Employment ; Humans ; Japan ; Surveys and Questionnaires

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.

Objective:To describe PACS hardware infrastructure experimental design and summary under big data environment.Methods: A real DICOM communication test of PACS hardware infrastructure experimental design.Results: Archive test figures of DICOM communication for 64 channel CT, 1.5T MRI and DR.Conclusion: Currently, an efficient, reasonable hardware infrastructure design is essential to guarantee large hospital PACS application.

Objective To compare contrast-enhanced ultrasonography (CEUS), contrast-enhanced CT (CECT) and combined detection of two methods in the diagnosis of small renal masses, and differential diagnosis of different types of small renal masses by CEUS. Methods In 95 cases of small renal masses, there were 79 patients with small renal cell carcinoma and 16 patients with benign tumor. The diagnostic results of the three methods were compared based on the pathological results, which were used as thegold standardfor the diagnostic efficacy. The ROC curve was drawn, and the area under the curve (AUC) was compared. The characteristics of the two groups were analyzed and compared by Q-Lab software in CEUS. The angiographic parameters included arrival time (AT), time to peak (TTP) and peak intensity (PI). CEUS patterns for several pathologic types of renal tumors with larger sample sizes were compared. The characteristic manifestations of small renal masses under CEUS were analyzed. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of CEUS were 87.37%, 93.67%, 56.25%, 91.36%, 64.29%and 0.750, the values for CECT were 88.42%, 93.67%, 62.50%, 92.50%, 66.67%and 0.775, and the values for combined detection of two methods were 95.79%, 98.73%, 81.25%, 96.30%, 92.86%and 0.869 respectively. The sensitivities of the three methods were high, but the specificities were the same. The combined detection showed better diagnostic efficacy than that of single diagnostic method. The AT and TTP of CEUS were earlier in small renal carcinoma group than those of benign nephrotic group, and PI was higher than that of benign nephrotic group (P<0.05). There were significant differences in the contrasts ofcontrast enhancement methods between clear cell carcinoma, papillary cell carcinoma, chromophobe cell carcinoma, and angiomyolipoma (P<0.01). There was little difference in contrast enhancement between the other types of carcinoma. False envelope can be observed by CEUS.'Cystic area'of the detection rate was increased significantly by CEUS than that of conventional ultrasound. Conclusion Combined detection of CEUS and CECT can improve the diagnostic accuracy of small renal tumors. CEUS has great clinical value in the differential diagnosis of small renal masses, which is worthy of clinical promoting.

BACKGROUND: Recently, Chinese herb and comprehensive therapy are widely adopted for the treatment of chronic atrophic gastritis (CAG), while infrared ray is widely used in the fields of physical therapy and scientific research. Therefore, some scholars suggest whether the physical characteristics of infrared ray have effects on the treatment of chronic atrophic gastritis.OBJECTIVE: To observe the effect of infrared ray on the changes of gastric mucosa tissue in rat models with chronic atrophic gastritis.DESIGN: Randomized controlled observation.SETTING: Hebei North University.MATERIALS: Thirty-five adult Wistar male rats weighing from 180 to 230 g were purchased from Hebei Experimental Animal Center [SCXK (ji) 2003-1-003]. The experiment was disposed with the ethical standard. Sodium salicylate powder produced by Beijing Fangcao Chemical Company (batch number: 890720). The drug was prepared with distilled water. Infrared lamp (220 V, 200 W) was bought by Equipment Division of our college.METHODS: The experiment was carried out in the Experimental Center of Hebei Beifang College from June 2005 to January 2006. ① Experimental intervention: Rats were fed with conventional standard granules for one week. Among them, 8 rats were selected as the normal control group, and other rats underwent model establishment. Rats were perfused with sodium salicylate and alcohol to stimulate gastric mucosa, and then chronic CAG models were established for 8 weeks based on exertion, irregular diet and other factors. Five rats were randomly selected for the check of histopathology before the end of model confirmedly making, and then the model rats were randomly divided into model group and infrared group with 11 in each group. Infrared lamp (220 V, 200 W, 0.76–1.5 μm in wavelength) was used to vertically radiate at the gastric projective area of rats in the infrared group, once a day, ten minutes once for twenty days. The rats in normal group and model group were regularly breed. ② Experimental evaluation: The body mass was weighed every week in 1, 4, 9 and 12 weeks after modeling. The infiltration of inflammatory cells and thickness of gastric mucosa were observed under optic microscope.MAIN OUTCOME MEASURES: ① Changes of body mass; ② pathohistological changes of gastric mucosa.RESULTS: All 30 rats were involved in the final analysis. ① Changes of body mass: From the end of the 4th week, increasing percentage of body mass in the model group and infrared group was decreased gradually as compared with that in the normal group, and there was significant difference (P < 0.05). ② Pathohistological changes of gastric mucosa: Gastric mucosa of rats in the model group was thinner, and atrophic glands, notable inflammatory infiltration and partial intestinal metaplasia were observed under optic microscope. The thickness of gastric mucosa in the infrared group was significantly thicker than that in model control group, and there was significant difference (P < 0.01); the inflammatory cells in the infrared group were less than those in the model group, and there was significant difference (P < 0.05). Morphologic structure and volume of the parietal cells were all recuperated or closed to normal.CONCLUSION: Infrared ray can decrease thickness of gastric mucosa and reduce inflammatory cells of rats with chronic atrophic gastritis, and it has greatly therapeutic achievements.

