The paper discusses the basic contents, characteristics, and development trend of training programs abroad for high level hospital administrators as represented by MHA (Master of Hospital Administration) programs. Those programs establish curricula and training modes in light of the primary tasks and responsibilities of high level hospital administrators. They attach importance to the cultivation of concepts of macro health and ideas of modern management, provide training in methodologies of public health as represented by bio statistics and epidemiology, emphasize practical matters of operation and management such as hospital planning, quality control and financial accounting, and make wide use of case studies so as to enhance the abilities to solve practical problems. Hospital reform and development make it imperative to improve the training of high level hospital administrators, which must be properly oriented, and to develop domestic MHA programs with Chinese characteristics by utilizing existing resources of health administration education and integrate relevant courses.

Objective To investigate the technique and feasibility of video-assisted thoracoscopic surgery (VATS) in the treatment of esophageal carcinoma. Methods Sixteen patients with esophageal carcinoma underwent esophagectomy by VATS between October 2002 and October 2003. The tumors were found in mid-segment in 13 patients and lower segment in 3 patients. Their TNM staging was: stage T 1 2 patients, stage T 2 5 patients and stage T 3 9 patients; stage Ⅰ 2 patients, stage Ⅱ 8 patients and stage Ⅲ 6 patients. Results No conversion to open surgery was required. The operation time of VATS was 90～150 min (mean, 110 min). The number of removed mediastinal lymph nodes was 6～14 (mean, 7.3). Drainage tube was taken out 2～3 days after operation and the drainage volume was 300～600 ml. No complications were seen. Conclusions VATS for esophageal carcinoma is feasible. Indications for VATS should be stage Ⅰ～Ⅱ and in addition no outward infiltration (≤stage T 3).

The effects of low-level radiation on cAMP in peasma, adrenal and testis and cGMP in adrenal of rats were studied. Adult male rats were given whole-body irradiation with x-rays at a dose rate of 15 mGy/min. They were irradiated with 50 and 100 mGy daffy for 30 days within 5 weeks with cumulative doses of 1.5 and 3.0 Gy respectively. One, two and four weeks after termination of irradiation, the levels of cAMP in plasma, the adrenal gland and testis, the level of cGMP in the adrenal gland and the weights of the body, testes and pitutary were examined. The weights of testes decreased within 4 weeks after irradiation as compared with the control and the level of cAMP in the testis was significantly increased at weeks 1 and 2 in the 3.0 Gy group. At week 4, it returned to near normal. In another experiment, animals were irradiated with ~(60)Co ?-ray at a dose rate of 45.3?Gy/min, 16.3 mGy/6h/day and 6 days per week. At 6, 10, 14, 18 and 22 weeks, with cumalative doses of 0.59, 0.98, 1.37, 1.76 and 2.15 Gy respectively, the levels of cAMP in the pitutary and testis and testicular weight were quantified. No significant changes were found. These results suggest that dose rate is an important factor In the determination of the degree of damage of the testis following low-level irradiation.

Diabetic retinopathy (DR) is a common disease of ophthalmology,often causes irreversible decline of patients' vision,which has two features including macular oedema,diabetic retinal neovascularization.Diabetic retinal neovascularization is one of the most important reasons leading to blindness.Endostatin (ES) is one of the most effective agents inhibiting angiogenesis,whose biological function has a close relationship with its chemical construction.However,its mechanisms of treating diabetic retinal neovascularization are very complicated and remain unclear.Therefore,in this review we summarized several possible mechanisms,including regulating the expression of extracellular matrix,inhibiting the expression of pro-angiogenic factors,and regulating the signaling pathways,by which ES may inhibiting diabetic retinal neovascularization.

Three basic functions of the working principle of Caritational Ultrasonic Surgical is introduced:ultrasonic emulsification, ultrasonic incise homeostasis and ultrasonic sterilization and debridement. As a new-style surgical equipment, it is widely used in clinical operations, upgrading interrelated medicine technology. The basic structure, working principle, main characteristics and clinical applications are introduced, thus redounding to broadening the knowledge of doctors and nurses in the safe operation of the machine.

