目的探讨实施社保医疗后肺部感染患者的治疗效果与费用。方法随机选择肺部感染的住院患者60例(社保组30例,非社保组30例),社保组根据社保文件精神对患者进行检查治疗,非社保组仍按以往治疗方案并结合患者意愿进行检查治疗,分析两组的疗效与费用。结果社保组的肺部感染住院患者总的直接医疗费用平均为(1540.73±991.43)元,非社保组为 (2232.02±844.98)元;总医疗费用社保组平均为(1716.65±1028.33)元,非社保组为(2653.89±966.39)元;住院天数社保组平均为(11.8±6.42)天,非社保组为(15.3±4.71)天 ,社保组总的医疗费用显著低于对照组(P<0.001),但疗效无显著性差异。结论实施社保医疗可在有效降低肺部感染患者总的医疗费用的同时,保证疗效,真正把有限的医疗资源用在需要的患者身上。

The paper introduces the ideas of designing hospital information system, including comprehensive cabling, network cover-age, ward calling system, ward monitoring system, queuing management, media teaching, multi -function hall, digital meeting and se-curity system, which would provide reference for the designing and implementation of hospital information system.

To identify the expression of the molecule recognized by Pf18-3 mAb (Pf18-3 molecule) on various cells. Meth-ods: The expression of pr18-3 molecule was assayed by flow cytometry and confocal laser scanning microscope . Result: The molecule recog-nized by Pf18-3 mAb expressed on TSC and other stromal cells. Whereas, fresh thymocytes were Pf18-3 negative. Interestingly, the expressionof Pf18-3 molecule was gradually up-regulated on thymocytes after activation by ConA. This molecule mainly expressed on CD4+ CD8+ andCD4+ CD8- cells. Under confocal laser scanning microscope, the staining of fluorescence showed as ring around the cell, it changed grsduallystronger and thicker with activation. Conclusion: This study indicated that the Pf18-3 molecule was co-expressive molecule of MTSC and acti-vated tlymocytes,it was concemed closely about the activation of CD4+ C D8+ and CD4+ CD8- cells.

Objectives: To research the effects of recombinant human growth hormone on hypoproteinemia after severe head injury. Methods: Thirty six patients with hypoproteinemia after severe head injury were randomized into study group and control group. In study group, the rhGH was administered subcutaneously in the dose of 8 U every day for 7～10 days. Serum albumin, prealbumin and transferin were determined in 5 days and 10 days after giving rhGH. Results: The serum albumin, prealbumin and transferin were increased obviously in study group. Conclusions: rhGH can effectively correct hypoproteinemia after severe head injury.

OBJECTIVE:To analyse the advantages and disvantages of split tablets given to in-patients.METHODS:We collected13kinds of oral tablets(10tablets each kind and260pieces of the split tablet altogether),which were often splitted by pharmaceutists.We tested and analysed the weight variation of the split tablet on the basis of the dosage consistency metioned in the USP which is applied to the whole tablet.RESULTS:None of the13kinds of prescription drug passed the consistent testing after splitting.There was some relationship between the effect of the split tablet and its shape.It was relatively easy to break off the tablet with nick in half.The loss of dosage inevitably occurred during the process of splitting the tablet.CONCLUSION:Breaking off the tablet in half led to high ratio of weight variation.The modus operandi of splitting the tablet in half for saving expenses can only be applied to those drugs with low toxicities and relatively flat dose-effect curve.In the case of those drugs which bear high toxicities and steep dose-effect curve,carefulness should always be taken when applying such method.

Objective To establish the triplex Taqman probes real-time RT-PCR method for simultaneously detecting of EV71,CA16 and EV.Methods Retrospective study.Specific primers and probes were designed based on conserved regions of EV71,CA16 and EV.The sensitivity,specificity and reproducibility were assessed by the optimized reaction system.A total of 176 throat swabs as the experimental group were collected from children with suspected hand foot mouth disease (HFMD),who admitted from April 2012 to July 2012 in Nanjing Children's Hospital affiliated to Nanjing Medical University.During this time,10 cases of healthy children,10 cases of outpatients with flu-like symptoms and 90 cases of inpatients in pneumology department of our hospital were recruited as control group,whose throat swabs were also collected.All of 286 samples were tested by the triplex Taqman probes real-time RT-PCR for simultaneously detecting EV71,CA16 and EV.SPSS13.0 was used to analyze the results.Results The sensitivities of the triplex Taqman probes real-time RT-PCR was 1.0 × 103 copies per milliliter for EV71,CA16 and EV.It showed 100％ specificity for 9 enterovirus and 3 non-enterovirus.Analysis with 1.0 × 103-1.0 × 105 copies per milliliter constructed plasmids demonstrated high reproducibility with coefficient of variation of 0.44％-1.04％ for EV71,0.38％-0.73％ for CA16,and 0.46％-0.90％ for EV.More over 176 samples collected from children with suspected HFMD were detected by triplex Taqman probes real-time RTPCR and real-time RT-PCR.The results showed 97.2％ (171/176)agreement and 0.94 Kappa value with high concordance.Conclusions The triplex Taqman probes real-time RT-PCR detecting EV71,CA16 and EV simultaneously has been established successfully.The assay,with high sensitivity and specificity,provide good basis for the rapid clinical diagnosis of EV71,CA16 and EV and open up broad prospects for clinical and relevant researches.

