From the Government’s fully guarantee stage to the stage of independent organization of medicine, then to the market-oriented reforms and the new health care reform exploration stages, the public hospitals reform fol-lows different institutional logics, but the institutional dilemma have emerged at all stages including the little coupling between the institutional arrangements and environment, the public welfare and benefit wandering, the management system instability, and the breakdown of the financial investment and control costs mechanisms. The Government should elaborate conditions for the spontaneous public hospitals reform on the institutional environment in order to em-bed intrinsic motivation of the induced institutional change into the imposed institutional change. There should be positive interaction between the government and the market in order to form a reasonable and orderly competitive land-scape to the market of medical services. Payment should be reformed which has significant influence on internal medi-cal service system incentives.

Objective To explore the efficacy of zolpidem in improvement of sleep quality of patients received methadone maintenance treatment (MMT).Methods 80 cases of MMT with insomnia were randomly divided into the study group (administered with zolpidem)and the control group (administered with placebo), 40 cases in each group.Pittsburgh sleep quality index (PSQI)and treatment emergent symptoms scale (TESS)were assessed before treatment and at the weekend of 4th,8th after treatment.Results The scores of PSQI in the study group were much lower than those in the control group (t =-2.517,P =0.014;t =-3.611,P =0.000),while the effective rate in the study group was significantly higher than that in the control group (χ2 =4.949,P =0.026). Conclusion Zolpidem could improve the sleep quality of patients with MMT.

Cervical anterior decompression and fusion is currently used in the treatment of cervical spondylosis.This paper reviews the surgical complications and its prevention measures,so as to provide some references to reduce the complications and improve operative efficacy.

Objective To explore the variation about the application of fast-track surgery and laparoscopy in treatment for colorectal cancer in recent years.To investigate the probability of combining protocols of the two for treatment for colorectal cancer.Methods The clinical and basic literatures of related researches about colorectal treatment of laparoscopy and fast-track surgery were collected and reviewed.Results Compared with the traditional treatment modalities,both of fast-track surgery and laparoscopy used for the treatment of colorectal cancer have better clinical effects.Conclusions Fast-track surgery and laparoscopic techniques used for the treatment of colorectal cancer are feasible,but the combination of the two should be confirmed by further randomized controlled trials.

Objective: To study the chemical constituents in the roots of Aconitum bulleyanum Diels. Methods: The air-dried roots of A. bulleyanum were powdered and extracted by methanol with percolation. After removing the solvent under reduced pressure, the crude extract was dissolved in 1. 5％ HCl solution, and then basified to pH 9 by NaOH (5％) and extracted by ethyl acetate to ob-tain crude alkaloidal extract after ethyl acetate removal. The alkaloidal extract was isolated and purified by column chromatography, and their structures were identified based on spectral analysis ( 1 H-NMR, 13 C-NMR, MS) . Results:Totally 12 diterpenoid alkaloids were isolated from A. bulleyanum and characterized as foresaconitine (1), crassicauline A (2), chasmanine (3), talatisamine (4), 14-debenzoyl-franchetine (5), pengshenine A (6), crassicautine (7), yunaconitine (8), franchetine (9), liljestrandisine (10), transconitine B (11) and pseudoaconine (12). Conclusion:Compounds 3-7, 10-12 are isolated from this plant for the first time.

Objective To assess the value of procalcitonin( PCT) in anti-infective therapy by observing PCT concentration change in therapy. Methods Sixty-eight patients with bacterial infection meet the diagnostic criteria were divided into effective group and invalid group,the PCT level on day 1,day 3,day 5 and day 7 were observed respectively. Results PCT concentrations of two groups showed no sig-nificant difference on day 1. The PCT level of effective group gradually declined and PCT level of invalid group gradually rised with significant difference on day 3,day 5 and day 7(P<0. 05). Conclusion PCT level that is positively correlated with inflammation of infectied patients, which can be used as an effective indicator to optimize antibiotic therapy.

Acupuncture Therapy ; Diarrhea ; therapy ; Female ; Humans ; Young Adult

Sponge Dysidea avara-associated bacteria were isolated by dilution-plate method and the bacterial anti-microbial activities were screened for Escherichia coli,Staphylococcus aureu, Pseudomonas fluorescens, Bacillus subtilis,Aspergillus niger, Candida albicans,Pacecilomyces variotii by agar diffusion method.At the same time, morphology observations, biochemical and physiological identification of active strains were made. In this paper, 149 strains were isolated from sponge Dysidea avara.20 strains, which amount to 13.4% of the total isolated strains, were found to have anti-microbial activity against fungi and gram-positive bacteria and were identified to be the genus Bacillus sp.

China ; Death ; Humans ; Tissue and Organ Procurement

Finite element analysis can be used to study the change of the structure and the interior field intensity of human and animal body organs and tissues with simulation experiment. We in our research used finite element analysis software to analyze and solve the spinal cord surface potential problems, and investigated the transmission features of signals generated by interneurons in spinal nerves which were related with body motion control and sensory processing. A three dimensional model of electrical source in rat spinal cord was built, and the influence on potential distribution on spinal cord surface caused by position changes of electrical source in transverse direction and dorsoventral direction were analyzed and calculated. We obtained the potential distribution curves of spinal cord surface and found that the potential distribution on spinal cord surface showed monotone. In addition, potentials of some registration points were smaller than that of registration points around.
Action Potentials ; Animals ; Computer Simulation ; Finite Element Analysis ; Humans ; Interneurons ; physiology ; Models, Anatomic ; Rats ; Spinal Cord ; physiology