Objective: To build total cost allocation model based on Time Driven Activity-based Costing (TDABC) and explore how to use it to improve the hospital cost accounting system. Methods: Take an ultrasonic cardiogram department of public hospital as a cost object to estimate the cost of medical service, as well as the efficiency of service and operating benefit analysis by using TDABC method. Results: Parts of routine services of the ultrasonic cardiogram departments having policy loss in a public hospital, the department’ s capacity are not fully utilized in a certain period. Conclusion: TDABC not only plays positive role in raising the level of hospital cost management, but also provides useful references and scientific basis for the formulation and revision of medical service fee and carring out the DRGs payment.

Necrotizing pneumonia(NP)is a serious pulmonary complication of community acquired pneumonia(CAP), and can occur in adults and children.NP was first reported in adults, and in recent years the incidence of NP in children is growing.Until now, there is little description compare the etiology, clinical manifestation, auxiliary examination, risk factors, treatment and prognosis in children and adults with necrotizing pneumonia.This article systematically reviews several aspects of NP between children and adults, which would be helpful for diagnosing and treating NP in different age groups.

genetic screening offered prior to preimplantation genetic diagnosis.

Objective To determine the importance of aneuploidy screening in preimplantation genetic diagnosis for the couples of chromosome translocation carriers. Methods To perform 11 prenatal genetic disgnosis (PGD) cycles for 7 couples of chromosome translocation carriers from January 2006 to March 2009 in the Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University. To re-analyze the well-fixed, non-multinuclear and non-debris nuclei using the probes of LSI 13, 18, 21,CEPX, CEPY to detect the aneuploidy rate which come from the PGD cycles of the couples of chromosome translocation carriers. The euploid embryo was defined as two fluorescence in situ hybridization (FISH)signals of LSI 13, 18, 21 respectively and two signals of CEPX, or one signal of CEPX and one signal of CEPY. The other abnormal signals were defined as aneuploid embryo. Results (1) A tolal of 130 nuclei from 11 PGD cycles got the integrated re-FISH signals. Nine hundred and thirty-seven FISH signals were analysized, including 304 signals from 38 euploid nuclei and the others from 92 aneuploid nuclei. (2) The number of the aneuploid nuclei from grade Ⅰ , Ⅱ and Ⅲ embryo was 20 (22%), 36(39%), and 36(39%). The number of the euploid nuclei from grade Ⅰ , Ⅱ and Ⅲ embryo was 13(34%), 17(45%),and 8(21%). There was no significant difference of aneupioidy rate between the embryos form different grades (P＞0.05). However, the rate of aneuploid nucleus from good quality embryos (grade Ⅰ + grade Ⅱ) was 60% (59/92). (3) The euploidy rate was 71.4% (30/42) from balanced embryos, while 9.1%(8/88)from unbalanced embryos. There was significant difference between them (x2=53.4, P＜0.05).The rate of aneuploidy from balanced embryos was lower than those from unbalanced embryos (P＜0.05).Conclusions Since higher rate of aneuploidy was detected in embryos of the couples of chromosome translocation carriers. It is advisable to recommend the FISH re-analysis for aneuploidy screening to preimplantation genetic diagnosis for the couples of chromosome translocation carriers.

Objective To investigate the relativity between c.553G/T polymorphism in exon 4 of Apolipoprotein A5 gene and hypertriglyceridemia (HTG) in Zunyi Han Nationality. Methods c.553G/T polymorphism of 103 HTG patients and 165 healthy individuals were tested by polymerase chain reaction and restriction fragment length (PCR-RFLP) assay. The distributions of genotypes and allele frequencies in HTG patients and healthy group were analyzed between Zunyi population and others. Results The genotype frequency of the Apo A5 gene c.553G/T showed statistical difference between patients group and normal groups (P < 0.05). The distribution of ApoA5 c.553T gene in HTG was higher than the normal group significantly (P < 0.05), and it had effect on triglyceridemia level independently (OR = 15.768, 95%CI: 5.916 ~ 42.025, P < 0.001). In the normal Han nationality groups, gene frequency of Zunyi was lower than that in Taiwan, Jiangsu and Hubei (P < 0.05), but similar to that in Hunan and Xinjiang (P > 0.05). In HTG groups, gene frequency of Zunyi was similar to that in Jiangsu (P>0.05), but higher than that in Xinjiang (P<0.05) and lower than that in Taiwan (P > 0.05). Conclusion There is relativity between Apo A5 gene c.553G/T polymorphisms and HTG in Zunyi Han nationality and the differences vary across different areas. It could be an independent risk factor for HTG.

