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.

The paper described practices in QC management pathway of death cases of the hospital.These refer to intensive education,clarification of access standard,death cases quarterly readings and administrative investigation,strict supervision among others.Authors pointed out that QC pathway can improve quality of care significantly,yet QC pathway calls for fair accountability,systemic care for patient safety,and all-staff involvement in QC improvement.

Objective Exploration of TSH, FT3, FT4 changes in critical condition prior to death.Methods 84 patients that were anti-tumor therapy acceptable and not associated with the treatment of thyroid disease in patients with terminal tumors. Age from 24 to 85-year-old, male 56, female 28. The use of SELDI technology (surface-enhanced laser description / ionization time-of-flight mass spectrometry protein chip technology) checks to M/Z for the 11 100 + H～11 900 + H peak of the cluster, divided into the positive group for critically ill patients with early warning protein (LGT) and the negative group for it. All patients were given TSH, FT3, FT4 inspection. The results were statistically analyzed. Results TSH, FT3, FT4 in the LGT positive group was significantly lower than in the negative LGT group. There was no correlation between TSH,FT3 and FT4 in the LGT positive group;In the negative LGT group FT3 and FT4 had a positive correlation,and FT3 and TSH no relevance. Conclusion Thyroid function is normal in the stage of cancer patients stable condition. Possible pituitary-hypothyroidism may occur as the disease advances to the end or before death.This may be an important factor causing the acceleration to the death of the patients. However, the cause and effect between this phenomenon and the early warning of protein fingerprint group(LGT) is still not clear. In critical condition checking thyroid function and render supplementary amount of thyroid hormone in accordance with the checking results may be beneficial.

Objective To study the effect of herbal reyanbao combined with rehabilitation training on the rehabilitation of patients with lumbar disc herniation.Methods 120 cases with lumbar disc prolapse as the research object from January 2015 to December 2016 in Wuhan integrated traditional Chinese and western medicine hospital were divided into two groups(the control group and the observation group).The control group were treated with routine conservative+conventional nursing plan, and the observe group were given herbal reyanbao combined with rehabilitation training.Clinical data were compared in the two groups.Results The clinical effect and rehabilitation degree in the observation group were better than those in the control group, the difference was statistically significant(P< 0.05).Conclusion It can help patients with lumbar disc herniation recover as soon as possible which herbal reyanbao combined with rehabilitation training were used on the rehabilitation of patients, and it is worthy of application.

ObjectiveTo develop a stable model of focal cerebral infarction in rat to study the curative effect of neural stem cells transplantation.MethodsThirty-seven rats were selected which were divided into two groups in random, experimental group and control group. The focal infarction model was developed by the ligation of the left middle cerebral artery followed by the ligation of the ipsilateral common carotid artery and the temporary clip occlusion of the contralateral common carotid artery for 1.5 h. The operation adopted minimally invasive craniotomy though temporal bone. The model was evaluated by examining the neurologic deficits, ink perfusion, TTC staining and Magnetic Resonance imaging.ResultsAll the rats were in good condition after the operation, the mortality rate was 6.25% after 4 weeks. Ink perfusion and TTC staining confirmed that the ischemia was confined to the cortex. The areas of infarction measured 83.52 mm3 by Magnetic Resonance imaging after 4 weeks.ConclusionA stable focal cerebral infarction model can be achieved by minimally invasive craniotomy. It is superior for its homogeneity of infarction volume and site, and its low mortality. It can be used for the study of transplantation of neural stem cells.

