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 find out the trends and associated factors of birth defects in Guangdong province,and to provide the scientific evidences for setting the preventive strategies.Methods Retrospective description and trending analysis were conducted to analyze the birth defects surveillance data from 1996 to 2004 in Guangdong province.Results The total incidence of birth defects in Guangdong province from 1996 to 2003 was 134.4/10 000(7301/543 062),and increased to 212.1/10 000(2129/100 394)in 2004.Significant different birth defects rate was found between different maternal age(P

Objective To analyze the consistency of the detection results of glycosylated hemoglobin (HbA1c) by SMART POCT and Hitachi 7180 biochemical analyzers .Methods Firstly the accuracy of HbA1c detected by the SMART POCT and Hita‐chi 7180 biochemical analyzers were evaluated .And then 20 randomly selected samples were tested by both equipments .A relevance analysis between detected data from two equipments was conducted .Results There was a good correlation between the results of the HbA1c detected by two detecting systems ,with the correlation coefficient of r2 =0 .981 1 .Conclusion There is a good consis‐tency in detection results of glycosylated hemoglobin (HbA1c) detected by SM ART POCT and Hitachi 7180 biochemical analyzer .

Objective:To obtain phage-displayed ScFv library targeting tumor tissues and to screen for antibodies specifically binding to tumor vessels using in vivo phage display,so as to lay a foundation for diagnosis and treatment of cancer.Methods:The membrane proteins were extracted from the specimens of esophageal carcinoma,stomach carcinoma,brain cancer,lung cancer,and spinal cord tumor.The recombinant phage-antibody system was used to construct a single-chain Fv fragment(ScFv)cDNA library from the total RNA of the BALB/c mice immunized with purified membrane protein.The specific primers of VH and VL were used to amplify the cDNA of VH and VL,respectively,which were then assembled into ScFv gene with a specially constructed linker DNA.The ScFv gene was ligated into the phagemid vector pCANTAB 5E and the ligated samples were transformed into competent E.coli TG1.The transformed cells were infected with M13KO7 helper phage to yield recombinant phage.Using the animal model of human cervical carcinoma(HeLa cells),sepecific phage-ScFvs were selected by phage displaying and panning in vivo.After four rounds,24 phage-ScFvs,which were identified by PCR,were analyzed immunohistochemically.The ScFvs expressed in the tumor tissue slices and negative in control kidney tissue slices were sequenced.Results:Tomors-bearing animal models were established with 7 different kinds of carcinoma cell lines in BALB/c nude mice.It was found that inoculation with HeLa cells resulted in most satisfactory tumorigenesis in nude mice.A ScFv library of 1.6?106 was obtained and a tumor vessel specific phage-ScFv named ScFvH1(VH-linker-VL)was selected from the library.Conclusion:A tumor targeting ScFv library has been successfully constructed and a tumor vessel-specifrc antibody has been identified from the library,which provides a new way for the early diagnosis and therapy of cancer.

OBJECTIVE:To investigate ADR induced by dasatinib,and to provide reference for clinical rational drug use. METHODS:By means of literature metrology method,dasatinib-induced ADR cases domestically and internationally reported were analyzed. RSEULTS:A total of 63 ADR cases were induced by dasatinib,and the age of patients were mainly 41-60 years old. The most cases(25.4%)occurred within 1 month of medication. The patients mainly were from Asian countries and regions(53.9%). Organs/systems involved in dasatinib induced ADRs were mainly respiratory system(40.1%),digestive system(17.5%)and hema-tologic system(11.7%). Main clinical manifestations were pleural effusion(23 cases),pulmonary artery hypertension(15 cases), expiratory dyspnea(8 cases),diarrhea(8 cases),etc. CONCLUSIONS:Daring the use of dasatinib,great importance should be attached to ADR monitoring and prevention so as to avoid serious ADR.

Objective To describe the psychological experience of the patients with end-stage cardiopathy in China. Methods Phenomenology method was used in the study. Fifteen end stage cardiopathy patients received a non-structured interview. Results Four themes were extracted including heavy psychological burden about the disease and the selection of treatment options; complex psychological responses to families and relatives; wishing of social support;lose heart to personal future and prospects. Conclusions The patients on the end stage cardiopathy have complicated and intensive psychological responses. Medical staff should focus on the emotional of these patients, and provide effective strategies to promote patients'physical and psychological rehabilitation.

