Objective Beijing plans to run a DRGs-PPS pilot.Cost estimation of each DRG group needs a set of scientific reasonable standards for inpatient charge category.MethodsResource consumption accounting Classify charge item by practitioners,services,resources; medical consumables are singled out to emphasize the value of medical personnel's services; some of old categories are subdivided in order to be compatible with new categories.Results 19 old charge categories of patient discharge chart turn to 31 new items by dividing medical service into treatment,surgery,nursing,imaging,examination,management,paramedic,pharmacy,etc.ConclusionRegulating the charge categories of services,medical data is more consistent by using the same statistical coverage.Also it accurately present the incoming of all operationstreatment,surgery,nursing,imaging,examination,management,paramedic,pharmacy,etc.It gives government directions of decision-making to adjust the weight of DRG groups.

Objective To study the effect of low-level 84 disinfection solution on reproductive physiology of mice . Methods 72 KM mice were randomly divided into three groups :0.5%84 disinfection solution group ( group A) , 2.0%84 disinfection solution group (group B) and saline solution group (group C).12 males and 12 females in each group. Corresponding medicine was given once a day by intragastric gavage for 9 weeks.The estrous cycle of female mice was observed by exfoliative cytology of vagina .After 9 weeks, The sperm abnormality test was performed , Serum samples were taken for sex hormone test by ELISA, and the histological change of testis (or ovary), heart, liver, lung and kidney were observed.Results Compared with group C , No significant difference was observed in the weight variation and serum sex hormone level in group A and B (P >0.05).The difference of the estrous cycle of female mice was not significant (P >0.05).No histopathological abnormality was observed .Compared with group C, There was no significant difference in the rate of sperm abnormality in group A ( P >0.05 ) , but the rate in group B was significantly increased ( P <0.05 ) . Conclusion 0.5% 84 disinfection solution has no significant effect on reproductive physiology of mice , The concentration of disinfection solution must be strictly controlled when used .

Objective To investigate the clinical efficacy of nerve growth factors in the treatment of sudden deafness.Methods A retrospective analysis was performed on 124 cases of hospitalized patients who suffered from unilateral sudden deafness from November 2013 to February 2015.The patients were divided into two groups: 59 in the treatment group and 65 in the control group.Each group was further divided into four subgroups according to different audiometric curves: the low-frequency declining type, the high-frequency declining type, the flat type, the completely deafness type.The control group: the patients were treated with the conventional therapy according to different audiometric curves.The treatment group: intramuscular mouse nerve growth factor treatment was added on the basis of conventional therapy mentioned above.The both treatments lasted 10 days.The total efficiency of two groups was compared ,and the efficiency of the subgroups was also compared.Results The total efficiency of the treatment group was 64.40% and 44.62% for the control group.The total efficiency of the treatment group was significantly higher than the control group.The analysis revealed as having statistically significant differences (x2=4.877,P=0.032<0.05).The total efficiency of the sub-groups by different audiometric curves was further analyzed.All the total efficiency of the sub-groups in treatment group were higher than the sub-groups in the control group, but the results were notconsidered as significantly different(P>0.05).Conclusion The mouse nerve growth factor has a positive effect on the treatment of sudden deafness, and has shown the acceptable clinical efficacy without side-effect.Thus the mouse nerve growth factor is a safe and effective drug for treating sudden deafness.

Objective To observe the changes in cytokines, oxygen free radicals, acidulous production in serum and to investigate the effectiveness of monitoring metabolism of cells and the method for evaluating cell injury in patients with severe trauma. Method The detailed data of 117 patients rescued and managed carefully from May 2005 to February 2007 were assessed and stratified with ISS and APACHE Ⅱ , and the serum levels of arterial blood lactate(ABL) ,base deficit(BD) ,superoxide(SOD) ,lipid peroxide(LPO) ,TNF-α and IL-6 were measured in real-time according to the condition of the patient. Results The monitoring biomarkers obviously changed with injury severity which endangered the situation of patients after trauma (P < 0.05) , especially in the patients with ischemia , hypoxia, shock, iniection, SIRS, and MODS (P < 0.01). The persistence of extremely elevated levels of biomarkers meant the organ failure and fatality of patients after trauma, and there was a obvious differece between those cases and cases without elevation of biomarkers ( P < 0.01). Conclusions The outcome of patients after trauma is closely correlated with injury severity,infection and MODS,and the levels of biomarkers including ABL, SOD, IPO, TNF-a and IL-6 are useful indicators of outcome measure.

