Limited Price Charge for Single Disease means that hospitals limit price for the patient who has only single disease in the diagnosis and treats process. The charge includes the process from the time when he had been diagnosed and been in hospital to the time when he had been charmed off. Limited Price Charge for Single Disease could solve many ethical problems which exist in current medicine realm, so it means too much in Medical Ethics, and it gives Hospital Administration and Health Care Administration new inspiration.

Objective:To explore the expression of IL-22 in the patients with rheumatoid arthritis,and to define the clinical sig-nificance of IL-22 cells for RA. Methods: A total of 50 RA patients, 15 OA patients and 15 healthy controls were enrolled. The proportion of Th22 cells in peripheral blood and synovial fluid( SF) of RA patients was detected by flow cytometry;the levels of IL-22 in serum and synovial fluid of RA patients were detected by ELISA. The clinical parameters of disease activity were assessed including ESR,RF,CRP,DAS28,anti CCP and the degree of bone erosions determined by X-rays. Pearson correlation analysis,t test and Kruskal-Wallis H test were used for statistical analysis. Results:The proportion of Th22 cells in RA patients was higher than that of OA patients (t=2. 290 ,P=0. 021) and healthy controls(t=2. 524,P=0. 015). IL-22 levels in RA patients were higher than that of OA patients (t=2. 560,P=0. 014) and healthy controls(t=2. 768,P=0. 009). IL-22 in the RF positive group were higher than that of RF negative group(t=2. 322,P=0. 035). IL-22 in the anti-CCP antibody positive group were higher than that of anti-CCP antibody negative group (t=2. 504,P=0. 015). The levels of IL-22 were correlated positively with ESR,RF,DAS28(r=0. 312,0. 314,0. 332,P<0. 05). The levels of IL-22 were increased gradually along with the aggravation of bone erosions. There were statistical significant difference among different X-ray stagings(H=9. 14,χ20.05(3)=7. 81,H> χ20.05(3),P<0. 05). Serum IL-22 levels in the RA patients with joint effusion were higher than that of without(t=2. 587,P=0. 012). The levels of IL-22 in SF were higher than that in serum(t=2. 668,P=0. 011),and had no correlation with the proportion of Th22 cells in SF. Conclusion: The expression of IL-22 in serum and joint effusion of RA patients increase. The level of IL-22 may be useful marker for assessment of disease activity and finding of bone erosions. Therapeutic targeting of IL-22 may be valuable for the intervention of RA.

Objective:To compare the effectiveness and safety of Dengzhanhuasu and Danshen Injection in the treatment of the patients with angina pectoris of coronary heart disease with Meta-analysis, and to provide basis for their application in clinic.Methods:Computer search was performed using Cochrane Central Register of Controlled Trial,Ovid-medline,EMBASE,PubMed,CNKI,Wanfang,VIP and CBM,and the literatures about the effectiveness and safety of Dengzhanhuasu and Dansheng Injection in the treatment of the patients with angina pectonis of coronary heart disease were obtained.According to the principle of selection and elimination, the literatures were selected, and the qualities of literatures were evaluated.The related data were extracted from the literatures.RevMan 5.3 software was used to extract the data for Meta-analysis.Results:A total of 167 literatures were retrieved, and 8 randomlized-controlled studies were selected according to the selection criteria.The evaluation results of the effectiveness of angina pectoris according to symptom showed that χ2=2.62,df=7,P=0.92,Z=6.85 (P<0.000 01), 95%CI:2.73-6.10. The evaluation of the effectiveness of angina pectoris according to electrocardiogram,χ2=6.37,df=7,P=0.50,Z=6.37(P=0.000 01),95%CI:1.94-3.49.The results of Meta-analysis showed that there were significant differences in the relief of symptoms and improvement of the electrocardiogram efficacy between Dengzhanhuasu and Danshen Injection in the treatment of angina pectoris of coronary heart disease (P<0.05).Conclusion:Dengzhanhuasu has better effectiveness in the treatment of the patients with unstable angina than Dansheng Injection and they have the same safety.

Objective To evaluate the clinical application of susceptibility-weighted imaging(SWI) in the early diagnosis of massive cerebral infarction with hemorrhage and analysis of collateral circulation.Methods Fifty patients with massive cerebral infarction underwent MRI (T1WI,T2WI,DWI,MRA and SWI) scan in acute stage and decubation respectively in Hanrison International Peace Hospital from January 2012 to January 2014.Analysis T1WI,T2WI,DWI,MRA and SWI differences in the delection of cerebral infarction with hemorrhage and analysis of Collateral circulation.Record the magnetic resonance angiography hemorrhagic transformation and display the ischemic area of collateral circulation in the detection of cerebral infarction remodeling differences.Results (1)SWI detected out 18 cases of cerebral infarction with hemorrhage (36％),including 14 cases of hemorrhagic infarction(HI) type(28％),4 cases of parenchymal hemorrhage(PH) type 8％).MRI detected 11 cases of cerebral infarction with hemorrhage (22％),including 7 cases of HI type 14％),4 cases of PH type (8％).SWI detected 106 focuses,the detection rate was 100％,MRI detected only 26,and the detection rate was 32.51％,and the missing mainly for micro hemorrhage.There was statistical significance between the groups(x2 =21.045,P＜0.05).(2) SWI can display the condition of micrangium in the area of cerebral infarction clearly.The number of micrangium decreased or disappeared in acute stage,but the micrangium increased in decubation.The ratio of capillary vessels increased to 66％.MRA detected 82％ of criminal vessel in patients with cerebral infarction.Conclusion SWI is more sensitive than conventional MR in the early diagnosis of massive cerebral infarction with hemorrhage.MRA combined with SWI could not only detect the criminal vessel of cerebral infarction area,but also monitor the reconstruction of collateral circulation in the infarction region,and there will be extremely valuable to the treatment massive cerebral infarction and evaluation of prognosis.