Objective To observe the morphology of ethanol-wet dentin surfaces and detect their nano-scale adhesion force (Fad) by atomic force microscopy (AFM) in order to explore the potential mechanism of ethanol-wet bonding in improving clinical dentin bonding effectiveness.Methods Dentin slices from human premolar roots were prepared into flat ones, polished, and then randomly divided into five groups.All the specimens were acid-etched, rinsed, and left moist.They were then treated with 100％ ethanol for 0s (control group), 20s, 60s, 3×60s, or stepwise ethanol application.Afterwards, each group was scanned for the morphology in air and the Fad was probed by AFM.One-way ANOVA followed by Tukey`s test was employed for multiple comparisons using SPSS16.0.Results Compared with control group, ethanol-wet dentine produced a less undulating and relatively smooth surface topography.Ethanol-wet protocol significantly decreased the value of Fad in the experimental groups (P<0.001), in which 3×60s and stepwise ethanol application groups showed the lowest Fad.No difference was found between these two groups (P>0.05).Conclusion When using AFM in air, ethanol-wet protocol with longer time can produce a less undulating and relatively smooth surface topography and decrease the Fad, whichindicates that the water saturated in dentin matrix was replaced more thoroughly by longer ethanol application time.This will benefit hydrophobicity of the dentin bonding interface.

Objective To evaluate clinical and radiographic outcomes associated with total hip arthroplasty (THA) using metal-on-metal prosthesis with large diameter femoral head.Methods From October 2007 to December 2007,41 patients (49 hips) underwent large diameter femoral head metal-on-metal THA in our hospital were involved in this study.Clinical outcomes measures were Harris score,hip range of motion and incidence of complications.Abduction angle and anteversion angle of cup were measured on radiological films.The radiolucent line and osteolysis around the prosthesis were also recorded.Results Thirty-nine patients (47 hips) were followed up at least 2 years.The average Harris hip score had improved from (43.8±13.1) points preoperatively to (92.0±5.4) points at final follow-up.All the patients had attained satisfactory results.No late complication happened.For the rang of motion at final follow-up:flexion of the hip had improved from 79.8° to 113.2°,abduction had improved from 20.9° to 40.2°,external rotation had improved from 12.0° to 30.8°.Radiological measurement showed the mean abduction angle of cup was 39.5°±4.9°,the mean anteversion angle of cup was 14.5°±2.1°.No radiolucent line and osteolysis were found after THA.Conclusion The short-term effects of THA using metal-on-metal prosthesis with large diameter femoral head is encouraging,especially for young patients.

0.05)in healthy volunteers.

Objective To explore the expression of EphB4 and VEGF in esophageal cancer tissues and their relationship with microvessel density (MVD ) ,and analysis the curative effect of postoperative esophageal cancer radical under thoracoscope . Methods Theexpression of EphB4 and VEGF was detected by immunohistochemistry in tumor specimens from 76 cases of esopha-geal squamous cell carcinoma and paratumor normal specimens ,used CD34 as marker to count MVD .According to the situation of expression of EphB4 and VEGF ,we analysis their relationship with lymph node metastasis rate ,recurrence and 5-year survival rate . Results The positive expression rate of EphB4 and VEGF in cancerous tissue (57 .89% and 61 .84% ) ,were significantly higher than that in tissue adjacent to carcinoma(0 and 7 .89% )(P<0 .05) .The positive expression rate ofEphB4 and VEGF in high MVD values of patients (67 .44% and 76 .19% ) ,were significantly higher than thatin low MVD values of patients (45 .45% and 44 .11% )(P<0 .05) .The positive expression rate ofEphB4 and VEGF in the patientswith lymph node metastasis group and associ-ated with recurrence ,were significantly higher than that of group without lymph node metastasis and group without recurrence (P<0 .05) .The positive expression rate of EphB4 and VEGF in patients of greater than or equal to 5 years of survival rate(45 .00% and 45 .45% ) ,were significantly lower than in patientsof Less than 5 years of survival rate (80 .36% and 85 .19% )(P<0 .05) .Conclu-sion EphB4 and VEGF are highly expressed in esophageal cancer tissue ,which may be closely associated withmicrovessel density , and lymph node metastasis ,recurrence and 5 years survival rate ;the curative effect of positive expression rate of EphB 4 and VEGF is poor .

To explore the dynamic state of traditional Chinese medicine (TCM) syndromes in acute ischemic stroke patients within 30 days of onset when treated with acupuncture, and to analyze the discrimination effects of the functions based on "decision trees" in identification of TCM syndromes of ischemic stroke.