Objective: To prevent the error of overcharging fees, missing fees and mistaken identity fees, check the inpatient expense rationality with using the self-developed software system. Methods:With extracting data from HIS and other systems, check and audit the inpatient expense, such as billing classification, red account records, logic checks, integrity checks, etc, according to pre-established rules. Results:Using the auditing software can greatly improve the work efficiency and the accuracy of inpatient expense, reduce the incidence of billing dispute issue. Conclusion:This system has valuable reference and be worth generalizing because it can bring the social benefit to hospital.

ObjectiveTo study the speciality of cerebral blood flow velocity of patients with spinal cord injury at different stages after injury.MethodsCerebral blood flow velocity of 46 patients with spinal cord injury were examined by color Doppler ultrasonic technique.ResultsThere was significant difference in diastolic velocity of CBF between patients with course of disease being 3-6 months and >6 months. ConclusionUltrasonography provides an basis for the diagnosis of cerebral blood flow velocity at clinical.

Background: Endoscopic surgery of Western medicine has developed rapidly in treating ureteral calculi while traditional Chinese medicine (TCM) therapy also has its advantage, thus the integrated traditional Chinese and Western medicine therapy may have an even better efficacy in dealing with this problem. Objective: To observe the clinical effects of sequential therapy of Quantong Recipe, a compound traditional Chinese herbal medicine, combined with ureteroscopic laser lithotripsy on ureteral calculi. Design, setting, participants and interventions: A total of 151 patients with ureteral calculi (stone diameter of 3 to 21 mm) from Department of Urology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine were included, of which 106 patients with stone diameter of 3 to 10 mm were treated with Quantong Recipe for the first two weeks. Twenty patients with unexpelled stones and 45 patients with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy. The 65 patients except one open operation were divided into regular treatment group (32 cases) and regular treatment combined with Quantong Recipe group (32 cases) after lithotripsy. The efficacy was assessed after one week. Main outcome measures: Cure rate in the patients with stone diameter of less than 10 mm after two-week Quantong Recipe treatment was calculated, and clearance rate in the patients with residual stone for ureteroscopic laser lithotripsy after one-week Quantong Recipe treatment was also observed. Results: After taking Quantong Recipe for two weeks, the stones in 86 patients were completely discharged, and the stones in 6 patients were not completely discharged, but the unexpelled stones had moved down more than one segment of ureteral stenosis; the total response rate was 86.79% (92/106). The 64 patients with stones unexpelled or with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy, and the clearance rate of residual stone was 93.8% in regular treatment combined with Quantong Recipe group, and was 71.9% in regular treatment group, and there was a significant difference between the two groups (P<0.05). Conclusion: Sequential therapy of Quantong Recipe integrated with ureteroscopic laser lithotripsy demonstrates a significant advantage of integrated traditional Chinese and Western medicine therapy in treating ureteral calculi.

BACKGROUND:Fibroblast-like synoviocytes (FLS) in the synovial lining layer are related to the cell proliferation, invasion, migration and apoptosis as well as bone resorption in rheumatoid arthritis. OBJECTIVE:To compare the migration and invasion abilities of FLS (MH7A) in rheumatoid arthritis and normal FLS (HFLS). METHODS:The capacities of cell migration and invasion were evaluated by Transwell cell migration and invasion assays. The primers of the indicated microRNAs were designed and synthesized, and the expression levels of miRNAs were determined by real-time PCR according to the SYBR?PrimeScript?miRNA RT-PCR Kit instruction. RESULTS AND CONCLUSION:MH7A possessed stronger migration and invasion abilities than HFLS. Compared with HFLS, obviously upregulated miR-132, -155, -203, -223 and -124, and significantly downregulated miR-15a, -16, 18a, -19a, -26a and -146a were found in MH7A. These findings suggest that the differentially expressed 11 kinds of rheumatoid arthritis-associated miRNAs participate in the pathogenesis of rheumatoid arthritis probably by enhancing the migration and invasion capacities of MH7A.