From the perspective of humanistic care,the article explores the dilemmas and misunderstandings in the treatment of patients with terminal cancer,and states great significance to develop palliative treatment and hospice service.The importance to establish the center for pain prevention and hospice care hospital for patients with terminal cancer is also clarified so as to improve the quality of their life.The development of palliative care and hospitalpice service also plays an active role in the establishment of a harmonious society in Hunan province.It is also called for to include the education of proper values on death as a part of public education.

Objective: To study the effects of hydrolysed casein in different doses on plasma and liver antioxidant capacities in mice. Methods: Fifty mice were divided into 5 groups: control group, vitamin E group (VE), low dose of hydrolysed casein group (CH1), medium dose of hydrolysed casein group(CH2)and high dose of hydrolysed casein group(CH3). The mice were supplemented with 0.25ml normal saline,7.2 mg/ml Vitamin E,4,12 and 20 mg/ml hydrolysed casein respectively by gavage one time a day. The mice were euthanatized after ten days. The activities of SOD, GSH-PX and the level of MDA were determined. Results: Hydrolysed casein in different dosese vidently increased the activities of SOD and GSH-Px in serum, and reduced the level of MDA in serum and liver of mice; group CH3 significantly increased the activities of GSH-Px in liver. Conclusion: Different doses of hydrolysed casein could raise plasma and liver antioxidant capacities in mice, especially the high dose of hydrolysed casein.

OBJECTIVE:To optimize the preparation technology for enteric-coated changbiqing granules.METHODS:The concentration of acrylic resin and the four factors like the quantity of castor oil,pulvis talci and methylsilicone oil on the yield of changbiqing enteric-coated granules were determined by orthogonal test design;The effects of the enteric-coated granule plasticizer on the quantity of castor oil and the weight increment of the coating were determined by the release rate test.RESULTS:The optimized formula of the coating solution was described as follows:the concentration of acrylic resin was5%,the relative amount of castor oil to acrylic resin was35%,the dosages of pulvis talci and methylsilicone oil were3%and1%,respectively,the weight increment of the coating was30%.CONCLUSION:Changbiqing enteric-coated granules pre?pared on the optimized technology are in line with the quality requirements and which have ideal enteric soluble drug releasing characteristics.

