OBJECTIVE:To evaluate the effect of the implementation of comprehensive reform with“zero drug profit”and the like in Jingjiang City People’s Hospital. METHODS:Comparative analysis was made to the data for the adjustment of medical ser-vices and medicine specifications,control of medical expenses,general condition of hospital operation and hospital compensation mechanism before (2012) and after (2013) comprehensive reform in this hospital. RESULTS & CONCLUSIONS:After the com-prehensive reform,the number of medical services provided by this hospital increased from 1 408 to 1 426 (with increase rate of 1.28%),in which the prices of 949 services raised (accounting for 66.55%);the number of medicine specifications decreased from 1 875 to 1 670 (with decrease rate of 10.93%),but the number of essential medicine specifications increased from 261 to 377 (with increase rate of 44.44%);total medical expense and total medical expense per capita respectively increased from 477 565.0 thousand yuan and 633.21 yuan to 524 865.9 thousand yuan and 686.91 yuan(with increase rate of 9.90% and 8.48%), but total medicine expense and total medicine expense per capita respectively decreased from 207 656.8 thousand yuan and 275.33 yuan to 199 052.7 thousand yuan and 260.51 yuan(with decrease rate of 4.14% and 5.38%),the proportion of medicine revenue in total hospital revenue also decreased from 43.48%to 37.92%(with decrease rate of 5.56%);total medical revenue and expendi-ture respectively increased from 453 825.5 thousand yuan and 217 516.3 thousand yuan to 524 865.9 thousand yuan and 263 733.3 thousand yuan (with increase rate of 15.65% and 21.25%),but total drug revenue and expenditure respectively changed from 208 380.8 thousand yuan and 176 054.1 thousand yuan into 199 052.7 thousand yuan and 196 407.5 thousand yuan(with increase rate of -4.48% and 11.56%);although the compensation reached 26 596.0 thousand yuan after raising the prices of hospital ser-vices,the subsidies(including the subsidy for basic construction and equipment procurement,fund for public health services,fund for the retirement conforming to requirements and subsidy for the balance found after checking revenue and expenditure) which should be granted by the government has not become available. It is an urgent issue that government departments and the hospital further improve relevant management policies to promote sound development of medical and healthcare program.

Evaluation of regional health service system can provide guidance for regional health planning,improve the ability of the national macro-control and supervision,and optimize the medical resource allocation.China has yet to establish a set of scientific and comprehensive evaluation index system.Through the introduction of the importance,influence factors and the current methods in evaluation of regional medical service system in US,suggestions are provided for establishing and improving China's evaluation system of regional health service.

Objective To observe the effect of sensory reeducation on the motor function and activities of daily living (ADL) in stroke patients with proprioceptive disturbance. Methods Sixty patients with proprioceptive disturbance after stroke were randomly divided into the treatment group and observation group, and 30 stroke patients with no proprioception disturbance were recruited as the controls. Three groups were treated with routine rehabilitation interventions, but the treatment group were given sensory reeducation in addition to the regular treatment. Fugl-Meyer motor assessment scale (FMA) and sensory assessment scale, and with Barthel index (MBI) for activities of daily living (ADL) were used to evaluate the patients before and after treatment. Results FMA and MBI scores of patients in three groups were increased significantly (P<0.01) after treatment. The scores of patients in observation group were significantly lower than those of the control group and treatment group (P<0.01). Those of the treatment group and the control group were with no significant difference (P>0.05). Conclusion The proprioception disturbance significantly affects the rehabilitation process, and sensory reeducation can improve the sensory function, motor function and activities of daily living (ADL).

Lactate is considered a dead-end product of glycolysis.Its generation and accumulation promotes tumor growth and metastasis,and it is related to the poor prognosis of tumor.But recent studies have found,tumor cells can also uptake and utilize lactate.With the recent advances in tumor metabolism and gene therapy,lactate is a potential therapeutic target in tumors.

Pancreaticobiliary maljunction(PBM)is closely related to many surgical diseases in which are commonly seen in clinical practice.However,diagnosis of PBM is difficult and it is easily missed.The lack of knowledge and awareness of PMB has once made PBM “the forgotten corner of abdominal surgery”.This essay summarized the current knowledge on the diagnosis of PBM by medical imaging.

[Objective]To probe the research and treatment for Hashimoto thyroiditis in Th1/Th2 migration.[Methods]By referring to related literature from both home and abroad,the author tries to analyze and sort the literature and comes to a reasonable conclusion. [Result]There is a lot of experimental re-search on correction of Hashimoto thyroiditis Th1/Th2 migration at home and abroad,but less clinical treatment research.[Conclusion]Th1/Th2 cellmigra-tion is one of the reasons for Hashimoto thyroiditis.It can promote the development of the disease, have something to do with the rise of thyroid autoanti-bodies.

OBJECTIVE: A series of Bobath concept, Bobath theoretical hypothesis and clinical practice were summarized, to proVide a better understanding of Bobath concept involved in nervous tissues repairing and functional reconstruction. METHODS: Articles concerning the Bobath treatment for stroke-related literature were retrieved in Highwire press, MEDLINE, and Google from 2001 to 2009, using the key words of "Bobath concept, stroke physical therapy". Data of each study were extracted and analyzed following retrieval. Inclusion criteria:①Bobath concept and its theoretical hypothesis. ②New development of Bobath concept in clinical practice. Exclusion criteria: Repetitive studies. The results of retrieved literatura were analyzed. RESULTS: The theoretical basis of Bobath concept is based on present-day knowledge of motor control, motor learning, neural and muscle plasticity, and biomechanics. The latest theories and viewpoints are rasourced from International Bobath Instructors Training Association and the British Bobath Tutors Association. They expounded on the Bobath concept from linking participation, activities and underlying impairments, organization of human behavior and motor control, the consequences of injury and dysfunction in the execution of movement, neural and muscle plasticity, motor learning and so. This article also discusses several important questions which meet in clinical practice. CONCLUSION: Bobath therapy, as a traditional method for stroke rehabilitation, is constantly absorbing the research results from current neuroscience, psychology and other disciplines, and blended with other treatments to promote the development of neuro-rehabilitation medicine.

As originated from hematopoietic stem cell clonal diseases,bcr-abl-negative chronic myeloproliferative neoplasms (MPN) include polycythemia vera (PV),essential thrombocythemia (ET) and primary myelofibrosis (PMF).With the discovery of JAK2 mutations,many new mutations have been identified.With the in-depth study of gene mutation,the pathogenesis of MPN has been gradually uncovered.Novel drugs have been developed accordingly.

As one of the latest anti-angiogenic tumor molecular targeted therapy drugs,bevacizumab has achieved better clinical effect on the treatment of gastrointestinal cancer and ovarian cancer.This review focuses on the significance of bevacizumab combined with chemotherapy for the treatment of cervical cancer.

Pediatric blood purification requires reliable access to the circulation.Central venous catheters play an important role in the delivery of pediatric blood purification.A central venous noncuffed,nontunneled catheter is the best choice for short-term(less than 3 weeks) blood purification.A cuffed,tunneled catheter is preferable to long term(more than 3 weeks) blood purification.However,there are many complications associated with central venous catheters,such as catheter-induced thrombosis,catheter-related infection,and central vein stenosis.This article reviews the prevention and treatment of complications most frequently occurring with central venous catheters.