A case of the H syndrome was reported.An 18-year-old man presented with an 8-year history of progressive cutaneous sclerosis,skin hyperpigmentation,and hypertrichosis on the trunk and extremities.In addition,he suffered from short stature,hearing loss,cardiac anomaly,hepatosplenomegaly,and scrotal masses.Laboratory examination revealed hypogonadism.Cutaneous histopathologic examination showed hyperpigmentation of the basal layer with acanthosis,widespread fibrosis (moderate in dermis and severe in subcutis) and an infiltrate composed of histiocytes and plasma cells.A perivascular lymphocyte infiltrate was also observed throughout the dermis and subcutaneous fat tissue.These findings were consistent with the H syndrome.Differential diagnosis must be made with Winchester syndrome and polyneuropathy, organomegaly,endocrinopathy,M-protein and skin change (POEMS) syndrome.

Objective: To investigate effective matching between computerized physician order entry and charging items in the hospital. Methods: Standard data of computerized physician order has been established, in which physician order items and charging items have been matched. It has effectively solved the problems in the process of computerized physician order entry. Results and Conclusion: The implementation of matching computerized physician and costs has effectively controlled the errors and missing of costs, which released the complaint of patients and received the good reputation and welcome, the compliance of doctors using computerized physician order entry has been obviously improved, meanwhile, it has provided new application experiences for implementing the following charging of national medical services prices in hospitals.

Objective To apply cervical pedicle screw system (CPSS) to treat cervical disorders and discuss its surgical indications, techniques and clinical effectiveness. Methods A total of 52 patients with middle and lower cervical spine lesions who underwent cervical transpedicular fixation were analyzed retrospectively. There were 41 males and 11 females aging from 16 to 62 years. The diagnosis of the patients were fractures and dislocations of cervical spine accompanied by complete paralysis (28 cases) or incomplete paralysis (19 cases) in 47 cases, and metastatic bone tumor in 5 cases. Prior to surgery, anteroposterior and lateral radiographs, CT scan through bone windows, and/or magnetic resonance images were carried out in all patients. During surgery, all screws were inserted into the pedicle under the guidance of lateral or oblique image intensifier to confirm the direction and insertion depth of screws. In 7 to 14 days after surgery, physical examination and roentgenograms evaluations were performed in all patients, and CT scans were obtained in 31 patients, the location of screws were evaluated with the radiographic examinations and CT scan. The follow-up period averaged 13 months (range, 1 to 36 months) in 38 patients. The authors experiences in achieving accurate pedicle screw insertion was introduced, the clinical value of using cervical pedicle screw system to manage cervical lesions was summarized, the possible complications of CPSS were analyzed, the candidates of using CPSS were discussed as well. Results Pedicle screws were inserted successfully in all cases, 9 cases were found to have nerve irritating symptoms by 10 pedicle screws when which were introduced into pedicles, however, by changing the direction of the screws, all symptoms disappeared and screws were successfully inserted. Postoperative radiographic evaluation confirmed proper insertion of screws except 2 screws perforating the lateral pedicle wall but without injury of the vertebral artery demonstrated on CT scans. In the followed-up, no screw breakage and loosening was observed. By applying distractive force between the screws placed into pedicles, the space between the affected vertebrae and discs could be increased, displaced anterior fragments of bone or disc could also be indirectly reduced from the spinal canal, and additional anterior decompression interventions might be avoided. Conclusion CPSS can be considered as one of alternative in posterior cervical internal fixation systems. However, specific caution must be taken. The candidates of utilizing CPSS should be properly selected.

Each WHO CC forms part of an inter-institutional collaborative network set up by WHO in support of its pro-gramme at the country,inter-country,regional,interregional and global levels.WHO Collaborating Centre for Diagnostics and Laboratory Support provide quality assurance programs for diagnostic technologies and diagnostic products on infectious disease for WHO and other international organization and act as a source of technical information for WHO,staff of national regulatory authorities and manufacturers.To promote the development of global health.It is very important for our country to establish the cooperation center of this function,to enhance the ability of our country’s in vitro diagnostic products in-spection,and to promote the development of the in vitro diagnostics industry.

BACKGROUND:Articular cartilage injuries can result from a variety of causes. Conventional therapy cannot obtain the optimal clinical results. Low-intensity pulsed ultrasound has been shown to promote the repair of injured articular cartilage. OBJECTIVE:To investigate the effects of low-intensity pulsed ultrasound on the repair of injured articular cartilage. METHODS:Twenty New Zealand white rabbits were used to establish knee arthritis models and equal y randomized into study and control groups, respectively. Rabbits in the study group received low-intensity pulsed ultrasound treatment, and sham low-intensity pulsed ultrasound treatment was given in the control group. At 8 weeks after treatment, pathological change and histological scores in articular cartilage tissue col ected from both groups were determined. Moreover, the ultrastructure and type II col agen expression of chondrocytes were determined. Matrix metal oproteinase-13 mRNA expression was detected by quantitative real-time PCR. RESULTS AND CONCLUSION:At 8 weeks after treatment, toluidine blue staining showed a disordered arrangement of cel s, decreased number of cartilage cel s in each layer and cluster in the control group. Light disordered arrangement of cel s, decreased appearance of the superficial layer cel s and the cluster phenomenon were observed in the study group. Articular cartilage tissue scores were significantly decreased in the study group compared with the control group (P<0.05). The chondrocytes were smal , enlarged intracel ular mitochondria and rough endoplasmic reticulum, cytoplasmic swel ing, col agen fibrils coarse, wel developed Golgi apparatus, and nuclear fragmentation were observed in the control group. In addition, the normal structure of organel es disappeared and cel degeneration was observed in the control group. In the study group, the size of chondrocytes and the Golgi complex and other organel es were normal, and the protein polysaccharide granules were observed in the cytoplasm and membrane. The mRNA expression of matrix metal oproteinase-13 in the study group was significantly lower than that in the control group (P<0.05). Type II col agen immunoreactivity in the study group was stronger than that in the control group. No incision infection, suppuration, red swel ing appeared in al rabbits. Our results suggest that low-intensity pulsed ultrasound can be used for the treatment of articular cartilage injury by al eviating the degradation of col agen type II and inhibiting the expression of matrix metal oproteinase-13.

