To design an inpatient charging management system to optimize the patient accounting flow. The problems in all links were analyzed, and auditing mode and flow were modified. Under the existing HIS, the sys-tem was developed with added datasheets, determined elements, desired rules, .Net framework and C# language. The system made the prescription linked with the charging so that the doubtful items could be marked automatically. The system facilitates the fee auditing, shortens the waiting time of the patient, enhances the communication between the departments and promotes the quality of medical records.

Objective: To study the effect of continuous nursing care on quality of life in patients with rheumatoid arthritis after discharge. Methods: Patients with rheumatoid arthritis who were admitted to hospital from August 2016 to August 2017 were selected as the study subjects. According to the random number table method, they were divided into the control group and the research group, and the lost cases were eliminated. There were 99 cases in the control group and 94 cases in the research group. The control group was given routine care, and the research group conducted continuous nursing care measures on the basis of the control group. The morning stiffness time, pain score, disease activity, patient health status and nursing satisfaction of the two groups were observed before and 6 weeks after discharge. Results: Six weeks after discharge, the morning stiffness time (23.76±12.76) min of the research group was significantly higher than that of the control group (38.22±14.53) min, the difference was statistically significant (t=3.865, P<0.05). Six weeks after discharge, the VAS (2.01±0.68) and HAQ (0.42±0.34) points of the research group were lower than those of the control group (4.17±1.30), (0.92±0.63) points, the difference was statistically significant (t=4.073, 3.916, P<0.05). The nursing satisfaction of the research group was 94.68%(89/94), and that of the control group was 78.79%(78/99), and the difference was statistically significant (χ²=9.416, P < 0.05). Conclusions The implementation of continuous care mode after discharge from patients with rheumatoid arthritis is beneficial to alleviate clinical symptoms such as morning stiffness and pain. Moreover, it can also improve patient health and quality of life, increase risk of disease progression, and care satisfaction is high which can help to protect the harmony between nurses and patients.

OBJECTIVE: To compare 3 commonly used methods for drug delivery via the lumbar spinal subarachnoid space in rats. METHODS: We compared the effects of 3 methods for drug delivery via the lumbar spinal subarachnoid space in Sprague Dawley rats, namely acute needle puncture, chronic catheterization via laminectomy, and non-laminectomized catheterization. Body weight changes of the rats were measured, and their general and neurological conditions were assessed after the surgeries. The motor function of the rats was examined using rota rod test both before and after the surgeries. Nociceptive tests were performed to assess nociception of the rats. HE staining was used to examine local inflammation caused by the surgeries in the lumbar spinal cord tissue, and lidocaine paralysis detection and toluidine blue dye assay were used to confirm the precision of drug delivery using the 3 methods. RESULTS: Both needle puncture and catheterization via laminectomy resulted in a relatively low success rate of surgery and caused neurological abnormalities, severe motor dysfunction, hyperalgesia, allodynia and local inflammation. Catheterization without laminectomy had the highest success rate of surgery, and induced only mild agitation, slight cerebral spinal fluid leakage, mild sensory and motor abnormalities, and minimum pathology in the lumbar spinal cord. Catheterization without laminectomy produced less detectable effects on the behaviors in the rats and was well tolerated compared to the other two methods with also higher precision of drug delivery. CONCLUSIONS Catheterization without laminectomy is a safe, accurate and effective approach to lumbar drug delivery in rats.

Patients with hepatocellular carcinoma (HCC) and bone metastasis (BM) suffer from greatly reduced life quality and a dismal prognosis. However, BM in HCC has long been overlooked possibly due to its relatively low prevalence in previous decades. To date, no consensus or guidelines have been reached or formulated for the prevention and management of HCC BM. Our narrative review manifests the increasing incidence of HCC BM to sound the alarm for additional attention. The risk factors, diagnosis, prognosis, and therapeutic approaches of HCC BM are detailed to provide a panoramic view of this disease to clinicians and specialists. We further delineate an informative cancer bone metastatic cascade based on evidence from recent studies and point out the main factors responsible for the tumor-associated disruption of bone homeostasis and the formation of skeletal cancer lesions. We also present the advances in the pathological and molecular mechanisms of HCC BM to shed light on translational opportunities. Dilemmas and challenges in the treatment and investigation of HCC BM are outlined and discussed to encourage further endeavors in the exploration of underlying pathogenic and molecular mechanisms, as well as the development of novel effective therapies for HCC patients with BM.
Bone Neoplasms/secondary* ; Carcinoma, Hepatocellular/therapy* ; Humans ; Liver Neoplasms/therapy* ; Prognosis