Objective:To investigate the method of how to realize one stop payment service between hospitals, enrich its connotation, and expand its outreach.Methods: The establishment funds unified trading platform can realize the settlement of one stop payment service between hospital, and at the time achieve a unified account management, real-time account transactions, and perfect reconciliation.Results: Through the research, we can conclude that we can realize the one stop payment service between hospitals, and will improve the usage and satisfaction of the system, achieve better results.Conclusion: With the deepening of the one stop payment service model, it will play a greater role; achieve more satisfactory economic and social benefits.

Objective To investigate the cause and treatment for ischemic ophthalmopathy after cataract phacoemulsification.Methods A total of 3000 patients with cataract underwent phacoemulsification were retrospectively analyzed,and 13 patients with ischemic ophthalmopathy.The ischemic optic neuropathy (ION) were in 8 cases,7 cases occurred in age related cataract,1 cases occurred in the dislocation of lens;The central retinal artery occlusion (CRAO) were occurred in 5 cases,1 cases of age-related cataract,2 cases of congenital cataract,2 cases of traumatic cataract.The patients were diagnosed with fundus,visual field and fundus fluorescein angiography respectively,and then were treated with dilation of blood vessels,nutrition nerves and symptomatic treatment.Results The visual acuity in 6 cases with ION after the treatment were improved in different degrees;The visual acuity in 2 cases with CRAO after treatment were improved,3 cases was not recovered.Conclusion Ischemic ophthalmopathy caused by phacoemulsification cataract surgery may be related to the main vascular disease or optic nerve ischemia and hypoxia during operation,and with early detection and treatment,visual acuity can be improved to some extent.

Objective To evaluate effect of construction with dual plates via olecranon osteotomy approach in treatment of type C distal humeral fractures.Methods The study involved 19 patients with type C distal humeral fractures treated by olecranon osteotomy and double plate fixation between July 2008 and April 2010,including 11 males and 8 females at a mean age of 49.2 years (range,27-71 years).Fractures were causes by traffic accidents in 10 patients,tumble in seven and fall from height in two.According to Association for Osteosynthesis/Orthopaedic Trauma Association (AO/OTA) classification,there were nine patients with type C2 and 10 with type C3 fractures.Besides,two patients were complicated by ulnar nerve injuries and one by radial nerve injury.Results Primary wound healing was achieved in all patients after operation.All patients were followed up for average 15.9 months (range,12-20 months).X-ray films revealed that both fracture and olecranon osteotomy sites were healed in average 12 weeks (range,8-18 weeks).No fixation failure,myositis ossificans,malunion,delayed union or disunion occurred during the follow-up.Average Mayo elbow performance score (MEPS) was 94.8 points (range,75-100 points) at the last follow-up,which showed excellent results in 14 patients,good in three,and fair in two,with excellence rate of 90％.Conclusions Double plate fixation via olecranon osteotomy gains advantages of solid fixation and early functional exercise in treatment of comminuted intercondylar fractures of humerus.Moreover,postoperative outcome is satisfactory.

Objective To investigate the surgical strategies for management of unstable fractures of intertrochanteric lateral wall.Methods From July 2012 to June 2014,50 patients with unstable fractures of intertrochanteric lateral wall received osteosynthesis with proximal femoral nail anti-rotation.They were 37 men and 13 women,with an average age of 65.6 years (range,from 42 to 87 years).According to our morphology classification,25 patients belonged to type Ⅰ (comminuted fracture of lateral wall),4 to type Ⅱ (split fracture of lateral wall with loss of medial support),21 to type Ⅲ (comminuted fracture of lateral wall and subtrochanteric part with loss of medial support).The fractures were managed differently according to our classification.Type Ⅰ were treated by intramedullary fixation with compression screws to reconstruct the lateral wall,type Ⅱ by intramedullary fixation after reconstruction of the lateral wall lby cables,and type Ⅲ by intramedullary fixation after optimal reduction of the coronal plane and neck-shaft angle because the lateral wall could not be reconstructed.Results The 50 patients obtained an average follow-up of 17 months (range,from 5 to 24 months).No deep infection or wound dehiscence happened.Deep vein thrombosis occurred in 2 patients.No nonunion,cutout of the sliding screw,or coxa vara occurred.The operation time,blood loss,time of weight loading after operation and time of union increased with our increased classification.One patient died from a heart disease 5 months after operation.Functional outcome of the other 49 patient was assessed by Harris hip score one year after operation.Forty patients were excellent,6 good and 3 fair,giving an excellent to good rate of 93.9％.Conclusion Unstable fractures of intertrochanteric lateral wall should be treated using different surgical strategies based on the morphology classification system.

