AlM: To compare the impact of different thickness of corneal cap design on small incision lenticule extraction ( SMlLE) operation.METHODS: Forty-six cases of myopia patients ( 92 eyes) intends to SMlLE operation in our hospital were collected , and were randomly divided into 2 groups:corneal cap thickness design for 110μm in group A and 120μm in group B. Other operation parameters designs were consistent. All patients were surgeried by the same surgeon. The incidence of opaque bubble layer ( OBL ) , the ratio of difficult separation of lens, uncorrected visual acuity ( UCVA ) of each time points, and spherical equivalent ( SE) were compared.RESULTS: lntraoperative OBL incidence rate of 110μm group was higher than that of 120μm group with significant difference between the two group (P<0. 05). the ratio of difficult separation of lens was significantly different between the two groups: 110μm group was higher than in 120μm group (P<0. 05). The UCVA in the 120μm group was better than that in the 110μm group at postoperative 1 and 7d. But with the passage of time, postoperative 1, 3, and 6mo of UCVA of 2 groups was similar, showed no significant difference (P>0. 05). SE were compared at 7d and 6mo after operation, showed no significant difference (P>0. 05)CONCLUSlON: Compared with 120μm group, corneal cap design SMlLE operation in 110μm group are more prone to OBL and difficult separation of lens, thus affects UCVA and postoperative recovery rate. There is no significant difference in long-term UCVA.

Authors described characteristics of medical service performance evaluation,and strategy options for scientifically evaluating such performance,and systematically presented the conditions and methodology of DRGs-based evaluation of medical service performance.Six evaluation indicators were cited in terms of the capacity,efficiency and medical safety of medical service providers,with detailed introduction to the computation process of such indicators.Cases in hand indicate that the first-page data completeness and accuracy of medical records are preconditions for using DRGs in medical service performance evaluation.

ObjectiveTo evaluate the performance of diagnosis-related groups,Beijing version (BJ-DRGs) which were locally developed in Beijing.MethodA total of 1.3 million inpatient records from 149 hospitals in Beijing in 2008 were drawn from Beijing Public Information Center.Coefficient of variation (CV) was used to measure the performance of DRGs system.ResultsBJ-DRGs produced the best CV results for expenditure.ConclusionsUnder Beijing's medical information condition,BJ-DRGs produced good performance.

This article reviewed the connotation,developing process and utilization theory of diagnosis related groups (DRGs).DRGs,which is one of ease mix systems,is now used widely in healthcare management.DRGs classify inpatient based on diagnose and procedure.Practices have shown that it has relative high capacity for the risk adjustment of acute care cases; therefore,it can improve the efficiency of expenditure and performance management of inpatient services.Currently,there are more than 30 countries and regions using DRGs,and the theories and methodologies of DRGs get mature.China's new round healthcare reform have developed in depth.The study and development of DRGs related health management tool will promote China' s healthcare system becoming more scientific,normalized and systematic.

Objective To evaluate the clinical efficacy and toxicity of rituximab combined with CHOP (R-CHOP) in the treatment of relapsed or refractory diffuse large B cell lymphoma (DLBCL).Methods 30 patients were enrolled.All patients,pathologically confirmed to be CD20 positive DLBCL (all in stages Ⅲ-Ⅳ ), were relapsed or refractory after received 2-6 cycles of chemotherapy. Then all of them received R-CHOP schedule for 4 to 6 cycles, each cycle was 21 days. Clinical data before and after R-CHOP were collected.A retrospective analysis of the R-CHOP therapy,either compared to the literature or self-control was performed to evaluate the efficacy and toxicity. Results All the 30 patients were evaluable, induding 15 cases were complete remission (CR), 10 cases were partial remission (PR), 3 cases were stable disease (SD),and 2 cases were progressed disease (PD).The CR rate was 50.0 ％ (15/30),the total response rate (RR) was 83.3 ％ (25/30).All patients were well tolerated to the therapy.Only 3 cases were Ⅱ degree neutropenia,1 case was Ⅰ degree thrombocytopenia, and 2 cases suffered nausea and other mild gastrointestinal discomfort. Conclusions R-CHOP regimen could also achieve good response for relapsed or refractory DLBCL significantly.The common adverse effects of rituximab were mild.All the patients were well tolerated.

Objective To explore the significance of perioperative management of percutanous laser lumbar disc decompression. Methods Retrospective analysis was carried out in 86 patients with lumbar disc herniation in order to evaluate the results of preoperative and postoperative managements. Results All patients passed through operative period safely. Total efficiency rate reach 78%(67/86). Conclusions It can be ensuring operative effect and decreasing the operative complication for the patients with lumbar disc herniation by intensifing the perioperative managment.