Objective To investigate whether 17β-estradiol (E2) can stimulate the proliferation,migration,and secretion of trefoil factor family 1 (TFF1) in papillary thyroid cancer K-1 cells and explore the molecular mechanisms.Methods ELISA was used to detect the content of TFF1 in the supernatant of K-1 cells after the treatment of E2,propylpyrazoletriol (PPT,ERα agonist) or diarylpropionitrile (DPN,ERβ agonist).The expression of ERα and ERβ in the untreated cells was measured by Western blotting.ERα siRNA and ERβ siRNA by RNA interference were designed and synthesized,and the change of TFF1 was measured by ELISA again after the transfection.The interaction between TFF1 promoter and ER was evaluated by chromatin immunoprecipitation analysis (CHiP).The proliferation and migration were detected in the K-1 cells after E2 treatment by MTT assay and Transwell chamber test respectively.Festults After E2 treatment,the TFF1 content in the supernatant of K-1 cells was increased gradually,reached peak at 24 h,and then declined slowly.PPT treatment enhanced the secretion of TFF1 but DPN decreased it in the K-1 cells.Transfection of ERα siRNA obliterated the inductive effect of E2 on the secretion of TFF1,but that of ERβ siRNA increased the inductive effect in the K-1 cells.Western blotting showed that the expression level of ERα was higher than that of ERβ in the K-1 cells.ChIP results confirmed that ERα protein was bound to the promoter of TFF1 gene in K-1 cells.E2 treatment promoted cell proliferation and improved cell migration in the K-1 cells.Conclusion E2 induces the expression and secretion of TFF1 in K-1 cells through ERα-dependent manner,and thus promotes the proliferation and migration of the cells.

Objective To evaluate the PDCA cycle on the rehabilitation of postoperative patients with anal fistula, aiming at improving the recovery of patients and preventing recurrence. Methods 144 postoperative patients of anal fistula were randomly divided into the observation group and the control group with 72 cases in each group. The observation group received intervention based upon the PDCA cy-cle, and the control group was given the traditional oral propaganda. The recovery time, recurrence rate, mastering of education content and self-control ability were compared in the two groups using t test and χ2 test. Results The mastering level of education content and the self-management skills in the observation group were superior to those of the control group. After 3 to 24 months of follow-up, the observation group showed shorter recovery time and less recurrence rate than that of the control group. Conclusions Nurs-ing intervention based upon PDCA cycle can strengthen the patients' mastering of related knowledge, pro-mote the recovery, reduce recurrence rate and improve the patients' quality of life.

