The index weight has very significant role in the performance evaluation system for the public hospitals’ financial governance. This paper employed the analytic hierarchy process associated with the Delphi method to determine the index weight based on the previous studies. The index of maximum weight is non-profit (0. 35), fol-lowed closely by financial responsibility(0. 18), asset performance(0. 18), financial performance and risk (0. 18), and the index of minimum weight is society satisfaction ( 0 . 06 ) . The index weight guidance and the practical index system application were also interpreted in order to really play the significant role during the performance evaluation for the public hospitals’ financial governance.

Objective To investigate the clinical efficacy of acupuncture plus Huayu Paishi Decoction (stagnation- eliminating and stone-removing decoction) in treating nephrolithiasis of qi and blood stagnation type.Methods Sixty patients with nephrolithiasis of qi and blood stagnation type were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture plus oral administration of Huayu Paishi Decoction and the control group, oral administration of Huayu Paishi Decoction alone. The symptoms and signs were scored and renal hydrops was measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 76.7% in the treatment group and 56.7% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in the symptom and sign scores in the two groups (P<0.05). There were statistically significant differences in pre-/post-treatment symptom and sign score difference values between the treatment and control groups (P<0.05). There was a statistically significant pre-/post-treatment difference in renal hydrops volume in the treatment group (P<0.05). There was a statistically significant difference in pre-/post-treatment renal hydrops volume difference value between the treatment and control groups (P<0.05).Conclusions Acupuncture plus Huayu Paishi Decoction is an effective way to treat nephrolithiasisi of qi and blood stagnation type. It can markedly improve the clinical symptoms and reduce renal hydrops in the patients.

Objective To observe the effect of Fuyuan Capsule (FC) on vascular endothelial cell function of rats with qi deficiency and blood stasis.Method Forty-eight 16-month-old SD rats were equally randomized to 5 groups:FC group,positive control group (Qishen Capsule),model group and blank control group.Rat models of qi deficiency and blood stasis were induced by exertion,starvation and cold.The mice were given the drugs by gastric perfusion for 4 weeks.After treatment,endothelin (ET),6-keto-prostaglandin F_(1a) and nitric oxide (NO) levels were mea- sured.Results NO and 6-keto-PGF_(1a) levels were lower in the model group than those in the blank control group (P

[Objective]To evaluate the value of distraction osteogenesis for treatment of deformity of spine during development.Distraction osteogenesis could be used for patients with campylorrhachia,dwarfism eccyliosis of spine or those combined with thoracocyllosis and obliquity pelvis.[Method]According to the principle of Halo-pelvic distraction apparatus which was divided into two parts of halo and pelvic,the halo was 4-nail fixation and the pelvic was 2-nail fixation.The halo and pelvic were connected by 4 standing pillar.Through the daily extending of 4 standing pillar the curved spine was extended and stretched gradually.As a result,action of 3D correction of deformity of spine was achieved.[Result]Ten patients of this group were treated by this methods.The action of 3D correction and automatic correction of deformity were showed in 70~120 days distraction that the wedge-shaped vertebra changed into squareness,curved spine was stretched and rotatory vertebra was reduced.[Conclusion]Distraction osteogenesis is a minimally invasive surgery instead of internal fixation of spine for the treatment of deformity of spine during development.

[Objective]To report the records of 185 patients in whom severe scoliosis had been treated with preoperative halo-pelvic distraction and following total spine osteotomy and internal fixation.[Method]Preoperative halo-pelvic distraction was applied to all patients to reduce the severity of curvatures and make the following treatment possible.Then total spine osteotomy and internal fixation were performed to rectify the remained deformity of the spine.Halo-pelvic distraction was maintained during the operation and postoperatively to limit the mobilization of the patients.At one day after the operation,the patients were able to get out of bed,stand up and move around,making nursing care more convenient.[Result]Between 1983 and 2003,a total of 185 cases of severe scoliosis were treated by this approach and an average correction rate of 70.32% was achieved.Complete bone fusions were achieved at the cut ends of thc bone.The average loss of correction rate was less than 5 degrees.In the late stage of postoperative duration,rod release occurred in four cases and was resolved by second surgical intervention,showing no adverse effect on the clinical outcome.At one year postoperative infective complication occurred in one case and the patient fully recovered after the removal of the inserted device.X-ray examination confirmed good healing of the hone grafts.Root pain occurred in one case and the patient gradually recovered without any medical intervention.None of the rest patients had evidence of spinal cord or nervous system complications.[Conclusion]Halo-pelvic distraction instrumenation,in combination with total spine osteotomy,is an effective treatment modality for severe spinal curvatures.Halo-pelvic distraction can facilitate the operative procedure for those cases that can not be cured by application of single instrumentation or have difficulty in the insertion of the internal fixation device.The combined total spine osteotomy can further correct the spinal curves,reduce the burden of the fixafion device and avoid the occurrence of release or break down of the rods,eventually cure the severe scoliosis effectively.