Objective To investigate the prevention efficiency of spanishneedles herb eye drops on rabbit model with dry eye syndrome caused by sex hormones decline in peri-menopause. Methods Totally 26 rabbits ( 26 right eyes) with dry eye model were studied,and divided into two groups:group A ( the control group, n=12) and group B ( the spanishneedles herb eye drops group, n=12) ,another two rabbits were used as normal control.The Schirmer I tests (SIT), and corneal fluorescein ( FL) were detected, and the total protein content in tear, amylase activity, lactoferrin and lysozyme contents were measured and confocal scanning microscopy were performed at pre-therapy and 1 week,2 weeks,1 month,2 months after therapy,respectively. Results There were no significant difference in the total proteins,lysozyme,lactoferrin and amylase activity between two groups at pre-therapy (P>0.05).After 2 months treatment, there were statistical differences in all items of group A(P<0.05), and SIT, FL in group B(P<0.05).There were significant differences in all indexes between group A and B at 1 wk,2wk,1mo,2mo after therapy.After 2 months treatment,the mean numbers of corneal basal cell in the group B were significantly lower(3 452±422)than those in the group A ( 4 104 ± 568 ) ( P<0. 05 ) . The mean numbers of the inflammatory cells in the group B ( 42 ± 18 ) were significantly lower than those in the group A(208±69)( P<0.05). Conclusion Spanishneedles herb eye drops has significant prevention effect on dry eye syndrome caused by sex hormones decline in peri-menopause.

OBJECTIVE: To evaluate the genetic damage induced by occupational chromate exposure, and to analyze the association between human 8-oxoguanine-DNA N-glycosylase 1(hOGG1) polymorphisms and genetic damage in population with chromate exposure. METHODS: A total of 136 chromate exposed workers were recruited as exposure group by judgmental sampling method, and 156 workers without chromate and other occupational hazard factors exposure were recruited as control group. The whole blood chromium(WB-Cr) level was measured by inductively coupled plasma mass spectrometry. Urinary 8-hydroxy-2′-deoxyguanosine(8-OHdG) was determined by enzyme-linked immunosorbent assay. Four single nucleotide polymorphisms of hOGG1 gene were genotyped by the matrix assisted laser desorption ionization/time of flight mass spectrometry. RESULTS: The WB-Cr level was higher in the exposure group than that in the control group(meclian: 3.41 vs 0.90 μg/L, P<0.01). The urinary 8-OHdG level was higher in the exposure group compared with that in the control group(meclian: 6.02 vs 4.72 μg/g·creatinine, P<0.01). In study subjects(exposure group and control group), after adjusting the potential influencing factors such as age, body mass index(BMI), gender, smoking and drinking, chromate exposure might be a risk factor for increasing urinary 8-OHdG level(P<0.05), and the recessive models of rs293796 and rs13096551 were observed as risk factors of increasing urinary 8-OHdG level(P<0.05). In chromate exposure group, the additive and recessive models of rs293796 and the recessive model of rs13096551 were observed as risk factors of increasing urinary 8-OHdG level(P<0.05), while the dominant model of rs3219008 was protective factor of increasing urinary 8-OHdG level(P<0.05), after adjusting the potential influencing factors such as age, BMI, gender, smoking, drinking. However, after multiple Bonferroni correction tests, only the recessive model of rs293796 was the risk factor of increasing urinary 8-OHdG level in the exposed group(P<0.01). There was significant interaction between chromate exposure and rs293796 on urinary 8-OHdG(P<0.01). CONCLUSION: The rs13096551 and rs293796 of hOGG1 were associated with the alteration of urinary 8-OHdG level induced by chromate. There was interaction between rs294796 of hOGG1 and chromate exposure on urinary 8-OHdG level.

