Objective: In order to provide references for drawing up related health policy reasonably, the current status of medical insurance payment in third level hospital. Methods: Through analyzing the payment situation of medical insurance in third level hospital from 2010 to 2012, to understand the related situation of gross prepayment system in large publich hospital since this year. Results: In recent years, the coverage rate of health insurance in the whole city is increasing continuously, while the rising extend of annual gross prepayment limit is not obvious, refusal in medical insurance fund is serious and the accounting method of prepay limit is not scientific. Conclusion: While satisfying the quality of patients’ visiting, it needs to implement gross prepay accounting method, enhance medical management and reduce the economic burden of the hospital.

Background and purpose: NF-?B is activated by tumor necrosis factor,some chemotherapeutic agents,and ionizing radiation.The activation of NF-?B could result in inhibition of apoptosis.NF-?B,regulated by PDTC(pyrrolidine dithiocarbamate),is a specific inhibitor of NF-?B.The purpose of our study was to explore the impact of inhibiting expression of NF-?B on radiation-induced apoptosis of uterine cervix cancer HeLa cells.Methods:Inhibition of NF-?B in HeLa cells was performed by treatment with 100 ?mol/L PDTC for 2 hours.Cells were irradiated at 0,2,4 and 6 Gy with or without PDTC.The expression of NF-?B in nuclear was determined by western blot,and apoptosis was evaluated by using the TUNEL assay.Cell proliferation was evaluated by using MTT assay.Results:NF-?B activation was induced by radiation and inhibited by PDTC.Inhibition of radiation-induced NF-?B activation resulted in inhibiting cell proliferation(P

Objective To investigate the clinical value and pathogenic mechanism of virulence genes of Helicobacter pylori from different sources of digestive diseases patients.Methods From January 2015 to July 2016,628 cases of gastric biopsy samples were collected from gastroscopy room of People′s Hospital of Wuwei City,through separating and culturing of Helicobacter pylori,detecting of viral virulence genes,to explore the relationship between Helicobacter pylori and chronic atrophic gastritis CAG),chronic superficial gastritis(CSG),peptic ulcer(PUD).Results Among the 628 gastric biopsy specimens,214 cases of Helicobacter pylori were successfully isolated,and 172 strains were serected to extracting DNA,which contained various virulence genes of cagA,vacA,dupA,iceA,oipA and luxS.VacA s1m1 was a risk factor for CSG,VacA s1m2 and iceA1+/iceA2+ increased the incidence of PUD,DupA + increased the risk of duodenal ulcer.Conclusion Different digestive diseases and Hp infection were related closely,dupA was considered as Hp induced duodenal ulcer marker gene,vacA s1m2 and iceA1+/iceA2+ increased the risk of PUD.

In this paper, the concept, policy support and existing modes of transitional care in America were introduced in detail. It can provide reference for the development of transitional care mode in our country, provide continuous nursing services for the elderly, and improve the health status of the elderly.

Objective To explore MR imaging features of synovial chondromatosis,and evaluate the diagnostic value of MR imaging.Methods The imaging data of 16 cases with pathologically confirmed synovial chondromatosis were analyzed retrospectively,who underwent the preoperative X-ray plain film and MR plain-scan and enhanced-scan.Two cases of should joint,4 cases of hip joint,8 cases of knee joint(ten joints),2 cases of ankle joint.Results Eleven cases (13 joints) were truly diagnosed according to X-ray plain film,the typical features of synovial chondromatosis were hyperdense free bodies in the joint space and adjacent soft tissue,which showed the concentric lamina sign.Fourteen cases (16 joints) were truly diagnosed according to MR imaging,which clearly showed thickened synovium with significant enhancement,multiple intraarticular cartilage or bony nodules with the surface enhanced,and some nodules connected with thickening synovial membrane,joint effusion and joint degeneration.MR could display the synovial abnormalities that could not be displayed in X-ray plain film,which was helpful to distinguish the characteristics of free bodies in joint,and superior to X-ray plain fdm in showing the lesions in detail.Conclusion MR could clearly show the synovial abnormalities and free body in the joints,which has important value for the diagnosis of synovial chondromatosis,determination of the extent of lesions and the characteristics of free body.

Objective To test the reliability and validity of the Chinese Version of the Depressive Cognition Scale (DCS) among the older people.Methods The sample consisted of 570 old people,collected by a demographic questionnaire,the Chinese version of DCS,and the Center for Epidemiological Studies Depression Scale (CES-D),then all the data was analyzed by SPSS 21.0.Results The item-to-total correlation coefficients of DCS ranged from 0.65 to 0.84 (P＜0.01),and the average coefficient was 0.77.The content validity index(CVI) was 0.88.The result of exploratory factor analysis (EFA) was that one factor explained 59.72％ of the total variances,and the concurrent validity between DCS and CES-D was positive related (r=0.24-0.82,P＜0.01).Regarding CES-D as the gold standard,the sensitivity was 84.7％ and the specificity was 90.7％.The inter-item correlation coefficients of DCS ranged from 0.40 to 0.73 (P＜0.01);the Cronbach α was 0.82,and the retest reliability (intra-class correlation coefficient,ICC) was 0.92 (95％CI=0.86-0.95,P＜0.01).Conclusion DCS is proved to be a reliable and valid instrument,and it can be used to assess the depressive cognition and screen the early depressive symptoms of Chinese old adults.