Data of 39 patients (51 knees) undergoing total knee arthroplasty (TKA) in the Department of Orthopaedics,Fourth Affiliated Hospital of Guangxi Medical University between October 2001 and March 2008,were analyzed retrospectively,including 6 males (6 knees) and 33 females (45 knees) aged 59-72 years. Among the 39 cases,there were 35 cases of osteoarthritis,2 of rheumatoid arthritis,1 of osteoarthritis and pigmented villonodular synovitis,and 1 of advanced tuberculosis. Different degrees of pain,swelling,genu valgum,genu varumand and functional impairment of knee joints were found in all cases. The prosthesis adopted included 3 knees of DePuy,10 of Stryker,3 of Link,5 of Zimmer,7 of Taiwan Unite,and 23 of Pulus (made in China). Among all the cases,47 knees were treated by posterior stabilized prosthesis,and 4 knees were treated with posterior cruciate ligament-retaining TKA. Careful medical examination and evaluation were performed to control blood sugar level before operation; the operation duration was shortened as possible. Reasonable proposals were formulated to prevent the postoperative infection and deep venous thrombosis. Clinical data were analyzed using the HSS score standard. All patients were followed up for 6-57 months. No deep infection,prosthetic loosening or death was found. Postoperatively,2 patients (2 knees) developed cutaneous necrosis at incision margin,of which 1 patient (1 knee) was cured by changing dressings,and 1 patient (1 knee) was healed after incision of skin and relaxation suture. The range-of-motion of 51 knees all exceeded 90?. The motion of knee joint were increased from 65?(32?-95?) in average preoperatively to 96?(90?-110?) after the operation. The preoperative pain of all patients disappeared instantly after operation,beside one case (2 knees) and the other had a little pain. The Harris knee joint scores were increased from 39 points (25-53 points) in average preoperatively to 91 points (82-97 points) after the operation at the final follow-up; 25 cases (34 knees) were excellent,12 cases (15 knees) were good,2 cases (2 knees) were fair and the excellent and good rate was 96%. Although TKA has a satisfactory surgical effect,associated factors should be paid more attention.

In this paper,we focus on how to planning and implementing CRM system in hospital,and address this topic in three main sections.Firstly, The comprehending and urgent need of hospital leaders and managers about CRM are the most important.Secondly,before implementing CRM,the status of information management in hospital and characteristic of relationship between customers(or patients) and hospital should be sufficiently understood.Thirdly,which kind of CRM,and how much investment what you need should be analyzed.A general principle is put forward,that is "clear aim,macro planning,(uniform) disposal and stepping into implementing".

To observe the preventive effects of flumeprednisolone and spongia gelatinosa on peridural adhesion after nucleus pulposus resection of lumbar intervertebral disc, 153 cases with lumbar intervertebral disc protrusion were selected from the Department of Orthopaedics, Fourth Affiliated Hospital of Guangxi Medical University between June 2002 and August 2006. Among them, the flumeprednisolone and spongia gelatinosa were put surrounding nerve root and dura mater of spinal cord in 83 cases. According to the Macnab criterion, the Lasegue symptom was effectively relieved after operation, and 96.4% of excellent and good result was achieved by periodic follow-up with good functional recovery and satisfactory surgical effect. It indicates that flumeprednisolone and spongia gelatinosa composite is effective in preventing peridural adhesion after intervertebral disc operation.

Objective:To investigate the relationship of micro-inflammation,cellular and humoral immune function and kidney disease of patients with diabetic nephropathy. Methods:124 cases of DN were randomly divided into normal albuminuria group ( NA, n=35),microalbuminuria group (MA,n=45) and clinical albuminuria groups(CP,n=44) based on 24 h urinary albumin excretion rate ( UAER) and the healthy subjects were selected as the control group ( n=35 ) . The levels of C-reactive protein ( CRP ) were measured with radioimmunoassay,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α) and humoral immunity(IgG enzyme-linked immunosorbent assay,IgA,IgM) were measured with ELISA. The levels of immune response ( CD4+Th17,Th17/Treg, CD4+ CD25+ Treg) were measured with flow cytometry cellular. The levels of creatinine ( Scr) ,cystatin C ( CYSC) and UAER of each groups were analyzed with fully automated biochemistry. Results:The levels of CRP,IL-6,TNF-α,Scr,CYSC,UAER of NA group,MA group,CP groups were higher than control groups(P<0. 05),the levels of CRP,IL-6,TNF-α,Scr,CYSC,UAER of CP groups were higher than NA,MA group (P<0. 05). The levels of CD4+CD25+ Treg,IgG were lower than the control group (P<0. 05),while the levels of CD4+ CD25+ Treg,IgG of CP groups were higher than NA group,MA group (P<0. 05). The levels of IgA,IgM,Th17/Treg, CD4+ Th17 of NA group,MA group,CP groups were higher than control groups(P<0. 05). The levels of CRP,IL-6,TNF-α were positively correlated with Scr, CYSC, UAER ( P<0. 05 ) and were negatively correlated with Th17/Treg, CD4+CD25+ Treg, IgG ( P<0. 05). Conclusion:DN patients with micro inflammatory status and immune function disorder,through the control or elimination of pro-inflammatory factors,improve the immune function of DN patients to delay the occurrence and progress of DN patients has important significance.