Aim To study the role and mechanism of opioid receptor on IL-1?-induced fever.Methods Rats were dealed with intracerebreventricular administration of naloxone and/or IL-1?.Changes in body temperature were measured.The content of cAMP and HSP70 expression in hypothalamus were detected.Results Naloxone can limit IL-1?-induced fever and decrease the content of cAMP and HSP70 expression in hypothalamus(P

In order to train the medical professionals with good English communication skill,this article aims to offer some effective measures to perform bilingual education of clinical hematologic laboratory science smoothly by analyzing the true significance of clinical hematologic laboratory science,researching the effective bilingual teaching,promoting the building of the rank of teachers and adopting various means in the classes.

Objective:To study B cells proliferation and activation induced by tumor derived-autophagosomes ( TDA). Methods:Splenocytes of mice were incubated with 10μg/ml TDAs in vitro ( with the 10μg/ml whole cell lysate as the control).At the 3rd day,the expression of MHCⅠ,Ⅱand co-stimulate molecules including CD86,CD40 were detected by flow cytometry,and B cells proliferation was detected at the 5th day.B cells were selected from spleen of mice using anti-CD43 dynabeads,and incubated with 10μg/ml TDA in vitro ( with the same concentrated whole tumor cell lysate as the control).At the 7th day,IgM in the supernatant were tested by ELISA.Results:When compared with whole cell lysate stimulated B cells,TDA efficently stimulated B cells division in vitro ( TDA group:28.6%, Whole cell lysate group:4.4%) , and significantly up-regulated the expression of MHC class Ⅰ,Ⅱ and co-stimulatory molecules (CD86 and CD40) on B cells,and enhanced the levels of total IgM secretion in vitro.Conclusion:Tumor-derived autophagosomes ( TDA) ,as a vacuole antigen vector, could stimulate B cells proliferation, activation, and increased IgM secretion in vitro.

BACKGROUND: Primary progressive aphasia is a degenerative disease of nervous system clinically characterized by the progressive decrease of speech ability and the relatively reserved memory. OBJECTIVE: To investigate the characteristics of speech dysfunction and the clinical features of primary progressive aphasia we by reported onel patient with primary progressive aphasia. DESIGN: A case analysis. SETTING: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences. PARTICIPANT: One male patient of 56 years old with primary progressive aphasia was selected from the Department of Neurology, Beijing Tiantan Hospital in March 2004, he had got education in senior middle school. The patient had been unable to tell the names of daily living objects at the beginning of 2001. Not only his ability of listening comprehension had gradually declined, but his characters had gradually changed except that his memory had not been affected obviously since 2003. Although he was able in self-care now, he could not normally work. METHODS: ① The spoken fluent types of the patient were evaluated with the standards for the fluency of spoken language in Aphasia battery of Chinese. Western battery aphasia was used to assess the type of aphasia of the patient. Boston diagnostic aphasia examination severity grading standard was applied to grade the severity of aphasia. ② The cognitive psychological tests of visual character-figure matching, denomination for figures and oral reading were used to judge whether the patient had verb-noun dissociation. ③The memory of the patient was assessed with clinical memory scale. MAIN OUTCOME MEASURES: ① spoken fluency, the type and grade of aphasia; ② condition of verb-noun dissociation for the patient; ③ memory of the patient. RESULTS: ① Examination of aphasia: The patient presented the spontaneous talking that named the fluent type, there were wrong meanings in his talks so that he was diagnosed as sensory aphasia. The severity of aphasia was separated into grade 3 levels. ② Cognitive psychological test: The correct rates of verbs and nouns in the test of denomination for figures were 15% and 53% respectively, and there was obvious difference (t=0.231, P ＜ 0.05). ③ Clinical memory scale: The memory quotient was 111,and the clinical memory grade was higher than normal. CONCLUSION: The most outstanding clinical characteristics of patients with primary progressive aphasia is speech dysfunction, and there is verb specific injury.

We use PBL teaching mode in experimental teaching of clinical hematologic laboratory.By this method,the knowledge can be mastered by the students more efficiently and the analyzing ability was also improved.We hope that these experiences can be useful in our country's clinical laboratory teaching.

Objective To evaluate the long-term therapeutic efficacy of subtotal colectomy,ascending colon-rectum anastomosis, pelvic floor hernia repair, functional rectal suspension, and uterine suspension surgery for slow transit constipation with pelvic floor hernia and rectal mucosal prolapse.Methods From June 2007 to May 2008, 35 patients with intractable constipation caused by slow colonic transit combined with pelvic floor hernia and rectal mucosal prolapse underwent subtotal colectomy and ascending colon-rectum anastomosis, pelvic floor hernia repair, functional rectal suspension, and uterine suspension surgery. Postoperative defecation, complications, quality of life, and degree of satisfaction were followed-up. Results The average follow-up period was two years. At one month after the operation, the average defecation frequency was five times (2 -8 times) a day, with a semi-liquid stool consistency; After two years the frequency was twice ( 1 -3 times) a day, with solid stool consistency. Of the 35 patients, 19 were satisfied with the surgical efficacy, and 16 were very satisfied. All the patients' quality of life improved significantly. Conclusions For patients suffering from slow transit constipation with pelvic floor hernia and rectal mucosal prolapse subtotal colectomy, ascending colon-rectum anastomosis, pelvic floor hernia repair,functional rectal suspension, and uterine suspension surgery has satisfactory results.