Traditional funding allocation methods often only consider working hours or income ratios,making it difficult to fully measure the quality and technical complexity of medical work.Therefore,it first analyzed the difficulties in managing the cost of personnel expenses in public hospitals.Then,the limitations of two traditional allocation methods,namely the labor based econometric allocation model and the profit oriented allocation model,were analyzed.Subsequently,a work achievement sharing method based on performance bonuses in one hospital with multiple districts was proposed,which comprehensively integrates multidimensional factors such as workload,technical difficulty,surgical category,and personnel titles.The results indicate that for the allocation of personnel and hospitalization expenses,the econometric allocation model has the highest allocation ratio,which is 54.35%,Next is the profit oriented allocation model,with an allocation ratio of 30.64%.The proposed performance-based bonus based work achievement sharing method has the lowest sharing ratio of 20.55%and better reflects the quality and labor value of doctors'work.The research aims to provide reference for optimizing the cost accounting system and improving operational efficiency of public hospitals.

Traditional funding allocation methods often only consider working hours or income ratios,making it difficult to fully measure the quality and technical complexity of medical work.Therefore,it first analyzed the difficulties in managing the cost of personnel expenses in public hospitals.Then,the limitations of two traditional allocation methods,namely the labor based econometric allocation model and the profit oriented allocation model,were analyzed.Subsequently,a work achievement sharing method based on performance bonuses in one hospital with multiple districts was proposed,which comprehensively integrates multidimensional factors such as workload,technical difficulty,surgical category,and personnel titles.The results indicate that for the allocation of personnel and hospitalization expenses,the econometric allocation model has the highest allocation ratio,which is 54.35%,Next is the profit oriented allocation model,with an allocation ratio of 30.64%.The proposed performance-based bonus based work achievement sharing method has the lowest sharing ratio of 20.55%and better reflects the quality and labor value of doctors'work.The research aims to provide reference for optimizing the cost accounting system and improving operational efficiency of public hospitals.

Objective To investigate the pathogenic mutations of BRCA1 and BRCA2 in patients with early-onset breast cancer(≤35 years) and explore the relationships between BRCA1/2 mutations and clinical features.Methods Seventy-four patients with early-onset breast cancer were enrolled,who were treated in Hospital 307 between September 2014 and June 2016.High-throughput sequencing was used to test the 49 exon sequences and adjacent sequences of BRCA1 and BRCA2.χ2 test was used to analyze the distribution of BRCA1/2 pathogenic mutations in each group that was set up according to clinical features.Results Fifteen mutations(20.27%) were identified,including 5(6.76%) in BRCA1 and 10(13.51%) in BRCA2.Eleven new pathogenic mutations were discovered,and BRCA1:c.5470_5477delTGCCCAAT was found in one patient.The frequency of BRCA1/2 mutations in the group with a family history of breast cancer or ovarian cancer was higher than in the group without a family history (40.91% vs 11.54%) (χ2=6.534,P=0.011).Conclusion BRCA1/2 pathogenic mutation is significant for early-onset breast cancer,especially for those with a family history of breast or ovarian cancer.The new mutations may be specific to Chinese people.BRCA1:c.5470_5477delTGCCCAAT may be the ancestor mutation among the Chinese.

BACKGROUND:Magnetic bone cements have been used to treat bone metastasis in Japan, which are made by adding Fe3O4 nanoparticles to bone cements. Magnetic bone cements containing micron carbonyl iron powder have not been reported.
OBJECTIVE:To prepare polymethylmethacrylate-based cements containing carbonyl iron powder, and to test the magnetic characterizations and the heat-generating abilities of al samples according to ISO 5833 standard in vitro. METHODS:The carbonyl iron powder was mixed with polymethylmethacrylate-based bone cement power to prepare magnetic bone cements containing 0%, 20%, 30%, 40%, and 50%carbonyl iron powder, respectively. The setting time, polymerization temperature, compressive strength, magnetic property and in vitro heat-generating ability were tested.
RESULTS AND CONCLUSION:The setting time and polymerization temperature were increased with the increased content of carbonyl iron powder. The highest polymerization temperature of each sample was 65-70 ℃. The increased content of carbonyl iron power could not change the highest polymerization temperature but delay its appearance. The compressive strength of each sample was higher than 60 MPa, and moreover, the compressive strength of the pure polymethylmethacrylate-based bone cement was higher than 60 MPa, which met the ISO 5833 standard. The saturation magnetic intensity was increased with the increasing of carbonyl iron power content. The heat-generating ability of magnetic bone cements had a positive correlation with the magnetic field strength and the content of carbonyl iron powder.

Objective To evaluate the efficacy of pressure bladder indicator in guiding epidural puncture.Methods Test Ⅰ Thirty-two patients scheduled for epidural puncture were studied. After successful epidural puncture, the end of the epidural needle was connected to a pressure sensor to measure the epidural space pressure. Test Ⅱ Seventy patients scheduled for epidural puncture were studied. The epidural puncture was performed using the pressure bladder indicator. The successful condition of the pressure bladder indicator in guiding epidural puncture was recorded. Results The epidural space pressure was ( 10 ± 4) cm H2O. Seventy patients completed epidural pucture under the guidance of the pressure bladder indicator. The success rate was 100%.Conclusion The pressure bladder indicator can serve as an assistance for epidural puncture and has clinical application value.