Objective To investigate the current policy of medical insurance expenditure control in Shanghai and put forward feasible advice. Methods Survey in 5 tertiary first-class hospitals in Shanghai involving 400 doctors and patients was conducted.The result of the questionnaire was tracked with Microsoft Excel 2000.The expense reports during 2001 to 2006 from the Office of Medical Insurance of Shanghai Renji Hospital was collected.All the data were statistically analysed. Results The global budget system was accepted by both the doctors and patients.Charging based on disease categories was proved a relatively satisfying method.Drug expenditure control was concerned by both the doctors and patients. Conclusion Ever since the global budget system of medical insurance is implemented in Shanghai,the medical insurance expenditure has been effectively controlled.The key point is the restraint of irrational consumption during the medical treatment.

Endoscopy ; instrumentation ; methods ; trends ; General Surgery ; methods ; Humans

To improve the precision of image registration based on corner detection, a relative position function between multiple points to determine matching points accurately. First the corners in images are detected using Harris detector, and clustering method is used to eliminate most wrong matches after coarse screening. Then the proposed relative position function is used as a criterion of precise matching. Finally the image registration process is accomplished by affine transformation. Results show that the proposed algorithm is more effective and accurate than conventional registration algorithm.

ObjectiveTo investigate the language cortex organization characteristics of native Chinese. Methods20 patients who underwent language mapping via intraoperative direct cortical electrical stimulation (ioDCES) under awake anaesthesia for glioma in dominant hemisphere were analyzed retrospectively. Results16 patients were identified at least one language site, 3 patients located in the frontal and 1 patient in the temporal lobe. The language sites mostly located in the perisylvian region. The frontal language sites conformed to traditional Broca's areas, but the superior temporal gyrus contained much more language sites than the middle temporal gyrus.ConclusionHigh individual variability in language organization indicates a need for revision of the classical model of language localization. Because of the samples were too small, our current dates can't fully reflect language cortex organization characteristics of native Chinese.

Objective:To compare the therapy effects of chemotherapy and non-chemotherapy groups and to determine the value of chemotherapy for adult diffuse low-grade gliomas. Methods:We reviewed and analyzed 64 patients with adult diffuse low-grade glio-mas admitted to the Beijing Tiantan Hospital from May 2005 to April 2008. Among the patients, 18 received 4 to 12 cycles of temozolo-mide chemotherapy after operation and radiotherapy, whereas the other 46 cases only received radiotherapy. The progression-free survival of the two groups was compared. Results:The median progression-free survival of the chemotherapy and the control groups were 67.8 and 51.3 months, respectively. The results of the comparison implied a significant difference (χ2=8.741, P=0.003). Conclu-sion:Chemotherapy can improve the progression-free survival of the patients with adult diffuse low-grade gliomas, and thus, can be recommended as its effective therapy.

Diverticulum ; diagnosis ; diagnostic imaging ; Heart Defects, Congenital ; diagnosis ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Objective To investigate the effect of intrathecal (IT) dexmedetomidine on the expression of cAMP response element-binding protein phosphorylation (p-CREB) in spinal dorsal horn in a rat model of bone cancer pain. Methods Sixty-four adult female Wistar rats weighing 200-240 g were randomly divided into 4 groups (n = 16 each): sham operation group (group S); bone cancer pain group (group BP); normal saline group ( group NS) ; dexmedetomidine group (group D) . Bone cancer pain was induced by injecting Walker 2S6 mammary gland carcinoma cell suspension (2 ×106 cells/ml) 10μl into the medullary cavity of the tibia in BP, NS and D groups. Groups S and BP received no IT injection. Croups NS and D received IT injection of NS 10 μl and dexme detomidine 5 μg/kg respectively 7 days after successful establishment of the model. Ten animals were selected from each group at 1 day before IT administration (T0), immediately before IT administration (T1 ) and at 1, 6, 12 and 24 h after IT administration (T2-5 ) and paw withdrawal threshold (PWT) to mechanical stimuli was measured with von Frey filaments. The other 6 rats in each group were sacrificed at T4 and the spinal cord was removed for determination of p-CREB expression in the spinal dorsal horn.Results PWT was significantly decreased at T1-5 and pCREB expression up-regulated at T4 in BP, NS and D groups compared with group S ( P ＜ 0.05) . Compared with group BP, PWT was significantly decreased at T2-5 and p-CREB expression down-regulated at T4 in group D ( P ＜0.03), while no significant change in PWT and p-CREB expression was found in group NS (P ＞ 0.05) .Conclusion IT dexmedetomidine can reduce the bone cancer pain through inhibiting the phosphorylation of CREB in rat spinal dorsal horn.

0.05).There was a positive correlation between the tempo of the engraftment and the progressive increase of the doses of MNC in the range of (3～5.99)?108/kg,but which was not found in the range of 6?108/kg.Conclusion These results indicate that MNC taken as an index for the measurement of the hematopoietic stem cell/progenitor content can reliably predict hematopoietic reconstitution after both HLA-matched and-mismatched sibling donor peripheral blood stem cell transplantation,with the rate and tempo of engraftment comparable with that in CD34+ cell group,and however,the target dose was reached with one apheresis in all 83 donors in MNC group(100%),as compared with 14 donors in CD34+ cell group(37.84%),suggesting that MNC may replace CD34+ cell as an independent index for the assessment of the stem cell/progenitor content in clinical practice.

Objective To discuss the imaging features of the localized fibrous tumor of pleura(LFTP).Methods 10 cases of LFTPproved patholgically were underwent CT scanning,while MRI scanning was performed in 3 cases.The imaging findings of LFTP wereanalysed.Results 9 cases were benign tumors and 1 case was malignant tumor.The main CT manifestations were single soft tissue massadhering to the pleural surface,clearly boundary,homogeneous or unhomogeneous density,obvious homogeneous or non-uniformityenhancement."Pleura mass hat"was characteristic appearance located the pleura mass.The mass formed acute angle or obtuse angle with the adjacent pleura,which was related to mass size and shape.MRI manifestations were hypointense or isointense on T_1WI and T_2WI,non-uniformity signal.1 case of giant LFTP showed scattered in disorder and clutter signal on T_2WI.Inside tumor peduncle of the giant LFTP was connected with the pericardium.Conclusion CT is a main imaging diagnostic technique for LFTP,while MRI is commonly superior to CT in localizing the mass and showing inner characteristics for the bigger pleural masses.The appearance of pleuraL tumor peduncle is an important sign in diagnosis of LFTP.

Objective To examine cerebrovascular reactivity to CO2 inhalation in mice. Methods In vivo Two-Pho?ton imaging technique was used to record the reaction of cerebral cortical vessels including penetrating artery, surface vein and capillary in 5 male C57 mice after CO2 inhalation under a thinned-skull cranial window. Nitric oxide syntheses inhibitor L-NAME and Prostaglandin syntheses inhibitor Indomethacin were used to block different vasodilator pathways, respectively. Results Different mouse cortical vessels displayed different degrees of dilation to 1-minute 5%CO2 inhala?tion. The penetrating artery exhibited the most obvious dilation (45.01%±4.45%). L-NAME intervention significantly di?minished cerebravascular CO2 reactivity(P<0.05). Indomethacin significantly attenuated the dilation of artery but not capillary comparing with L-NAME intervention(P<0.05). Conclusions Different vessels react differently to CO2 inhala?tion in which postaglandins and NO signal pathways are involved.