Objective To study the effects of He-Ne laser irradiation dosage on the expression of heat shock protein ( HSP70) and CyclinD_1 in rats with chronic atrophic gastritis ( CAG). Method Fifty-two adult male Wistar rats were randomly divided into five groups: a normal control group, model group and three groups receiving different doses of He-Ne laser irradiation. CAC was induced using an enema of 2% sodium salicylate and 30% alcohol combined with irregular fasting and forced exercise as pathogenic factors. Laser irradiation was applied for 20 days (large dose 6.24 J/cm~2 , medium dose 4. 80 J/cm~2, small dose 3. 36 J/cm~2). The changes in HSP70 and CyclinD_1 expression were observed. Results The expression of HSP70 and CylinD_1 were highest in the normal control group and the small dose laser group. Compared with the model group, the average expression of HSP70 and CyclinD_1 increased significantly in the small dose group. Conclusions Irradiation with a He-Ne laser at 3. 36 J/cm~2 provides good adjuvant therapeutic effect for CAG in rats. After irradiation, the expression of HSP 70 and CyclinD_1 increased. HSP is important in improving mucosal defenses and promoting cell proliferation in CAG, and it can be promoted through small doses of He-Ne laser irradiation.

Objective To evaluate the effect of lidocaine and tramadol on remifentanil combined general anesthesia. Methods Eighty patients undergoing abdominal hysterectomy were divided into group LT,L,T and C by random digits table,each with 20 cases .In group LT,during induction,the patients were intravenously. In group L,only used lidocaine as introduced in group LT. In group T,only used tramadol as shown in group LT. In group C,used the same volume of saline solution. The changes of mean arterial pressure (M A P) and heart rate during the operation, dysphoria grade (RS), Ramsay score (RSS), pain score (VAS),extubation time(ET),medication and dose,complications were recorded. Results In group LT,the dosage of propofol [(450 ± 178) mg] was less (P ＜ 0.05), ET [(15.0 ± 4.8) min] was shorter (P ＜ 0.05),during recovery time, RS was lower, RSS was higher,the cases needad fentanyl (1 case), 48 h after operation, only 1 case needed pethidine to relieve pain was less than those in other groups (P ＜ 0.05). In group L there was a tend that its RS and the cases needed fentanyl and fentanyl dosage were more, RSS was less than those in group T during recovery time,but 48 h after operation,the cases needed pethidine was less than that in group T. Conclusions Using lidocaine during operation may relieve pain after operation, reduce the dosage of analgesic;giving tramadol may alleviate the acute pain and lower dysphoria incidence rate after remifentanil anesthesia. Combining them will get a better effect.

