Objective To establish a model of DRG-like grouping of cesarean section patients in the Beijing area so as to observe its feasibility of controlling rising medical costs.Methods DRG-like grouping of cesarean section patients was conducted by case-mix/DRG.The patients were divided into 3 groups according to complications: the serious complication group,the moderate complication group,and the minor or no complication group.Results The rate of cesarean sections remained at 50% or so in Beijing.A statistical analysis showed a significant difference between the 3 groups in costs and length of hospital stay.70% of the cases in the serious complication group belonged to the high cost group whereas 70 % of the cases in the minor or no complication group belonged to the low cost group.Conclusion The main ways of controlling rising costs for cesarean sections include reducing the rate of cesarean sections and(adopting) DRG-like PPS payments in view of the nature of medical insurance and government payments for cesarean sections.

Objective To investigate the effects of sericin pretreatment on the expression of extracellular matrix(ECM) associated protein in diabetic nephropathy(DN) rats' kidney.Methods Sixty six male SD rats were randomly divided into 3 groups(n=12):normal control group,DN model group and sericine pretreatment group.DN rats model in model group and sericine pretreatment group were established by intraperitoneally injection of streptozotocin(STZ).Blood glucose≥16.7 mmol/L was taken as the standard of successful modelization.The rats in sericine pretreatment group were lavaged with sericine(2.4 g·kg~(-1)·d~(-1)) for 35 days before injecting STZ.The enzymic method was used to measure the blood glucose.Type Ⅳ collagen(cⅣ)and laminin(LN)content in the serum were detected by ELBA.The expression of transforming growth factor-β_1,(TGF-β_1)and tissue inhibitors of maprix metalloproteinase-1(TMP-1) protein in the kidney was observed by immunohistochemical staining.The expression of Smad 3 protein in the kidney was detected by Western blot.Results Compared with normal control rats,the blood glucose,cⅣ and LN content in the serum,TGF-β_1,TIMP-1 and Smad 3 expression in the kidney of the model group rats increased obviously(P<0.01).The blood glucose,cⅣ and LN content in the serum,TGF-β_1,TMP-1 and Smad3 expression in the kidney of rats in sericine pretreatment group were significantly lower than those of the rats in model group(P<0.01).Conclusion Sericin pretreatment can inhibit the activation of TGF-β/Smad 3 signal pathway in the kidney of DN rats,and prevent the decrease of MMPs activity induced by up-regulation of TIMP-1.So sericin can prevent accumulation of ECM and glomerulosclerosis during DN,and has satisfactory apotropaic effects on the development of DN.

Objective To explore the neural basis of the visual illusory motion using the event-related potential(ERP).Methods One hundred trials(each duration 2 000 ms)of a visual illusory motion figure,rippling wheat pattern made by Akiyoshi Kitaoka,and a visual static figure made of modified rippling wheat pattern were randomly presented with equal probability.Ten healthy right handed undergraduate students as subjects were asked to judge the stimulus whether motional or not.The EEG was recorded from 128 scalp sites using with electrodes mounted in HydroCel GSN cap(Electrical Geodesics Incorporated,Oregon,USA).Results 1)The C1 component of ERP could be evoked by both visual illusory motion pattern and static pattern in POz.The peak of C1 component was presented about 75 ms after each stimulus.C1 component evoked with visual illusory motion was negative,but it's static pattern to be positive.2)P100 and P200 components could be obviously evoked by both kinds of stimuli,but in O2 the amplitudes of P100 evoked by different stimuli were significant different and in T3 the amplitudes of P200 were significant different too.Conclusion The visual illusory motion is formed at the primary visual cortex.It may be related to the organized mode of perception.

0.05); The result of FCM indicates that the cells transfected with p16 changed in cell cycle distribution ; proportion of G 2 M phase was increased, while that of S phase was decreased.Conclusions:Introduction of p16 gene into low expression human lung adenocarcinoma cell line Anip973 alters the radiation effect in a way which perhaps was correlated with the inhibition of sublethal damage repair and the cell cycle distribution change, but not in the high expression cell line AGZY83a.

