Objective To analyze the hospitalization expenses of cancer patients covered with byitem payment and quota payment packages,and probe into the impacts on such expenses for the two payment packages.Methods Inpatient records of 600 cancer patients were sampled by random from the medical insurance databases of Zhengzhou and Fuzhou to learn their hospitalization expenses and impact factors.Results Under the by-item payment package,the expenses of urban workers’ medical insurance were found higher than those of urban residents' medical insurance,with a per capita expense of RMB 32747.70 ± 32035.01 and 23035.83 ± 22875.65 respectively.Under the quota payment package however,there were no significant differences between expenses of the two kinds of inpatients,with a per capita expense of RMB 66043.41±47562.09 and 66576.54±73417.29 respectively.Conclusion There are gaps of reimbursement level between the two basic insurance schemes,which may not disappear in a short time.Under the by-item payment package,the gap exists in the difference of perreimbursement amount; under the quota payment package,the gap is negligible between the two populations under different insurance schemes.It is recommended to make reasonable use of these different payment schemes to minimize the relative gaps in medical service accessibility caused by the difference in reimbursement level.

Pancreatic cancer is a rapidly progressive and highly malignancy of the digestive system. In recent years, the diagnosis and treatment of pancreatic cancer has been in a slow stage of development, and the 5-year survival rate of patients remains very low. The main objective of translational medicine is to remove the barriers between basic medical research and clinical medical applications, to achieve practical integration between laboratory and clinic, and to accelerate the translation of the results obtained from basic research into clinical diagnosis, evaluation and treatment of diseases, thus promoting the development of life sciences. With the rapid development of the concept and technology of translational medicine, its application in the early diagnosis of pancreatic cancer can bring new hope for effectively improving the overall prognosis of patients. The authors comprehensively analyzed the latest research progress of translational medicine in the early diagnosis of pancreatic cancer in order to improve the early diagnosis and long-term survival of pancreatic cancer patient.

Objective To evaluate the clinical values of acoustic radiation force impulse(ARFI) elastography for liver fibrosis on hepatopath patients.Methods ARFI elastography was prospectively performed on 99 patients prepared to undergo hepatic surgery to get a shear wave velocity(Vs) which was the representative of liver stiffness.The fibrosis stages,inflammation grades and steatosis grades were evaluated histologically after surgery.Values of Vs were compared with the histological results.Results Values of Vs with fibrosis stage 0-4 was (1.14 ± 0.22) m/s,(1.30 ± 0.22) m/s,(1.36 ± 0.38) m/s,(1.47 ± 0.37)m/s and (1.87 ± 0.08) m/s,respectively.A significant difference was observed among them (P ＜0.001).There was a certain correlation between Vs and fibrosis stage(r =0.541,P ＜0.001).Vs was a significant predictor of stage ≥3 fibrosis with an area under the ROC curve of 0.812,sensitivity 73.2％ and specificity 81.4％ when 1.40 m/s was the cutoff value (P ＜ 0.001).Values of Vs with inflammation grade 0-3 was (1.17 ± 0.16)m/s,(1.43 ± 0.36) m/s,(1.59 ± 0.53) m/s and (1.89 ± 0.59) m/s,respectively,which were significantly different (P ＜ 0.001).A certain correlation was observed between Vs and inflammation grade(r =0.383,P ＜0.001).Values of Vs with steatosis grade 0-4 was (1.61 ±0.42) m/s,(1.47±0.58) m/s,(1.56 ± 0.71)m/s,1.13 m/s and (0.94 ± 0.95) m/s.Obvious difference didn't exist between Vs and steatosis grade (P =0.286).Obvious correlation wasn't observed between them,either (r =-0.177,P =0.080).Conclusions ARFI elastography has a certain value for the evaluation of liver fibrosis,while inflammation grade may affect its performance.

Objective To evaluate the application of dynamic magnetic resonance imaging in the diagnosis of female stress urinary incontinence(SUI). Methods Dynamic magnetic resonance imaging(DMRI)were performed on 30 healthy female volunteers and 35 female SUI patients.DMRI of the pelvic floor at rest and OR maximal strain were performed by using sagittal T2-weighted fast gradient sequences.The distance of Urethra-vesical junction to the pubococcygeal line,the posterior vesicourethral angle and angle of inclination of the urethral axis were measured at rest and on maximal strain position.The t-value exact test were used to analyze the data. Results At rest the Urethravesical junction laid above pubococcygeal line on both control and SUI groups.Mean distance from the Urethra-vesical junction to pubococcygeal line at rest had no difference between the two groups.On straining,the mean Urethra-vesical junction descent distance in the SUI group(-0.9±1.1cm)was significantly higher than in control group(-0.14±0.3 cm),(P＜0.001).On straining,the mean angle of urethral inclination in the SUI group(65±37°)was significantly bigger than in control groups (17±21°),(P＜0.05).The posterior vesicourethral angle in the SUI groups(156±36°)was significantly bigger than in control groups(113±28°),(P＜0.05). Conclusion Dynamic magnetic resonance imaging is a non-invasive.easily applied method in the diagnosis of SUI.

