rats with hyperlipemia.

ObjectiveTo investigate the effect of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.MethodsNinety-six ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr weighing 50-80 kg undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate short-term sleep quality in hospital.The patients were divided into 4 groups according to the types of preoperative sleep disturbance ( n =24 each):group Ⅰ no sleep disturbance;group Ⅱ long-term sleep disturbance; group Ⅲ acute short-term sleep disturbance; group Ⅳ long-term + acute short-term sleep disturbance.Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with iv infusion of remifentanil and propofol.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 30-35 nun Hg.Controlled hypoteasion was performed with nicardipine,MAP was maintained at 50-70 mm Hg and HR at 60-90 bpm during operation.The patients received iv flurbiprofen 50 mg at 15 min before the end of operation for postoperative analgesia.When VAS score was more than 3 during the fnrst 6 h after operation,flurbiprofen 50 mg was given iv as rescue analgesic.ResultsThe incidence of rescue analgesic administered after operation was significantly larger in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesic administered during the first 6 h after operation between groups Ⅱ and Ⅲ.ConclusionPreoperative sleep disturbance has adverse effect on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

Objective To evaluate contrast-enhanced MRI sequence for diagnosing cholangiocarcinoma.Methods Cholangiocarcinoma was confirmed by surgery and pathology in 17 cases,all underwent preoperative CT and MRI T1-VIBE scan with contrast-enhancement sequence.We retrospectively analyzed imaging signs in two scan methods,including lesion position,number,size,enhancement degree,expansion degree of bile duct,invasion of adjacent artery and portal vein,and portal vein tumor thrombosis.The differences on detecting lesions between two methods were compared.Results The contrast to noise ratio (CNR) between tumor and liver tissue in MRI T1-VIBE images was obviously superior to that in CT images.Peripheral lesion boundary in T1-VIBE enhanced images was clearer than CT.One hemorrhage lesion was shown in T1-VIBE images,and tumor thrombosis was visible in the left branch of portal vein in 1 case.Bile duct wall lesions in T1-VIBE enhanced images was more evident than CT in hilar cholangiocarcinoma and extrahepatic cholangiocarcinoma.The VIBE enhanced images find more lesions in 9 out of 11 multiple focus cases,compared with CT images.Conclusions Contrast-enhanced MRI T1-VIBE sequence can give more comprehensive and clear evaluation on cholangiocarcinoma,and has important clinical diagnostic values.

Objective To establish a 3D atlas of Letournel-Judet classifications of acetabular fractures which provides remote access on the web through hypertext markup language (HTML) and virtual reality modeling language (VRML) for efficient remote diagnosis. Methods Firstly,different Letournel-Judet classifications of acetabular fracture were simulated based on 3D reconstruction models of healthy volunteers via Mimics software.The files of VRML format were exported after geometry modeling.Secondly,The.wrl files were edited by adding nodes of Sensor,Route,and Script to the files to make the static scene respond to users' interaction.Finally,the homepage of 3D atlas was established with the Dreamweaver software.Results The 3D atlas of Letournel-Judet classifications of acetabular fractures was established which can be accessed online.These virtual worlds can be browsed via the Internet and hyperlinked with the World Wide Web. Conclusion The 3D atlas of Letournel-Judet classifications of acetabular fractures can be easily and convenicntly used by surgeons for consultation in clinical diagnosis of an acetabular fracture.

Objective To investigate the effects of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.Methods Ninety-six ASA Ⅰ or Ⅱ patients of both sexes (aged 20-60 years and weighing 50-80 kg) undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate the long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate the short-term sleep quality in hospital.The patients were divided into four groups according to the types of preoperative sleep disturbance (n =24 each):no sleep disturbance (group Ⅰ),long-term sleep disturbance (group Ⅱ),acute short-term sleep disturbance (group Ⅲ),and long-term + acute short-term sleep disturbance (group Ⅳ).Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with intravenous infusion of remifentanil and propofol.Then the patients received endotracheal intubation and mechanical ventilation.The end-tidal pressure of carbon dioxide was maintained at 30-35 mm Hg.Controlled hypotension was performed with nicardipine,and the mean arterial blood pressure was maintained at 50-70 mm Hg and heart rate at 60-90 bpm during operation.The patients received intravenous injection of flurbiprofen 50 mg 15 minutes before the end of operation for postoperative analgesia.When the visual analogue scale score was more than 3 during the first 6 hours after operation,flurbiprofen 50 mg was given intravenously as rescue analgesia.Results The incidence of rescue analgesia administered after operation was significantly greater in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and greater in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesia administered during the first 6 hours after operation between groups Ⅱ and Ⅲ.Conclusion Preoperative sleep disturbance has adverse effects on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

