Objective Probing into the rationale of DRGs payment standards for references to making DRGs payment standards.Methods Based on the DRGs grouping results of circulatory diseases cases admitted by a tertiary hospital from 2003 to 2005,two typical combinations were selected to determine the payment standard for each DRGs combination.Unnecessary medical expenses were excluded.Results According to the percentage of unnecessary medical expenses,Angina,non-special nursing,and class 1 nursing were in a group,with unnecessary medical expenses per ease of 758.00 yuan;CAG,single stent implantation,acute myocardial infaction as the main diagnose were in a group,with medical expenses per case of 2814.03 yuan;such expenses account for 6.20% of the total hospitalization expenses of both groups.Conclusions If the average expenses with unnecessary medical expenses excluded are set as the combined payment standard,hospitals will be restrained from unnecessary medical behaviors and expenses so incurred.

Equipment department plays an important role in medical consumables management. Institutionalized management and practical medical consumable purchase are key to medical consumables management.

Transpedicular screw and rod internal fixation system is the common implants in spinal surgery. Multi-slice spiral CT and magnetic resonance imaging can generate section image, become routine imaging modality in the assessment of the postoperative spinal patients. Magnetic resonance imaging can evaluate the bone marrow and soft tissue, which is the first choice for examination. However, to the patients with metal implants, the existed metal artifacts can decrease the imaging quality. Therefore, multi-slice spiral CT is an important evaluation method for inserted material, os integumentale and anatomy. This article reviewed the production mechanism of metal-related artifacts, influencing factors and decreasing technique.

Object to define defects of drug accurately and to initially discuss its law responsibility. Method With comparative study and system thinking,we acquired few scientific recognition of drug’s defects. Result & Conclusion Defects of drug are not equal to negative drug reaction. The former one should be an unreasonable and potential risk which induces no expectant therapeutic efficacy to provide. And its law responsibility could be no-fault liability accompanied by state compensation.

OBJECTIVE:To establish the gas chromatography (GC) fingerprint for the petroleum ether part of Areca peel and provide reference for the quality evaluation. METHODS:GC was conducted to establish the fingerprint for the petroleum ether part of Areca peel from 10 different areas,the cluster analysis and similarity of fingerprint data were conducted to study the similarity of GC fingerprint of Areca peel. RESULTS:There were totally 8 common peaks. All the medicine materials had the characteristics,but there were differences among the relative peak area. CONCLUSIONS:The GC fingerprint has high importance and precision and can be used for the quality control of Areca peel.

AIM: To establish the quality standard for Yanqingsong Granule (Radix P uerariae, Rhizoma Chuanxiong, Radix Paeoniae Alba, Radix Angelicae Dahuricae, et c.). METHODS: Radix Puerariae; Rhizoma Chuanxio ng; Radix Paeoniae Alba; Radix Angelicae Dahuricae. in Yanqingsong Granule were identified by TLC, and the content of puerarin was determined by HPLC. RESULTS: Radix Puerariae; Rhizoma Chuanxio ng; Radix Paeoniae Alba; Radix Angelicae Dahuricae could be identified by TLC. P uerarin showed a good linear relationship at a ran ge of 0.1716～0.8580?g,r=0.9999. The average recovery was 97.49% (RSD= 1.77% and n=6). CONCLUSION: The methods are available with a reproducibility and ca n control the quality of this granule effectively.

Objective The aim of this study is to address learning curve and clinical outcomes of totally robotic atrial septal defect repair on the basis of a single - center experience.Methods 54 cases of atrial septal defect (ASD) were repaired using “da Vinic S surgical system on arrested ( group Ⅰ,54 cases) or beating heart ( group Ⅱ,40 cases) from January 2007 to December 2010.Learning curves were assessed by means of regression analysis with logarithmic curve fit.The effect of operative variables on clinical outcome was analyzed by linear by regression using the Spearman's rho coefficient.Results All cases were accomplished successfully without complications.No residual shunt was detected at intraoperative or postoperative echocardiography.Significant learning curves were noted for corss clamp time in group Ⅰ:y (min) =68.741 -8.283 (n) (x)( r2 =0.489 ; P ＜ 0.01 ) ; the operation time in group Ⅱ:y (min) =355.51 - 56.29 (n) (x) ( r2 =0.581 ; P ＜ 0.01 ).No correlation was detected between operation time,cardiopulmonary bypass time,or cross clamp time and intubation time,intensive care unit stay,or total length of stay.Conclusion The robotic atrial septal defect repair can be performed safely.The learning curves is steep and the longer cardiopulmonary bypass times,operation time or cross clamp time had no negative impact on intraoperative and postoperative outcome.

Objective:To study the effect of portal vein occlusion on intestinal mucosal barrier in rats and the protection of ulinastatin to the injury,to present the experimental data for the clinical surgery.Methods:70 Sprague-Dawley rats were randomly divided into controlled group (n=10),operation group (n=30) and operation+medication group (n=30).The portal vein were occlused 40 min in the operation groups and operation+medication groups.2ml blood from portal vein,lymph nodes around appendix,1cm small intestine wall were taken for endotoxin levels,bacterial translocation and pathiology examinations in the all rats 280 mins after operation.The mocusal barrier and microscopic structure of intestine were observed.Results:Compared between the control group and the operation group,endotoxin levels,bacterial translocation rates rise greatly and gut structure change obviously in the latter.Compared between the operation group and operation+medication group,the former changes is also obvious.Conclusion:The occlusion of portal vein can leads the decrease of intestine mocusal barrier and the increase of its permeability.Ulinastatin has a good protective effect on the damages above.

Objective To study CT features of thymoma,so that to improve the accuracy of CT diagnosis and differential diagnosis.Methods 31 cases of thymomas proved by surgery and pathology were examined with conventional CT scans.CT findings of thymoma were analyzed.Results The lesions in 27 cases(87.1%)were located in the anterior upper and middle mediastinum.There were benign lesion in 11,including mass-cardiovascular interface(MCI) with convex type(8 cases),flatness type(1 cases) and concave type(2 cases).20 cases were malignant lesion,including MCI with cast type(18 cases) and concave type(2 cases).Irregular invasion to adjacent organs was found in 11 cases,others included pericardiac effusion(n=6),pericardial and mediastinal invasion(n=2),pleural effusion(n=4),pneumonia(n=2),lung,bone,mediastinal lymphadens metastasis(n=2) and liver,pancreas metastasis(n=1).Conclusion CT scans is of significant value in diagnosis and differential diagnosis of thymoma.

OBJECTIVE:To improve information management of hospital infections.METHODS:The hospital infection monitoring and management software developed by the hospital where the authors work was applied to monitor the risk factors of hospital infections at real time and selectively.RESULTS:The software could be applied to investigate the situation of antibacterial use in hospital,evaluate the rationality of drug action,monitor the incidence of hospital infections,and analyze the risk factors of hospital infections.CONCLUSIONS:The hospital infection monitoring and management software is con-venient and easy to operate,which can enhance the efficiency and effect of the management of hospital infection.