The new current versions of Hospital Finance System and Hospital Accounting System promote the reform of medicine accounting. It requires the method of the drugs cost accounting to change the retailing price accounting to the purchasing price accounting. It clearly defines individual valuation method, “first-in, first-out” method or weighted average method should be used to determine the actual cost of the materials based on the actual situation. It analyzes the problems of medical management and cost accounting, and proposes the practical solutions to strengthen the standard management of medicine and the medical cost accounting.

Objective To investigate the effects of rosuvastatin calcium on bone mineral density and carotid atherosclerotic plaque in patients with type 2 diabetes mellitus complicated with osteoporosis.Methods Eighty-two T2DM patients with osteoporosis were randomly divided into two groups,41 cases in the treatment group and 41 cases in the control group.The control group received routine treatment,including insulin and Caltrate D treatment.The observation group was treated with rosuvastatin calcium 10 mg 1 time/d orally,on the basis of the routine treatmentv.The two groups were treated for 12 weeks.After treatment,the blood glucose level,bone mineral density and carotid atherosclerotic plaques were compared.Results After treatment,the levels of blood sugar,FBG ((7.2±0.4) mmol/L),2 hBG ((9.2±0.6) mmol/L),HbAlc ((7.2±0.4) mmol/L) in the observation groups were lower than those before treatment ((9.6±0.5) mmol/L,(12.3±0.6) mmol/L,(9.8±0.7) mmol/L,t=24.0,23.39,20.65,P<0.05),the levels of blood sugar,FBG,2 hBG,HbAlc in the control group were (8.4±0.3) mmol/L,(10.5±0.6) mmol/L and (8.3±0.6) mmol/L,lower than those before treatment ((9.3±0.3) mmol/L,(12.0±0.8) mmol/L,(9.9±0.5) mmol/L,t=13.58,9.60,13.12,P<0.05).The three indexes in the observation group were lower than those in the control group (t=-15.37,-9.8,-9.77,P<0.05).After 1 course of treatment,the femoral neck BMD value in the observation group was higher than that before treatment ((0.699±0.111) g/cm2 vs.(0.665±0.106) g/cm2,t=0.790,P<0.05),there was no significant increase in the BMD value in the control group after treatment ((0.669±0.130) g/cm2 vs.(0.662±0.119) g/cm2,t=-0.25,P>0.05),the BMD of femoral neck in the observation group after treatment was higher than that in the control group (t=0.842,P<0.05).After 1 course of treatment,IMT value and plaque score in the observation group were lower than those before treatment ((1.202±0.18) mm vs.(1.582±0.369) mm,(3.62±0.33) points vs.(4.39±0.37) points,t=0.778,9.945,P<0.05),in the control group,the intima-media thickness of the carotid artery and plaque score after treatment were not significantly increased compared with those before treatment ((1.487±0.345) mm vs.(1.499±0.356) mm,(4.16±0.26) points vs.(4.28±0.28) mm,t=0.155,2.011,P>0.05).The differences between the observation group and the control group after treatment were statistically significant (t=0.534,0.645,P<0.05).Conclusion Rosuvastatin calcium can effectively improve the curative effect of type 2 diabetes mellitus in patients with osteoporosis and improve bone mineral density and carotid atherosclerotic plaques.

Based on the "Grayscales average distribution" method which equally distributes the input gray levels to output gray levels, three improved methods named: "Reduce the gray range expressed by the less significant subfields", "Low levels preset" and "Modify the exponent of inverse-gamma function" are proposed in this paper. Using these methods, the inverse-gamma relation subfields code can be obtained easily which can improve the low level expressions of AC-PDP. And a program, "gray scales distribution validate program", which can enhance the expressions of the demanded gray levels range, is also proposed in this paper.

Objective: To observe the effect of electroacupuncture (EA) at Lower He-Sea points on the expression levels of interleukin-1β (IL-1β) in the serum and gallbladder tissues, and nuclear factor-κB (NF-κB) in gallbladder tissues of the guinea pigs with acute cholecystitis (AC), and to explore whether Yanglingquan (GB 34), the Lower He-Sea point pertaining to Dan Fu (gallbladder), is relatively specific for the Dan Fu (gallbladder) disorders. Methods: Eighty-two healthy guinea pigs were randomly divided into 6 groups according to the random number table method, a blank group, a model group, a Yanglingquan (GB 34) group, a Zusanli (ST 36) group, a Shangjuxu (ST 37) group, and a Xiajuxu (ST 39) group, with 12 guinea pigs in the blank group while 14 in the other groups, respectively, half males and half females in each group. Except for the blank group, guinea pigs in the other groups were injected with E. coli into the gallbladder to establish AC models. Guinea pigs in the blank group were fed routinely without special treatment; those in the model group were daily tied up for 30 min without EA treatment; those in the 4 groups receiving EA treatment were acupunctured at the corresponding Lower He-Sea points after daily binding and stimulated with the SDZ-V EA instrument. After successful modeling and treatment for 5 d, blood was collected from the abdominal aorta of the guinea pigs, and the gallbladder tissues in each group were isolated for hematoxylin-eosin (HE) staining to observe the morphological changes. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum IL-1β level, and immunohistochemistry (IHC) was used to detect the expression levels of NF-κB and IL-1β in gallbladder. Results: On the 3rd day after modeling, the guinea pigs in the five groups with modeling were mentally depressed with decreased appetite, significantly reduced activities, slouch, lassitude, slack and matted fur, and loose stools; two guinea pigs were selected from each group (one male and one female, not included in the final statistics) to isolate the gallbladder after sacrifice; macroscopic observation showed that the gallbladder wall was differently thickened; the bile color was dark green and opaque with particles suspended or accumulated; light microscope observation showed that the submucosal blood vessels of the gallbladder were congested, along with mucosal edema, ulceration, necrosis, shedding, and a large number of inflammatory cells infiltrating in the lamina propria, indicating that the AC model was successfully prepared. Compared with the model group, the gallbladder tissue injuries of the four groups receiving EA treatment were all differently repaired, the serum IL-1β levels were reduced (P<0.01 or P<0.05), and the IL-1β levels in the gallbladder tissues were reduced (P<0.01 or P<0.05). Compared with the model group, the NF-κB expression level in the Yanglingquan (GB 34) group was significantly reduced (P<0.01), but was not statistical different in the Zusanli (ST 36) group, Shangjuxu (ST 37) group and Xiajuxu (ST 39) group (all P>0.05). Compared with the Yanglingquan (GB 34) group, the gallbladder tissues of the Zusanli (ST 36) group, Shangjuxu (ST 37) group and Xiajuxu (ST 39) group were more severely damaged, and the expression levels of serum IL-1β, the NF-κB and IL-1β in the gallbladder tissues were increased (P<0.01 or P<0.05). Intervention effect of Yanglingquan (GB 34) on AC guinea pigs was superior to that of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39). Conclusion: EA at the Lower He-Sea points of the stomach, large intestine, small intestine and gallbladder can produce curative effects on AC guinea pigs and reduced the inflammatory symptoms. Intervention effect of Yanglingquan (GB 34) on AC guinea pigs is superior to that of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39). The mechanism of EA at Yanglingquan (GB 34) in treating AC may be regulating IL-1β and NF-κB to control the inflammatory response and improve the gallbladder tissue damage.