Based on the concept of empowerment theory and innovation behavior, this paper summarizes the status quo of the impact of empowerment theory on nurses′ innovative behavior, analyzes the essence and influencing factors of innovation behavior of nurses according to the elements of empowerment theory, analyze the empowerment theory and nurses′ individual innovation behavior scale, and puts forward the feedback mechanism of empowerment theory. In order to further improve the innovative behavior of nurses by applying the empowerment theory management mode, it is helpful for nursing managers to train nursing talents by using empowerment theory.

OBJECTIVE:To provide reference for rational use of antibiotics to treat Pseudomonas aeruginosa (PA) infection in the clinic. METHODS:Resistant rate of PA in our hospital during 2011-2015 were analyzed retrospectively. Antibiotics use densi-ty(AUD)of 10 commonly used antibiotics were analyzed statistically,and the correlation of resistant rate with AUD was investi-gated by Spearman correlation analysis. RESULTS:One thousaud and eleven strains of PA were isolated in our hospital during 2011-2014,detection rate of PA always occupied the top 5 place. Top 3 antibiotics in the list of AUD were levofloxacin,ceftazi-dime,cefoperazone sodium and tazobactam sodium. AUD of piperacillin sodium and tazobactam sodium,levofloxacin,ciprofloxa-cin and meropenem were positively correlated with resistant rate of PA(r were 1.000,0.900,1.000,1.000,P<0.05). AUD of ce-foperazone sodium and tazobactam sodium were negatively correlated with resistant rate of PA(r=-0.900,P<0.05). AUD of imi-penem and cilastatin sodium,ceftazidime,gentamicin,aztreonam and amikacin had no correlation with resistant rate of PA(P>0.05). CONCLUSIONS:There is correlation between AUD of antibiotics and resistant rate of PA. It is of important significance to detect resistant rate of PA and the use of antibiotics regularly. Antibiotics should be selected cautiously in accordance with bacterial monitoring data,results of drug sensitivity tests,the amount and resistant rate of antibiotics,etc,in order to reduce resistant PA.

Objective To investigate the value of contrast enhanced ultrasonography (CEUS) in the treatment of small hepatic malignancies with radiofrequency ablation(RFA). Methods Seventy patients with 104 pathologically proved malignant liver lesions treated by RFA (size 0.7 -2.7 cm) were divided into 2 groups including CEUS group and control group. In CEUS group,39 patients(54 lesions) were treated with RFA guided by CEUS, while in control group 31 patients (50 lesions) were guided by conventional ultrasonography. There was no significant difference between clinical data of the two groups. Results Seventeen tumors(among them,12 lesions were less than 1.5 cm in diameter) in 13 patients showed more clearly on CEUS image than on conventional ultrasonography image (31.5% ) in CEUS group. The tumor necrosis rate at one month after RFA was 100% in CEUS group,and 92% in control group ( P = 0. 034).The number of RFA sessions per tumor was 1.00± 0.00 in CEUS group,and 1.08 ± 0.27 in control group (P = 0.000). Local tumor progression rate was 0 in CEUS group and 4% in control group ( P = 0. 138)during the period of 8 - 52 months follow-up (average 21 months). Conclusions CEUS can not only improve the display of small hepatic malignancies but also provide precise guidance in contrast with conventional ultrasonography. Compared with control group, RFA of small hepatic malignancies guided by CEUS lower the number of RFA sessions, enhance the tumor necrosis rate, decrease post-RFA local progression and therefore it has extensive clinical value.

