Objective To discuss the issues encountered in fee charging,mainly the automatic recognition of charging agent.Methods Based on No.1 Military Medical Project,the present status of fee charging in the hospital was analyzed.The single disease payment system and charging system adapting to all kinds of medical insurance policies were designed,whose payment decomposition flow was introduced.Results The payment decomposition flow,compatible with all medical payment regulations in China,was applied in the outpatient department charging system of General Hospital of PLA.Conclusion The payment decomposition flow,is gifted with universal validity for complicated charging conditions in China.

OBJECTIVE:To discuss the dispensing of prescriptions of traditional Chinese medicine.METHODS:According to the dispensing procedure of Chinese traditional medicine and the principle of drug use,the problems occurred during Chinese traditional medicine dispensing were pointed out and analyzed.RESULTS:The problems occurred in the dispensing of prescriptions of traditional Chinese medicine were mainly resulted from doctors,pharmacists and nurses' lack of basic rationale or they had no intimate knowledge of operation regulations.These problems can be avoided if with efforts.CONCLUSION:Only through strictly following the prescription of Chinese traditional medicine can the quality and efficacy of Chinese drugs dispensing be guaranteed.

13 C isotopic abundance of intracellular free amino acid with a characteristic of fast- turnover can quickly reflect changes in intracellular metabolic state. But the concentration of intracellular free amino acid is low, the existed 13 C isotope detection method based on GC-MS can not satisfy the requirement with full scan mode. In this study, the selected ion monitoring method was used to detect accuracy higher likelihood of analysis of 13 C isotopic abundance of free intracellular amino acid. First, in the full scan mode we analyzed of the fracture law of different amino acids, found the feature corresponding to each amino acid fragments, and established 16 kinds of free intracellular amino acids characteristic fragment library. Then using this characteristic fragment library, only specific m/z signal was detected in sample analysis, which realized the selected ion monitoring and improved the quality of signal. The results of amino acid standards showed that the signal-to-noise ratio, measurement precision and accuracy were improved by 17, 2. 0 and 3. 8 times compared with the full scan mode. In the analysis of coenzyme Q10 producing strains of samples, this method was successfully used to detect isotopic abundance of 8 kinds of free intracellular amino acids. This method plays an important role in the detection of 13 C isotopic abundance of the intracellular free amino acid in cell metabolism research.

A method for measuring 13C isotopic abundance of intracellular metabolites of Saccharopolysporaerythraea by ultra-high performance liquid chromatography (UPLC)-triple quadrupole mass spectrometry was established.First, the chromatographic conditions of UPLC were optimized, and then the MS conditions such as unique tube lens voltage, collision energy, and ion pair were optimized.On the bases of length of the parent and daughter ions carbon chains and whether the daughter ions contain 13C atoms, the one-to-one method, one-to-many method and SIM method were established for measuring 13C isotopic abundance.Then these methods were used to measure naturally labeled intracellular metabolite standards and 13C labeled samples, and according to the gap between the experimental value and the theoretical value, the best method was established for each metabolite of different characteristics.The results showed that one-to-one method was most effective for measuring the metabolites of daughter ions not containing 13C atoms represented by sugar phosphates, one-to-many method was the best for measuring the metabolites of both parent and daughter ions containing 13C short carbon chains represented by carboxylic acids, SIM method could play a role in measuring the metabolites of both parent and daughter ions containing 13C long carbon chains represented by coenzyme A.This method had a good measurement precision and could be applied to the measurement of Saccharopolysporaerythraea intracellular metabolites, which contributed to the consequent study of metabolic mechanism and the efficient expression of erythromycin.

OBJECTIVE To evaluate the effect of antiviral agents in treating of severe acute respiratory syndrome(SARS). METHODS Based on the particular data (including medical history,examiuations and treatments) of 1702 patients of with SARS which were offered by the Health Bureau of Guangdong Province,the inpact factors of death and the course of diseases of SARS were retrospectively analyzed with unifactorial and multifactors statistic analysis methods. RESULTS It did not show any signs that the death rate could be decreased by the six antiviral agents in common use,but vidarabine could help to shorten the course of disease(OR=1.399,P=0.025),while oseltamivir might be prolonged the course of disease(OR=0.708,P=0.000). CONCLUSIONS The data showed that the effect of the six antiviral agents for curing SARS is limited,and a new antiviral treatment for SARS should be explored further.