Objective To test the reliability and validity of the Chinese version of the sense of coherence (SOC) scale (13-items) among the older people.Methods A random sample of 1 032 old adults was selected from community in Jinzhou,Shenyang,Dalian of Liaoning.A demographic questionnaire,the SOC-13 scale,the WHO-5 and the Center for Epidemiological Studies Depression Scale (CES-D) were used to collect the data.All the data was analyzed by SPSS 21.0 and AMOS17.0.Results The item-total correlation coefficients of SOC-13 ranged from 0.625 to 0.760 (P＜ 0.01).The result of exploratory factor analysis (EFA) was that three factors explained 74.745％ of the total variances,and the CFA confirmed the hypothesized three-factor model.SOC scale had an ideal criterion(x2/df =2.908,CFI =0.975,GFI =0.949,NFI =0.963,IFI=0.975,RMSEA=0.061).Criterion related validity test showed that the total score of SOC-13 was negatively correlated with CES-D(r=-0.55,P＜0.01),and positively correlated with WHO-5 (r=0.73,P＜ 0.01).SOC-1 3 had a Cronbach's α of 0.916,the Guttman split-half coefficient was 0.828,and the retest reliability (intra-class correlation coefficient,ICC) was 0.872 (P＜0.01).Conclusion SOC-13 is a reliable and valid instrument,which can be used to measure the lever of sense of coherence among Chinese old adults.

Objective To explore the relationship among structural empowerment,psychological empowerment and nurses' job burnout,and to provide new approach for relieving nurses' job burnout.Methods Conditions for Work Effectiveness Questionnaire-Ⅱ (CWEQ-Ⅱ),Psychological Empowerment Scale (PES),and Maslach Burnout Inventory (MBI) were used to investigate 233 nurses working at three general tertiary-level hospitals in Tianjin.Results The total scores of structural empowerment,psychological empowerment,and burnout were (43.498 ±9.977),(38.871 ±7.052) and (45.489 ± 11.331),respectively.Relevant Analysis results showed that structural empowerment,psychological empowerment and nurses' job burnout had significant correlation,and the absolute value of coefficient of correlation between 0.358-0.560.The structural equation modeling results showed that fit indexes for fully mediating effect model were excellent(x2 =57.703,x2/df =1.202,GFI =0.965,AGFI =0.933,NFI =0.948,RFI =0.916,IFI =0.991,TLI =0.985,CFI =0.991,RMSEA =0.030,CN =263).Structural empowerment had a positive significant influence on psychological empowerment; structural empowerment and psychological empowerment had a negative significant influence on nurses' job burnout; psychological empowerment played a fully mediating role between structural empowerment and nurses' job burnout.Conclusion Nurse psychological empowerment has direct effect on job burnout.Nurse structrual empowerment affects job burnout via the full effects of psychological empowerment.

Objective:To study the influence of harvest time on the characters of Chaenomeles Spciosa ( Sweet) Nakai to determine the optimal harvest time with traditional characters of the Chinese medicine. Methods: In order to explore the optimal harvest time of Chaenomeles Spciosa ( Sweet) Nakai, the content of alcohol-soluble extract, weight and acidity of Chaenomeles Spciosa ( Sweet) Nakai with different harvest time were determined, the weather conditions in recent 3 years was summarized, and the drying process was also studied. Results:The average weight of Chaenomeles Spciosa(Sweet)Nakai was the lowest in June and highest in August, and the den-sity reached maximum in mid-July. During the whole harvest time, the content of alcohol-soluble extract was stable. The weather con-ditions from mid-July to late-July were with high temperature, dry and little rain, which was suitable for drying of Chaenomeles Spciosa ( Sweet) Nakai. Conclusion:The optimal harvest time of Chaenomeles Spciosa( Sweet) Nakai is confirmed in mid-July according to the traditional customs, drying conditions and characters of the Chinese medicine.

Objective To investigate cause and prevention of dysuria after hyperplasia of prostate operation. Methods To analyze 66 cases of dysuria after hyperplasia of prostate operation retrospectively. Result The most common reasons to dysuria are orderly stenosis of bladder neck; inflammatory edema of bladder neck; urethral stricture; rehyperplasia of remained prostate tissue; neruogenic bladder; prominence of ureteral crest; clot obstruction. Conclusion Prevention of dysuria after hyperplasia of prostate operation consists in preoperative satisfied diagnosis and correct treatment in operation and after operation.