Building a contemporary hospital management system is inevitable in the reform and development of public hospitals in China.With a background introduction to public hospital reform in major countries and China,this article named the goals and analyzed the main problems in the establishment of a contemporary hospital management system.On such basis,the authors proposed the roadmap to establish such a system.

Establishing a corporate governance structure is an important goal in this round of public hospital reform.The “group plus corporate governance” model in Zhenjiang is highly typical and significant for building such a structure.This paper introduced the main measures of the group,analyzed the main problems found and proposed policies correspondingly.

The public hospital non-administration action is a strong power push to deepen the public hospital reform, also as an important goal of the institution reform, which has great significance. It introduces the goal of public hospital administrative, analyzes the key problems to be solved in the process of administration and puts forward the concrete path to the administration.

Starting from the experiment of Zhenjiang Rehabilitation Group in establishing a tightly-organized medical association,the authors detailed the practices and outcomes of the group in deepening the system and mechanism reforms,promoting the hierarchical medical system,and other reforms of public hospitals.Key roadblocks and causes were identified,with reform measures proposed as well.

The authors described the hospital group reform made by Jiangsu Kangfu Medical Group,and its main actions taken and initial success in public hospital organizational structure.Based on such studies, they recommend further clarification of the rights and responsibilities, for sectional integration;appropriate adjustment to update the supervision mechanism;building of the appointment system to speed up personnel system reform.

This paper introduced overseas experiences and theories of health systems in view of the ongoing medical and health system reform in China.It proposed the super health ministry reform,justified its necessity,and clarified key issues of such a reform,in addition to discussing how to improve the system of macro-health.

Objective To explore the exercise risk of urban residents aged18 to 65 years old.MethodsHealth screening and cardiovascular risk stratification were performed among adults18 to 65 years old in 2010by using exercise risk assessmentrecommendedbyAmerican College of Sports Medicine.Result A total of15 498 subjects were recruited 9293 males and 6205 females,mean age (44.8 ±11.1) years,8929(57.6％ ) in the lower risk group,5323(34.3％ ) in the moderate risk group,and 1246(8.1％ ) in the higher risk group.The proportion of those in the higher risk group was increased with age.Conclusion Risk assessment and Physical Activity Readiness Questionnaires should be used before physical activity programme is initiated,especially in middle aged or elderly people.

OBJECTIVETo verify the pharmacological hypothesis of prescriptions by studying the targeted distribution of major components in stewed rhubarb in the rat model with acute pancreatitis (AP).

METHODNormal SD rats (control group, n = 5) and the AP model induced with intraperitoneal cerulein (model group, n = 5) were taken as the experimental objects. Rats of the two groups were orally administered with stewed rhubarb granules (20 g x kg(-1)). Their heart, liver, spleen, lung, kidney and pancreas were collected two hours after the administration. Such constituents as emodin, chrysophanol, physcion, rhein and aloe-emodin and their concentrations in each tissue homogenate were detected by high performance liquid chromatography-mass-mass.

RESULTAloe-emodin and physcion in stewed rhubarb whose concentrations in liver and kidney of normal rats were higher than that in pancreatic tissues, while the distribution spectrums and concentrations of the remaining components in pancreatic tissues had no significant difference with that of other organs. The concentrations of emodin, aloe-emodin, rhein and chrysophanol in stewed rhubarb in pancreatic tissues of the AP model group were higher than that in other tissues and organs, while their concentrations in pancreatic, renal and splenic tissues were notably higher than that in the normal group.

CONCLUSIONIn the conditions of AP, effective components in stewed rhubarb show a targeted distribution feature in pancreas, which provides experimental basis for the pharmacological hypothesis of prescriptions.

Acute Disease ; Animals ; Anthraquinones ; pharmacokinetics ; pharmacology ; therapeutic use ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacokinetics ; pharmacology ; therapeutic use ; Male ; Organ Specificity ; Pancreatitis ; drug therapy ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rheum ; chemistry

Objective To learn the relationship and operating mechanism between medical staff's loyalty and patient satisfaction.Methods Medical staff and inpatients of a tertiary hospital in Nanjing were sampled at a 1:2 ratio for study,with 840 questionnaires released and 269 valid questionnaires recovered;medical staff service quality as perceived by inpatients served as the intermediate variable,with Mplus7.0 used to build a structural formula model for an empirical study of the relationship between staff loyalty and patient satisfaction.Results Staff loyalty exerts certain positive influence on patient satisfaction and staff service quality ( P < 0.001 ); service quality also exerts some positive influence on patient satisfaction (P<0.001);staff loyalty indirectly exerts positive influence(P<0.001)via the service quality as perceived by patients(mediation effect value 0.364 > direct effect value 0.143).Conclusions Structural formula model can reveal the relationship and extent of the influence of staff loyalty on patient satisfaction.This indicates that hospitals should enhance the loyalty,medical competence and communication skills of their medical staff for higher patient satisfaction.

Objective To investigate the relationship of stress hyperglycemia,cystatin C and estimated glomerular filtration rate (eGFR) with short-term prognosis in elderly patients with acute myocardial infarction.Methods 242 consecutive patients with acute myocardial infarction were divided into two groups according to age:the elderly group (n=182),and the non elderly group (n=60).The clinical data including cystatin C (Cys C),eGFR and stress hyperglycemia levels were collected.The major adverse cardiovascular events (MACE) were observed during hospitalization and 30 days after discharge.Results The incidences of stress hyperglycemia,the levels of creatinine,Cys C and brain natriuretic peptide (BNP),as well as the total MACE were higher and eGFR was lower in elderly group than in non-elderly group (all P＜0.05).Cys C level was positively correlated with age,body mass index and levels of creatinine and BNP (all P＜0.05),and negatively correlated with fasting glucose and eGFR in elderly group (both P＜0.05).The eGFR was positively correlated with body mass index (P＜0.05),and negatively correlated with age,creatinine and BNP levels in elderly group (all P＜0.05).Logistic regression analysis indicated that stress hyperglycemia [OR=1.871,95％CI:1.071-3.269,P=0.03],Cys C [OR=7.093,95％CI:2.261-22.249,P=0.00] were the independent risk factors for MACE.Conclusions Cys C level and eGFR can predict the early renal dysfunction and its prognosis in elderly patients with acute myocardial infarction.The incidence of stress hyperglycemia is higher in the elderly,and stress hyperglycemia and Cys C level are the independent risk factors for MACE.