Payment system reforms have become an important part of Chinese healthcare reforms, and global budget has been seen as a major trend. Based on the practice and data of four pilot hospitals in Beijing which have implemented the global budget, this paper focuses on analyzing the effects of implementation on the following aspects and provides references for policy improvements: medical services, average medical cost, total health expenditure, medical cost structure, average length of stay and out-of-pocket expense percentages.

AIM: To investigate the clinical effect of phacoemulsification and intraocular lens ( IOL ) implantation for cataract patients after corneal refractive surgery, and to compare the accuracy of the different refractive IOL.
METHODS:The data of 120 myopia cases (160 eyes) in our hospital, who underwent cataract surgery and corneal refractive surgery were analyzed. Corneal curvature K value before corneal refractive surgery were obtained and calculated by using history method. Corneal curvature correction numerical method and corneal topography were used to record K value of patients with incomplete data before and after treatment. The K value was substituted into the formula. By comparing the actual cataract surgery and refractive state expected refractive status (-0. 50D), the accuracy of IOL refractive obtained from three methods was compared.
RESULTS: The average best corrected visual acuity before cataract surgery was 0. 25 ± 0. 05, and it was improved ( 0. 80 ± 0. 05 ) after surgery. The average spherical equivalent (SE) was -1. 98±1. 75 before surgery and +0.85±3.38 after surgery (P<0.05). The K values of 48 cases were calculated by clinical history method ( CHM ) and that of 73 cases was calculated with the adjusted keratometry method ( AKM) . The K values of 39 cases were calculated using the corneal topography method ( CTM) .
CONCLUSION: For patients with corneal refractive surgery, the appropriate method can be selected according to clinical symptoms, history, etc. and this may help to accurately calculate IOL. For patients with complete data, CHM can be used to provide corneal K values, while for those with incomplete data, AKM and CHM can be used.

Objectives To explore the effects of control measures and dynamic prevalence of drinking water endemic fluorosis in China, to provide basis and technique support for endemic fluorosis control in China. Methods The survey was carried out according to the national surveillance Scheme of Endemic Fuorosis. The fulfillment of control measures and the quality of water improving projects were surveyed. Household water sample and urine of children aged 8-12 years were collected and fluoride content was detected by iron selective electrode method. Check the teeth of children aged 8-12 years. Dental fluorosis was diagnosed by Dean's method. Results projects were build in 84 endemic villages in 2006, and the average water improving rate came to 73.98% fluoride contents of half the surveyed spots were over the standard, mainly between 1.0-2.0 mg/L, and the urine controlled just in only few spots and it was in moderate or severe status in some endemic areas for many years. Conclusions Little progress of control measures in drinking water endemic fluorosis counties surveyed has been made in these two years. Projects of running out of status and over standard of water fluorosis are frequently seen. Dental fluorosis in many spots is not controlled.

Medical metrology work is the base of quality control for hospital medical equipment.It guarantees the accuracy of hospital medical instruments.It is important to set up a complete management system for hospital metrology institutions.

Objective:To study the relationships between age,the state of genital tract and vaginitis,cervical erosion and vulvae leukoplakia in married women.Methods:Gynecologic inspection and laboratory examination were performed in 1 253 patients diagnosed vaginitis,cervicitis and vulvae leukoplakia in a women screen in a certain area in Chongqing in 2007.Statistics analysis was made by SAS8.1.Results:Of 1 253 patiens,45.89% had vaginitis,44.69%,cervical erosion,and 3.35%,vulvae leukoplakia,6.07%,the other conditions.Age,vaginal cleanness degree,candida infection were risk factors of vaginitis;Age,vaginal cleanness degree were related to cervical erosion and vulvae leukoplakia.Conclusion:Vaginitis,cervical erosion and vulvae leukoplakia should arouse more attention in the prevention and treatment of women genital tract disease in the future,and the standard etiology treatment should be performed to get microcosmic ecological balance.The perfect control and monitoring system for gynecologic disease should be established,and service quality of women health care should be improved.

