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 investigate the clinical efficacy of combined acupuncture and medicine plus ultrashort wave diathermy in treating post-stroke complicated urinary tract infection.Methods One hundred and twenty patients with post-stroke complicated urinary tract infection were randomly allocated to groups A, B and C, 40 cases each. Group A received acupuncture, ultrashort wave diathermy and treatment with anti-infective drugs; group B, ultrashort wave diathermy and treatment with anti-infective drugs; group C, treatment with anti-infective drugs alone. The clinical therapeutic effects and the recurrence rates were compared between the three groups.Results The total efficacy rate was 92.5% in group A, 90.0% in group B and 72.5% in group C. There was a statistically significant difference in the total efficacy rate between group A or B and group C (P<0.05). The recurrence rate was 8.1% in group A, 27.8% in group B and 31.0% in group C. There was a statistically significant difference in the recurrence rate between group A and group B or C (P<0.05).Conclusion Combined use of acupuncture and medicine plus ultrashort wave diathermy is an effective way to treat post-stroke complicated urinary tract infection.

BACKGROUND:Mechanical property test is an important method to evaluate the effect of drug treatment on the animal model of osteoporosis. But there are rare reports on the tensile mechanical test for evaluating the therapeutic effects of a variety of drugs on a female rat model of senile osteoporosis. OBJECTIVE: To evaluate the effects ofGusukang capsule, alendronate, vitamin K and calcium on tensile properties of the humerus in the rat model of osteoporosis. METHODS: Totaly 180 female Wistar rats, 4-5 months old, were randomized into six groups, 30 in each group. Except the rats in the normal control group, al the rats were subjected to make ovariectomized osteoporosis models. Then, rats were givenGusukang capsule (0.9 g/kg/d), alendronate (1 mg/kg/d), vitamin K (0.1 mg/kg/d) and calcium (2 mg/kg/d) in theGusukang capsule, alendronate, vitamin K and calcium groups, respectively. After 15 weeks, the bilateral humeri were taken from al the rats, and the tensile test was carried out on an electronic universal testing machine at a speed of 5 mm/min. The fracture morphology of the specimen was observed. RESULTS AND CONCLUSION: The maximum load and maximum strain of the rat fumerus were significantly lower in the model group than in the normal control,Gusukangcapsule, alendronate and vitamin K groups (P < 0.05). There were no differences in the maximum load, maximum stress and maximum strain between the calcium group and model group (P > 0.05). These findings indicate that the tensile properties of the humerus can be improved by Chinese medicine, western medicine and vitamin K, especialy by the Chinese medicine.

Objective To explore the clinical and radiological features of bilateral thalamus venous infarction.Methods The cases definitely diagnosed as thalamus venous infarction were collected and the corresponding clinical and radiological data were retrospectively analyzed.Results Four cases confirmed as thalamus venous infarction by digital substraction angiography (DSA) were collected.Bilateral thalamus lesions were detected in all cases by brain MRI scans which mainly presented as thalamus edema with high T1 and T2 signals with partial enhancement.Mild hemorrage was also shown in one case.Acute or subacute onset with clinical manifestations of headache,hypomnesia and hypersomnia were reported in all cases.The neurological examination showed conscious disturbance,memory impairment and positive Babinski sign.The venous thrombi were formed mainly in the transverse and the straight sinuses in 3 cases with the deep cerebral venous involved in 2 cases.All patients were improved after the anticoagulation therapy.Dural arteriovenous fistula was found in the other case drained by the Rosenthal's vein,and the symptoms were ameliorated after the embolotherapy.Conclusions As the thalamus is drained by the thalamostriate vein and the lateral thalamic vein towards the internal cerebral vein with the caudate portion drained particularly by the Rosenthal's vein,venous thrombosis or fistula drainage into these veins would probably disturb the normal drainage of the thalamus and result in further edema and infarction.Thus,the venous infarction should be taken into consideration whenever bilateral thalamus lesions are encountered in clinical practice and DSA is necessary to confirm the diagnosis.

Objective To investigate the distribution and clinical significance of EGFR mutations in phase Ⅰ non-smallcell lung cancer(NSCLC).Methods We examined 272 consecutive phase Ⅰ NSCLC patients' tumor samples for EGFR mutations in exons 18,19,20 and 21 using the Amplification Refractory Mutation System(ARMS).Results 154 patients (56.62％)were identified with mutations in the series of 272.Of all the mutations identified,2 (1.3％) were aminoacidic substitutions (G719 S) in exon 18,53 (34.4 ％) were in frame deletions (19-del) in exon 19,6 (3.9 ％) were insertional mutations (20-ins) in exon 19 and 97 (63.9 ％) were aminoacidic substitutions (L858 R) in exon 21.There were 11 patients with coexisting mutations in other exons.The probability of the coexisting resistance mutations (20-ins) in exon 21 was significantly higher than that in exon 19 (P ＜ 0.05).Mutations in adenocarcinoma samples (148/223,66.4％) were more frequent than that in squamous carcinoma(2/40,5％),while mutations in adeno-squamous carcinoma were highest in all histologic types (P ＜ 0.05).Conclusion EGFR mutations in phase Ⅰ NSCLC in Shanghai and surrounding areas were 56.62％.Mutations were more frequent in particular histologic types,e.g.adenocarcinoma and adeno-squamous carcinoma.Exon 19 deletion mutations and the substitution mutation L858R in exon 21 are the most frequent in NSCLC.And the probability of coexisting 20-ins mutations in exon 21 was significantly higher than which in exon 19.