OBJECTlVE To study the anti-HBV activity of prepared recombinant human serum aIbu-min-interferon α-2b fusion protein(HSA-IFNα-2b) in vitro. METHODS HepG2 ceIIs were infected with recombinant adenovirus with green fIuorescence protein and 1.6-foId HBV DNA(AdGFP-HBV). The ex-pression of HBV antigens,HBsAg and HBeAg in cuIture medium was detected by ELISA assay. The tox-icity of HSA-IFNα-2b on HepG2 ceIIs was evaIuated by mTT assay.The reIative expression of HBV RNA in ceIIs and the absoIute quantity of HBV DNA in cuIture supernatant were determined by quantitative PCR assay. The activity of HBV enhancer Ⅰ was detected by DuaI-Reporter gene assay. RESULTS HBV couId repIicate and express in HepG2 ceIIs after infection with AdGFP-HBV. The expression of HBsAg and HBeAg in cuIture serum of HepG2 ceIIs infected with AdGFP-HBV decreased by 51.32%(P﹤0.01)and 50.26%(P﹤0.01),respectiveIy,when HSA-IFNα-2b 500 kU·L-1 was added. The same concentration of HSA-IFNα-2b didn't inhibit the proIiferation of HepG2 ceIIs,but inhibited HBsAg in a concentration-dependent manner. The regression formuIa between HBsAg inhibitory rate(Y)and con-centration of HSA-IFNα-2b(X)was Y=21.11 IgX+11.91(r 2 = 0.954),IC50 = 63.76 kU·L-1 . HBV RNA in ceIIs and HBV DNA in the cuIture serum decreased by 52.83%(P﹤0.01)and 53.07%(P﹤0.01), respectiveIy,when HSA-IFNα-2b 500 kU·L-1 was added. The activity of enhancer Ⅰ decreased by 40.04%(P﹤0.01)when HSA-IFNα-2b 500 kU·L-1 was added. CONCLUSlON The ceII modeI of HBV repIication for evaIuating anti-HBV agents is successfuIIy estabIished. HSA-IFNα-2b exhibits noticeabIe anti-HBV effect invitro.

AIM: To observe the effects of Egr-1 gene knockout on the expression of inflammatory-related factors in pancreatic tissue in a mouse acute pancreatitis model.METHODS: The experimental pancreatitis was induced by high-dose of cearulein in wildtype mice and Egr-1 knockout mice.The pancreatitis indexes,such as serum amylase,pancreata edema,and myeloperoxidase(MPO) levels in pancreata and lungs were recorded.The mRNA levels of tissue factor(TF),plasminogen activator inhibitor(PAI-1),monocyte chemoattractant protein(MCP-1),Gro-1,IL-6 and ICAM-1 were measured by quantitative PCR.RESULTS: Contrary to wildtype mice,typical pancreatitis was not induced by high-dose cearulein in the Egr-1 knockout mice,not only markedly reduced edema in pancreata and lungs,but decreased MPO levels in lungs as well were found.Furthermore,the mRNA of TF,PAI,MCAP,ICAM-1 and IL-6 in pancreata were significantly decreased in Egr-1 knockout mice.CONCLUSION: The severity of pancreatitis and lung damage is ameliorated in Egr-1 knockout mice stimulated by high-dosage of cearulein,which was probably mediated by decreasing expression of inflammatory-related factors in pancreata,such as TF,PAI,MCP-1,ICAM-1 and IL-6.

Objective To explore the key molecular targets and possible mechanisms of Aidi injection in the treatment of ovarian cancer using network pharmacology and cell experiments.Methods TCMSP database was used to screen the active ingredients and tar-gets of Aidi injection,and the abnormal expressed genes of ovarian cancer were screened,and the possible targets of Aidi injection in o-varian cancer were obtained after intersection analysis.Then,protein-protein interaction analysis,drug-compact-target network con-struction and enrichment analysis of possible targets were performed.The target was further screened,and the key genes related to the prognosis of ovarian cancer were experimentally verified.After treated with 50mg/ml Aidi injection,the cell proliferation ability was ob-served by CCK-8 assay,and the expression of core target genes was detected by real-time quantitative polymerase chain reaction.Results A total of 13 possible targets of Aidi injection in ovarian cancer were screened.These targets were mainly enriched in signaling pathways closely related to the occurrence and development of tumors,such as apoptosis,platinum resistance and interleukin-17.Among the 13 genes,claudin 4(CLDN4),secretory leukocyte peptidase inhibitor(SLPI)and baculoviral IAP repeat containing 5(BIRC5)were associated with the prognosis of ovarian cancer.Cell experiments showed that Aidi injection significantly inhibited the proliferation of ovari-an cancer cell,promoted the expression of BIRC5,a protective target of ovarian cancer,while significantly decreased the levels of ovarian cancer risk factors CLDN4 and SLPI.Conclusion Aidi injection may achieve multi-component,multi-target and multi-pathway anti-ovarian cancer and combination chemotherapy by affecting the expression of CLDN4,SLPI and BIRC5.