Objective To investigate the clinical efficacy and safety of Ganciclovir combined with interferon-α1 b inhalation for children with infectious mononucleosis(IM).Methods A total of 177 childhood cases of IM were selected,and they were divided into 3 groups,59 cases in each group according to the random number table.Three therapeutic methods were applied in different groups for 5-7 days in different groups:Ganciclovir (group A),Ganciclovir + interferon-α1 b inhalation (group B) and Ganciclovir + interferon-α1b intramuscularly (group C).The time of post-drug recovery from isthmitis,less than 0.05 of heterotypic lymphocytes,shrink of cervical lymph nodes shrink,liver retraction,spleen retraction among groups were compared.The Epstein-Barr virus (EBV)-DNA copy number and T lymphocyte subsets were compared before and after treatment.Adverse reactions were observed in each group.Results Compared with group A,the time to defervescence [(3.20 ± 1.81) d,(3.17 ± 1.76) d vs.(4.01 ± 2.34) d],duration of isthmitis was [(3.15 ± 1.33) d,(3.09 ± 1.37) d vs.(3.98 ± 1.31) d],and the time of heterotypic lymphocytes less than 0.05 [(3.12 ± 1.55) d,(3.10 ± 1.33) d vs.(3.95 ± 1.26) d] in group B and group C,were obvious shorter,and there were significant differences(F =4.150,4.580,4.060,all P ＜ 0.05).EBV-DNA negative conversion rate of group B and group C were higher than that of group A [53 cases(89.8％),52 cases (88.1％) vs.41 cases (69.5％),x2 =10.403,P ＜ 0.05],and the cellular immune function was improved significantly than that of group A after treatment for 7 days [CD3 +:(63.00 ±4.39)％,(62.75 ±4.84)％ vs.(68.70 ± 7.70)％;CD4+:34.08(30.21,41.70)％,33.94(29.17,45.17)％ vs.32.34(28.16,43.53)％;CD8+:30.59 (27.14,40.22)％,30.09(27.54,40.48)％ vs.32.57(28.68,41.17)％;CD4+/CD8+:1.12(1.03,1.31),1.11 (0.99,1.64) vs.0.94 (0.87,1.59),F/x2 =11.020,1.217,1.121,6.728,all P ＜ 0.05].The differences in indexes between B group and C group were not significant,and there was no statistical significance (all P ＞ 0.05).There were 2 cases with fever in the group C,and 2 cases of granulocytopenia in all group.Conclusions Ganciclovir combined with interferon-α1 b inhalation or intramuscular injection is effective and safe in treating children with IM.It can improve clinical symptoms,cellular immune function and EBV-DNA negative conversion rate.Since inhalation is of less side effects and no pain,it can be accepted by children and their parents easily.Therefore,it is recommended that Ganciclovir be used together with interferon-α1 b inhalation in the treatment of children with IM.

Thermo-therapeutic has been proved to be an effective approach for cancer therapy.This paper introduces a kind of new equipment suitable for liver oncology based on this theory,which uses the RF field as the thermal energy and adopts sequential-delivering technology.Its principle and advantages are introduced in detail.

Objective To evaluate the effectiveness of applying simulation based medical education (SBME) in critical care medicine PBL teaching. Methods Totally 46 undergraduates in medical college of Shanghai JiaoTong University , who participated in critical care medicine PBL teaching in our Hospital from 2012 to 2013 were chosen as research objects. These students were divided into two groups: PBL group (2009 grade, n=24) and SBME-PBL group (2010 grade, n=22). The teaching effectiveness was evaluated by questionnaire survey, theoretical exam, direct observation of procedural skills (DOPS) and mini-clinical evaluation exercise (Mini-CEX). Data were analyzed by SPSS 17.0 software. The data of questionnaire survey were expressed as percentage and the assessment results were expressed as x±s. Chi-square and t test were used to do statistical analysis. P<0.05 signi-fies for statistically significant differences . Results ①The results of questionnaire survey showed that:there was no significant difference between two groups in study interests(P=0.665, 0.937, 0.746) and study ability(P=0.937, 0.665). But regarding collaboration ability, SBME-PBL group performed better than PBL group (P=0.019, 0.038, 0.024). ②These was no significant difference in the theo-retical knowledge exam between PBL and SBME-PBL group(P=0.743). But the DOPS scores of car-diopulmonary resuscitation (P=0.000), endotracheal intubation (P=0.023), defibrillation (P=0.002) and central venous catheterization(P=0.047) were all significantly higher in SBME-PBL group than in PBL group. ③In Mini-CEX, there was no statistical difference in physical examination skills (P=0.790) and clinic judgment(P=0.426) between the two groups. However, SBME-PBL group performed better in medical interviewing capacity(P=0.002), humanistic care (P=0.001), counseling skills(P=0.017), organization efficiency(P=0.029) and overall clinical competence(P=0.024) than PBL group. Conclusions SBME can promote the students' team work spirit, basic clinical skills and comprehen-sive clinical capacity in critical care medicine PBL teaching and can improve the teaching quality of critical care medicine.