The new current versions of Hospital Finance System and Hospital Accounting System promote the reform of medicine accounting. It requires the method of the drugs cost accounting to change the retailing price accounting to the purchasing price accounting. It clearly defines individual valuation method, “first-in, first-out” method or weighted average method should be used to determine the actual cost of the materials based on the actual situation. It analyzes the problems of medical management and cost accounting, and proposes the practical solutions to strengthen the standard management of medicine and the medical cost accounting.

Objective To investigate the effects of rosuvastatin calcium on bone mineral density and carotid atherosclerotic plaque in patients with type 2 diabetes mellitus complicated with osteoporosis.Methods Eighty-two T2DM patients with osteoporosis were randomly divided into two groups,41 cases in the treatment group and 41 cases in the control group.The control group received routine treatment,including insulin and Caltrate D treatment.The observation group was treated with rosuvastatin calcium 10 mg 1 time/d orally,on the basis of the routine treatmentv.The two groups were treated for 12 weeks.After treatment,the blood glucose level,bone mineral density and carotid atherosclerotic plaques were compared.Results After treatment,the levels of blood sugar,FBG ((7.2±0.4) mmol/L),2 hBG ((9.2±0.6) mmol/L),HbAlc ((7.2±0.4) mmol/L) in the observation groups were lower than those before treatment ((9.6±0.5) mmol/L,(12.3±0.6) mmol/L,(9.8±0.7) mmol/L,t=24.0,23.39,20.65,P<0.05),the levels of blood sugar,FBG,2 hBG,HbAlc in the control group were (8.4±0.3) mmol/L,(10.5±0.6) mmol/L and (8.3±0.6) mmol/L,lower than those before treatment ((9.3±0.3) mmol/L,(12.0±0.8) mmol/L,(9.9±0.5) mmol/L,t=13.58,9.60,13.12,P<0.05).The three indexes in the observation group were lower than those in the control group (t=-15.37,-9.8,-9.77,P<0.05).After 1 course of treatment,the femoral neck BMD value in the observation group was higher than that before treatment ((0.699±0.111) g/cm2 vs.(0.665±0.106) g/cm2,t=0.790,P<0.05),there was no significant increase in the BMD value in the control group after treatment ((0.669±0.130) g/cm2 vs.(0.662±0.119) g/cm2,t=-0.25,P>0.05),the BMD of femoral neck in the observation group after treatment was higher than that in the control group (t=0.842,P<0.05).After 1 course of treatment,IMT value and plaque score in the observation group were lower than those before treatment ((1.202±0.18) mm vs.(1.582±0.369) mm,(3.62±0.33) points vs.(4.39±0.37) points,t=0.778,9.945,P<0.05),in the control group,the intima-media thickness of the carotid artery and plaque score after treatment were not significantly increased compared with those before treatment ((1.487±0.345) mm vs.(1.499±0.356) mm,(4.16±0.26) points vs.(4.28±0.28) mm,t=0.155,2.011,P>0.05).The differences between the observation group and the control group after treatment were statistically significant (t=0.534,0.645,P<0.05).Conclusion Rosuvastatin calcium can effectively improve the curative effect of type 2 diabetes mellitus in patients with osteoporosis and improve bone mineral density and carotid atherosclerotic plaques.

Based on the "Grayscales average distribution" method which equally distributes the input gray levels to output gray levels, three improved methods named: "Reduce the gray range expressed by the less significant subfields", "Low levels preset" and "Modify the exponent of inverse-gamma function" are proposed in this paper. Using these methods, the inverse-gamma relation subfields code can be obtained easily which can improve the low level expressions of AC-PDP. And a program, "gray scales distribution validate program", which can enhance the expressions of the demanded gray levels range, is also proposed in this paper.

