Adult ; Aged ; Digoxin ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart Failure ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy

Actins ; metabolism ; Dermatofibrosarcoma ; classification ; pathology ; Desmin ; metabolism ; Head and Neck Neoplasms ; metabolism ; pathology ; Histiocytoma, Benign Fibrous ; classification ; metabolism ; pathology ; Histiocytoma, Malignant Fibrous ; classification ; metabolism ; pathology ; Humans ; Oncogene Proteins, Fusion ; metabolism ; Skin Neoplasms ; metabolism ; pathology ; Vimentin ; metabolism ; Xanthomatosis ; pathology

Chromosome Aberrations ; Gene Fusion ; Genes, Tumor Suppressor ; Humans ; Oncogene Proteins, Fusion ; metabolism ; Oncogenes ; Pathology ; standards ; trends ; Soft Tissue Neoplasms ; genetics ; metabolism ; pathology

It is the core of provider payment reform in healthcare that payment methods can be chosen correctly.According to the framework of contract theory,this paper compared the“pricing cost”and“monitoring cost”between diagnosis related groups perspective payment system(DRGs-PPS)and feefor-service.And then,based on contract theory,this paper further turn to analyzed the main management problems during the implementation of DRGs-PPS,and put forward relevant policies key points from the aspects of“monitoring”and“maintaining”.This paper drawn the basic conclusions that,comparing to feefor-services,DRG-s-PPS have relative low transaction; therefore,the transformation from fee-for-service to DRGs-PPS will benefit the virtuous circle of the healthcare market.However,DRGs-PPS is new deal for China,so it need to be pushed forward steadily with the full consideration of healthcare regulations and system maintenance.

Biliary-pancreatic-duodenal junction is a special region in the human body.It is difficult to diagnose and treat diseases in this region because of the complicated anatomy,the limitation of diagnosing methods,the variety of disease,the high risks of operation and the severity of complications. We should pay more attention to the pathophysiology aspects and the laboratory researches of diseases in this region.Proper diagnosis and combination of different diagnosing methods could improve the rate of early diagnosis and identify the characteristics of the disease. Individualized operation should be considered to deal with iatrogenic injury of biliary-pancreatic-duodenal junction according to different patients' condition.The principle of operation is to control damage firstly and to preserve the function of biliary-pancreatic-duodenal junction and the physiological passway of bile and pancreatic juice to the greatest extent.

Surgical site infection(SSI) is one of post-operative complications in gastrointestinal surgery. SSI may increase the morbidity and mortality of surgical patients and increase their hospital stay and expense. The risk factors can come from patients, physicians and hospital environments. Improving patients nutritional status and organ function, appropriate control of blood sugar level and abstinence from smoking can reduce the occurrence of SSI. Compare to current practice in China, the following recommendations have been identified as priorities for implementation: hair removal done immediately before operation; maintenance of normothermia intraoperatively; the abdominal wall should be closed with an absorbable suture and drains should be removed as early as possible. SSI could be diagnosed by symptoms, local signs and lab examinations and confirmed by physician. Source control is the key point in the management of SSI. Ultrasound and CT guided percutaneous abscess drainage is effective in the localized deep space surgical site infection and critically ill patients. Antibiotics should be used following clinical assessment and evidence based on local formulary.
Digestive System Surgical Procedures ; adverse effects ; Humans ; Infection Control ; Risk Factors ; Surgical Wound Infection ; diagnosis ; etiology ; prevention & control ; therapy

Object: To explore the best modern appeearance of the nurse. Methods: Investigate the nursing students and clients and analysis the results. Result: The difference between the nursing clients and the nursing students is sure existence. Discuss: (1) Nursing teaching still should pay attention to the effect of biomedicine model. (2)To develop nursing speciality to make the nursing clients have a right understand to nursing

ObjectiveTo explore the diagnosis value of color Doppler ultrasound of the carotid atherosclerosis plaques in diabetic patients. MethodsColor Doppler ultrasonic assessment of carotid was performed in 124 diabetic patients(test group)and 100 normal controls(control group).The intima-media thickness(IMT)and the carotid atherosclerosis plaques parameters were measured.The results were compared and analyzed between two groups. ResultsThe IMT and the incidence rate of carotid atherosclerosis plaques in the test group were higher than those in the control group(all P＜0.05).There was no statistical difference in the site of the plaques between test and control group(P＞0.05). ConclusionThe incidence rate of the carotid atherosclerosis of type 2 diabetes was higher.Carotid color Doppler ultrasonography was an optimal technique for screening and diagnosing atherosclerosis.

Fibrin related markers include several proteins and fragments developed in the conversion of fibrinogen to cross-linked fibrin and following degradation.FDP played as a more important role than conventional global coagulation test before application of D-dimer in clinical settings,moreover,combination of FDP and D-dimer improve the diagnostic of DIC greatly,and D-dimer has become an effective tool excluding venous thromboembolism besides the imaging.Whether basic or clinical research on soluble fibrin monomers and complexes were focused in an early stage,however,limited by diversity of analytes and nonstandardization,no full application was come into being.It is worthwhile to note that fibrin related markers release into plasma sequentially from initialization of fibrinogen activation to fibrinolysis.Thus,the combination of these index is useful to understand patient's condition (such as DIC),prognosis of VTE recurrence,and prophylaxes of post-operation thrombosis.

To explore and discuss the challenge and solutions of medical ethics management in case of rapid development of medical research.Analyzed changes of the model,contents,and methods in modern medical research.Identified the significance of ethics review in medical research.Introduced some practices at Peking Union Medical College Hospital (PUMCH) in recent years.Ethical review is one of the key elements for quality of medical research. Management should be improved and strengthen for the protections of research subjects effectively in the case of rapid development of life science.