Objective To calculate the cost of inguinal hernia disease .Methods With the inguinal hernia clinical pathway standardized diagnosis and treatment project as the basis , cost was estimated using activity based cos-ting.Results Inguinal hernia treatment project cost is 4 594.96 yuan, higher than the current charges 1 448.36 yuan.Conclusion According to the clinical pathway , cost accounting of disease activity based costing method , can be more scientific to measure out of inguinal hernia disease cost .

Objective To study the effect of vitamin D3 on breast cancer xenografted on a nude mouse model. MethodBalb/c nude mouse was injected subcutaneously with 10 6 human breast cancer cell line MCF-7.Two thousand units Vitamin D3 was administered in mice i?m every the other day. Tamoxifen (5 mg/kg) was fed per mouse daily. Mice were divided into four groups with ten mice in each group: Vitamin D3 group, Vitamin D3 and tamoxifen group, tamoxifen group and control group. After 4 weeks, mice were killed to measure volume of tumor and calcium and phosphorus levels in serum. Tumor cells were analyzed with flow cytometery to detect apoptosis and cell cycle. Results Calcium levels in serum of mice treated with vitamin D3 were higher than that of other two groups, but phosphorus levels in serum were lower . Apoptosis rate was higher than that of control group and tumor cells were arrested in G0/G1 phase, especially those treated with vitamin D3 and tamoxifen. ConclusionsVitamin D3 could significantly induce apoptosis of breast cancer cells and arrest tumor cells in G0/G1 phase. It is synergic with tamoxifen and this may have clinical significance in the treatment of breast cancer.

Objective To investigate the effect of liver transplantation on hepatitis B associated diseases and the efficiency of prevention and treatment on the re-infection of hepatitis B.Methods The data of 17 patients undergoing liver transplantation were analyzed after treatment of lamivudine and hepatitis B immune globulin (HBIg). Results Of the 17 cases of hepatitis B pretransplantation, 2 cases were positive for HBsAg. Liver function was normal in all patients.Conclusions Liver transplantation is an effective therapy for hepatitis B. Lamivudine and HBIg could effectively prevent and treat the re-infection of hepatitis B after liver transplantation.

Objective To explore the Troponin I(cTnI) ,myoglobin(MYO) and creatine kinase isoenzyme(CK‐MB) in early di‐agnosis of acute myocardial infarction(AMI) ,and compare their significance in the diagnosis of AMI .Methods used chemilumines‐cence method in 126 patients with AMI and 82 cases of myocardial infarction group to test cTnI ,MYO and CK‐MB ,the results were compared .Results The cTnI ,MYO ,CK‐MB quality appear time and peak time was different ,in patients with acute myocardial in‐farction(cTnI ,MYO and CK‐MB joint detection sensitivity ,specificity ,negative predictive value ,positive predictive value was higher than single test .Conclusion cTnI ,MYO and CK‐MB joint detection is helpful to early diagnosis of AMI .

ObjectiveTo evaluate the relationship between microalbuminuria(MAU) and cardiac autonomic neuropathy in diabetes.MethodsThe urinary albumin excretion (UAE) was measured,and the cardiac autonomic function was detected using 24 hour ambulatory ECG spectral analysis of heart rate variability (HRV) in 46 patients with diabetes and 31 normal control subjects.ResultsParameters of time and frequencydomain of HRV were reduced in patients with diabetes.The high frequency at night reflecting the cardiac vagus nerve function was significantly lower in diabetic patients than control group.In diabetic patients with MAU,the detected values of HRV were significantly decreased,combined vagosympathetic impairment occurred,and 24 hour rhythm from day to night in autonomic nervous activity disappeared.ConclusionMAU in diabetes is related with HRV.

Polyethylene glycol(PEG) with good hydrophilicity and flexibility can improve pharmacokinetic and pharmacodynamic properties of the nano-preparation,so PEG modification in the surface of nano-preparation can increase the in vivo residence time and concentration of drugs.At present,the targeted nano-preparation with PEG modification has become a research hotspot in the field of pharmaceutics.In this paper,the physical and chemical methods of PEG modification in targeted nano-preparation was summarized,which includes physically inserting PEG-lipid derivatives in nanostructure of targeted nano-preparation or modifying PEG with targeted nano-preparation.In addition,the influence of PEG parameters (molecular mass,modified density and spatial conformation) on properties of targeted nano-preparation was also discussed,which is important to preferably structure PEGylated targeted nano-preparation.