Objective To explore the characteristic of ACE gene I/D polymorphism in Han broad jumpers .Methods Distribu‐tion of ACE gene I/D polymorphism for broad jumpers was analyzed by PCR ,DNA sequencing ,Hardy‐Weinberg and SPSS ,and the results were compared with that of normal people .Results There were II ,DD and ID in gene ACE 16 ,and the Hard‐Weinberg re‐sults showed that the subjects were group representative .The ACE DD genotype and D allele in broad jumpers was statistically higher than normal controls (P<0 .05) .Conclusion The results suggest that ACE DD genotype and D allele are associated with training sensitivity of broad jumpers and could be the molecular marker for athletes choosing genetically .

Randomized controlled trial (RCT) can be designed as explanatory trial and pragmatic/practical trial (PCT) for clinical effect evaluation.The pragmatic/practical trial reflects the intervention effect under actual clinical condition,which has relatively good extrapolation,but its internal validity is relatively poor.In contrast,explanatory trials conducted under ideal conditions have better inner validity but inferior external validity.However,in the design of RCT,PCT and explanatory trials are not always opposite.Many RCTs have the properties of the two designs at the same time,Pragmatic-explanatory continuum indicator summary (PRECIS) can be used in the design of RCT for the balance between internal validity and external validity.There are few available reports about the application of PRECIS in China at present,so this paper summarizes the basic principles,characteristics of PRECIS and the application of PRECIS in order to provide reference for the clinical trial design in China.

Objective ToinvestigatethecorrelationbetweenCTimagingfindingsoflungadenocarcinomaandepidermalgrowth factorreceptor(EGFR)genemutation.Methods Theclinicaldataof150lungadenocarcinomapatientsinthehospitalfrom October 2015toOctober2017werecollectedretrospectively.AccordingtotheEGFRgenemutation,thepatientsweredividedintononeffectivemutation group (n=78)andeffective mutationgroup (n=72).Univariateanalysisand multivariate L o g istic regression modelwereperformed toexplorethepredictionsignsofeffectiveEGFRgenemutationinlungadenocarcinoma.Results Univariateanalysisshowedthatthe proportionsoffemalepatients,smokinghistory,CTfindingsofspiculesign,necroticsign,pleuralindentationandnonfibrosisin theeffectivemutationgroupweresignificantlyhigherthanthoseinnoneffectivemutationgroup(P<0.05).However,therewereno significantdifferencesbetweenthesetwogroupsinage,diameteroflesions,locationoflesions,densityoflesions,lobulatedsign, cavitation sign ,air bronchogram and pleuralthickening sign (P>0 .05 ).M ultivariate L o g istic regression analysis showed thatfemale (OR=2.612),spiculesign(OR=2.476),necroticsign(OR=2.846),pleuralindentation(OR=2.221)andnonfibrosis(OR=2.476)were independentpredictorsofeffectiveEGFRgenemutationinlungadenocarcinoma(P<0.05).Conclusion FemaleandlungadenocarcinomaCT findingsofspiculesign,necroticsign,pleuralindentationandnonfibrosisarerelatedtoEGFRgenemutation,whichisofgreatsignificanceto distinguishingwildtypefrom mutanttypeofEGFRgeneandguidingtheclinicaltreatment.

Biomonitoring can be applied to assess internal exposure and environmental exposure by exposure markers with providing internal exposure to biological characterization and individual exposure information, which is a key tool to evaluate the risk exposure to disease by biological alternation information. With the development of high throughput, broad spectrum and high efficiency screening and detection technology, biomonitoring is defined as traditional biological monitoring (targeted monitoring) and non targeted monitoring analysis (exposomic approaches). An exposomic approach differs from traditional biomonitoring in that it can theoretically include all exposures of potential health significance, whether they are derived from exogenous sources. Both traditional and nontraditional biomonitoring methods should be used to understand the complexity of exposures faced throughout the lifespan. Through hybrid approaches, emerging techniques and the integration of bioinformatics, and developing the detection methods for low abundance chemicals, improving the differentiation ability between endogenous and exogenous chemical, the health outcomes and exposures can be widely recognized and characterized, which can finally contribute to improving the precise prevention and intervention for diseases under the new exposomic model.