Objective:To further analyze the reasons for operating loss of the sample hospital so as to resolve the developing predicament of children's hospitals.Methods:The financial data of the sample hospital from 2013 to 2015 were selected to compare the workload,incone structure,average cost and project cost before and after the medical reform so as to analyze the reason for the operation loss of the sample hospital.Results:According to the analysis results,the operating loss of sample hospital could be attributed to the following reasons:the healthcare pricing was underpaid with the high service costs,the quantity of outpatient service declined with the change of income structure,the financial compensation by legal was not fully funded.Conclusion:From the perspective of external policy,government medical service pricing should reflect the particularity of pediatrics.Government should increase the public subsidy to children's hospital.From the perspective of hospitals,children's hospital should optimize the service process,develop the characteristics of specialized pediatrics and control the medical cost to improve health care quality while improving market competitiveness.

Objective To explore the clinical efficacy and complications of vitreoretinal diseases and cataract treated with combined surgical approach.Methods A retrospective analysis of 294 eyes received vitrectomy combined with cataract surgery was conducted.The clinical effect and complications of combined surgery in the treatment of various vitreoretinal diseases with cataract were analyzed.Results Of 294 eyes,visual acuity improved in 236eyes(80.3％);unchanged vision in 32 eyes; vision loss in 26 eyes.Phase Ⅰ of the implanted IOL for a total of 34eyes,visual acuity was improved (100.0％),there were 260 eyes not implanted IOL,corrected visual acuity improved in 202 eyes (78.0％),the vision improvement between the two groups had no statistically significant difference (x2 =0.301,P ＞ 0.05).Conclusion The combined treatment of vitreoretinal surgery is an effective way to cataract disease,the clinical effect is good,which is worthy of promotion.

To investigate the clinical effect of pantoprazole combined with traditional Chinese medicine for gastroesophageal reflux. A total of 50 cases of gastroesophageal reflux selected from January 2019 to December 2019 in Aviation General Hospital were randomly divided into the control group and the observation group. The control group was given pantoprazole, and the observation group was given traditional Chinese medicine combined with pantoprazole. Both groups were treated for 28 days. The recovery of clinical symptoms, status of esophageal mucosa by endoscopy and the incidence of adverse reactions were compared between the two groups. The clinical symptoms and status of esophageal mucosa in both group were obviously improved. Efficiency of the observation group was significantly higher than that of the control group( P<0.05). No serious adverse reactions happened during treatment. Pantoprazole combined with traditional Chinese medicine has definite clinical effects in the treatment of gastroesophageal reflux, which can improve the clinical symptoms and the recovery of esophageal mucosa of patients with high safety.

Aplastic anemia(AA)is a rare disease oringed from hematopoietic cell,characterized by failure of the bone marrow and pancytopenia in peripheral blood.The mechanism of AA is indistinct,it can be congenital,or acquired disposition.Acquired AA may be secondary to poisonous,radiation,virus infection and some medicine.All these factors can injure bone marrow directly,suppressing the proliferation and differentiation of bone marrow,on the other hand,the immune system play a pivotal role indirectly.This review focused on the pathologic classification,mechanism of drug-induced aplastic anemia.

Objective To compare efficacy and complications of endoscopic sphincterotomy(EST) and limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD) for choledocholithiasis.Methods A total of 120 choledocholithiasis patients (stone diameter ≤ 2 cm)underwent endoscopic treatment,including 60 cases of EST,60 ESBD.The stone-free rate,complication rate of postERCP pancreatitis,hemorrhage,perforation and recurrence rate of stones were compared between two groups.Results Success rates of one-time removal were 90.0％ (54 cases) and 93.3％ (56 cases) in group EST and ESBD (x2 =0.436,P =0.743).Eleven case (18.3％) and 4 case (6.7％) underwent mechanical lithotripsy(x2=3.733,P =0.053).There were 4 cases of hemorrhage,6 post-ERCP pancreatitis and 1 perforation in EST group,while in ESBD group,there was 1 case of hemorrhage,4 pancreatitis and no perforation.The total rates of early complications were 18.3％ (11/60) and 8.3％ (5/60) in two groups (x2 =3.322,P =1.422) and recurrence rate of stones were 21.7％ (13/60) and 6.7％ (4/60) respectively (x2=5.551,P =0.034).Conclusion There are no significant differences between EST group and ESBD group in treatment of choledocholithiasis,in success rate of one-time removal and the occurrence of early complications,but the recurrence rate of late complications in ESBD group is lower than that in EST group.ESBD shows high efficacy and safety for younger patient of choledocholithiasis.

Objective To discuss the microsurgical treatment for tethered cord syndrome (TCS) caused by intraspinal lipomas. Methods Thirty-two patients with intraspinal lipoma TCS were treated microsurgically. On surgery the tethering lesions of lipoma were excised and anomalies restricting the spinal cord were removed. Results Following the operation, cerebrospinal fluid subcutaneous leakage had occurred in 3 patients, who were cured by expectant treatment. The patients were followed for 3~12 months (mean, 6 months). Five patients were cured, 21 got improved, and 6 had no change. Conclusions Application of microsurgical technique for intraspinal lipoma TCS has advantages of fewer complications and better improvement of nerve functions.

Objective To investigate advantages and disadvantages of unilateral hemilaminectomy for the microsurgical removal of cervical intraspinal tumors. Methods Twenty-three patients with cervical intraspinal tumors were treated microsurgically with unilateral hemilaminectomy. In condition that the vertabral lamina was kept intact in bony structure, an opening (key-hole) was made in the unilateral lamina by using a drill or a small-sized bone rongeur. Then cervical intraspinal tumors were removed via the “key-hole”. Results Tumors were completely removed in all the 23 patients and no symptoms relating nerve injuries were observed. Postoperative follow-up for 3~16 months (mean, 8 months) revealed no recurrence and spinal deformity. Conclusions Unilateral hemilaminectomy for the treatment of cervical intraspinal tumors is a mini-invasive procedure which benefits the spinal stability. The pitfall of the technique lies in limited surgical field.

Liver transplantation,as a new treatment for terminal-stage liver diseases,has made remarkable strides in the past decades.Animal models play an essential part in liver transplantation research,but differ from one another and have different limits to be used in imitating human clinical conditions.Therefore,it is the base for the development of liver transplantation to build and improve animal models by correctly selecting and utilizing different characteristics of different animals.

Objective To study the effect of unsaturated fatty acid of Pinus koraiensis on lipid metabolism in rats. Method Unsaturated fatty acid was extracted and concentrated from Pinus koraiensis by supercritical fluid extraction and urea inclusion method. 40 rats were divided into 8 groups randomly. Except normal control group, the other groups were fed high fat diet. Normal control and obesity control groups were fed i.g. normal saline,Seed oil control group was fed i.g. pine nut oil and the other groups were fed i.g. 0.4, 0.8, 1.2, 1.6 and 2.0 g/kg bw unsaturated fatty acid. Body weights were weighed every week. After 4 w, the rats were killed, the serum total triglycerides(TG), total cholesterol(TC), high density lipoprotein cholesterol (HDL-C) and hepatic lipase(HL), lipoprotein lipase(LPL), liver lipofuscin (LP) were assayed. Results Compared with obesity control group, the body weight, body fat ratio, serum TG, LP and TC level were reduced remarkably. HL and total lipase (LA) level enhanced remarkably. Conclusion The unsaturated fatty acid of Pinus koraiensis could enhance the lipid metabolism in obese rats.