The authors first describe the "three pursuits" and "eight expectations" characteristic of the current mentality of hospital staffs and then expound the positive and negative impacts of this mentality on hospital development. Finally they discuss ways of transforming this mentality: ①insisting on combining science and technology with the learning of theories, laws and management expertise so as to cultivate a contingent of staffs with "four haves"; ②insisting on uniting leaders and the masses so as to gradually achieve the integrated power of ideological and political work; ③insisting on unifying the running of a hospital according to law with the running of it according to moral standards so as to gradually create a cohesive internal environment; ④insisting on linking centralized control with democratic management; ⑤combining the solution of ideological problems with the solution of practical problems; ⑥combining the guarantee of interests of patients with the guarantee of interests of hospital staffs so as to resolve the ideological problems of the latter.

Objective To analyze the results of treatment of complicated tibial plateau fractures with open reduction and internal fixation with bilateral plates .Methods 29 elder patients with C type tibial platform fractures underwent internal fixation with bilat-eral plates and bone grafting .Fixation with bilateral plates was performed during operation with dynamic compression plate or 1/3 Tubular steel plate placed medially and the dissection plate or LISS system ones inserted laterally after the underlying separation . Meanwhile ,sufficient bone grafting during operation could effectively support reduction of articular surface .Results All patients were followed up of an average of 13 .8 ± 2 .43 months .According to Rasmussen score standard ,the excellent and good rate was 82 .7% .There was significant difference of TPA and PA between postoperation and postoperation one year later .Conclusion It is a simple and effective method to treat complicated elder tibial platform fractures with bilateral plates .It will improve the effect and re-duce complications significantly to perform sufficient bone grafting intraoperatively ,and make the drainage unobstructed and do the early functional exercises postoperatively .

Objective To evaluate the toxic effects and efficacy of the intra-arterial chrono-chemotherapy on patients with liver metastasis arised from colorectal cancer. Methods Chemotherapy of 42 patients were randomly divided into group A (n = 20) with continuously constant arterial infusion, and group B (n = 22) with arterial chrono-modulated infusion. And the toxic effects and efficacy of two groups were compared. Results A significant difference was found in the toxic effects of digestive system between the two groups. The treatment response was similar in the two groups. Conclusions Intra-arterial chrono-chemotherapy may decrease the toxic effects and improve the life quality of these patients.

Objective To determine the effect and safety of metallic stents in the treatment of acute malignant colorectal obstruction.Methods From May,2000 to June,2003, self-expanding metallic stents were implanted in 15 patients with acute left colonic obstruction caused by malignancies. The postoperative remission and complications were observed.Results Stents were implanted successfully in 12 cases(80.0%,12/15).Of the 12 cases,the obstruction were all disappeared within 24h. No death or colonic perforation happened in this series. Stent migration and anal pain developed each in one case after stent implantation. Elective radical resection was performed on 8 cases after bowel preparation and supportive therapy; and stents reserved permanently in other 4 cases. Conclusions The implantation of self-expanding metallic stents is a safe and effective method for the temporary remission or permanent treatment of acute left-colonic or rectal obstruction caused by malignancies,it can instead of colostomy.

OBJECTIVE: Evaluation and analyze the characteristics of balance function in patients with type 2 diabetes, and to find out the importance of proprioception, vision and vestibular in postural control. METHOD: All subjects were divided into two groups, 37 normal individuals, 33 patients with type 2 diabetes mellitus. All were assessed by computerized posturography under six upright stance.conditions: including standing on the firm surface and foam with eyes open and closed. RESULT: (1) On anteroposterior,the scores of proprioception, vision and vestibular were 93.96 ± 7.95, 80.22 ± 16.24, 70.87 ± 20.99, the normal were 98.00 ± 2.18, 91.44 ± 6.01, 80.44 ± 7.81. There were significances between diabetes mellitus group and normal control group (P < 0.05) respectively. (2) On lateral, the scores of vision and vestibular were 80.39 ± 12.60, 73.96 ± 16.04, and the normal were 92.11 ± 4.50, 83.18 ± 9.45. There were significances with P < 0.05 between diabetes mellitus group and normal control group. However, there was no obvious difference in proprioception scores between the two groups. (3) The limit of stability of normal group were (176.47 ± 44.13) mm²; diabetic group was (143.13 ± 62.30) mm². There was statistical significance between the group with P < 0.05. (In diabetic patients, there was no significant difference between the no dizziness group and the dizziness group of the scores of proprioceptive, visual, vestibular as well as stable limits, P > 0.05. CONCLUSION The balance function of patients with type 2 diabetes decreased. It is the main characteristic that the vision and vestibular decreased more significantly in the postural control.
Case-Control Studies ; Diabetes Mellitus, Type 2 ; physiopathology ; Dizziness ; complications ; Humans ; Postural Balance ; Proprioception ; Vertigo ; complications ; Vestibule, Labyrinth ; physiopathology ; Vision, Ocular

Objective To investigate the efficacy of biphasic insulin aspart 50(BIAsp50)twice daily(bid) versusbiphasichumaninsulin50(BHI50)(bid)plusmetforminonbloodglucosecontrolfollowingastandardmealtest in Chinese patients with type 2 diabetes mellitus(T2DM). Methods A randomized, open-label, 2-sequence, crossover trial for two 4-week treatment periods was conducted in 14 Chines institutes. Eligible subjects inadequately controlled with BHI50(bid)plus metformin were randomized to two sequences in a 1 : 1 ratio(A:BIAsp50-BHI50, B:BHI50-BIAsp50 ) . Standard meal tests were performed at baseline and the ends of two periods within 4 weeks. Primary endpoint was 2h postprandial plasma glucose ( PPG) increment following standard meal test, with insulin dose standardized at 0. 3 IU/kg. Results A total of 161 subjects were randomized into two sequences(81 to sequence A, and 80 to sequence B) and finally analysed. After 4 weeks of treatment, mean 2h PPG increment with BIAsp50 was lower than that with BHI50 [ treatment difference of BIAsp50 vs BHI50: -1. 12 mmol/L ( 95% CI-1. 66,-0. 58), P<0. 01], suggesting superiority of BIAsp50 over BHI50. Incremental area under the curve for PPG(0-2 h)with BIAsp50 was lower than that with BHI50 [treatment difference:-38. 8 mmol·L-1·min-1(95%CI-77. 3,-0. 26), P=0. 049], as was the mean 2h PPG [treatment difference:-0. 58 mmol/L(95% CI -1. 13,-0. 03), P=0. 040]. The FPG value with BIAsp50 was higher than that with BHI50 [treatment difference:0. 52 mmol/L(95%CI 0. 18, 0. 86), P=0. 003]. The rate of nocturnal hypoglycemia with BIAsp50 was lower than that with BHI50(1. 13 vs 2. 86 events per subject year, P<0. 01). Conclusion In patients with T2DM inadequately controlled with BHI50 plus metformin, BIAsp50 was proven to be well-tolerated with improved postprandial glucose control compared with BHI50.