AIM: To explore the effects of peroxisome proliferator-activated receptor γ (PPARγ) on the activity and expression of γ-glutamylcysteine synthetase (γ-GCS), and its role in rats with chronic obstructive pulmonary disease. METHODS: COPD model was established by the method of combining fumigation and lipopolysaccharide (LPS) intra-tracheal dripping. Meanwhile, some of the COPD rats were administered with rosiglitazone (RGZ), a PPARγ activator. The pulmonary function and the pathological changes were determined. ROS content and γ-GCS activity in lung tissues were detected. The levels of PPARγ, γ-GCS mRNA and protein expression in lung tissues were measured by immunohistochemistry, Western blotting, in situ hybridization (ISH) and reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The pulmonary function (FEV_(0.3), FEV_(0.3)/FVC%, PEF) were significantly improved in RGZ group compared to COPD group. Under light microscope, lung pathological changes in COPD group conformed to pathological features of COPD. The pathological changes of lung tissue were obviously reduced in RGZ group compared to COPD group. In RGZ group, ROS content was obviously reduced and γ-GCS activity significantly increased compared to COPD group. Protein and mRNA expressions of PPARγ and γ-GCS in COPD group significantly higher than those in control group (all P<0.01), and those in RGZ group was markedly increased compared to COPD group (all P<0.05). Linear correlation analysis showed that PPARγ protein was positively correlated with γ-GCS activity (r=0.634, P<0.01), and was no significantly correlated with ROS content (r=0.214, P>0.05). PPARγ protein was positively correlated with γ-GCS protein and mRNA (r=0.553, r=0.442, all P<0.01). CONCLUSION: PPARγ activation by RGZ reduces the extent of COPD oxidant/antioxidant imbalance, which plays an important role in the prevention and treatment of COPD. In addition, PPARγ may play an important antioxidant protection role by reducing ROS production, and increasing activity and gene expression of γ-GCS in the lung.

Objective To evaluate the assistant diagnostic value of low dose CT in patients with pulmonary embolism (PE) based on ventilation/perfusion (V/Q) SPECT imaging.Methods One hundred and two patients with clinical suspected PE had been enrolled for this retrospective study.The final diagnosis of PE was made according to the 2008 guidelines of European Society of Cardiology (ESC).All patients underwent V/Q SPECT/CT (Hawkeye 4,GE).The imaging findings from low dose CT lung window were used for differential diagnoses of abnormal regions in SPECT imaging.The diagnostic efficiency of V/Q SPECT alone was compared with that of V/Q SPECT combined with low dose CT scan.Crosstabsx2 test was performed using SPSS 13.0 software.Results Twenty-nine patients (28.43％,29/102) were finally diagnosed as PE.V/Q SPECT alone had a sensitivity of 93.10％ (27/29),a specificity of 90.41％ (66/73),and an accuracy of 91.18％ (93/102).With additional diagnostic information from low dose CT,the diagnostic specificity increased to 95.89％ (70/73,X2 =1.72,P ＞ 0.05 ),and the accuracy increased to 95.10％ (97/102,x2 =1.23,P ＞ 0.05) though the sensitivity remained the same.Conclusion Imaginginformation from low dose CT in hybrid SPECT/CT may enhance V/Q diagnostic accuracy for PE.

Objective To evaluate of the clinical effect of triple arthrodesis and bone grafting combined with plat screw internal fixation for treatment of necrosis of talus. Methods The clinical data of 24 patients with necrosis of talus who were treated by triple arthrodesis and bone grafting combined with plat screw internal fixation from April 2011 to January 2015 in Xiangya Second Hospital of Central South Univer-sity were retrospectively analyzed. And the clinical effect were measured by AOFAS Ankle Hind-foot Scale System. Results The 24 patients were followed up for 26 months averagely (12~36 months). According to AOFAS Ankle Hind-foot Scale System, there were 4 cases of mod-erate and 20 cases of bad before treatment, and there were 18 cases of excellent, 4 cases of good, and 2 cases of moderate after the treat-ment. Conclusion It can achieve good clinical results in treatment of necrosis of talus through triple arthrodesis and bone grafting combined with plat screw internal fixation.