Objective To investigate the effects of different concentrations of dexmedetomidine on the expression of Toll-like receptor 4 (TLR4) mRNA in rat peripheral blood monocytes exposed to lipopolysaccharide ( LPS ). Methods Peripheral blood monocytes isolated from male Wistar rats were seeded in 24-well plate in RPMI 1640 liquid culture medium in CO2 incubator at 37 ℃ and 5% CO2 for 2 h, and were randomly divided into 5 groups ( n = 8 each): group A negative control; group B was exposed to LPS 1 μg/ml and C, D and E groups were exposed to LPS 1 μg/ml + dexmetomidine 0.5, 5.0 and 50.0 ng/ml respectively. The monocytes were then incubated for 24 h. The concentrations of TNF-α, IL-1β and IL-6 in the supernatant of the cultured monocytes were detected by ELISA. The expression of TLR4 mRNA in the monocytes was detected by RT-PCR.Results Exposure to LPS significantly increased the expression of TLR4 mRNA and the concentrations of TNF-α, IL-1β and IL -6 in group B as compared with group A ( P ＜ 0.01 ). Dexmedetomidine attenuated the LPS-induced increase in the expression of TLR 4 mRNA and the concentrations of TNF-α, IL-1β and IL-6 in a dose-dependent manner ( P ＜0.05or 0.01 ). Conclusion Dexmedetomidine can inhibit the synthesis of TLR4 and inhibit the secretion and dilivery of TNF-α, IL-1β and IL-6 by down-regulating the gene expression of TLR4 in rat peripheral blood monocytes exposed to LPS.

Objective To explore the related risk factors of injuries caused by non-motor vehicle crashes in Hefei,Anhui Province. Methods From June 2009 to June 2011,the wounded from nonmotor vehicle crashes in Hefei were admitted to our hospital.The data of the wounded were collected to perform hypothesis test to screen out the related risk factors,which were then analyzed with multiple-factor non-conditional Logistic regression analysis. Results A total of 205 cases who were wounded in the non-motor vehicle crashes were admitted to our hospital from June 2009 to June 2011.Among all the cases,146 cases were wounded in electric bicycle crashes and 59 cases in bicycle crashes.There were 147cases (71.7％) of mild to moderate injuries ( ISS ≤ 15 ),and 58 cases (28.3％) of severe injuries (ISS ＞ 15 ) including six deaths (2.9％).Single factor of different categories of the hypothesis test suggested that age,category,driving behavior,crash model,impact type,vehicle type were all related with the severity of injuries caused by non-motor vehicle crashes in Hefei.The multiple-factor non-conditional Logistic regression analysis showed four risk factors for the injury severity in non-motor vehicle crashes in Hefei,ie,vehicle type,crash model,violations of rules and regulations as well as age,according to the degree of correlation.Conclusion With the study of non-motor vehicle crashes in Hefei,primary identification of the risk factors for the traffic injuries is obtained,which provides scientific basis for the decrease of casualty and establishment of intervention measures.

Objective:To explore therapeutic effect of atorvastatin on aged patients with mild to moderate hyperten-sion.Methods:A total of 427 aged patients with mild to moderate hypertension treated in our hospital from Jul 2011 to Jul 2013 were randomly divided into routine treatment group (n=210)and atorvastatin group (n=217,received atorvastatin additionally based on routine treatment)according to number table.All patients were treated with a continuous 24 months.Therapeutic effect of controlling blood pressure,changes of blood pressure level and high sensitive C reactive protein (hsCRP)level and occurrence of adverse reactions during treatment were compared be-tween two groups.Results:Compared with routine treatment group,there was significant rise in total effective rate of long-term (24 months)controlling blood pressure (76.8% vs.85.9%),and significant reductions in blood pres-sure [(145.3±10.1/88.6±6.7)mmHg vs.(136.9±6.8/83.0±5.2)mmHg]and hsCRP [(2.02±0.29)mg/L vs. (1.60±0.18)mg/L]level in atorvastatin group,P<0.05 or <0.01. There was no significant difference in inci-dence rate of adverse reactions during treatment between two groups (P>0.05).Conclusion:Atorvastatin combined antihypertensive drugs can well control blood pressure and reduce inflammatory reactions,which is suitable for long term use in aged patients with hypertension.

Objective The policy of quota payment for specific diseases has been carried out at the hospital for several years, yet proven a failure. This paper aims at searching for a new way of management.Methods Since 2013,attempts have been made for classification of medical costs and the quota setting for specific diseases, and for development of a real-time supervision software for classification of disease-specific costs.The attempts prove a success with a new model for management of quota management for specific diseases.Results This practice has proved to be effective in 2014,and used in other likewise diseases,which has been embraced by administrators of medical insurance sector. Conclusion This model proves useful for reducing inpatient expenses and regulating medical behaviors. but also shorten the average hospitalization days,improve the satisfaction of patient.The method of management control can be expanded and imitated.