Objective To study the application of the selective regional anemia hepatectomy. Methods The hepatic veins and hilar plates of 5 liver samples of posthepatitic cirrhosis were measured. Results Out of the 5 samples, the average width and depth of the left branch of hilar plate were 1.78cm and 0.82cm, of the left medial branch were 1.04cm and 1.02cm, of the left lateral superior branch were 0.96cm and 0.74cm, of the left lateral inferior branch were 1.02cm and 0.76cm, of the right branch were 2.02 cm and 1.28cm, of the right posterior branch were 1.20cm and 1.10cm, and of the right anterior branch, 1.22cm and 1.16cm. The average width and depth of the left hepatic vein were 0.82cm and 0.74cm, of the right hepatic vein were 1.16cm and 1.04cm, and of the middle hepatic vein, 0.92cm and 1.18cm. The regional anemia hepatectomy was performed successfully in 2 cases. Conclusions Selective occlusion of the blood flow in and out the hepatic segment or lobe may contribute to a safe and reliable hepatectomy.

Objective To investigate the status of personality disorder and the relationship with childhood trauma in heroin addicts.Methods 108 heroin dependent patients were investigated by Personality Disorder Ques-tionnaire -4 +(PDQ -4 +)and Childhood Trauma Questionnaire -Short From (CTQ -SF).Results The comor-bidity rate of heroin dependence and personality disorder was between 47.2% and 10.2%,which had a higher posi-tive rate of for borderline (47.2%)and antisocial (38.0%)personality disorder and the lowest for depression (10.2%).The borderline personality disorder score was highest[(4.63 ±2.16)points]and the lowest was histrionic personality disorder [(2.65 ±1.49)points]in 12 subscales,which were significantly higher than those in the national norm,and the differences were statistically significant (t =13.54,2.57,all P <0.05).It had significantly positive correlation between borderline and antisocial personality disorder and the each five factors of childhood trauma experi-ence (r =0.265,0.390,0.207,0.303,0.276;0.225,0.219,0.228,0.236,0.287,all P <0.05 ).In addition, depressive personality disorder and physical abuse,emotional neglect and body ignored showed significantly positive correlation (r =0.226,0.227,0.196,all P <0.05).Conclusion There was the comorbidity rate of personality disorders and heroin dependence,and the higher positive rate was borderline and antisocial personality disorders.It was a certain correlation of childhood traumatic experience and personality disorders,especially borderline,antisocial and depressive personality disorder.

Objective:To better understand the clinical characteristics of children with pneumocystis pneumonia(PCP).Methods:Seven cases of non-human immunodeficiency virus infected children with PCP admitted to pediatric intensive care unit(PICU) at Xi′an Children′s Hospital from January 1, 2019 to December 31, 2019 were enrolled.Clinical findings, laboratory examination results, diagnosis, treatment, and outcome data were retrospectively reviewed.Results:There were seven children enrolled in this study including six boys and one girl.The average age was(6.09±3.80)years.Six patients received a long-term steroid or immunosuppressive therapy, and the average duration of medication was(80±30)days.One patient was eventually diagnosed with immunodeficiency disease despite no history of steroid and immunosuppressive therapy.Fever, cough and progressive dyspnea were the main manifestations.The pulmonary signs were not obvious, however, the chest radiographs showed serious ground glass changes.Laboratory examination showed that white blood cell counts were normal, lymphocyte counts were decreased to varying degrees, while C-reactive protein, calcitonin and lipopolysaccharide increased slightly or normal.Lactate dehydrogenase significantly increased and PaO 2/FiO 2 decreased, respectively.All children combined with different degrees of heart, liver and digestive tract damage.Pneumocystis jirovecii infection was diagnosed by metagenomics next-generation sequencing(mNGS), of which one case was detected by bronchoalveolar lavage fluid, and the remaining six cases were detected by peripheral blood.After entering PICU, mechanical ventilation, intravenous injection of human immunoglobulin, and continuous renal replacement therapy were performed.None of the children used TMP-SMZ for prophylaxis outside the hospital.Among them, one case was diagnosed with PCP before entering PICU and was given TMP-SMZ for 20 days, while the remaining six patients started to receive TMP-SMZ after entering PICU.Finally, one patient was cured, three died and another three cases died after giving up treatment.The average hospitalization days were(11.28±8.78)days, and the average hospitalization costs were (78, 000±24, 000) RMB. Conclusion:Children with non-human immunodeficiency virus infected PCP usually have underlying diseases or immunodeficiency diseases.Due to non-specific manifestations, rapid progression and high mortality, clinicians should pay more attention to it.It is necessary to dynamically observe the respiratory symptoms, perform mNGS as soon as possible, and give TMP-SMZ treatment in time.TMP-SMZ prophylaxis can be given to patients who are highly suspected of PCP but unable to perform pathogenic examinations.