Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; diagnosis ; prevention & control ; therapy ; Intracranial Hemorrhages ; diagnosis ; prevention & control ; therapy ; Phenobarbital ; therapeutic use

Delicacy management proves a pressing need in cost management of medical service items in the current hospital operation.This paper first covered the methodology and system of hospital costing.It went on to describe the costing for four major medical service items in a quarter in 2011 using the activity-based costing method with the ultrasonographic section of a large hospital as an example.The outcomes were compared to the traditional costing method and the statutory pricing standards,resulting in the proposal and recommendation on reforming the costing methodology of service item pricing,and applying the activity-based costing management of medical service items in the hospital.

Objective:To investigate the neuropsychological characteristics of Chinese agraphia caused by basal ganglia(BG)infarction.Methods:The writing abilities of 40 patients with BG infarction were detected by Chinese agraphia battery(CAB),and all the writing scores and agraphia quotient were calculated.The head CT/MRI images in agraphia and non-agraphia groups were standardized,the infarction were revealed and the superposition of two-dimensional arrays were performed,so that the central tendency of infarction was visually displayed.Results: Among the 40 patients,21 had left BG infraction,and 17 had agraphia;19 had right BG infraction,and 4 had agraphia.The two-dimensional superimposing neuroimages showed that BG infarctions caused agraphia was mostly in the left BG,including the left putamen,the head and body of the caudate nucleus,but there were fewer infarctions in the right putamen and the body of the candate nucleus.BG infarction caused agraphia was mostly aphasic agraphia,which was characterized by the orthographic disorders,paragraphia,and grammar mistakes.Conclusions: BG infarction may result in aphasic agraphia,which suggested that BG is involed in writing and processing,and it is the subcortical center of this advanced neurofunction in writing.

Objective:To investigate the relationship between gene polymorphisms of disease-relevant multiple cytokines including TNF-α,IL-6,IL-10,TGF-β1,IFN-γand acute graft versus host disease(aGVHD) in allogeneic hematopoietic stem cell trans-plantation ( allo-HSCT ) . Methods:32 cases of recipients received allo-HSCT and 36 cases of normal groups in January 2014 to December 2015 were selected as objects of study. We detected genotypes on specific SNP of target genes by polymerase chain reation ( PCR) combined with gene sequencing and observed the occurrence of aGVHD in postoperative recipients. The influence of cytokine gene polymorphisms on prognosis of allo-HSCT patients was analyzed,and the potential relationship between specific SNP mutation of the disease-relevant cytokine genes and severity of aGVHD was discussed. Results:Distribution of cytokines gene polymorphism including TNF-α-308(G/A),IL-6-174(G/C),IL-10-1082(A/G),TGF-β1+915(G/C),IFN-γ(T/A) had no significant differences with incidence of severe aGVHD(P>0. 05). However,the occurrence of severe aGVHD in allo-HSCT recipients with C/T genotype was significantly higher than C/C and T/T in SNP of TGF-β1+869(P<0. 01). Conclusion:Gene polymorphism of TGF-β1+869(C/T) in allo-HSCT patients was closely related to the occurrence of severe aGVHD. The research show allo-HSCT patients with C/T genotype occurred severe aGVHD more frequently, which is an important potential risk factor to induce the incidence of severe aGVHD. Therefore,detecting gene polymorphism of TGF-β1+869 ( C/T ) in allo-HSCT recipients and developing the appropriate therapeutic regimen may be helpful to reduce the incidence of aGVHD.

Objective:To improve the safety,rationality and efficacy of medication for ovarian cancer patients complicated with cirrhosis by the participation of clinical pharmacists in the therapy. Methods:Clinical pharmacists participated in the therapy for an ovarian cancer patient with cirrhosis,and provided a rational and individualized therapeutic regimen through the drug experience of clinical pharmacists as well as the relevant medical guides and literatures. Results:The therapeutic efficacy was increased by the participation of clinical pharmacists in the therapy,the potential risk of the chemotherapy was avoided and the security of medication was assured. Conclusion:The participation of clinical pharmacists in therapeutic practice can improve the normalization of pharmacotherapy for ovarian cancer patients with cirrhosis,which also can provide ideas and methods for treating the similar patients.

Objective To study the EEG discharge index, intelligence test and event-related potential P300 in BECT, and to analyze the change of EEG discharge index and cognitive function before and after the treatment.Methods Sixty patients with BECT were enrolled in this study, they were treated with EEG, intelligence tests and P300 before and after the treatment.Results (1) The EEG discharge index were reduced remarkly after treatment in BECT with levetiracetam and lamotrigine, the difference was statistically significant (P ＜ 0.05).(2) Comparing before and after 3 or 6 months treatment, the latency of P300 had reduced with significant difference (P ＜ 0.05).(3) After 3 months treatment, VIQ and FIQ has no obvious improvement, but PIQ has improved.After 6 months treatment, VIQ、 PIQ and FIQ were improved.The difference was statistically significant (P ＜ 0.05).(4) There was a negative correlation of EEG P300 latency (r =0.175), as well as there was a negative correlation between EEG discharge index and intelligence test (r =0.044).Conclusion There is impaired cognitive function in BECT, especially the more frequently the EEG discharge, the more extended of P300 latency, as well as the more serious damage of intelligence and cognition after treatment.The intelligence were improved after treatment with Levetiracetam and lamotrigine, the longer the treatment time, the more obvious of intelligence levels improve.

