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 observe the curative effect of lumbar sympathetic nerve injury combined with systemic and local medication in intractable lower limb ischemic pain.Methods21 patients with intractable lower limb ischemic pain accepted lumbar sympathectomy,at the same time foot topical Votalinemulgel used and Combined with anticonvulsants and opioids according to circumstances,the visual analogue scale of resting pain(visual analogue scale,VAS),the Local skin temperaturebefore and after treatment were observed and evaluated.ResultsAfter Lumbar sympathetic nerve block and topical Votalinemulgel,21 patients had pain relief.After treatment, 2 patients had poor effect,the remaining 19 patients had pain relief to VAS<3, 4 patients did not need systemic analgesic drugs,the rest of the patients need systemic analgesic drugs.ConclusionIt is necessary to adopt multimodal comprehensive treatment for intractable lower limb ischemic pain.

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.

Objective To evaluate the role of hippocampal histone acetylation in isoflurane-induced amnestic effect in mice.Methods Fifty-four male C57BL/6J mice,aged 8 weeks,weighing 18-22 g,were randomly divided into 3 groups (n =18 each) using a random number table:control group (group C),isoflurane group (group ISO) and histone deacetylase inhibitor sodium butyrate group (group SB).Group C inhaled 35％ oxygen for 30 ain,and ISO and SB groups inhaled the mixture of 35 ％ oxygen and 0.4％ isoflurane for 30 min,and then the animals underwent contextual fear conditioning training.After the end of training,normal saline 6 ml/kg was intraperitoneally injected in C and ISO groups,while in group SB,sodium butyrate 1.2 g/kg was intraperitoneally injected.One hour after the end of training,3 mice were sacrificed randomly in each group and their hippocampi were immediately removed for determination of the expression of acetylated histone-H3 (Ac-H3) and Ac-H4 by Western blot.Twenty-four hours after the end of training,contextual fear conditioning test and open field test were conducted.The freezing time,total distance and time of staying at the central zone were recorded.Results Compared with group C,Ac-H3 and Ac-H4 expression was significantly down-regulated,and the percentage of freezing time during testing was decreased in group ISO (P ＜ 0.05).Compared with group ISO,Ac-H3 and Ac-H4 expression was significantly up-regulated,and the percentage of freezing time during testing was increased in group SB (P ＜ 0.05).There was no significant difference in the percentage of freezing time during training,total distance and time of staying in the central zone among the 3 groups (P ＞ 0.05).Conclusion Hippocampal histone acetylation is involved in the regulation of isoflurane-induced amnestic effect in mice.

Objective To analyse the long-term result and prognosis of 18 FDG PET/CT positioning three - dimensional conformal radiotherapy ( 3 DCRT ) for stage Ⅲ non - small cell lung cancer. Methods Sixty-four cases with stage Ⅲ non-small cell lung cancer (clinical stage Ⅲa- Ⅲb ) were randomly divided into two groups: PET/CT positioning three-dimensional conformal radiotherapy group (PET/CT group) and the conventional CT positioning three-dimensional conformal radiotherapy group (conventional CT group). In the PET/CT group, the target volume and critical organs were sketched according to PET/CT after fusion of the PET and the CT images; the treatment plan was worked out, then conventional fractionated 3DCRT ( total dosage around 40 Gy) followed by field-shrinked radiotherapy to a total dose of 65 Gy or sowas performed ;in the conventional CT group, the target volume and critical organs were sketched according to CT and 3DCRT were performed to the same total dose; All cases were treated with the TP scheme (paclitaxel 175 mg/m2,d1 ,cisplatin 40 mg,d2-4) adjuvant chemotherapy for 6 cycles after the radiotherapy. Results The followup rate was 100%. The number of patients who completed the 1-,2-and 5-year follow-up were 40,20 and 11 respectively ;The number of patients of the PET/CT group and conventional CT group were 23 and 17,11 and 9,7 and 4 respectively. Target volumes of 13 cases in the PET/CT group were changed. The complete remission and partial remission rates of the two groups were 13% 、66% and 19% 、53% (x2 = 0. 33, P =0. 564), respectively. The 1-,2-and 3-year local control rates of the PET/CT group and conventional CT group were84 % 、66% 、53 % an d72% 、59% 、44% ( x2 = 2.36, P = 0. 124 ) respectively. The1 -, 2-and 3-year survival rates were 72% 、34% 、22% and 53% 、28% 、13% (x2 =2. 46,P =0. 117) respectively. The level-1 and level-2 lungs' and trachea's late radiation injury of the PET/CT group and the conventional CT group were 28% and 53% ( x2 = 4. 14, P = 0. 042 ), respectively. The hilar and mediastinal lymph node recurrence rates of the PET/CT group were lower than those of the conventional CT group, were 3% ,25%(P = 0. 026) and 6%, 28% ( P = 0. 042 ), respectively. The main reason for treatment failure was distant metastasis both in the PET/CT group and conventional CT group,56% and 47% (x2 = 0. 56,P = 0. 453 ),respectively. Conclusions PET/CT, as a method of sketching the target of stage Ⅲ non-small cell lung cancer, can improve the radiation treatment plan, reduce the recurrence rate of hilar and mediastinal lymph nodes, meanwhile it can not improve the long-term survival rate; Distant metastasis was the main reason of failure.