An efficient method is provided to detect simultaneously some important veterinary drugs from different classes in highly complex animal tissue matrix.This method using matrix solid-phase dispersion (MSPD) and high performance liquid chromatography (HPLC) with diode array detection (DAD) is developed to effectively determine two fluoroquinolones (enoxacin and lomefloxacin),two sulfonamides (sulfanilamide and sulfamethoxazole) and one tetracycline (tetracycline) simultaneously in porcine tissues.In the process,MSPD methodology was used to treat samples,washed by n-hexane to remove lipid,eluted the analytes with acetonitrile-dichloromethane (1∶1,v/v).Solvent acetonitrile and solvent acetic acid (0.1％) were combined in a gradient.HPLC-DAD analysis of the tissue samples was performed within 15min at a flow rate of 1.0mL/min.The results showed that a recovery at 0.1,0.5 and 1.0 μg/g fortification levels ranged from 80.6％ to 99.2％ with satisfactory relative standard deviations (RSDs) (below 6.1％.n=3) and the limits of quantitation (LOQ) ranged from 7 μg/kg to 34 μg/kg in porcine tissues.Utilization of the method in successfully simultaneous analysis of porcine tissue incurred with veterinary drug multiresidues is described.

Objective Beijing plans to run a DRGs-PPS pilot.Cost estimation of each DRG group needs a set of scientific reasonable standards for inpatient charge category.MethodsResource consumption accounting Classify charge item by practitioners,services,resources; medical consumables are singled out to emphasize the value of medical personnel's services; some of old categories are subdivided in order to be compatible with new categories.Results 19 old charge categories of patient discharge chart turn to 31 new items by dividing medical service into treatment,surgery,nursing,imaging,examination,management,paramedic,pharmacy,etc.ConclusionRegulating the charge categories of services,medical data is more consistent by using the same statistical coverage.Also it accurately present the incoming of all operationstreatment,surgery,nursing,imaging,examination,management,paramedic,pharmacy,etc.It gives government directions of decision-making to adjust the weight of DRG groups.

Objective To investigate the operative treatment of Sanders' type Ⅲ displaced intra-articular fractures of the calcaneus using a small dorsolateral incision.Methods From October 2006 to April 2012,90 patients with displaced intra-articular calcaneal fracture of sanders' type Ⅲ were treated by open reduction and internal fixation through a small dorsolateral incision at our department.The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal.They were 69 men and 21 women,aged from 17 to 61 years (average,39 years).On the right side were 49 cases and on the left side 41 cases.According to Sander's classification,26 fractures were of type Ⅲ AB,36 of type Ⅲ AC and 28 type Ⅲ BC.The displacements of articular facet were all larger than 1 mm.The foot functions were evaluated before and after operation by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system.Results For each patient,4 to 6 calcaneal cannulated screws of 4.0 mm and 2 full threaded screws of 6.5 mm were used.No incision infection,skin necrosis or injury to the posterior tibial nerve or vessels occurred after surgery.Seventy-six patients were followed up for 10 to 56 months (average,20.5 months).Clinical union was achieved after 8 to 12 weeks (average,9.5 weeks).The lateral and axial X-ray films of the calcaneus at the last follow-up showed fine reduction and fixation of the fracture fragments and significant improvements in the length,width,height,and B(o)hler and Gissane angles of the calcaneus compared with the preoperation (P ＜ O.05).The ankle and hindfoot scored 70 to 100 AOFAS points at the last follow-up.Forty-five cases were excellent,24 good,5 fair and 2 poor (excellent to good rate of 90.8％).Follow-up observed no infection,nonunion or osteomyelitis.Conclusion Open reduction and internal fixation through a small dorsolateral incision is a good option for Sanders' type Ⅲ calcaneus fractures with a displacement of more than 1 mm,because it leads to minimal soft tissue damage,excellent exposure and convenience for later removal of internal fixators and subtalar arthrodesis.

