Discussion on the county -level public hospitals reform from the point of medical care management / 中国基层医药

County -level public hospitals reform is an important measure of deepening reform of the medical and health system.Medicare payments system reform is therefore an important part of public hospitals reform.By abolishing drugs addition,registration fee,treating fee and setting up medical service fee instead,our hospital carried on a diversified management style in the aspect of medical insurance total prepaid system.The implementation of the reform measures turns out a good result:reasonably keeping a control on the medicare spending and really embodying the transformed of interests patterns.On the premise of ensuring patients interests,medical personnel′s interests are improved to a new level and medical insurance fund are also brought under a reasonable control.The medicare payments system reform puts equity in access and people benefit as the starting point and footing of county -level public hospitals reform,thus lays a foundation of further development of public hospitals reform.

Clinical experience of early surgical treatment to acute biliary pancreatitis / 国际外科学杂志

Objective To investigate the opportunity and methods of acute biliary pancreatitis.Methods A retrospective review was performed in 85 consecutive patients from June 2008 to October 2014 with acute biliary pancreatitis in Beijing Yanqing County Hospital.Results Eighty-five patients were performed operation.Sisty-two patients underwent laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration.Fifyfourcases were found biliary calculi and take away the stones.All patients were no complications such as infection,bile leakage,hemorrhage,bile duct injury,cicatrical stenosis of papilla.After three months of follow-up without biliary residual bile stones and recurrent pancreatitis.Conclusions The early surgical treatment for no severe acute biliary pancreatitis is necessary,safe and feasible.Actively biliary tract exploration can avoid bile duct residual stones.

Study of ulnar artery cutaneous perforators with color Doppler flow imaging / 中华超声影像学杂志

ObjectiveTo study the distribution,location and hemodynamics of perforating branches of the ulnar artery with color Doppler flow imaging (CDFI).MethodsPerforating branches of ulnar arteries were examined in 80 healthy volunteers in both forearms using CDFI.Following parameters were detected:number,diameter,jumping-off point,course,location and peak blood velocity.All the parameters data were analyzed statistically.ResultsThree hundred and forty-five perforating branches were detected in total 160ulnar arteries.These branches were classified into three types:type Ⅰ,myocutaneous perforator (10.3 ％);type Ⅱ,septocutaneous perforator(87 ％ ) ; type Ⅲ,direct cutaneous perforator (2.7 ％ ).The most dominant branches were located in the mesial of the upper third,middle third and lower third of the forearm.There was no significant difference among all age groups and no difference in peak blood velocity between left side and right side( P ＞0.05).The peak blood velocity was higher in male than that in female.( P ＜0.05).In relaxing period,the blood flow rate was almost disappeared and the frequency spectrum showed the characteristics of single direction,lower blood velocity and higher blood resistance.ConclusionsCDFI with high resolution showed better results of distribution and location of perforating branches of the ulnar artery and a better quality evaluation of the these branches.CDFI was helpful to design the skin flap containing cutaneous perforators of ulnar artery.