Objective:To evaluate the quality and the effectiveness of therapeutic studies on chemotherapy and/or radiotherapy-induced oral mucositis published in Chinese journals by means of evidence-based medicine. Methods:Relevant papers were searched in Chinese Biological Medical Disc (CBMDisc)database and China National Knowledge Infrastructure(CNKI) database. Papers using randomized controlled trials (RCT) were identified and analyzed according to the international standards of evidence-based medicine. Results:There were totally 98 articles focusing on therapeutic studies of chemotherapy and/or radiotherapy-induced oral mucositis and only 22 of them met RCT criteria. Study design, diagnostic standards, therapeutic effects and adverse effects decribed in those 22 papers were fully evaluated by means of evidence-based medicine. Conclusions:Research quality of the analyzed papers could not meet clinical needs and Meta analysis could not been done due to their low quantity and poor quality. However, as far as the published articles concerned, GM-CSF showed a good short-term treatment effect.

[Objeetive] To investigate the effect of minimally invasive V-shaped osteotomy instead of traditional operative technique for correction of ankylosing kyphosis.[Method]The C-arm X-ray was used under the local anaesthesia to select the space of osteotomy,the length of incision were 6~8 cm and only exposed one interlaminal space,the width of laminar V-shaped osteotomy were 8~10 mm.The operating table was changed from reverse V to type after finished osteotomy,the space of osteotomy would be automatica ly closed and replaced,if the space could not be automaticly closed,careful manipulation would be applied to close it.The bone mass of osteotomy was used in posterior bone graft of lamina.Postoperation,stric and standardized regulation were performed to send the patient back to ward.The fractional manual correction and external fixation of hyperextended plaster vest were performed respectivly 2 weeks after operation.[Result]Fifty patients of this group acquired more satisfied results except 1 case appeared recurrent deformity due to early removing of the plaster vest.[Conclusion]Minimal damage,lower medical expenses(without internal fixation)and satisfied results demonstrated the minimally invasive V-shaped osteotomy is a very effective method.It has advantages of Mutual intercalated V-shaped osteotomy space and better stability after reduction,posterior bone graft of lamina and external fixation of hyperextended plaster vest,therefore,all patients can acquire the bone graft fusion afer 6 months.

[Objective]To introduce the operative method and clinical experience of 200 cases with halo pelvic distraction and elastic growing rods fixation for treatment of scoliosis during growing period and comparison with pedicle screw systems. [Method]According to the principle of Harrington hook-rod system,inferior extremity was one hook hanged on the total lamina of lumbar vertebrae and superior extremity were two hooks hanged on the inferior articular process of thoracic vertebrae,rod I and rod II were connected by joint,between the end of rod I and joint set the spring cover for automatic extension followed spine growth.For the longer growing period children,the small incision could be performed between the hook and rod for fractional distraction to help the spine longitudinal grown until skeletal development and maturation.[Result]The average rate of correction of 200 cases with Scoliosis were 70.32% after 2~15 years follow-up survey,the height of the patients were increased by 5~22 cm and the preserved range of spinal motion was better than pedicle screw systems in long term follow up.Incidence of hook displacement was 2% and rod breaking was 3%.Reasons of hook displacement and rod breaking was related to unfitting installation and methods of internal fixation,incidence of hook displacement and rod breaking were decreased significantly post reform.[Conclusion]Halo pelvic distraction and elastic growing rods fixation for treatment of scoliosis during growing period which is a kind of biological method,does not affect the longitudinal growth of spine and prevent the complication of crankshaft phenomenon caused by pedicle screw systems.

[Objective]To discuss and analyze the effect of the treatment of high-energy Pilon fractures.[Method]Twenty-four patients with R?edi-Allgower type Ⅱ and Ⅲ Pilon fractures(Ⅱ=14,Ⅲ=10) were treated by open reduction and internal fixation.Ten cases were combined with external fixation.Sixteen cases were treated by bone transplantation(spongy bone=10,big pieces of ilium=6).[Result]From June 2003 to December 2007,the restoration of fractures with Burwell-Charnley system was:excellent=16,good=8;the function of ankle joint with Mazur system was evaluated:excellent=12,good=10,fair=2.[Conclusion]In the time of treating Ruedi-Allgower type Ⅱ and Ⅲ Pilon fractures,the bone transplantation with big pieces of ilium is effective to solve the serious bone loss,strengthen the internal fixation and exercise ankle joint earlier.

[Objective]To sum up the experience of wearing the halo pelvic and level traction costoplasty to treat 35 cases of severe scoliosis combined with collapsed chest. [Methods]When scoliosis of patients were corrected to a certain degree after three weeks of halo pelvic distraction, the most serious collapsed ribs of concave side of the curve underwent a transverse incision the cross ribs. A special rib bender was used to bend the exposed 3 to 6 ribs. The bent ribs were pulled up by double-stranded 10# thick silk which was extended out through the skin and fixed in the upright post of the instrument of Halo pelvic distraction with rubber membranes.[Results]Thirty-three in 35 patients underwent costoplasty. The collapsed chest was turned round, respiratory function improved significantly and cyanosis of lips and nail bed disappeared. These offered advantages for next scoliosis correction.Two patients failed to undergo costoplasty due toprimary pulmonary atelectasis and pulmonary deficiency.[Conclusion]The instrument of Halo pelvic distraction is a good and convenient fixed point. Bending and turning round ribs can provide a convenient condition for recovery of collapsed chest. Halo pelvic distraction can be used not only for scoliosis correction but also for costoplasty.