The authors reviewed the development process of the concept of assessment augmentative and alternative communication (AAC) from focusing on prerequisite skills to communication needs and participation, introduced the team assessment and current three assessment models, including maximal assessment, criteria-based assessment and predictive assessment. Some factors which must be considered in all models were also given in this paper. The content and procedure of one most popular model were introduced in detail. The problems exsited in the application of AAC and the further development of AAC assessment were discussed.

ObjectiveTo observe the intraoperative techniques of artificial nasolacrimal duct and evaluate the effectiveness.MethodForty-nine cases(56 eyes) ofchronic dacryocystitis underwent artificial nasolacrimal duct placement.The artificial nasolacrimal duct was dilated and the stent was retrogradely placed.Dacryocystography was performed before operation.ResultsArtificial nasolacrimal duct placement was technically successful in 53 eyes(94.64％),improvement rate was 3.57 ％ (2/56).The total effective rate was 98.21％(55/56) after operation.ConclusionInterventional artificial nasolacrimal duct placement is a safe,simple and effective method for the treatment of chronic dacryocystitis.

Gene therapy of spinal cord injury (SCI) is the most promising method compared with the others, because it doesn't involve the problems of resource and higher exclusion which respectively exists in fetal nerve transplantation and peripheral nerve transplantation. There are two ways of gene therapy to be chosen: one is to transfer objective genes to the target-cells in vivo directly; the other is to transfer objective genes to one proper kind of transplantable cells firstly, then graft the highest expressing cells to the target-cells in vivo. To realize the transfer of genes to cells, two measures are used in common: physical or chemical measure such as micro infection et al and biochemical measure i. e. gene modified defective virus. Although there are some questions unresolved in this field, the clinical value of gene therapy of SCI in the future is depended.

OBJECTIVE:To discuss the quality problem commonly seen in the marketing and use of decoction pieces of traditional Chinese drugs and their quality control method. METHODS: We reviewed the pertinent Chinese journals and on which an aggregate analysis and evaluation was performed. RESUTLS: Drug name problem, slice cutting specification problem, the problem of the name of processed drugs in set recipe preparations and counterfeit problem etc were commonly seen in the marketing and use of decoction pieces of traditional Chinese drugs. CONCLUSION: To standardize drug name, drug processing and slice cutting specifications of Chinese crude drugs, and to prohibit counterfeits and conduct regular sampling inspection can effectively keep the quality of decoction pieces of traditional Chinese drug under control.

Objective To understand the gene distribution and drug resistance rate of integron gene of extended spectrumβ‐lac‐tamases(ESBLs) producing Klebsiella pneumonia infection in ICU elderly patients in order to provide the basis for rational use of antimicrobial agents .Methods The BioMerieux VITEK‐2 Automated Microbes Identification System was adopted to conduct the bacteria identification and drug susceptibility test on various clinical specimens of ICU elderly patients in our hospital from January 2013 to December 2015 .The integron gene in 167 strains of ESBLs‐producing Klebsiella pneumoniae was analyzed by PCR ,and the gene was identified by sequencing .Results Among 386 strains of Klebsiella pneumoniae ,the detection rate of ESBLs‐producing strains was 43 .26% ;the positive rate of integron was 50 .89% ,the detected integron was class Ⅰ integron;aadA2 ,aadA1 ,aada16 , dfra27 and arr‐3 genes were amplified from integron variable region;the drug resistance rate of ESBLs‐producing integron gene pos‐itive strains was significantly higher than that of integron gene negative strains .Conclusion the ICU elderly patients with ESBLs‐producing Klebsiella pneumoniae infection is closely related to the integron gene and integron plays an important role in bacterial drug resistance .

Precision medicine is a medical model that proposes the individual therapy,with a joint medical method of genomics,proteomics,metabolomics and clinical big data tailored to the individual patient.The diagnosis and treatment of colorectal cancer have entered the model of precision medicine with the entering the era of precision medicine.In this article,authors summarized the recent progress of diagnosis and therapy under the guidance of precision medicine,with an aim to provide some new clues for surgeons and supports for precision prevention,diagnosis and therapy.