2% hydroxypropyl methyl cellulose (HPMC, medical grade, Taian Ruitai Cellulose Co., Ltd.) was added into calcium phosphate cement (Orthopedics Institute of General Hospital of Chinese PLA) and the mixture was put into distilled water to observe whether the surface was corrupt. Some calcium phosphate cement was immersed in water at different time and the residual cement was weighed 24 hours later. The results showed that there was no surface corruption in calcium phosphate cement with 2% HPMC after shake; the residual weight measured 24 hours later showed that 2% HPMC could shorten calcium phosphate cement cohesion time from 4 minutes to 1 minutes. The experiment indicates that 2% HPMC can significantly increase the waterproof performance of calcium phosphate cement, increase the work time and is adaptable in clinical application.

Objectives: To evaluate the feasibility, safety and validity of the early enteral nutrition in severe acute pancreatitis(SAP). Methods: 15 patients of SAP during April 2002 and June 2003 had received early enteral nutrition through naso jejunal tube. The nutrition and immune index and the rates of complications were analyzed. Results: 2～3 days after nutrition tube placed to stomach, the tube heads in 11 cases reached the jejunum automatically, while 3 cases needed the help of X ray and 1 case needed the help of gastroscopy. All of 15 cases tolerated the enteral nutrition well, and there was no relapse of SAP. The nutrition and immune measurement were improved after 2 weeks' enteral nutrition, without infection of pancreatic necrosis. Conclusions: It is safe, efficient and feasible of the early enteral nutrition in severe acute pancreatitis(SAP) through naso jejunal tube. Early enteral nutrition can improve the nutrition, immune function and prognosis.

Articular cartilage repair is limited. Current treatments for cartilage defect are less satisfactory, and rarely restore full function or return the tissue to its native normal state. The rise of tissue engineering holds great promise for the generation of functional cartilage tissue substitutes. The history of cartilage tissue engineering and highlights the applications and advantages of various kinds of scaffolds in cartilage tissue engineering, such as native scaffolds, synthesis scaffolds, composite scaffolds and nanometer scaffolds had been introduced. But native scaffolds have weak strength and immunogenicity insufficiency, synthesis scaffolds degrade quickly, whose degrading products have cytotoxicity,which need further improvement. The application of superficial decoration overcomes the disadvantage of some scaffolds to an extend. Composite scaffolds possess the advantages of several scaffolds, it points out the direction of future scaffolds research. The development of Nanometer technique endows newly-synthesis scaffolds with nano-grade, thus it has some advantages and give a new way for the development of tissue engineering. At the end, the problems of these scaffolds, their trend of development and perspective studies were discussed.

Objective: To explore the cause and the strategy for air quantity signaling in old patients using mechanic air. Method: Summary and analysis of the causes for air quantity signaling in 187 cases of old patients using respiratory machine. Results: One hundred fifty-one cases showed low-limited air quantity signaling per minute whereas 36 cases presented high-limited air quantity signaling per minute. Conclusion: Judging and removing the obstacle in respiratory machine on time and accurately are the key point raising both the survival rate of severe patients and the successful rate of mechanic air.

Objective To identify the determinants of average length of stay of 16 upper first-class general hospitals from 2000 to 2007.Methods Relative data of 16 upper first-class general hospitals from 2000 to 2007 were collected, and descriptive analysis and multiple linear regression analysis were employed to explore the determinants of average length of stay. Results Operation ratio and days before operation of inpatients, ratio of salary to medical income, ratio of doctors to nurses, successful rescue rate in emergency, number of operation tables and staff had impact on average length of stay. Conclusion Resource allocation should be optimized, health care quality be enhanced, reasonable salary scheme be designed, and rational medical insurance policies be implemented in hospitals to shorten average length of stay.

Objective To comprehensively evaluate the competitiveness of hospitals so as to provide objective referrences for the long-term development. Methods Competitiveness evaluation index system and evaluation model were established. Using related data of 2007, 16 hospitals nationwide were evaluated and factor scores and comprehensive scores were obtained by means of factor analysis. Results Four factors were extracted, which were "technical efficiency factor", "economic income factor", "sustainable development factor" and "resource allocation factor". All hospitals were ranked by each factor score and comprehensive score. Conclusion Each hospital has its advantages and disadvantages, therefore, hospital managers should constitute individual development strategy accordingly.

Objective To describe the CT and MR imaging features of hepatic inflammatory myofibroblastic tumor(IMT).Methods The CT(n=12)and MRI(n=2)findings of pathologically proved hepatic IMT in 12 patients were retrospectively analyzed.Results All the tumors of the 12 patients were solitary and located in right hepatic lobe.Six tumors were solid and 4 tumors were solid-cystic.The other 2 tumors were periportal soft-tissue infiltration.The tumors appeared as solid or solid-cystic hypodense mass on CT images.The lesions were dark in T1-weighted sequences and slightly bright on T2-weighted sequences.There was homogeneous or inhomogeneous moderate to significant enhancement in solid portion of the tumors.Honeycomb-like enhancement was demontrated both in the peripheral part and at the intratumoral septa of the solid-cystic mass.Conclusion CT and MRI can provide helpful information for the clinical diagnosis and differential diagnosis of hepatic IMT.

Objective To accurately understand multi-spot medical practice in China and evaluate its effect.Methods Operation data of 2008 and 2009 were gathered from all medical institutions in Kunming to analyze the effect of the practice trial using the fixed effect model.Results Under control of such factors as the scale and type of the hospitals,clinic visits of the second certified hospital benefited by the practice increased by 14％than before,whereas the medical revenue of the institution increased by 29％.The effect proves more significant in terms of total clinic visits and medical revenues at level-1 and level-2 medical institutions.Conclusion Multi-spot medical practice in Kunming proves successful as it increased medical service supply and medical revenue,especially for level-1 and level-2 medical institutions.This effect possibly results from releasing high-level physicians down to lower-level institutions,helping these institutions to attract patients.

Objective:To evaluate the perioperative effects of glutamine-supplemented total parenteral nutrition support on immune function of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer randomized into three groups.The groups of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric 104.6 kJ/(kg?d) and isonitrogenous 0.20 g/(kg?d)total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.All variables were measured before and after operaition.Immune function and inflammatory responses were investigated.Results:No serious complication occurred in any group during the trial.The percentages of CD3~(+)cell and CD8~(+) cell decreased in three groups after operation.The percentage of CD4~(+)cell and NK cell and the ratio of CD4~(+)/CD8~(+) of group B was the highest in the three group on the sixth day after operation.Total lymphocyte count was higher in group B than that in group A and the levels of C reactive protein and prostaglandin E_(2) in group B were lower than those in group A.Conclusions:Glutamine-supplemented TPN is beneficial in raising total lymphocyte count and decreasing the level of C reactive protein and prostaglandin E_(2).And it can also modulate immunosuppressive status and inflammatory response of postoperative patients.

There are many subjects related to anesthesiology and the band between anesthesiology and clinical practicevery is close. So students can not be proficient in anesthesiology by traditional teaching methods. The use of three-dimensional case teaching method in anaesthesiology teaching is a good attemptment. three-dimensional case teaching method integrate case method, multimedia technology and clinical case. It can help medical students analyze and solve clinical problems, improvetheir academic performance and enhance their clinical basic skills.