Objective: To improve the low relief fund utilization rate, make the city minimal assurance relief patients enjoy double Medicaid assistance account and agricultural insurance or Medicare reimbursement policy. Methods: Based on the actual work, and actively explore, innovation, in the Oracle database platform, the transformation of His in outpatient service charge settlement system, establishing patient account data, through a patient's unique index related agricultural insurance or Medicare patient file information. Results:The outpatient service charge settlement system enabled for tailored low mental patients. Conclusion:the patients fully enjoy minimal assurance relief assistance account and agricultural insurance or Medicare reimbursement policy ofdouble Medicaid, andfirst diagnosis and treatment forbusiness conducted a preliminary exploration.

Objective To evaluate the clinical efficacy and safety of long-term repeated treatment of facial wrinkles with application of botulinum toxin A (BTXA). Methods A total of 52 patients had received 8 injections in seven years with BTXA against facial wrinkles, including forehead wrinkles, fishtail lines, glabellas wrinkles, and nasal dorsum transverse wrinkles. Besides day 1 (baseline) and day for the next injection (end-point), follow-up visits were scheduled on 1 week, 1 month, and 3 months after every injection. The therapy effect and safety were evaluated. Results For all the patients, it began to take effect on day 3 or 4 after the treatment and best effect appeared on 1 month post-treatment. Patients' selfevaluation as grade 1 for the improvement of forehead wrinkles, fishtail lines, glabellas wrinkles and nasal dorsum transverse wrinkles, accounted for 100%, 97.1%, 99.8% and 99%, respectively. Correspondingly, cases as grade 2 accounted for 0, 2.9%, 0.2% and 1.0%. Grades 3 to 5 had not been reported. With the repetition of treatment, the efficiency increased. The average of effective duration was (7.8±1.1) months, which lasted longer with the injection times increased (r= 0.256, P= 0.02). Adverse reactions observed in the previous several injections, including ecchymosis, feeling of tightness, rigid expression and severer wrinkles near the injected site, which were mild and the incidence rate decreased after the following injections (r= 0.850, P= 0.01). Severe adverse effects, such as allergic reaction,headache, blepharoptosis and dysraphism of eyes had not happened in all the 52 patients. Conclusion Long-term repeated application of BTXA against facial wrinkles is safe and the efficacy is confirmed. The approach can be applied repeatedly to those who have indications and good tolerance.

The paper analyzes deficiencies in traditional manual screening of critical values , telephone notifications and manual record-ing of critical value reports , as well as problems existing in current critical value reporting systems in China .It designs a stable , timely and accurate reporting system for test critical values and mainly introduces the system design , system function and application features .

Objective To investigate the relationship between intra-abdominal fat area(IAFA)in male with abdominal obesity and glycometabolism related indicators. Methods Ninety-four obesity males,aged from 21 to 62 years old,were selected as our subjects. They were divided into abdominal obesity group(n = 70)and non-abdominal obesity group( n = 24). The general information of all subjects was recorded. The indexes of height,weight,waist circumference,hip circumference,body mass index(BMI)were measured. The fasting oral glucose tolerance test was performed. The levels of blood glucose(0,1,2 h)and insulin(0,1,2 h)were measured,and insulin resistance index was calculated. MRI measurement was applied to calculate the IAFA. Compared the difference between the two groups in term of the level of blood glucose,insulin and insulin resistance index,and analyzed the correlation between glycometabolism related indicators and IAFA. Results BMI,waist circumference,hip circumference,insulin resistance index and IAFA in abdominal obesity group were (28. 67 ± 4. 20)kg/ m2 ,(99. 75 ± 4. 07)cm,(104. 42 ± 7. 62)cm,2. 60 ± 1. 80,(153. 06 ± 53. 23)cm2 respectively,higher than those in non-abdominal obesity group((21. 80 ± 1. 97)kg/ m2 ,(79. 50 ± 10. 05)cm, (91. 86 ± 4. 49)cm,1. 52 ± 0. 73,(71. 78 ± 25. 48)cm2 ),and the differences were statistically significant(t= - 7. 704,- 9. 583,- 7. 618,- 2. 877,- 7. 184,P < 0. 05). The level of blood glucose at 0,1,2 h of patient in abdominal obesity group were(5. 89 ± 1. 36)mmol/ L,(10. 55 ± 3. 07)mmol/ L,and(8. 41 ± 3. 63) mmol/ L,higher than that in non-abdominal obesity group((5. 29 ± 0. 53)mmol/ L,(8. 76 ± 1. 96)mmol/ L, (6. 54 ± 1. 50)mmol/ L). Meanwhile,The insulin at 0,1,2 h of man in abdominal obesity group were(9. 71 ± 5. 05)mU/ L,(83. 29 ± 64. 51)mU/ L,(63. 56 ± 21. 09)mU/ L),significantly higher than those in non-abdominal obesity group((6. 42 ± 2. 96)mU/ L,(33. 00 ± 19. 82)mU/ L,(63. 56 ± 21. 09)mU/ L),and the differences were significant( t = - 2. 098,- 2. 671;- 2. 447,- 3. 010;- 3. 784,- 3. 089;P < 0. 05). The IAFA in abdominal obesity was positively correlated with age,BMI,waist circumference,hip circumference,blood glucose(0,1,2 h)insulin(0,2 h)and insulin resistance index(r = 0. 254,0. 533,0. 521,0. 615,0. 245,0. 315, 0. 294,0273,0. 249,0. 225,P < 0. 05 ). After adjustment for confounding factors,age( x1 ),abdominal circumference(x2)and insulin resistance index(x3)were related to IAFA(y = 1. 369x1 + 4. 472x2 + 25. 072x3- 333. 626). Conclusion Compared with patients with non-abdominal obesity,the IAFA of patient with abdominal obesity with abdominal fat area size is associated with insulin resistance.

