A summary is made on a11 the experiences from five attached general hospitals which carried out Shanghai new policy of Work rescheduling and organization restracturing.The external pressure and internal motive of the change from"compulsory rescheduling"to"voluntary rescheduling" are analyzed.A search for the distribution of the points for attack on the problem of hospital control of medical cost is made.A comparative study is conducted on the relationship between time and the inten- sity of the control,the inner relationship between the independent variables and the intensity of control. The conclusion shows the change of the hospital's control role to the voluntary one has something to do with the equalibrium of relative forces.The point for breakthrough lies at the control of drugs.A search for the points for attack on the problem of hospital control of medical cost is not only necessary for arresting the rocketing of medical cost,but also helpful for capturing the confidence of the concerned and strengthening hospital management,thus laying a good foundation for a stable transition to a new healthcare insurance program.

The study on attitudes towards people with disabilities is one focus of special education, rehabilitation psychology and rehabilitation counseling. This article reviewed the measurement methods of the attitude towards people with disabilities from directed methods and indirect methods, and their limitation and future research tendency in this field were prospected.

A typical investigation on third-tier general hospitals, third-tier specialty hospitals, second-tier district or county central hospitals, urban community hospitals, and rural township health centers in Shanghai was conducted so as to examine the responsiveness of outpatients and inpatients to the health system. Most of the patients surveyed said that they could get prompt attention and that they had convenient access to medical information from the community or the mass media. More than half of the inpatients and outpatients thought that they had autonomy with regard to treatment and a greater number of patients made their own choices of doctors and nurses. Most of the patients were willing to talk freely with their doctors about their confidential medical history and could get rational explanations about their conditions from the doctors. The results indicate that reform of the health system in Shanghai has attached importance to the responsiveness of patients and that good effects have been achieved.

Objective:To analyze and the smile line of Zhuang-Chinese youths.Methods:1 00 Zhuang volunteers aged 1 8-25 years were recruited for this study.The faces were individually registered by digital videography.The length and thickness of upper lips and mandibular incisor crown height appearance at rest,smile and laugh were recorded.Statistical analysis was performed using Mann-Whitney-U Test and non-parametric analysis.Results:The upper lip in men was longer than that in women at rest(P<0.05 ).The upper lip length increased and thickness decreased at smile and laugh in all subjects,in men was longer and thicker than in women(P<0.05),but there was no significant difference of upper lip thickness at rest between sexes(P<0.05).The mandibular anterior teeth,gingival papilla of all subjects were appeared at smile and laugh,there was no significant difference between sexes(P<0.05). Gingiva appearance at smile was in less than 1 0%of the subjects.39%subjects had high smile line,46%had average smile line and 1 5% had low smile line.Conclusion:Most of the Zhuang youths have moderate smile line,less high smile line and least low smile line.

OBJECTIVE To investigate the clinical features and causes of nosocomial infection in schizophrenics with tuberculosis so as to take effective measures for better prevention and treatment.METHODS A retrospective investigation was used to analyze the clinical features and causes of nosocomial infection in 207 schizophrenics with tuberculosis.RESULTS The rate of nosocomial infection in schizophrenics with tuberculosis was 39.13%.The main infection way was via respiratory tract,followed by skin,soft tissue and gastrointestinal tract.The period and degrees of tuberculosis,the history of smoking,psychiatric symptoms and the complications were the causes of nosocomial infection.CONCLUSIONS Controlling psychiatric symptoms actively,preventing and treating somatic complications,using antibiotics rationally and less or no smoking are the effective measures to avoid nosocomial infection in schizophrenics with tuberculosis.

Objective To establish a simple ,stable acute liver injury model induced by CCl4 to observe effects of hepatocyte transplantation .Methods CCl4 plant oil with different concentration of 20% and 50% was used in mice by intraperitoneal injection , of which the dose was 2 mL/kg ,and then materials were taken at different time points respectively .Mice survival rate ,alanine amin-otransferase (ALT) ,aspartate aminotransferase (AST) and the pathological changes of the liver were detected .Results Mice sur-vival rate in 20% CCl4 intraperitoneal injection was significantly higher than that of 50% .ALT and AST in experiment group were significantly higher than that of control group ,but there was no significant difference between two experimental groups .Pathologi-cal examination showed that mice liver cells showed typical cytoplasmic ,ballooning ,scattered punctate ,piecemeal necrosis and in-flammatory cell infiltration in 20% CCl4 intraperitoneal injection ;while in 50% CCl4 ,there was obvious fibrosis ,in addition to the mentioned heavier lesions .Conclusion 20% -50% CCl4 intraperitoneal injection in 2 mL/kg dose can induce different degrees of relatively stable liver injury ,and its concentration determines the degree of liver injury .Acute liver injury induced by 20% -50%CCl4 was an ideal model for hepatocyte transplantation experiment .