Objective: To observe the effect of electroacupuncture (EA) at Lower He-Sea points on the expression levels of interleukin-1β (IL-1β) in the serum and gallbladder tissues, and nuclear factor-κB (NF-κB) in gallbladder tissues of the guinea pigs with acute cholecystitis (AC), and to explore whether Yanglingquan (GB 34), the Lower He-Sea point pertaining to Dan Fu (gallbladder), is relatively specific for the Dan Fu (gallbladder) disorders. Methods: Eighty-two healthy guinea pigs were randomly divided into 6 groups according to the random number table method, a blank group, a model group, a Yanglingquan (GB 34) group, a Zusanli (ST 36) group, a Shangjuxu (ST 37) group, and a Xiajuxu (ST 39) group, with 12 guinea pigs in the blank group while 14 in the other groups, respectively, half males and half females in each group. Except for the blank group, guinea pigs in the other groups were injected with E. coli into the gallbladder to establish AC models. Guinea pigs in the blank group were fed routinely without special treatment; those in the model group were daily tied up for 30 min without EA treatment; those in the 4 groups receiving EA treatment were acupunctured at the corresponding Lower He-Sea points after daily binding and stimulated with the SDZ-V EA instrument. After successful modeling and treatment for 5 d, blood was collected from the abdominal aorta of the guinea pigs, and the gallbladder tissues in each group were isolated for hematoxylin-eosin (HE) staining to observe the morphological changes. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum IL-1β level, and immunohistochemistry (IHC) was used to detect the expression levels of NF-κB and IL-1β in gallbladder. Results: On the 3rd day after modeling, the guinea pigs in the five groups with modeling were mentally depressed with decreased appetite, significantly reduced activities, slouch, lassitude, slack and matted fur, and loose stools; two guinea pigs were selected from each group (one male and one female, not included in the final statistics) to isolate the gallbladder after sacrifice; macroscopic observation showed that the gallbladder wall was differently thickened; the bile color was dark green and opaque with particles suspended or accumulated; light microscope observation showed that the submucosal blood vessels of the gallbladder were congested, along with mucosal edema, ulceration, necrosis, shedding, and a large number of inflammatory cells infiltrating in the lamina propria, indicating that the AC model was successfully prepared. Compared with the model group, the gallbladder tissue injuries of the four groups receiving EA treatment were all differently repaired, the serum IL-1β levels were reduced (P<0.01 or P<0.05), and the IL-1β levels in the gallbladder tissues were reduced (P<0.01 or P<0.05). Compared with the model group, the NF-κB expression level in the Yanglingquan (GB 34) group was significantly reduced (P<0.01), but was not statistical different in the Zusanli (ST 36) group, Shangjuxu (ST 37) group and Xiajuxu (ST 39) group (all P>0.05). Compared with the Yanglingquan (GB 34) group, the gallbladder tissues of the Zusanli (ST 36) group, Shangjuxu (ST 37) group and Xiajuxu (ST 39) group were more severely damaged, and the expression levels of serum IL-1β, the NF-κB and IL-1β in the gallbladder tissues were increased (P<0.01 or P<0.05). Intervention effect of Yanglingquan (GB 34) on AC guinea pigs was superior to that of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39). Conclusion: EA at the Lower He-Sea points of the stomach, large intestine, small intestine and gallbladder can produce curative effects on AC guinea pigs and reduced the inflammatory symptoms. Intervention effect of Yanglingquan (GB 34) on AC guinea pigs is superior to that of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39). The mechanism of EA at Yanglingquan (GB 34) in treating AC may be regulating IL-1β and NF-κB to control the inflammatory response and improve the gallbladder tissue damage.

Family physicians may be called upon to respond to trauma patients in their clinics or at scene of injury. Managing trauma can be daunting to any physician who encounters it infrequently. The physician first responder needs to shut out the chaos and distractions at scene and focus on a systematic primary survey to assess for injuries with the potential to cause rapid deterioration, institute crucial life-saving interventions and effect rapid evacuation to hospital. This article details a simple approach to guide the family physician to assess and prioritise management of the trauma patient, and augment the work of the paramedics in the pre-hospital phase.