Objective:To explore the expression of mammalian target of rapamycin (mTOR)and its relationgship with the prognosis of breast cancer,and to provide evidence-based basis for the using of mTOR inhibitor in the treatment of breast cancer.Methods: A systemical literature search was conducted based on the following databases:PubMed,EMBbase,Cochrane Library,ISI Web of Science,and CNKI up to November 24,2015.The outcome measures were hazard ratio (HR)with 95% confidence interval (CI) for the association between the mTOR expression and the prognosis of patients with breast cancer.The primary end points including disease-free survival (DFS ), and overall survival (OS ). STATA 12.0 was used to conduct the statistical analysis. Results:A total of seven cohort studies,1 758 patients were included. The risk of recurrence and metastasis of the breast cancer patients with positive expression of mTOR was 2.05 times of the patients with negative expression of mTOR (HR= 2.05, 95% CI: 1.01 - 4.13,P = 0.003);the risk of death in the breast cancer patients with positive expression of mTOR was 2.63 times of the patients with negative expression of mTOR (HR = 2.63, 95%CI:1.45-4.80,P = 0.736).Conclusion:The positive expression of mTOR can significantly increase the recurrence,metastasis and death risk of the patients with breast cancer.

AIM: To study the prognositic value of PTEN and Her-2 expression in primary breast cancer.METHODS: 81 breast cancer specimens with 15 years follow-up were obtained from 1989 to 2004.Immunohistochemical methods were used to detect the expression of PTEN and Her-2 in 81 paraffin-embedded specimens.The correlation between expression of PTEN and clinipathological factors was discussed with the Chi-square test.The survival rate analysis results were calculated with Kaplan-meier method.Long-rank test and Cox model by SPSS 10.0 software.RESULTS:(1) PTEN expression significantly affects 5-year and 10-year survival rate of breast cancer(P

OBJECTIVETo construct a recombinant lentiviral vector that stably express hepatocyte nuclear factor 6 (HNF6) in colorectal cancer cell line and examine its effects on the invasive ability of SW620 cells.

METHODSThe lentiviral vector pLeno-DCE-HA-HNF6 was constructed and transfected into 293T cells. The supernatant containing the lentivirus particles was harvested to determine the virus titer. A stable cell line was established by infecting SW620 cells with the lentivirus particles, and the transfection efficiency was examined by fluorescence microscopy and flow cytometry. The invasion ability of the transfected SW620-HNF6 cells was assessed by wound healing and transwell assays.

RESULTSThe recombinant lentiviral vector was correctly constructed and verified by sequencing. SW620-HNF6 cell line with stable HNF6 expression was established successfully, and the transfection efficiency reached 82.3%. Western blotting and quantitative PCR demonstrated significantly upregulated HNF6 expression in SW620-HNF6 cells, which showed obviously suppressed invasive ability in wound healing and transwell assays.

CONCLUSIONWe have successfully established a colorectal cancer cell line SW620-HNF6 stably expressing HNF6, which shows a lowered migration activity in vitro.

Cell Line, Tumor ; Cell Movement ; Colorectal Neoplasms ; metabolism ; pathology ; Genetic Vectors ; genetics ; Hepatocyte Nuclear Factor 6 ; biosynthesis ; genetics ; Humans ; Lentivirus ; genetics ; metabolism ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection

OBJECTIVETo compare the effect of rapid rehabilitation surgery (FTS) with the traditional operation method on postoperative immune function recovery, inflammatory reaction and the clinical efficacy in elderly patients with colorectal cancer.

METHODSA total of 144 elderly patients (older than 65 years) diagnosed as colorectal cancer in our department from February 2010 to August 2013 were prospectively enrolled in the study. According to the order of admission, patients were randomly divided into the fast track surgery group (72 cases, study group), and the traditional operation group (72 cases, control group). Preoperative and postoperative T cell subsets, inflammatory index and organ functional parameters were detected and compared.

