OBJECTIVE:To explore the safety and effects of liver function in patients with liver cirrhosis following virus B hepatitis(called“hepatitis B”for short)on drug half-life and analgesic effect of target controlled infusion of remifentanil. METH-ODS:100 patients with liver cirrhosis following hepatitis B underwent liver and gallbladder surgery under selective general anesthe-sia were collected from our hospital and divided into group A(mild abnormal liver function)and group B(severe abnormal liver function,3 cases withdrew from the test and 47 cases completed the test),with 50 cases in each group,according to Child-Pugh grading of liver function. Both group were given phenobarbital sodium 0.1 g+scopolamine 0.3 mg intramuscularly 0.5 h before oper-ation;midazolam 0.04 mg/kg+propofol 1.5 mg/kg+atracurium 0.6 mg/kg intravenously;target controlled infusion of Remifentanil hydrochloride for injection during operation with 0.125-0.250 μg/(kg·min). The distribution half-life and the elimination half-life of remifentanil were determined, and temperature pain perception threshold (tPDT) and electrical pain perception threshold (ePDT) were measured immediately after the operation;the occurrence of ADR was observed. RESULTS:The distribution and elimination half-life of remifentanil were (4.52 ± 1.25)min and(24.64 ± 1.30)min in group A and (4.68 ± 1.31)min and(25.45 ± 2.08)min in group B respectively,there was no statistical significance between 2 groups(P>0.05). tPDT and ePDT of group A were(8.88± 1.66)mA and(1.54±0.09)mA respectively,and those of group B were(9.16±1.58)mA and(1.34±0.15)mA,there was no sta-tistical significance between 2 groups (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:The abnormal liver function of patients with liver cirrhosis following hepatitis B have no significant effect on drug half-life and analgesic effect of remi-fentanil with good safety.

In recent years , lean management has been applied to hospital management from industrial management .This arti-cle cultivatesthe idea of administratorfrom innovative awareness and quality view aspect .The daily medical management was improved by consummating the rules and regulations , the implementation of structured electronic medical record system management , and the estab-lishment of a feedback mechanism .In the aspect of advanced ideas , psychological intervention , and harmonious culture to create a people-oriented atmosphere , etc.lean management was implied to improve work efficiency and quality control .

Objective To learn the extent to which the inpatients perceive the surgical operations to take,for the purpose of safeguarding inpatients' legitimate rights.Methods 1753 inpatients were surveyed with cluster sampling and individual interview,and their medical records were studied to learn their perception of the surgery and the completion of their surgery consent.Results Problems found include poor perception of the operation and poor completion of the surgery consent; significant differences(P＜0.01)are found in their perception of the risk and the complications,as well as their perception of options,and supervision of pre-surgery talks.Conclusion It is imperative to improve the completion of the surgery consent and supervision of the pre-surgery talks,and to provide medical workers with better legal education,for better protection of inpatients' legitimate rights.

BACKGROUND:Lumbar disc herniation is the most common cause of lumbago in clinic, which seriously affect the patient's daily life, study and work. Therefore, studies on biomechanics of lumbar intervertebral disk benefit to prevent and treat the diseases associated with lumbar intervertebral disk. OBJECTIVE: To summarize the biomechanical progress of lumbar intervertebral disk. METHODS: The first author retrieved China National Knowledge Infrastructure and PubMed database for literatures published from 2009 to 2014. The key words were intervertebral disc, nucleus pulposus, biomechanics, fibrosis annulus, cartilage in Chinese and English, respectively. Articles regarding biomechanical characteristics of lumbar intervertebral disk, nucleus pulposus, fibrosis annulus and cartilage were included, and repetitive studies were excluded. Totaly 5 072 articles were retrieved initialy. In accordance with inclusion and exclusion criteria, 41 articles were included in result analysis. RESULTS AND CONCLUSION:We can fuly understand the pathogenesis, development and adverse consequences of diseases related to the lumbar intervertebral disk by summarizing the structural features and internal pressure of lumbar intervertebral disk and the effect of different loads, biomechanical characteristics of lumbar intervertebral disk with degenerative changes and establishment of mechanical model of lumbar intervertebral disk. It is of directive significance for daily health care of the lumbar intervertebral disk and how to better use force, a physical factor, to solve the lumbar intervertebral disk problems.

Objective To study the effect of in utero exposure of TCDD on synthesis of EGF and EGFR in submandibular gland of rat offspring. Methods SD rats were treated with TCDD 5??g/kg on Day 15 of gestation, the expression of EGF and EGFR in submandibular gland of rat offspring were analyzed by immunohistochemistry method. Results On PND32 and PND49, the expression of EGF and EGFR in TCDD experiment group were more than that of control group, the difference was statistically significant.Conclusion In utero exposure of TCDD can promote the synthesis of EGF and EGFR in submandibular gland of rat offspring from prepuberty stage through puberty stage. [

This article is based on a questionnaire survey of healthcare professional organizations and interview leaders of them. The results of this investigation show that the number of staff is small, and lack of highly qualified human resources. The organizations rely on donation for income and some of them run at a deficit. The functions such as professional self-discipline are not well performed. The analysis reveals four reasons why functions are not well per-formed:the bureaucratic style of the professional organizations and unclear legal status;the limited authorization from legal and administrative bodies;the defects in the governance system and the lack of capacity. Four aspects of policy recommendations are were proposed: to clearly define the role of the professional organizations and authorization through legal and administrative procedures; to strengthen support of professional organizations through various poli-cies;to improve governance and build comprehensive regulation mechanisms;to enhance the capacity of these organi-zations and so on.

The characteristics of health care require that health care professional organizations play an impor-tant role in health governance. The role of health care professional organizations in China has not been clearly defined and their functions have not been fully developed. This paper explores the nature, and the functions of health care professional associations in China. Based on the analysis of health governance characteristics in China, the role, and functions of the health care professional organizations in China’s health governance were defined and relevant policy recommendations are were proposed.

Objective To investigate the risk factors of creatine kinase (CK) elevation in chronic hepatitis B (CHB) patients and treatment outcomes for better management of such patients. Methods The CHB patients complicated with CK elevation who were treated during the period from June 2013 to June 2015 were reviewed retrospectively with their clinical data. CK elevation was examined in terms of antiretroviral regimens, and glycyrrhizin therapies. The clinical outcome was evaluated in terms of grade 3/4 CK elevation. Results A total of 364 CHB patients with CK elevation were included in this analysis. CK elevation was primarily associated with telbivudine monotherapy and combination therapy, followed by entecavir treatment. Grade 3/4 CK elevation was identified in 30 patients, which was mainly associated with telbivudine monotherapy and combination therapy. Good outcome was observed in most of these?patients?(76.7?%,?23/30).?Myopathy?was?confirmed?in?one?patient?by?muscle?biopsy.?Glycyrrhizin?was?not?associated?significantly?with CK elevation in CHB patients. Conclusions Creatine kinase elevation usually occurs in the CHB patients receiving telbivudine-containing therapies. CHB patients should be monitored for CK level during antiviral therapy. Concomitant glycyrrhizin treatment is not associated with CK elevation.

The aim of the present paper intends to explore the international experiences of healthcare profes-sional organizations and its enlightenment for China. The functions of health professional organizations in advanced countries include certification and accreditation, self-discipline, academic exchanges, political participation, service for industry, member rights protection and so on. The legal authorization, comprehensive supervision and competitive market mechanisms which make sure these functions perform well are worth learning for China.