From Personal Network to Institution Building: The Lifanyuan and the Formalization of Manchu-Mongol Relations

The Qing emperors, who ruled over China from 1644-1911, managed to bring large parts of Inner Asia under their control and extended the territory of China to an unprecedented degree. This paper maintains that the political technique of patronage with its formalized language, its emphasis on gift exchange and expressions of courtesy is a useful concept for explaining the integration of Inner Asian confederations into the empire. By re-interpreting the obligations of gift exchange, the Qing transformed the network of personal relationships, which had to be reinforced and consolidated permanently into a system with clearly defined rules. In this process of formalization, the Lifanyuan, the Court for the Administration of the Outer Regions, played a key role. While in the early years of the dynasty, it was responsible for collecting and disseminating information concerning the various patronage relationships with Inner Asian leaders, over the course of the 17th and 18th centuries its efforts were directed at standardizing and streamlining the contacts between ethnic minorities and the state. Through the Lifanyuan, the rules and principles of patronage were maintained in a modified form even in the later part of the dynasty, when the Qing exercised control in the outer regions more directly. The paper provides an explanation for the longevity and cohesiveness of the multi-ethnic Qing empire. Based on recently published Manchu and Mongolian language archival material and the Maussian concept of gift exchange the study sheds new light on the changing self-conception of the Qing emperors.

Radiation dose in pneumatic reduction of ileo-colic intussusceptions--results from a single-institution study

BACKGROUND Air enema under fluoroscopy is a well-accepted procedure for the treatment of childhood intussusception. However, the reported radiation doses of pneumatic reduction with conventional fluoroscopy units have been high in decades past. OBJECTIVE To compare current radiation doses at our institution to past doses reported by others for fluoroscopic-guided pneumatic reduction of ileo-colic intussusception in children. MATERIALS AND METHODS Since 2007 radiologists and residents in our department who perform reduction of intussusceptions have received a radiation risk training. We retrospectively analyzed the data of 45 children (5 months-8 years) who underwent a total of 48 pneumatic reductions of ileo-colic intussusception between 2008 and 2012. We analyzed data for screening time and dose area product (DAP) and compared these data to those reported up to and including the year 2000. RESULTS Our mean screening time measured by the DAP-meter was 53.8 s (range 1-320 s, median 33.0 s). The mean DAP was 11.4 cGy ∙ cm(2) (range 1-145 cGy ∙ cm(2), median 5.45 cGy ∙ cm(2)). There was one bowel perforation, in a 1-year-old boy requiring surgical revision. Only three studies in the literature presented radiation exposure results on children who received pneumatic or hydrostatic reduction of intussusception under fluoroscopy. Screening times and dose area products in those studies, which were published in the 1990 s and in the year 2000, were substantially higher than those in our sample. CONCLUSION Low-frequency pulsed fluoroscopy and other dose-saving keys as well as the radiation risk training might have helped to improve the quality of the procedure in terms of radiation exposure.