Lu's acupuncture was found by two senior doctors, Lu Shou-yan and Zhu Ru-gong. As one of large schools in acupuncture academic circles in our country, Lu's acupuncture has relatively complete academic thought and theoretical system, and unique characteristics of clinical diagnosis and treatment. Doctor Su Zhao-jia studied under doctor Lu Shou-yan and inherited Lu's academic thought and diagnostic and therapeutic techniques. In decades of clinical practice, doctor Su adhered to Lu's acupuncture's treatment idea, treated diseases under the guidance of meridian theory and on the basis of syndrome differentiation, paid attention to acupuncture manipulation and accumulated relatively abundant clinical experience in applying acupuncture to composite treatment of senile vaginitis.

Iatrogenic gastrointestinal perforation is one of the severe adverse events of endoscopic therapeutic procedure. For acute iatrogenic perforation,management by endoscopic techniques is a simple and rapid modality to close the perforation with minimal invasiveness and avoiding the traditional surgical trauma. Endoclips,suture with special instruments,covered stents,degradable sheets combined with tissue adhesive,and combined endoscopic techniques such as snares combined with endoclips,are the major endoscopic therapeutic modalities for closure of iatrogenic gastrointestinal perforation. In this article,the current status and progress of endoscopic management for acute iatrogenic gastrointestinal perforation were reviewed.

OBJECTIVETo explore the molecular mechanisms of main active ingredients of Siwu decoction analogous formulae for treating primary dysmenorrhea of gynecology blood stasis syndrome by network pharmacology study, and to investigate the correlations between multi-compounds, multi targets and multi pathways.

METHODMajor active compounds from Siwu decoction analogous formulae, including ligustilide, butylidene phthalide, senkyunolide, ferulic acid, gallic acid, peoniflorin, jioglutin A, catalpol, transanethole, zingiberone, commiphoric acid, eugenol, isorhamnetin-3-O-neohesperidoside, wulingzhic acid, alpha-cyperone, cyperene, costunolide, costic acid, tetrahydropalmatine, protopine, amygdalin, 24-methylene cycloartanol, oleic acid, linoleic acid, 3-p-coumaroylquinic acid, hydroxysafflor yellow A, coptisine, berberine, jatrorrhizine, baicalein, baicalin, wogonin were collected to build component-protein networks based on PharmMapper database. The targets information access was used to construct and visualize components-targets-pathways network model using the kyoto encyclopedia of genes and genomes (KEGG) pathway database and Cytoscape software.

RESULT AND CONCLUSIONSerine threonine protein kinases play an important role in the process of cells. They were potential targets in the effect of Siwu decoction analogous formulae. The effect of main active ingredients involved 51 the pathway. Besides the same ones, Shaofu Zhuyu decoction had more effect on lipid metabolism, Xiangfu Siwu decoction on amino acid metabolism pathways, Taohong Siwu decoction on carbohydrate metabolism, while, Qinlian Siwu decoction on ErbB, VEGF signal transduction pathway. Siwu decoction and its derived formulae not only had common targets and pathways, but also had their own emphasis. This reflected the formulae effect mode of multi-ingredients, multi-targets and multi-pathways. It may provide clues to deeper study of molecular mechanism of Siwu decoction analogous formulae action.

Drugs, Chinese Herbal ; chemistry ; pharmacology ; Dysmenorrhea ; drug therapy ; genetics ; metabolism ; Female ; Gynecology ; Humans ; Medicine, Chinese Traditional ; methods ; Signal Transduction ; drug effects ; genetics