Objective To evaluate euthyphoria reduction combined with percutaneous iliosacral screw fixation in the treatment of irreducible sacroiliac dislocation.Methods From March 2012 to May 2015,29 patients with irreducible sacroiliac dislocation were treated using euthyphoria reduction followed by percutaneous iliosacral screw fixation.They were 18 men and 11 women,aged from 25 to 68 years (average,37.9 years).According to the Tile classification,there were 7 cases of type Cl,9 cases of type C2,and 13 cases of type C3.The intervals from injury to surgery ranged from 6 to 32 days (average,11.3 days).Results The operation time for this cohort ranged from 40 to 125 minutes (average,76.2 minutes).The intraoperative bleeding ranged from 50 to 360 mL (average,148.6 mL).Their follow-ups ranged from 24 to 41 months (average,28.9 months).According to the Matta criteria for reduction,20 cases were rated as excellent and 9 as good,yielding an excellent to good rate of 100％.Their Majeed scores at the final follow-up averaged 90.1 points (range,from 67 to 100 points),giving 20 excellent,7 good and 2 fair cases (with an excellent to good rate of 93.1％).No screw loosening or lameness of the affected limb was observed during follow-ups.Conclusions Euthyphoria reduction combined with percutaneous iliosacral screw fixation can lead to satisfactory outcomes in the treatment of irreducible sacroiliac dislocation.Additionally it may improve operative safety.

Objective:To explore the effect of leptin on B cells in patients with systemic lupus erythematosus (SLE).Methods:Peripheral blood mononuclear cells (PBMCs) were isolated from SLE patients, and then CD19 + B cells were purified with magnetic bead sorting method. PBMCs or purified B cells were cultured with recombinant leptin at 0, 100, 250 ng/ml for 3 or 5 days. The frequencies of plasma cells, follicular helper T (Tfh) cells and peripheral helper T (Tph) cells, as well as activation markers (CD80, CD86) and leptin receptor and the proliferation of B cells were determined with flow cytometry. The concentrations of antibodies and cytokines were examined with enzyme-linked immunosorbnent assay (ELISA). Data were analyzed with t test and analysis of variance (ANOVA). Results:Increased levels of leptin were positively correlated with systematic lupus erythematosus disease activity index (SLEDAI) and the frequency of plasma cells in SLE patients. Leptin receptor could be detected on SLE B cells, and recombinant leptin elevated the levels of its receptor on CD19 + B cells [(7.8±1.3)% vs (6.1±0.9)%, t=3.36, P=0.006]. Leptin enhanced the expression of CD80 [(21±4)% vs (19±4)%, t=2.84, P=0.004] and CD86 [(22±4)% vs (19±4)%, t=4.92, P=0.004] on SLE B cells in vitro. It also promoted B cells to differentiate into plasma cells [(7.6±1.5)% vs (5.2±1.3)%, t=6.42, P=0.025]. There was no statistical significant difference of the effect of leptin on B cell proliferation. Leptin also increased the levels of antibodies [IgG: (62±3) ng/ml vs (45±4) ng/ml, t=7.75, P<0.001; IgM: (112±24) ng/ml vs (56±18) ng/ml, t=5.38, P<0.001] and inflammatory cytokines [IL-6: (24±5) pg/ml vs (20±5) pg/ml, t=4.09, P=0.002; TNF-α: (19.1±3.8) pg/ml vs (14.1±2.9) pg/ml, t=3.38, P=0.006; IL-10: (24±5) pg/ml vs (20±5) pg/ml, t=4.09, P=0.002] secreted by B cells. In addition, leptin significantly upregulated the frequencies of Tfh cells[(2.82±0.49)% vs (1.28±0.20)%, t=4.56, P=0.001] and Tph cells [(4.5±0.5)% vs (3.4±0.4)%, t=3.88, P=0.003]. Conclusion:Leptin could directly promote the activation, differentiation and secretory capacity of B cells by binding to its receptor, and also modulate B cell responses indirectly via enhancement of Tfh and Tph cells, which may be involved in the pathogenesis of SLE.