Aim To evaluate the effects of notoginsen-oside R1 on store-operated calcium entry ( SOCE ) in pulmonary arterial smooth muscle cells ( PASMCs ) of chronic hypoxia ( CH)-and monocrotaline ( MCT)-in-duced pulmonary hypertension ( PH) rats. Methods Mn2+ quenching of Fura-2 and measurement of intra-cellular free calcium concentration ( [ Ca2+] i ) using fluo-3 were examined in PASMCs of CH-exposed and MCT-treated rats. Results ①CH-exposed and MCT-treated rats exhibited profound PH when examined 3 weeks after hypoxia exposure or MCT injection, respec-tively. ②In the presence of 3 μmol·L-1 nifedipine, 10 μmol · L-1 notoginsenoside R1 significantly re-duced cyclopiazonic acid ( CPA )-induced the percent reduction in Fura-2 fluorescence measured 500 sec af-ter application of Mn2+, the maximal rate of Mn2+quenching, the amplitude of the Ca2+ influx transient and the resting [ Ca2+] i in PASMCs of CH-exposed and MCT-treated rats. Conclusion Notoginsenoside R1 inhibits SOCE and reduces resting [ Ca2+] i in PASMCs of CH-and MCT-induced PH rats.

Based on the conception analysis of the organizational change leadership of the upper-and mid-level nursing manager,this review described connovations of the organizational change leadership and its applications in nursing field at home and abroad,and pointed out the current research status,limitations and the inspirations we got,so as to provide references for promotion and evaluation of the upper-and midlevel nursing manager's organizational change leadership.

Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer. Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer.

Objective To explore the diagnostic value of virtual touch tissue quantification (VTQ) for the assessment of liver fibrosis in patients with chronic hepatitis B.Methods VTQ was prospectively performed in 181 patients with chronic hepatitis B and a shear wave velocity (Vs) indirectly reflecting liver stiffness was obtained for each patient.With the gold standards of fibrotic stages and inflammation grades,the relationship between Vs,fibrotic stages and inflammation grades was evaluated.Results A relatively high correlation existed between Vs and liver fibrotic stages (r ＝ 0.812,P ＜ 0.001).Significant differences existed among groups with different fibrotic stages except for groups SO vs.S1 and S1 vs.S2 (P ＜ 0.05).The areas under the ROC curve were 0.971,0.96l,0.969 and 0.908 for Vs predicting S≥S1,S≥S2,S≥S3 and S =S4 fibrosis respectively.Moderate correlation existed between Vs and inflammation grades (r =0.476,P =0.000).Conclusion Capable of staging liver fibrosis and preliminarily grading inflammation,VTQ is helpful for the early diagnosis of liver fibrosis and assessment of therapeutic follow-up and prognosis in patients with chronic hepatitis B.

In this paper, five different methods were carried out for DNA extraction directly from soil. The result shows that all five methods could generate DNA with more than 15 kb in size. They were subsequently used as templates for PCR amplification with success, using primers of the bacterial 16S rRNA gene and Shiva-1 gene encoding an antibacterial peptide. However, method 5 is more suitable for DNA extraction directly from a small amount of soil sample as it produced a good yield of DNA in high integrity with reliable reproducibility.

Selection and affinities of Cd binding peptides were assayed by phage random dodecapeptide library and affinity chromatography. Two Cd binding peptides were obtained, it was found that the affinities of Cu~ 2+ ,Co~ 2+ ,Zn~ 2+ ,Ni~ 2+ for Cd binding peptides were higher than that of Cd~ 2+ and Cr~ 2+ after detection of the amplified Cd binding peptides displayed phages to different heavy metal-charged resins; the detoxification of E.coli to Ni~ 2+ and Cd~ 2+ was enhanced when infected by Cd binding peptide displayed phages as compared with those of the control. The interaction of Cd binding peptide displayed phages with heavy metals charged resins was also observed under microscope. The work would be of great value and consequences for the study of interaction between heavy metals and proteins(peptides), as well as thedetoxification and bioremediation of heavy metals.