Methods: Papers on the research of HUA prevention and treatment with medicine-food homology from December 15, 2002 to August 10, 2024 were screened and collected through China National Knowledge Infrastructure (CNKI), PubMed, ScienceDirect, and Google Scholar. Subsequently, the impact of these medications and their extracts, as well as the active compounds on HUA were assessed. Results: A total of 148 relevant papers were collected, including 43 kinds of Chinese medicines and 61 active compounds, all of which have anti-HUA activity. Among them, 41 kinds of Chinese medicines could inhibit the activity of xanthine oxidase, thus leading to the inhibition of uric acid production; and 22 kinds of Chinese medicines could facilitate uric acid excretion, while 15 kinds of Chinese medicines could reduce the inflammation levels in the body and promoting renal protection. Notably, polyphenols and flavonoids are the key active components for the uric acid-lowering effects. Conclusion This study systematically summarized and analyzed the uric acid-lowering effects and mechanisms of Chinese medicines with medicine-food homology, laying a foundation for their development as HUA agents.

OBJECTIVE To investigate the clinical characteristics and drug resistance of meticillin-resistant Staphylococcus aureus(MRSA) among inpatients in Huaxi Hospital in five years.METHODS We analyzed clinical distribution and resistant data on inpatients infected with MRSA between Jan 2003 and Dec 2007 in Huaxi Hospital,and collected the annual consumption of common used antibiotics,amount of MRSA isolates and MRSA isolated rate from Staphylococcus aureus(SA) strains.The data were analyzed by the method of Spearman analysis in SPSS.RESULTS We analyzed totally 1478 MRSA strains.The most common specimens of MRSA were sputum(70.8%),other secretions(14.2%) and blood(4.6%).The MRSA strains were frequently detected in ICU(29.8%),Department of surgery(17.3%) and Department of respiratory Medicine(6.4%).The drug resistance rate to ampicillin,tetracycline,rifampin,imipenem,ciprofloxacin,gentamicin,cefalothin,cefotaxime and cefazolin were beyond 90% in five years.The drug resistance rate against Erythromycin,Clindamycin and Clarithromycin decreased gradually from 93.1%,92.2% and 95.5% in 2003 to 82.3%,76.7% and 81% in 2007.It had not been found the vancomycin-resistant MRSA.Except Cotrimoxazole,the drug resistance rates of MRSA in ICU were almost higher than those in non-ICU departments.Based on the SPSS analysis,we concludea that annual consumption of etimicin had a positive correlation with MRSA,and

Objective To investigate the clinical efficacy and mechanism of vacuum-assisted closure (VAC) in the preoperative and postoperative treatment of bedsore united with skin flap.Methods Twenty two cases with bedsore were randomly divided into experimental and control groups.In the control group,the surgery of flap was performed after the treatment of continuous negative pressure about 7-10 days and the VAC was not applied after operation.While in the experimental group,VAC was not used before operation.It was applied on flaps as soon as sutured the border of flap and decubitus ulcers and removed after 7-10 days.By comparing the general appearance of two groups,microvessel count and the detection rate of bacterial culture and other indicators,the clinical effects of two treatments were investigated and the preliminary mechanism was analyzed.Results After preoperative VAC treatment,11 cases of control group showed a little granulation tissue growth,less subcutaneous hematoma and wound effusion,increased microvessel count and negative bacterial culture.However,there were 4 cases of death cavity residual,subcutaneous hematoma and wound effusion,positive bacterial culture and another 4 cases of delayed healing with skin flap repairing bedsore.The application of VAC in experimental group showed close contact of flap with the basement,less effusion,increased microvessel count and negative bacterial culture.One case of skin flap had a small area of separation,after the dressing of skin and the flap survived.The other wounds healed by first intention.Conclusions The use of VAC to repair bedsore can reduce the number of operation,and it is beneficial to the flap survival.

Objective To investigate the effect of high mobility group box‐1(HMGB1) on the migration of vascular smooth cells (VSMCs) and the role of TLR4‐dependent PI3K/Akt pathway in the process .Methods Primary VSMCs were isolated from the thoracic aorta of male SD rats and cultured in vitro .Control group ,TLR4 siRNA transfected group ,control siRNA transfected group and PI3k inhibitor (LY294002) intervention group were stimulated by HMGB1 (0 .1-1 000 .0 ng/mL) .Expression of TLR4 mRNA was detected by RT‐PCR ,protein expression of TLR4 ,Akt ,pAkt ,PI3K were detected by Western blot .Activity of the im‐munoprecipitated PI3K enzyme was assessed in a competitive ELISA .The migration and cell viability of every groups were ob‐served .Results HMGB1 (0 .1 -1 000 .0 ng/mL) stimulated VSMCs migration in a dose‐dependent manner and incubation of VSMCs with 100 ng/mL caused a rapid migration (P< 0 .05) .At the concentrations used ,HMGB1 did not cause any cytotoxic effects (P<0 .05) .Migration of VSMCs toward HMGB1 was significantly inhibited by silencing of TLR4 (P<0 .05) .Pretreated cells with TLR4 siRNA or the PI3K inhibitor LY294002 could markedly block PI3K/Akt pathway activation and VSMCs migration mediated by HMGB1 (both P<0 .05) .Conclusion HMGB1 stimulated VSMCs migration in a dose‐dependent manner and TLR4‐dependent PI3K/Akt signaling pathway played an important role in the migration of VSMCs mediated by HMGB1 .This research indicates that TLR4‐dependent TLR4/PI3K/Akt signaling pathway could be the target in the treatment of obstructive cardiovascu‐lar disease .