RESULTBasal clinical data of the two groups had no significant differences (all P>0.05). Three days after operation, CD4+ and CD8+ in both groups increased compared to preoperative levels (P<0.05), while the study group had greater increasing amplitude of CD4+ (t=1.685, P=0.003), and lower CD8+(t=1.145, P=0.005) than the control group. CD4+/CD8+ increased in the study group compared to preoperation and significantly higher than that in the control group (P=0.001). Inflammatory stress indexes were significantly increased, while study group had smaller amplitude than the control group. Serum creatinine, B-natriuretic peptide and Troponin-T increased after operation, while the study group had smaller amplitude than the control group (P<0.05). The study group showed faster resumption of oral intake, quicker bowel function return, time to first defecation, hospital stay, lower incidences of nausea, vomiting, incision infection, and less cost of hospitalization. All the differences were significant (all P<0.05).

CONCLUSIONFast track surgery can effectively protect the perioperative organ function, increase postoperative immune function, decrease inflammation stress reaction, reduce perioperative morbidity of complication, improve efficacy for elderly colorectal cancer patients.

Aged ; Colorectal Neoplasms ; surgery ; Defecation ; Humans ; Inflammation ; immunology ; Length of Stay ; Postoperative Period

Objective To test the agreement between two new self-care-related instruments,the Chinese version of the Appraisal of Self-care Agency Scale-Revised (ASAS-R-CHI) and the Chinese version of the Self-care Ability Scale for the Elderly (SASE-CHI) among older stroke patients by Bland-Altman method.Methods A random sampling was used to conduct this study in Neurology Department in a tertiary referral hospital in Henan Province,during November 2016 to October 2017.The sample consisted of 500 older stroke patients.Data were collected by a demographic questionnaire,SASE-CHI and ASAS-R-CHI.SPSS 21.0 was used to analyze the data.Results The mean total scores of ASAS-R-CHI and SASE-CHI were 54.98±5.06 and 61.92±7.34,respectively.Partial correlation coefficients between the total score of ASAS-R-CHI and SASE-CHI and their factors were from 0.217 to 0.953,showed significantly correlation (P＜0.01).The difference analysis and ratio analysis of Bland-Altman showed a good consistency of the two scales,with 5.0％ and 4.5％ of the points outside the 95％CI boundaries,separately.Conclusion There is a good agreement between the two instruments among older stroke patients.Each scale has its own characteristics,therefore the users should choose the most appropriate scale according to the specific situation.

Objective To compare the curative effects of Pauwels cannulated screws (PCS) and DHS-blade plus anti-rotation screw +anti-rotation screw(DHSA +AS) in the treatment of Pauwels type Ⅲ femoral neck fractures.Methods From December 2013 to December 2015,46 patients with fresh Pauwels type Ⅲ femoral neck fracture were treated with internal fixation at our department.They were divided into 2 groups according to different fixation methods.In the DHSA + AS group of 25 patients,13 were male and 12 female,with an average age of 49.2 ± 8.2 years,and there were 3 cases of Garden type Ⅱ,4 cases of Garden type Ⅲ and 18 cases of Garden type Ⅳ.In the PCS Group of 21 patients,11 were male and 10 female,with an average age of 48.7 ± 6.2 years,and there were 2 cases of Garden type Ⅱ,6 cases of Garden type Ⅲ and 13 cases of Garden type Ⅳ.The 2 groups were compared in terms of operation time,intraoperative blood loss,reduction quality,hospital stay,union time,postoperative complications and Harris hip score.Results DHSA + AS group needed significantly longer operation time (54.0 ± 7.3 minutes) and incurred significantly more intraoperative blood loss (102.3 ± 10.5 mL) than PCS group (46.3 ± 5.4 minutes & 77.4 ±9.1 mL,respectively) (P ＜ 0.05).There were no significant differences between the 2 groups in reduction quality,hospital stay,or union time (P ＞ 0.05).DHSA + AS group and PCS group obtained an average follow-up of 14.1 ± 1.6 months and 13.7 ± 1.2 months,respectively.For DHSA + AS group and PCS group,the rate of postoperative complications was respectively 12.0％ (3/25) versus 4.8％ (1/91),and the Harris hip score at the last follow-up respectively 83.6 ± 5.4 versus 85.1 ± 5.5,showing no significant differences between the 2 groups (P ＞ 0.05).Conclusions DHSA + AS and PCS are both suitable internal fixation options for patients with Pauwels type Ⅲ femoral neck fracture when reduction is fine.Compared with DHSA + AS,PCS may need less operation time and incur less intraoperative blood loss.