Objective To analyze the long-term results of fractionated stereotactie radiotherapy(FSRT)for the local residual lesion after the first course of radiotherapy for nasopharyngeal carcinoma.Methods From July 1997 to July 2002,46 patients were treated with FSRT.According to the 1992 Fuzhou staging system,the number of patients was 1,6,30 and 9 with stage Ⅰ,Ⅱ,Ⅲ and Ⅳ disease,respectirely;3,11,27 and 5 with T1,T2,T3 and T4 tumor,respectively;14,16,12 and 4 with N0,N1,N2and N3 disease.Radiotherapy was delivered to tumors with the total of dose 68-70 Gy in 7-8w.Chemotherapy(2 cycles of PVF or POF)was given to the patients with stage Ⅲ and Ⅳ a disease.FSRT was given to the residual disease with the total dose of 18-24 Gy in 3 fractions with an interval of 3-7 days.The reference dose line was 70%-90%.Resuits CR and PR rates in this group were 61%and 39%,respectively.The overall survival rates of each year from 1- to 5-year were 100%,87%,83%,78%and 76%.The 1-,3- and 5-year disease-free survival rates were 100%,93%and 89%;The distant metastasis-free survival rates were 100%,85%and 79%;The local-regional control survival rates were 100%,94%and 91%.Seventeen patients who died during the follow-up period were 1 for local cervical lymph node recurrence,2 for fatal nasopharyngeal hemorrhage,4 for local nasopharynx recurrence,and 10 for distance metastases. Conclusions Fraetionated stereotactic radiotherapy is safe and effective for the patients with residual lesion of nasopharyngeal carcinoma at the primary site after radiotherapy.The optimized fractionation and total dose requires the further investigation.

Objective To investigate the distribution of 16S rRNA methylase genes in Klebsiella pneumoniae strains producing Klebsiella pneumoniae ealbapenenase type 2(KPC-2).Methods A total of 37 Klebsiella pneumoniae isolates producing KPC-2 were collected.The minimal inhibitory concentrations (MICs)of these strains to amikacin,gentamyein and netilmicin were determinated by agal dilution method.Six 16S rRNA methylase genes(armA,rmtA,rmtB,rmtC,rmtD and npmA)were detected by PCR.Results The resistant rates to amikacin,gentamycin and netilmicin were 97.3%(MIC50≥1024μg/mL).Among those resistant strains,8 were armr/A positive,25 were rmtB positive,4 were both armA and rmtB positive.and no other 16S rRNA methylase genes were found.The total positive rate of 16S rRNA methylase genes was 78.4%(29/37).Conclusion 16S rRNA methylase genes armA and rmtB ale prevalent in Klebsiella pneumoniae strains producing KPC-2.

Objective To establish a method for determination of trace lead in alginate sodium.Method The lead in the samples was determined by fluorescence spectroscopy after been digested by hydrothermal decomposition.Results The detection limit of lead was 2.71?10-2?g?mL-1.The relative standard deviation of the three samples were 4.06%,1.57% and 2.12% respectively,the average recovery was 88.32%～100.8%.Conclusion The method had the advantages of simple operation,higher precision,higher sensitivity and repeatability and was suitable for the determination of trace lead in the alginate sodium

Objective To evaluate the relationship between ambulatory arterial stiffness index (AASI) and intracranial and extracranial arterial stenosis in 146 patients with ischemic cerebrovascular disease. Methods Degree of intracranial and extracranial arterial stenosis in 146 patients with ischemic cerebrovascular disease was assessed by CT angiography (CTA). Then all patients were divided into 4 groups according to the numbers of branches with stenosis: no stenosis group, 1 branch group, 2 branches group, and 3 and more than 3 branches group. Dynamic blood pressure was monitored to calculate the AASI. Results There was no significant difference of AASI among the extracranial arterial stenosis groups (P=0.614). AASI was positively correlated with the degree of intracranial artery stenosis (r=0.743, P<0.05), and with 3 and more intracranial artery branches stenosis (r=0.797, P<0.05). Conclusion AASI is closely correlated with the degree and numbers of branches of intracranial artery stenosis.

OBJECTIVE:To determinate the plasma concentration of ropivacaine in rabbits by HPLC,and study the secu?rity of ropivacaine in rabbits.METHODS:Nine rabbits were injected with ropivacaine drop by drop with a speed of1mg/(kg?min)until the rabbits died.RESULTS:The mean plasma concentration of ropivacaine in rabbits was224.54?107.45mg/L when the rabbits died.CONCLUSION:Ropivacaine has high security in rabbits.

Ten cell strains were obtained from the human gastric cancer cell line BGC-823 by using the method of single cell cloning. Through inoculation of these cell strains in nude mice and subsequent observation of their metastatic capability, four cell lines, C_1, C_6 with high, and C_5, C_8 with low metastatic capability were selected out; and their biological and morphological properties were studied. It was demonstrated that all of them did not show apparent difference in growth ability, but morphologically, the mictovilli of C_5 and C_8 cells were scarce and short; and their microfilaments were thick, straight and well organized. Whereas the microvilli of C_1 and C_6 strains were long and abundant comparatively, but their microfilaments were poorly organized. On the basis of present observation,we suggested that the organization of microfilaments in cancer cells appeared to bear reversed relationship with their metastatic capability.