Objective Probing into the rationale of DRGs payment standards for references to making DRGs payment standards.Methods Based on the DRGs grouping results of circulatory diseases cases admitted by a tertiary hospital from 2003 to 2005,two typical combinations were selected to determine the payment standard for each DRGs combination.Unnecessary medical expenses were excluded.Results According to the percentage of unnecessary medical expenses,Angina,non-special nursing,and class 1 nursing were in a group,with unnecessary medical expenses per ease of 758.00 yuan;CAG,single stent implantation,acute myocardial infaction as the main diagnose were in a group,with medical expenses per case of 2814.03 yuan;such expenses account for 6.20% of the total hospitalization expenses of both groups.Conclusions If the average expenses with unnecessary medical expenses excluded are set as the combined payment standard,hospitals will be restrained from unnecessary medical behaviors and expenses so incurred.

Objective:To understand the status and identify the determinants of self-treatment of rural floating population in Beijing. Methods: The data were derived from the Fourth National Health Service Investigation of China, part of which was about rural floating population in Beijing. According to Andersen health services utilization model, Binary Logistic Regression model was used to analyze the influencing fac-tors. Results:In the study, 51. 7% of the research objects were inclined to self-treatment when they ever felt uncomfortable or sick in Beijing. The Binary Logistic Regression model suggested that, some factors from predisposing, enabling and need, were statistically significant determinants of utilization of self-treat-ment. Conclusion:There exists a certain percentage of self-treatment behavior for rural floating population in Beijing, and we should take some measures to promote the efficacy and safety of self-treatment.

Objective This study was performed to investigate whether misoprostol (PGE1 analogue) is effective for the restoration of bone loss in female rats with osteoporosis induced by ovarectomy. Methods The model of osteoporosis was established by ovariectomy in rats, and then the rats were given different doses of misoprostol. Bone mineral density(BMD), serum BGP and urine HOP/Cr were measured. Results BMD (0 26?0 03)g/cm 2 and (0 28?0 02)g/cm 2 in the misoprostal treatment groups was significantly higher than that in the control group 〔(0 23?0 02)g/cm 2, P 0 05〕 Compared with the control group 〔(3 02?0 42)?g/L, P 0 05 〕. Conclusions Results of our study demonstrate that the bone loss caused by ovariectomy was restored by misoprostol administration. The effect of misoprostol mainly is due to its promotion of bone formation.

Objective To study the value of routine laboratory examinations, symptoms and soluble IL-2 receptor (sIL-2R) in the flare-prediction on systemic lupus erythematosus(SLE). Methods A prospective study was performed in 106 outpatients with SLE and the patients′ conditions were assessed according to Systemic Lupus Erythematosus Disease Activity Index(SLEDAI). Patients were asked to visit at no longer than 3-month interval. All patients were followed-up for 6 to 18 months. At each visit, laboratory examinations, symptoms, disease activity, as well as the changes in the treatment were recorded according to the protocol. The values of these parameters in flare-prediction were comprehensively assessed based on their frequency and time respectively when they became abnormal before the disease flare. Results Among the 106 patients, the disease activity of 67 cases were in remission and satisfied the prospective study criteria of the SLE flare. Thirty-one flares in 29 patients were observed. The frequency of flare was 0.44/patient/year. Comprehensively the most valuable predictor of those parameters was anti-dsDNA antibody, followed by complement components, sIL-2R, erythrocyte sedimentation rate(ESR), complete blood count, urine analysis, fatigue, mucous membrane ulceration, new rashes and alopecia. C3 was a better predictor for SLE flares than that of C4 and CH50. Conclusions The flares of SLE could be predicted. Early intervention will help to prevent patients from flare.

In the paper, 32 lots of intravenous immunoglobulin (IVIG)were tested by an animal model,the hypotensive test of rats. A linear correlation was found between prekallikrein activator (PKA)activity and hypotensive reaction if the inflow of human IVIG was made rapid (r=0.96,n=23). The preliminary observations indicated that it would be satisfactory that the PKA activity was below 35IU/ ml and the size of reduction in blood pressure was not 15% higher than that of control animal's level.The rat model can provide a method for safe usage of the intravenous immunoglobulin and reliable detection of and control over the residual PKA activity in blood products.

10 days.All the patients received operations.Results:The prognoses of 80.49% patients in the early and middle stages were well ,the fadeaway of edema was evident,on the contrary,the prognoses of 83.33% patients of the later stage were worse,the fadeaway of edema was slow.Conclusion:The patients of LEDVT should receive operation as early as possibly in 10 days,the patients should receive conservative therapy after 10 days.

In recent years,with the rapid development of orthopedic surgery and minimally invasive surgery,superficial fascia and its structures are receiving much recognition and more and more attention.Although opinions on naming and definition at different levels still vary,in-depth study of related structures offers clinical surgeons a broad prospect.

Neurologic complications are rare but devastating events after scoliosis surgery;a thorough preoperative work-up and effective intraoperative monitoring of the spinal cord may reduce the incidence.This review discusses the incidence,preoperative work-up,intraoperative monitoring,and managing strategies for neurologic complications of scoliosis surgery.

To accelerate the identification of HLA-DPB1 matched marrow donors from unrelated population, a very simple HLA-DPB1 genotyping method called PCR-fingerprinting (PCRF) was developed according to the theory about homoduplex and heteroduplex formation from different PCR coding strands and non-coding ones. Unlike PCR-SSCP, strict laboratory condition is not needed in the PCRF. After denaturing at 94℃ for 2 min and cooling at 37℃ for 8 min, the PCR product was separated by 8% PAGE for 5 h and polymorphism band patterns would appear when the gel staining was completed with either EB or silver staining procedure. To confirm its reliability, 21 individuals from 9 family whose DPB1 genotypes assigned by PCR-RFLP were verified. It was found that there were 8 PCRF patterns corresponding to the 9 HLA-DPB1 genotypes from the 21 cases and the same DPB1 genotypes produced identical PCRF pattern except one pair.The factors on efficient separation of heteroduplexes and homoduplexes were also discussed.

Objective To investigate the status quo of the medical staff in 6 village clinics in Fengjie County, and to put forward countermeasures and suggestions for improving the quality and overall quality of medical personnel in village clinics. Methods The research literature and questionnaires were used to investigate the basic situation of the village doctors, the role of the village doctors in the residents' health care, and the needs and satisfaction of the residents in the village clinics. The data were analyzed by SPSS 19.0, and the samples were analyzed by descriptive statistics. Results The average age of the medi-cal staff in village clinics was (46.74±10.17) years old, and there was no medical staff under 30 years of age. The medical staff of the village health clinics had an irrational age structure, and the educational back-ground was generally low; the medical staff generally thought that their income was not high. They hope to participate in more training in medical technology; residents generally believe that the doctors' ability to diagnose and treat the disease needs to be improved. Conclusion It is necessary to strengthen the leading role of the government and bring into play the positive work of the medical staff in the village health clinic. It is also necessary to strengthen the training of talents, lay a solid foundation for development, take the demand as the guide to change the service concept and model, to improve the relevant mechanisms to create good surroundings for the development of medical staff in village clinics.