BACKGROUND: It is very important to evaluate vascularization of postoperative hydroxyapatite (HA) orbital implants in human eyes. Recently, methods for evaluating vascularization of HA orbital implants are limited; however, ultrasonic contrast is a novel technique to high-precisely measure blood flow.OBJECTIVE: To investigate the feasibility of ultrasonic contrast to evaluate the vascularization of HA orbital implants, and to compare with enhanced MRI.DESIGN, TIME AND SETTING: The comparative observation was performed at Departments of Ophthalmology and Ultrasound,Jiangyin People's Hospital between January 2008 and January 2009.PARTICIPANTS: Ten patients including 8 males and 2 females were treated with eye ball extirpation and HA orbital implants. The patients were aged 24-61 years, with the mean age of (45.0±10.2) years. HA orbital implants were crossly coated using anterior part of pedicle scleral flap.METHODS: PHILIPS IU22 color Doppler ultrasound was used in this study, and SonoVue (59 mg) was the major contrast medium. Sulphur hexafluoride was dissolved in saline to make suspension. A 2.4-mL suspension was injected through peripheral vein of elbow. Enhanced MRI was additionally used in this study: Siemens Magnetom Avanto 1.5T, standard head coil, horizontal axis, 2.0-3.0 mm thickness, no interval, FOV 160 mmxi80 mm, 256x256 matrix, and SE sequence T1WI (TR 500 ms, TE 12 ms).Dimeglumine gadopentetate injection was used as a contrast medium.MAIN OUTCOME MEASURES: Vascularization characteristics and degrees between ultrasonic contrast and enhanced MRI at different time points after implantation.RESULTS: Ultrasonic contrast showed a well dynamic contrast-enhanced image of the anterior part of HA in early stage of post-operation, and showed distributing instance and density of blood vessel. Later stage of post-operation (about 3-6 months),contrast-enhanced image was unconspicuous. The enhanced MRI showed a clear vascularization of HA orbital implants at the stage of post-operation.CONCLUSION: Ultrasonic contrast is a effective investigative way to evaluate vascularization of HA orbital implants in early stage of implantation, and it is limited at the later stage of post-operation than enhanced MRI.

Objective To investigate the changes of serum trace elements and nutritional proteins in children with acute lymphoblastic leukemia and acute myeloid leukemia at the stage of remission.Methods Erythrocyte count,hemoglobin,serum levels of total protein,albumin,iron,ferritin,transferrin,lactate dehydrogenase,ceruloplasmin,cuprum,zinc and their ratio were measured in 43 patients with acute lymphoblastic leukemia,19patients with acute myeloid leukemia at stages of remission(remission groups),and 30 healthy controls(control group)enrolled from Shanghai Children's Medical Center using atomic absorption spectrometry,nophelometry assay,dry chemical method,and chemiluminescence method.The differences of these indicators between remission groups and control group were analyzed.Results Serum levels of total protein(P=0.454),iron(P=0.769),transferrin(P=0.903),and zinc(P=0.343)were not significantly different between the remission groups and the control group.Serum levels of ferritin(P=0.000),lactate dehydrogenase(P=0.000),ceruloplasmin(P=0.000),cuprum(P=0.002),and Cu/Zn ratio(P=0.003)in the remission groups were significantly higher than those in control group.On the contrary,erythrocyte count(P=0.000),hemoglobin(P=0.000)and albumin(P=0.046)were significantly lowerin remission groups than those of control group.Serum levels of all detected indicators were not significantly different between the acute lymphoblastic leukemia remission group and acute myeloid leukemia remission group(P>0.05)except for lactate dehydrogenase(P=0.025).Conclusion At the remission stage of acute lymphoblastic leukemia and acute myeloid leukemia,serum levels of some trace elements and nutritional proteins gradually returned to normal,and the original balance is established again.

Objective To investigate the possible existence of HBoV in children with acute respiratory infections in Nanjing area and explore its relationship with clinical characteristics.Methods A total of 397 nasopharyngeal secretion samples were collected from children with acute respiratory infection,admitted from July 2009 to June 2010 in Nanjing Children'S Hospital affiliated to Nanjing Medical University,and 50 cases of children without symptoms of respiratory infection were recruited as control group,whose nasopharyngeal secretion samples were also collected.HBoV was determined by real-time fluorescence quantitative PCR.MP and CT were detected by real-time fluorescence quantitative PCR in those HBoV-positive samples.RSV,ADV,IVA,IVB,PIV-1,PIV-2,PIV-3 and hMPV were detected by direct antigen-specific immunofluorescence assays.HBoV NP-1 fragments were amplified and sequenced in 5 HBoV positive samples randomly selected.The results were compared with the known GenBank sequence,and thereby the phylogenetic tree was established.The epidemiological characteristics,clinical presentation and the final clinical diagnosis of HBoV were analyzed according to the clinical data of the HBoV-positive patients.Results Thirty-three HBoV-positive cases were detected by real-time fluorescence quantitative PCR method with a positivity rate of 8. 3% ( 33/397 ). Among the 33 HBoV-positive cases, 19 cases (57.6%) were multiple infections with HBoV and other pathogens, the top three of which were MP (27.3% ,9/33 ),RSV (24.2% , 8/33 ) and PIV-3 ( 12. 1% ,4/33 ). Affected children aged from 7 to 36 months old accounted for 75.8% of the total ( 25/33 ). The measured HBoV NP-1 gene sequences of 5 specimens were consistent,indicating a high homology (99% to 100% ) with the stl, st2 and WHL-1. Conclusions HBoV is one of the pathogens of children's acute respiratory infections in Nanjing. HBoV NP-1 gene is highly conserved,with little variation in different seasons and in different regions and therefore can be used as a marker for real-time fluorescence quantitative PCR and other methods.