Objective To explore the relationship between methylenetetrahydrofolate reductase (MTHFR) 677C ＞ T and unexplained recurrent pregnancy loss (URPL).Methods All patients were recruited from the outpatient department of Obstetrics/Gynaecology & Genetics of Hangzhou First People's Hospital from January 2013 to May 2014.A case-control study was performed.According to the stochastic indicator method,there were 125 subjects with a history of ≥2 times URPL as the case group,and 905 healthy parous women with no history of URPL as the control group.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the distributions of the polymorphisms of MTHFR 677C ＞ T,and the results were validated using oligo-chip and direct sequencing.Results The allele and genotype frequencies of MTHFR were 60.0％ for C,40.0％ for T,32.0％ for CC,56.0％ for CT,and 12.0％ for TT in the case group and 67.4％ for C,32.6％ for T,41.4％ for CC,52.0％ for CT,and 6.6％ for TT in the control group,respectively.The prevalence of allele T was significantly higher in the case group than in the control group (OR =1.379,95％ CI =1.051-1.808,P =0.020),the frequency of genotype TT was also significantly higher in the case group than in the control group (OR =2.344,95％ CI =1.220-4.503,P =0.009).Conclusion The fertile women with MTHFR 677T allele and 677TT genotype may be susceptibility to URPL in a Chinese Han population from the Hangzhou area.

Objective Traditional nasolacrimal duct stenting possesses some shortcoming including difficulty of pulling ball head guide wire from the nasal cavity with turbinate hypertrophy and nasal septal deviation. The new method of nose-oral tube track establishment can overcome the forementioned and increase the successful rate. Methods 5 F catheter and arterial sheath were modified to be nasolacrimal duct stent delivery device respectively. Antegrade dacryocystography was taken firstly to display the obstructed site and followed by the modified protocol of inserting the guide wire through nasolacrimal duct and nasal cavity, and establishing the stent delivery track for retrograde stent placement. Results 5 epiphora patients with failure implantation by traditional method were all succeeded through the modified stenting(100%). During 6-mouth follow-up, no serious complications and reocclusion occurred. Conclusion The establishment of eye-nose-mouth-nose of external nasal guide wire track can improve the successful rate of nasolacrimal duct stenting.

OBJECTIVE:To provide reference for the development of pharmaceutical care for periconceptional women. METH-ODS:Probability proportionate to size sampling(PPS)method was adopted to select participants from periconceptional women in Yongchuan District. The participants were investigated by questionnaires about drug use safety knowledge,attitude and behavior. Ep-idata 3.0 software was used to establish database. The data were analyzed with SPSS 15.0 software. RESULTS:Totally 800 ques-tionnaires were distributed and then 779 valid questionnaires were collected with effective rate of 97.38%. The total awareness rate of knowledge about drug use safety was 57.69%. The awareness rate rise with the increase of educational level (P<0.01). The awareness rate was higher in pregnant women than in prepregnant ones,with statistical significance in most of the questions(P<0.05 or P<0.01). For questions about attitude for drug use safety,the positive answer rate was higher in pregnant women than in prepregnant ones,with statistical significance in most of the questions (P<0.01). Among 385 pregnant women,only 56.88% re-ceived folic acid following the WHO recommendation. Of 181 pregnant women who had taken medicine,8.29% indicated that the physicians or pharmacists did not inform that whether the medicine affected pregnancy. CONCLUSIONS:Among periconceptional women,awareness rate of drug use safety is in low level and varied by their educational levels. There are difference in awareness rate of drug use safety and attitude between prepregnant women and pregnant woman. Drug use behavior of pregnant woman is to be modified.

Objective To investigate the existence of the erythropoiesis inhibitors(?).Methods Twelve patients suffered from uremia with anemia were studied[5 males,and 7 females,(50?12)years].Methylcellulose culture technique was used to culture mice bone marrow cells.The sera from the uremia patients were added to CFU- E and BFU-E culture medium with final concentrations of 1,25%,2.5% and 5%,Mice bone marrow cells were ob- tained from the female Balb/c mice.In vitro CFU-E and BFU-E culture in the presence of sera from uremia patients was compared with that in the presence of normal human subjects with the use of normal mice bone marrows.Re- suits The effects of the sera from uremia patients on CFU-E and BFU-E colon growth were in a dose-dependent manner.The effect was correlated with the concentrations of the sera(P