Objective To evaluate the efficacy of erlotinib on advanced NSCLC, and observe its adverse events. Methods An open labeled, expanded access program (EAP) was conducted on 19 pathologically confirmed advanced NSCLC patients who had received at least one regimen chemotherapy.Erlotinib (150 mg) was orally administered daily till disease progression or intolerable adverse events developed.The efficacy was evaluated according to RECIST criteria; the adverse events were evaluated according to NCI criteria.Results In 19 patients, the objective response rate was 21.1% (4/19), and the disease control rate was 84.2 % (16/19); the median progression-free survival time was 7.5 months (3-36 months), and the median survival time was 15.9 months (9-39 months).Adverse events were generally mild (grade Ⅰ or Ⅱ ), including skin rash (84.2 %) and diarrhea (57.9 %). One (5.3 %) patient developed grade Ⅲ elevation of serum glutamate pyruvate transaminase.No grade Ⅳ drug-related adverse event occurred.Conclusion Erlotinib is effective and safe for locally advanced or metastatic NSCLC patients who have failed previous chemotherapy.

ObjectiveTo evaluate the performance of diagnosis-related groups,Beijing version (BJ-DRGs) which were locally developed in Beijing.MethodA total of 1.3 million inpatient records from 149 hospitals in Beijing in 2008 were drawn from Beijing Public Information Center.Coefficient of variation (CV) was used to measure the performance of DRGs system.ResultsBJ-DRGs produced the best CV results for expenditure.ConclusionsUnder Beijing's medical information condition,BJ-DRGs produced good performance.

This article reviewed the connotation,developing process and utilization theory of diagnosis related groups (DRGs).DRGs,which is one of ease mix systems,is now used widely in healthcare management.DRGs classify inpatient based on diagnose and procedure.Practices have shown that it has relative high capacity for the risk adjustment of acute care cases; therefore,it can improve the efficiency of expenditure and performance management of inpatient services.Currently,there are more than 30 countries and regions using DRGs,and the theories and methodologies of DRGs get mature.China's new round healthcare reform have developed in depth.The study and development of DRGs related health management tool will promote China' s healthcare system becoming more scientific,normalized and systematic.

OBJECTIVE:To investigate the use of antibacterials and to evaluate the distribution and drugs resistance of pathogenic bacteria causing hospital nosocomial infection between 2005 and 2007 in our hospital. METHODS:The antibiotic resistance and the data of drug use from 2005 to 2007 in our hospital were analyzed statistically. RESULTS:Over the 3 years,the production rate of ESBLs of Escherichia.coli ascended year by year. The proportion of methicillin resistant staphylococcus aureus (MRSA) in staphylococcus aureus were 79.4%,66.3% and 73.9% respectively over the 3 years. The DDDs of antimicrobials showed an year-on-year increase,with third-generation cephalosporins and fluoroquinolones topping the first two places. CONCLUSION:Antibacterial drugs should be used rationally in clinical practice so as to reduce antibiotic resistance.

Objective:To evaluate pathogenesis of nasal polypsis.Method:To detect HPV in 26 pathological samples of 13 cases by polymerase chain reaction(PCR).Ten cases of normal nasal mucous were used as control.Result:HPV-DNA was positive 12 cases(92.3%) in 13 cases of the first surgical operation by PCR.HPV-DNA was positive 5 cases(38.5%)in 13 cases of the second surgical operation by PCR.The most HPV type was HPV6.HPV-DNA was negative in 10 cases of control.Conclusion:The results showed that HPV plays an etiologic role in the development of nasal polypsis.

Authors described characteristics of medical service performance evaluation,and strategy options for scientifically evaluating such performance,and systematically presented the conditions and methodology of DRGs-based evaluation of medical service performance.Six evaluation indicators were cited in terms of the capacity,efficiency and medical safety of medical service providers,with detailed introduction to the computation process of such indicators.Cases in hand indicate that the first-page data completeness and accuracy of medical records are preconditions for using DRGs in medical service performance evaluation.

Objective To evaluate bone cement longer handle artificial femoral head replacement treatment the clinical effect of the treatment of femoral fractures between rotor-instability.Methods There were 98 patients with fracture of instability-between the femur rotor ,women 60 cases,38 cases,male,aged 75 to 94 years old,average 83.5 years.Fractured by Tronzo-Evans type III 56 cases,type IV 42 cases.All use of bone cement longer handle arti-ficial femoral head replacement therapy ,to observe clinical therapeutic effect .Results All cases of postoperative X-ray showed both fracture reduction and fixation well between the rotor and prosthesis position is good .96 cases of post-operative for 6 to 24 months followed-up,the average 15 months.Harris score was 85.4%.Conclusion Bone cement longer handle artificial femoral head replacement has quick postoperative functional recovery ,weight-bearing activities earlier,which can avoid the advantages of long-term complications in bed ,instability is treatment of older femoral frac-tures between rotor reasonable operation method .