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 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.

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 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.

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 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 evaluation the efficacy of dexmedetomidine mixed with dezocine and levobupivacaine for patient-controlled epidural analgesia (PCEA) after cesarean section.Methods A total of 300 patients, aged 23-35 yr, with body mass index of 24-28 kg/m2 , of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective cesarean section under epidural anesthesia, were randomly divided into 3 groups (n =100 each) according to the random number table: morphine and levobupivacaine group (ML group), dezocine and levobupivacaine group (DL group), and dexmedetomidine, dezocine and levobupivacaine group (DDL group).In group ML, the loading dose included morphine 2 mg + levobupivacaine 10 mg + 5 ml normal saline, and PCEA solution contained morphine 5 mg + levobupivacaine 150 mg + normal saline 100 ml.In group DL, the loading dose included dezocine 3 mg+ levobupivacaine 10 mg+ normal saline 5 ml, and PCEA solution contained dezocine 15 mg + levobupivacaine 150 mg + normal saline 100 ml.In group DDL, the loading dose included dezocine 2 mg+ levobupivacaine 10 mg + dexmedetomidine 0.5 μg/kg + normal saline 5 ml, and PCEA solution contained dezocine 7.5 mg+ levobupivacaine 150 mg + dexmedetomidine 1.5 μ g/kg + normal saline 100 ml.At 10 min before the end of operation, the loading dose was given via the epidural catheter, and the PCEA pump was connected and set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.Analgesia was maintained until 42 h after operation.Visual analog scale score was main-tained ≤ 3, and (or) visual analog scale for fatigue score ≤ 2.When PCEA failed, morphine 2 mg was injected epidurally as rescue analgesic.At 4, 8, 24 and 42 h after operation, the modified Bromage score and Ramsay sedation score were recorded, and patients' satisfaction with analgesia was evaluated.The occurrence of epidural analgesia-related adverse reactions was recorded.Results The consumption of PCEA solution and requirement for rescue analgesics were significantly lower in group ML than in group DL.Compared with group ML, Ramsay sedation score was significantly decreased at 4 and 8 h after operation, the degree of patients' satisfaction with analgesia was increased, and the incidence of nausea, vomiting, dizziness and pruritus was decreased in DL and DDL groups, and the incidence of urinary retention was decreased in group DDL.The degree of patients' satisfaction with analgesia was significantly higher, and the incidence of dizziness and urinary retention was lower in DDL group than in group DL.No patients developed epidural analgesia-relatcd hypotension, bradycardia, or respiratory depression in the three groups.Conclusion The efficacy of dexmedetomidine mixed with dezocine and levobupivacaine is good when used for PCEA after cesarean section, and the adverse reactions are fewer.

Objective To assess left ventricular(LV) longitudinal strain in patients with coronary heart disease by two-dimensional speckle tracking imaging (2DSTI),and to explore the clinical value of 2D longitudinal strain in detecting myocardial ischemia. Methods Forty-four patients with coronary heart disease (CHD group) and 28 age-matched subjects (control group) were enrolled into this study. The two-dimensional data were obtained in apical 4-chamble, 2-chamber and long axis view. And the longitudinal strains of every segments, the average longitudinal strain of LV 18 segments (SL18), the average longitudinal strain of 12 segments (SL12,excluded the 6 apical segments) were analyzed. Results In the patients with CHD, the longitudinal strain of ischemia segments and the global LV longitudinal strain were significantly decreased than that of the control subjects. Both in patients with CHD and in control subjects,the longitudinal strains in apical segments were higher than that of middle and basal segments. There was significant difference between SL18 and SL12 ( P=0.027 in CHD group and P =0.003 in control group).Receiver operating curve (ROC) analysis demonstrated that the cutoff point of SL18 to detect myocardial ischemia was - 18.8％ (sensitivity 80.2％ and specificity 74.1％ ) ,and the cutoff point of SL12 to detect myocardial ischemia was - 17.8％ ( sensitivity 81.7％ and specificity 85.6％ ). Conclusions 2D longitudinal strain was sensitive to detect myocardial ischemia, SL12 was better than SL18 in detecting myocardial ischemia. 2DSTI might be useful for identifying patients with severe CHD.

Objective To assess the left ventricular function of patients with acute myocardial infarction (AMI) and its correlation with cardiac troponin T (cTnT) and specific manifestation of electrocardiogram (ECG) by automated function imaging (AFI) of two-dimensional speckle tracking imaging.Methods Forty-six AMI patients who had AMI for the first time and had been treated by primary percutaneous coronary intervention and 30 healthy controls who were age and sex-related to infarct group were involved.The values of cTnT within 24 hours after admission of AMI patients were recorded and the values of ST segment elevation were measured accurately.All the subjects were analyzed for longitudinal peak systolic strain (LPSS) values and the bull' s eyes by AFI.Results Compared to control group, left ventricular ejection fraction (LVEF), global and infarcted LPSS of infarct group were significantly different and the values of ST elevation of infarct group were higher than those of control group.Both global,infarcted segmental LPSS were significant closely correlated to LVEF and cTnT,respectively (P＜0.001,all).Both global, infarcted segmental LPSS were correlated to ST elevation (P ＜0.05,all).Global LPSS had the closest correlation with LVEF (r = -0.565, P＜0.001) and so did infarcted LPSS with cTnT (r = 0.432, P ＜0.01).Conclusions As a procedural simple and rapid diagnostic tool,AFI provides reliable and useful information of the assessment of AMI.Both global and infarcted segmental LPSS have well described left ventricular function of AMI patients.Compared to LVEF, LPSS was more closely correlated to cTnT and ST segment elevation, which meant that LPSS was more sensitive and more closely related to real infarct size and actual involved range of AMI.