Family physicians may be called upon to respond to trauma patients in their clinics or at scene of injury. Managing trauma can be daunting to any physician who encounters it infrequently. The physician first responder needs to shut out the chaos and distractions at scene and focus on a systematic primary survey to assess for injuries with the potential to cause rapid deterioration, institute crucial life-saving interventions and effect rapid evacuation to hospital. This article details a simple approach to guide the family physician to assess and prioritise management of the trauma patient, and augment the work of the paramedics in the pre-hospital phase.

BACKGROUND: Three-dimensional (3D) printing technology is a new rapid prototyping and rapid manufacturing technology. OBJECTIVE: Through the analysis of the related papers, the paper summarizes and discusses the research progress of 3D printing technology, the prospect of application in joint replacement and the status quo and development trend of 3D printing technology in joint replacement.METHODS: The relevant literature was retrieved by the first author with the China Journal Full-text Database (CNKI) and PubMed database from 1985 to 2015. The key words were 3D printing technology, rapid prototyping, arthroplasty, joint replacement. The included 81 articles were analyzed.RESULTS AND CONCLUSION: Basic research and clinical application of 3D printing technology and joint replacementtechnology are becoming more and more popular. 3D printing further optimizes in the communication and teaching in joint replacement, and avoids intraoperative and postoperative complications. According to the needs of different teaching materials, 3D printing can print out different parts of the real body with different characteristics of print by 3D printer. The surgical simulation exercises with 3D limb printing different materials are the best way to improve theoperation skills. 3D printing technology in the osteotomy guide precision has basically completed multicenter clinical trial,and toward to the clinical application of small scale stage. The construction of individualized treatment plan and theapplication of active biological organs by 3D printing technology will become the new research direction of jointreplacement.

ObjectiveTo observe the intraoperative techniques of artificial nasolacrimal duct and evaluate the effectiveness.MethodForty-nine cases(56 eyes) ofchronic dacryocystitis underwent artificial nasolacrimal duct placement.The artificial nasolacrimal duct was dilated and the stent was retrogradely placed.Dacryocystography was performed before operation.ResultsArtificial nasolacrimal duct placement was technically successful in 53 eyes(94.64％),improvement rate was 3.57 ％ (2/56).The total effective rate was 98.21％(55/56) after operation.ConclusionInterventional artificial nasolacrimal duct placement is a safe,simple and effective method for the treatment of chronic dacryocystitis.

Perihilar surgery is full of challenge,risk,variability and uncertainty.Because of the anatomic variability,the pathophysiological complexity and invasion of the diseases,hepatic hilar biliary surgery has the characteristics of high operative difficulties,low resection rate,easy intraoperative bleeding,more postoperative complications,high recurrence rate and mortality rate.The cure rate and safety of the operation can be improved only through comprehensive imaging examinations and preoperative evaluation of liver function as well as the correct use of surgical techniques of anatomic paths,lesions excision and hepatic hilar reconstruction.The core of perihilar surgical techniques is hepatic hilar anatomy and explosion,including hilar plate dissection,dissection of liver along the medial fissure,quadrate lobe of liver resection and perihilar resection.Perihilar surgery is a comprehensive technique involving preoperative,intraoperative and postoperative procedures.The cure rates of perihilar biliary diseases can be improved by a combination of enhanced recovery after surgery and optimized and individualized surgical plans for patients.

The establishment animal model of Graves’ disease contributes to the study of etiology, pathogenesis and therapeutic modalities. After decades of studies and making improvements, the method of building mice model of Graves’disease has achieved a great development. Although there were many reports of animal model building in Graves’disease, as a mature technology A-subunit of thyrotropin receptor( TSHR)-expressing adenovirus was used to establish Graves’disease mice model, which has been accepted widely because of its high efficacy.