Humans ; Occupational Diseases ; prevention & control

The frequency and influence on prognosis of hemorrhagic transformation (HT) after acute ischemic stroke are still uncertain with mixed results in previous studies.Slight hemorrhage transformation may will not worsen stroke patients' short-and long-term prognosis,but some MRI studies suggest that HT may impede patients to get a dramatical improvement of neurological function.We aimed to determine the overall frequency of and risk factors for HT.More importantly,we discussed the mechanism,subtypes of HT and the influence of HT subtypes on prognosis.

Objective To investigate the expression and clinical signification of tumor M2 pyruvate kinase in pa-tients with CRC, and to try to find a reliable and atraumatic method to predict the progress and pronosis in the CRC. Methods ELISA method was used to determine the serum levels of tM2-PK in 68 patients with CRC,40 pa-tients with colorectal polyps and 40 cases of normal subjects; immunohistochemistry ( IHC ) methods were respec-tively used to detect the expression of tM2-PK in tissues. Results ① The level of serum tM2-PK in patients with CRC was significantly higher than the group of patients with polyps and the normal subjects ( P<0.05 ) . The serum tM2-PK levels was closely correlated to tumor size and Duke stage.②The positive rate of tissue tM2-PK was signif-icantly higher in CRC than in colorectal polyps and normal subjects ( P<0.05 ) . Tissue tM2-PK levels was closely correlated to tumor size,Duke stage and differentiation grade. ③Serum tM2-PK levels was correlated to tissue tM2-PK levels (r=0.357,P=0.003). Conclusion Combined detection of expression of tM2-PK can provide the basis theory for the diagnosis and prognosis evaluation of CRC.

Objective Detected Her-2/neu, matrix metalloproteinases-2 (MMP-2) and Leptin in stomach cancer serum and tissue, discussed their roles in occurance and development of gastric cancer. Methods Detected the ex-pression of Her-2/neu, MMP-2 and Leptin in serum by ELISA, and detected the expression of Her-2/neu, MMP-2 and Leptin in stomach cancer tissue by IHC. Results The positive rates of Her-2/neu, MMP-2, Leptin in gas-tric cancer serum were higher than the positive rates in control group ( P<0.05 ) . The positive rates of Her-2/neu, MMP-2, Leptin in gastric cancer tissues were higher than the positive rates in adjacent tissues (P<0.05 ). The positive expressions of two tests had consistency. In tissues, the positive expression rates of Her-2/neu,MMP-2 and Leptin were correlated with the depth of invasion,lymph node metastasis, clinical stage(P<0.05). Their ex-pression was not correlated with sex, age, size, site of tumor and the degree of differentiation. In serum, the posi-tive expression of Her-2/neu was correlated with the depth of invasion, lymph node metastasis, clinical stage( P<0.05 ) . The positive expression of MMP-2 was correlated with lymph node metastasis ( P<0.05 ) . The positive ex-pression of Leptin had no significant correlation with pathological features. Conclusion Her-2/neu,MMP-2 and Leptin promote the occurrence, development and transfer process of gastric cancer. It can be used for clinical diag-nosis, guide the targeted therapy and provide scientific and reasonable reference for gastric cancer prognosis.

Caudal-type homeoboxgene transcription factor 2 is one member of the caudal- related homeobox family,is a transeription factors important in intestinal epithelial development and in the differentiation and maintenance of the intestinal phenotype.In adulthood,these two proteins are strictly confined to the gut and are predominantly expressed by the epithelium of the small intestine and colon,but not by the normal epithelium of the oesophagus and stomach.In intestinal metaplasia,caudal-type homeohoxgene transcription factor 2 upregulation can be a direct effect of injurious agents on epithelial cells and/or can be due to the inflammatory environment of EpM,exposure to acid and/or bile acids may activate caudal-type homeoboxgene transcription factor 2 expression in human esophageal epithelial cells through promoter demethylation,and ectopie caudal-type homeoboxgene transcription factor 2 expression in esophageal squamous epithelia.It has been suggested to play an important role with retinoic acid,MUC2,p63 gene,BMP4 and many other factors working together to promote the development of this process in intestinal metaplasia and cancers.