Objective To compare the level of interleukin 6 (IL 6),interleukin 8 (IL 8),human chorionic gonadotropin(hCG) with transvaginal ultrasonographic measurement in prediction of the cervix ripening and the time of term labor Methods The 79 cases of primiparous women of term pregnancy were chosen as the research subjects The maternal level of IL 6,IL 8,hCG in cervicovaginal secretions were measured The cervical length, internal cervical os wedge width and forebag length were measured by transvaginal ultrasonography The cervical Bishop score was also determined Results (1) The levels of IL 6,IL 8,hCG in cervicovaginal secretions were significantly higher in women they are in labor than that of women at term not in labor (782?508) ng/L, (10 539?8 680) ng/L,(114?86) IU/L, versus (155?75) ng/L, (7 113?6 050) ng/L,(35?21) IU/L, respectively (2) The levels of cervicovaginal secretions IL 6,IL 8,hCG and the length of cervical, forebag were significant correlation with the cervical Bishop score ( P

Objective To study the combined effect of chlorotoluron and atrazine on the testis of mice. Methods Kunming mice were divided into groups and treated with chlorotoluron and atrazine alone or in combination by gavage at different doses for 25 consecutive days. Microscope and electron microscope were used to observe the morphological changes. Results The herbicides used alone or in combination, at all the test doses, caused the morphological changes in degrees in the testis. Under the light microscope, seminiferous epithelium arrayed loosely and disorderedly, spermatogenic cell shed, and layers lessened compared with the control group. Under the electron microscope, mitochondria in the seminiferous epithelium appeared vacuolated, karyotheca swelled, bent and the function of sustentacular cell declined. Compared with alone use groups, the pathological changes were more serious in combination use groups. Conclusion Chlorotoluron and atrazine can produce a combined toxic effect on the testis of mice.

Diagnosis related groups (DRGs)have been widely used in many countries and regions.The versions of DRGs in different regions are modified according to the local circumstances and conditions.Beijing version DRGs (BJ-DRGs)is the first DRGs system in Chinese,which was developed locally based on the conditions of medical information system and health relative policies in Beijing.This paper introduced the grouping principles,logic and methodology of BJ-DRGs.Taking“ear,nose,mouth and throat disorders”for example,this paper demonstrated the grouping process of BJ-DRGs.

OBJECTIVETo investigate clinical effect and safety of bone-setting manipulation in treating isolated systolic hypertension combined with cervical spondylosis.

METHODSFrom January 2012 to January 2015, 320 patients suffered from isolated systolic hypertension combined with cervical spondylosis were randomly divided into treatment group and control group. In treatment group, there were 160 patients including 84 males and 76 females with an average age of (39.82 ± 10.33) years old, average blood pressure was (149.61 ± 10.75)/(81.01± 8.25) mmHg, NPQ score was 24.61 ± 8.14; treated with flexion top spin and lock bone-setting manipulation of cervical spine, once every two days for 20 days. While in control group, there were 160 patients including 90 males and 70 females with an average age of(41.37 ± 9.42) years old, average blood pressure was (151.48 ± 11.32)/ (79.65 ± 9.32) mmHg, NPQ score was 25.78 ± 9.53; treated with manipulation of reposition cervical spine by rotation, once every two days for 20 days. Blood pressure and NPQ score were tested and compared for evaluating clinical effects.

RESULTSBefore and after a period treatment, systolic pressure in treatment group was (149.61 ± 10.75) mmHg and (129.67 ± 12.26) mmHg; (151.48 ± 11.32) mmHg and (132.02 ± 11.73) mmHg in control group. After treatment, systolic pressure in both two groups was obviously decreased, and treatment group was better than control group. Before and after a period treatment, diastolic pressure in treatment group was (80.01 ± 8.25) mmHg and (78.15 ± 10.34) mmHg, (79.65 ± 9.32) mmHg and (76.89 ± 9.79) mmHg in control group, and there was no significant difference between two groups. NPQ score in treatment group was 24.61 ± 8.14 before treatment, 12.46 ± 7.94 after treatment, while in control group was 25.78 ± 9.53, 14.17 ± 8.86; NPQ score of the two groups after treatment was better than before treatment, while there was no obviously significance between two groups after treatment. The whole clinical effect in treatment group was better than control group.

CONCLUSIONBone-setting manipulation for isolated systolic hypertension combined with cervical spondylosis at early stage could receive good clinical result, and flexion top spin and lock bone-setting manipulation of cervical spine was better and safety than manipulation of reposition cervical spine by rotation.

Adult ; Case-Control Studies ; Cervical Vertebrae ; Female ; Humans ; Hypertension ; etiology ; therapy ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Spondylosis ; therapy ; Systole