BACKGROUND:The electrospinning technique has been used to prepare biological scaffolds to simulate nano-fiber structure of extracelular matrix; therefore, widespread attention has been paid to the electrospinning technique in the field of regenerative medicine and tissue engineering. OBJECTIVE: To review the articles about increasing electrospun nanofiber scaffold porosity, enlarging pore diameter, promoting cel infiltration with related technologies, in order to discover the most practical and economical technology. METHODS:The first author retrieved CNKI database, Wanfang database and PubMed with the keywords of “cel infiltration, 3D scaffold, electrospinning” in Chinese and English, respectively. Literature retrieval period was from January 2004 to October 2014. RESULTS AND CONCLUSION:Electrospinning technology is the most effective method for preparation of nanofiber scaffolds. Electrospinning scaffolds as tissue engineering scaffolds have become an issue of concern in the basic research year by year. However, the internal nano-scale pore of nanofiber scaffolds limits the cels to grow on the surface, so recent research has been focused on highly porous three-dimensional structure which can promote the permeable growth of cels instead of two-dimensional scaffolds. Several techniques have been used, which go from the adjustment of materials and speed of electrospinning to the applications of various kinds of complicated machines. However, the existing researches are stil not mature and stable, the majority of which are applied onlyin vitro as cel implantation or subcutaneous implantation in smal animals. The above-mentioned methods stil need long-term comparative studies to confirm the feasibility in the tissue-engineered repair of organs.

Objective To explore the possible role of proline-rich tyrosine kinase (Pyk2) in the pathogenesis of systemic lupus erythematosus (SLE).Methods The expression of Pyk2 in the peripheral blood mononuclear cells (PBMCs) of 50 patients with SLE and 36 healthy controls were tested with RT-PCR assay.The activation of Pyk2 was inhibited using specific inhibitor Pyk2 (TyrA9).Semi-quantitative PCR methodwas used to detect the Blys expression of PBMCs.One-way ANOVA and Pearson's correlation analysis were used for statistical analysis.Results The Pyk2 expression level (28.31 ±0.91) of SLE patients was significantly higher than that in healthy controls (33.69±0.04),the difference was statistically significant (P＜0.05).The activation of Pyk2 was stimulated and the expression levels of Blys in the PBMCs of patients with SLE was elevated.By inhibiting the activation of Pyk2,the BLyS expression levels decreased significantly.Conclusion Pyk2 may be involved in the abnormal activation of lymphocytes which lead to the pathogenesis of SLE.Pyk2 expression is associated with SLE disease activity,disease aggravation,and the Pyk2 expression levels is also increased significantly.In addition,the expression level of Pyk2 is higher in patients with renal involvement than those patients with other organ involvement.

Objective By detecting the expression levels of Foxp3 in CD4+CD25+ regulatory T cells of peripheral blood mononuclear cells (PBMCs) in rheumatoid arthritis (RA),and the Foxp3 gene promoter region methylation to explore its role in the pathogenesis of RA.Methods Twenty-five RA patients and 10 healthy controls were selected,and the PBMCs were extracted by density gradient centrifugation.Foxp3 expression levels of CD4+CD25+ regulatory T cells were detected by flow cytometry.The real-time fluorescence quantitative PCR assay was used to detect the Foxp3 mRNA expression in PBMCs; and bisulfate processing gene sequencing was used to determinethe differences in Foxp3 gene promoter sequence methylation level of PBMCs.The comparison between groups was analyzed using one-way ANOVA; two sets of qualitative data were compared using Fisher's exact test.Results The expression levels of Foxp3 mRNA in the CD4+CD25+regulatory T cells of active RA patients (2.31±0.25) was significantly lower than inactive RA group (3.68±0.26) and healthy controls (5.67±0.34),the difference was statistically significant (P＜0.05).The Foxp3 mRNA expression level in inactive RA group was lower than that of the healthy controls (P＜0.05).Foxp3 promoter region-67,-74 sites of methylation level in PBMCs of RA patients (46％) was significantly higher than that of the healthy controls (6％).Conclusion Reduction in the number of CD4+CD25+ regulatory T cells may be involved in the pathogenesis of RA and Foxp3 gene promoter methylation levels plays a key role in this process.