The article presented the drugs supply management mode reform in place since 2009 in the one district of Shanghai.Authors analyzed and commented the implementation and outcomes,and studied the potentials of successful promotion nationwide.They hold that such a mode works to some extent in terms of reducing management costs of medical institutions,lowering drug purchase price,encouraging rational drug use of such institutions,and reforming the compensation manner for medical institutions.This mode,however,calls for an operating environment in need of not only funding support,but also new concepts and economic development strength of the society as a whole.This means that such a mode is only recommended in developed areas in China.

Objective To understand the clinical characteristics during clinical diagnose and treatment of young women patients under 35 years with cervical cancer. Methods The clinical data of 95 cervical cancer patients under 35 years was reviewed and analysed retrospectively. Results The percentage of the patients at this age set was 18. 59% ,accounting for almost one fifth of all the same period patients with cervical cancer. The most common primary clinical representation was sexual bleeding of vigina (90.53% ,86/95) ;28 cases (29. 47%, 28/95) were misdiagnosed by naked eye examination and local treated as cervicitis; 13 cases (13. 68%, 13/95) with severe pathological changes were missed diagnosed by biopsy under colposcopy ;53 cases (55. 79% ,53/95) had their ovary preserved by one or two and had no metastasis or recurrence with carcinoma. Conclusions Sexual intercourse bleeding is the most common manifestation of young women with cervical cancer,which demands more attention. The biopsy under colopscopy has certain limitations,and should be performed along with conization while necessary. It is safe and feasible to retain ovary in cervical cancer patients before Ⅱ stage.

Objective To evaluate the application of Endoscopic ultrasonography (EUS)in preoperative diagnosis of gastric cancer and staging. Method 78patients were assigned to EUS and gastroscope examination before operation,the staging result were compared with pathological staging result. Result Compared with pathological staging,the accurate rate of EUS in T staging and N staging before gastric cancer was 85.9% and 80.77%. Conclusion EUS can be used in judgment of gastric cancer staging accurately,may be of significance in the decision of operation plan.

AIM: To investigate the effect of erigeron on intercellular adhesion molecule-1 (ICAM-1) and mRNA expression during cerebral ischemia/reperfusion. METHODS: The rat models of middle cerebral artery (MCA) focal cerebral ischemic reperfusion were established with the suture method in the study. The ICAM-1 mRNA and protein expression were measured by RT-PCR and immunohistochemistry techniques, respectively. RESULTS: By down-regulating the expression of ICAM-1 protein and mRNA and alleviating inflammation in cerebral ischemic region, erigeron exerted a protective effect in cerebral ischemia and reperfusion. CONCLUSION: The results suggest that erigeron protects the brain against cerebral ischemia and reperfusion injury via inhibiting ICAM-1 expression. [

The most effective treatment for acute ischemic stroke is intravenous thrombolysis and endovascular treatment. The proportion of patients with acute ischemic stroke receiving intravenous thrombolysis and endovascular treatment in China is low, and pre-hospital delay is an important reason. This article reviews the influencing factors and intervention measures of pre-hospital delay.

Objective To detect TCRγ gene rearrangements in skin lesions and peripheral blood of patients with parapsoriasis, and to study their clinical significance. Methods Totally, 20 patients with parapsoriasis were included in this study. BIOMED?2 multiplex PCR was performed to detect TCRγgene rearrangements in lesional skin (n=20)and peripheral blood(n=11)samples from the patients with parapsoriasis. Statistical analysis was performed to assess the relationship of TCRγ gene rearrangements with clinical types of parapsoriasis as well as general information and histopathological manifestations(including non?specific manifestations and atypical manifestations)of patients. Results TCRγ gene rearrangements were positive in lesional skin from 7 of the 20 patients, in peripheral blood from 3 of 11 patients, and in both lesional skin and peripheral blood from 2 patients. Positive TCRγ gene rearrangements in skin lesions were significantly correlated with mycosis fungoides(MF)?related atypical histopatho?logical manifestations(P<0.05), but those in neither skin lesions nor peripheral blood were correlated with gender and age of patients or clinical course and types of parapsoriasis(all P>0.05). During an average follow?up time of 44.85 ± 18.48 months, 1 case progressed into MF, and 2 were cured. Conclusions Positive TCRγgene rearrangements in skin lesions of patients with parapsoriasis may be correlated with MF?related atypical manifestations. The presence of TCRγgene rearrangements and atypical histopathological manifestations may suggest the possibility of progression from parapsoriasis into MF.

Objective To compare the treatment effects of minimally invasive exfoliation's point of varicose veins pump-stripping surgery and traditional treatment of varicose veins of lower extremity surgery.Methods 106 cases with lower extremity varicose veins were simple randomly divided into A,B groups.A team exfoliation new minimally invasive devices for minimally invasive varicose veins stripping point-pumping operation,B group is the traditional line of lower extremity venous stripping pump surgery,after the results of comparative assessment.Results Hemorrhage (15.3 ± 5.4) mL,operation time (58.9 ± 14.3) min,hospitalization time (4.8 ± 1.3) d and operation cost (5124.5 ± 524.7) yuan of group A were lower than those of group B [(65.4 ± 25.1) mL,(72.5 ± 18.6) min,(6.8 ±2.4) D and (6 179.6 ± 623.8) yuan] (P =0.023,0.035,0.019,0.027).Conclusion The minimally nvasive exfoliation's saphenous vein high ligation stripping point-pumping operation not only small wounds,easy to operate,and less post-operative complications and rapid recovery,and on the cost of hospitalization is superior to traditional surgery.

Objective To make recommendations on the development of private hospitals,by means of investigation and analysis of their business operations.Methods Quantitative and descriptive analysis were used to study business operation data from 2011 to 2013 of the 172 private hospitals,in order to learn their present status and development trends.These data were compared with public hospitals in average to identify problems.Results The revenue and expenditure of theses private hospitals increased at a fast pace,with a revenue growth rate of 22.0% and an expenditure growth rate of 15.7% in 2013.Number of visits gradually improved,with an increase of 12.9%.But the rate of bed occupancy was only 68.1%,lower than the average of public hospitals.Conclusions In view of the low resource utilization,the authors recommend such hospitals to improve hospital management systems,and uphold the integrity of business,so as to compete with public hospitals differentially.

The paper probed into corporate governance and the feasibility of introducing corporate governance into China' s public hospitals based on the principal-agent theory and successful experiences of overseas hospitals.It also described the incentive and restriction mechanism of such governance.The authors proposed such key factors as evolution in property right/shareholding relationship,organization structure of introducing corporate governance,appropriate supervision,sufficient competition,and perfecting corporate governance mechanism.

Animals ; Calcitonin Gene-Related Peptide ; blood ; Electric Stimulation ; Endothelin-1 ; blood ; Female ; Heart Arrest ; blood ; Male ; Rabbits ; Resuscitation ; methods