BACKGROUND:Pore diameter,size and porosity of biomaterials are important for cell attachment,infiltration and growth.OBJECTIVE:To primarily evaluate the biocompatibility of novel bionic scaffold of poly(3-hydroxybutyrate-co-3-hydroxyvalerate)/sol gel bioactive glass (PHBV/SGBG) with nanostructure in vitro.DESIGN,TIME AND SETTING:Cell-material experiment was performed at the Central Laboratory of Third Hospital of Sun Yat-sen University from March to September 2006.MATERIALS:PHBV/SGBG was provided by the Institute of Materials Science and Engineering,South China University of Technology;bone marrow stroma cells (MSCs) were prepared by our team.METHODS:The standard concentration of PHBV/SGBG extracting solution should be 10 mL/ cm2 of the ratio of culture solution to material surface.PHBV/SGBG was immersed into the complete culture solution and incubated in 5% CO2 at 37 ℃ for 2-3 days.The extracting solution was drawn and stored under sterile condition.In addition,PHBV/SGBG extracting solution of 8,4,2,1,0.5,0.25 and 0.125 times of standard concentration was prepared.MAIN OUTCOME MEASURES:PHBV/SGBG ultrastructure was observed by scanning electron microscopy;PHBV/SGBG porosity was measured by routine measurement.MTT methods were used as a quantitative assessment for cytotoxicity of the biomaterials.Adherence and spreading of MSCs on the surface of specimen was observed using direct contact cultivation.RESULTS:The PHBV/SGBG was porous,with connecting pores under electron microscopy.Nanometer SGBG particles were imbedded or encapsulated in pore wall of PHBV,with the porosity ＞90%.The toxicity gradation of the novel bionic scaffold ranked from grade 0 to 1 at 1,3,5 days of culture.MSCs slightly attached and grew on the surface of the biomaterials,and proliferated rapidly.Obvious cell processes stretched into the micro-pores structure.CONCLUSION:The novel bionic scaffold of PHBV/SGBG has excellent cellular affinity,possibly due to the porous structure,with no cytotoxicity to MSCs.

To compare the effect of insulin glargine combined with nateglinide and continuous subcutaneous insulin infusion(CSII) during intraoperative period in type 2 diabetic patients with fracture. Both of the managements made blood glucose under control [fasting blood glucose(6.89±1.96)vs(6.75±2.33)mmol/L] in similar period [(3.6±1.6)vs(2.9±1.2) d,both P>0.05]. The mean blood glucose was lower in patients treated by CSII than that of the other group.

Objective To investigate the genotype ,distribution and drug resistance of 24 multi-drug resistant Escherichia coli i-solates from the patients in the hospital 24 cases of multi-drug resistant genotyping and resistance ,the distribution of its depart-ments in the hospital ,to provide basis for rational use of antibiotics in clinical patients .Methods By MIC method to analyze antimi-crobial susceptibility of Escherichia coli ,Enterobacter Genetics adopt consistent between repetitive sequences (ERIC)-polymerase chain reaction (PCR) screening carried out the multi-drug resistant Escherichia coli genotyping .Results Statistics showed that the hospital were isolated 24 strains were divided into two types A and B2 type genotype .Distribution is 10 in respiratory ,6 in urology , 5 in ICU (B2 type 3) ,3 in hematology and oncology (B2 type 1) .Drug susceptibility results of 4 type B2 ,for cefoxitin ,ceftazidime , amikacin ,ticarcillin + clavulanic acid are all manifestations of resistance .24 strains of Escherichia coli ,amoxicillin ,cephalothin , gentamicin ,ticarcillin ,piperacillin resistance rate reached more than 70% .Conclusion B2-type strain showed multidrug resistance , pathogenicity strong ,and mainly in the ICU and hematology and oncology ,the use of antibiotics should be based on reasonable ad-justments in patients infected with different genotypes of Escherichia coli .

Objective:To analyze clinicopathological characteristics of trauma-related melanoma and their relationship with the prognosis of patients.Methods:Clinical data were collected from 87 cases of trauma-related melanomas in Department of Dermatology, Xijing Hospital, the Fourth Military Medical University from 2009 to 2020, and their clinicopathological characteristics were retrospectively analyzed. Mann-Whitney test was used to analyze the difference in Breslow thickness of tumors between patients of different ages or genders; Spearman rank correlation analysis was used to analyze the correlation between the time from trauma to the notice of melanoma and Breslow thickness, Kaplan-Meier survival analysis and Log-Rank test were employed to analyze the relationship between clinicopathological characteristics of melanoma and the prognosis of patients; Cox regression model was used to analyze risk factors for survival duration of patients with trauma-related melanoma.Results:Among the 87 patients with trauma-related melanoma, 47 (54.02%) were males and 40 (45.98%) were females. Among them, melanoma occurred in 50 (57.47%) cases after sharp injuries, and in 37 (42.53%) after blunt injuries. In addition, 31 (35.63%) cases presented with primary lesions on the hands, and 48 (55.17%) on the feet. The Breslow thickness of the primary tumors was significantly higher in the group aged > 55 years than in the group aged ≤ 55 years ( U= 623.500, P= 0.010) , but there was no significant difference between patients of different genders ( P= 0.138) . The time from trauma to the notice of melanoma was negatively correlated with the Breslow thickness of tumors ( r=-0.203, P= 0.037) . The age of patients, Breslow thickness of tumors, Ki67 proliferation index and genetic background of tumor significantly affect the survival duration of patients with trauma-related melanoma ( P= 0.011, 0.031, 0.002 and 0.031, respectively) ; the gender, type of trauma and ulceration of tumor mass did not significantly affect the survival duration of patients ( P= 0.618, 0.114 and 0.379, respectively) . Cox regression model analysis showed that the Ki67 proliferation index and Breslow thickness were independent risk factors affecting the prognosis of trauma-related melanoma (risk ratio [ RR] and 95% confidence interval [ CI] were 1.946 (1.234, 4.217) and 1.839 (1.014, 3.332) , P= 0.039 and 0.045, respectively) . Conclusion:The Breslow thickness of trauma-related melanoma is related to the age of patients and time from trauma to the notice of melanoma; the age, Breslow thickness of tumors, Ki67 proliferation index and genetic background of tumor all affect the survival duration of patients with melanoma, and Ki67 proliferation index and Breslow thickness are independent risk factors affecting prognosis.