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.

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.

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

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.

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.

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 To investigate the efficacy of a modified duodenum-preserving pancreatic head resection (DPPHR) for the treatment of chronic pancreatitis.Methods The clinical data of 109 patients with chronic pancreatitis who received modified DPPHR at the Union Hospital of Huazhong University of Science and Technology from January 2004 to June 2013 were retrospectively analyzed.Of the 109 patients,66 were with mass in the head of the pancreas,29 were with calcification of the head of the pancreas,14 were with atrophy of the head of the pancreas and stones in the main pancreatic duct.The level of glucose of 56 patients were normal,34 patients had glucose tolerance abnormalities and 19 were complicated with diabetes mellitus.Modified DPPHR was carried out after confirming the diagnosis of chronic pancreatitis and excluding the malignancies by frozen pathological examination.The head of the pancreas was completely resected.The posterior pancreaticoduodenal aortic arch running parallel to the duodenum was preserved to guarantee the blood supply to the remaining duodenum.A thin sheet of the pancreatic tissue behind the intrapancreatic common bile duct and between the common bile duct and the duodenum was preserved to guarantee the blood supply to the common bile duct.The gastrointestinal tract was reconstructed with an anastomosis of the distal pancreas and the jejunum and an end-to-en anastomosis of the proximal jejunum and the distal jejunum.Patients were followed up via out-patient examination to learn the frequency of abdominal pain,analgesics usage and the endocrine function.The pain scale,life quality and endocrine function were evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30),Gastrointestinal Quality of Life Index (GLQI) questionnaire,and oral glucose tolerance test (OGTT),respectively.Patients were followed up till January 2014.The measurement data and the count data were analyzed using the t test and the chi-square test,respectively.Results No patients died during the operation.The operation time,volume of blood loss and blood transfusion were (3.5 ± 0.7) hours,(360 ± 125) mL and (260 ±220) mL,respectively.After the operation,5 patients were complicated with pancreatic leakage,5 with bile leakage,2 with duodenal fistula and 1 with peritoneal bleeding,and all the patients were cured after conservative treatment.Four patients were complicated with abdominal abscess,1 patient of whom was treated by conservative treatment,and the remaining 3 patients were cured by drainage guided by B sonography.The duration of hospital stay was 13.8 days (range,10.0-32.0 days).The median time of follow-up was 18.0 months (range,3.0-24.0 months).A total of 102 patients were followed up for more than 9 months.At postoperative month 9,the ratio of patients with abdominal pain was decreased from 78.90％ (86/109) to 18.63％ (19/102),and the ratio of patients administered analgesics was decreased from 76.47％ (78/102) to 12.75％ (13/102),with significant difference between the indexes before and after operation (x2=76.57,74.31,P ＜ 0.05).The score of the EORTC QLQ-C30 was decreased from 58 ±36 before operation to 15 ±4 after operation,with significant difference (t =11.39,P ＜ 0.05).The score of GLQI was increased from 69 ± 8 before operation to 87 ± 15 after operation,with significant difference (t =20.05,P ＜ 0.05).The patient with diabetes mellitus was cured,and no newly onset of diabetes was found.Two patients received reoperation because of recurrence of stones in the distal pancreatic duct and pancreatogenic portal hypertension.Conclusion Modified DPPHR is effective for the treatment of chronic pancreatitis with low incidence of postoperative complications.

Objective To evaluate the feasibility of transfection of Sonic hedgehog gene (SHH)into bone marrow mesenchymal stem cells(BMMSC).Methods After the SHH gene was transfected into BMMSC by electroporation apparatus,the transfection rate was evaluated by fluorescence inverted microscope.The growth curves of untransfected and transfected BMMSC were drawn,respectively,to observe the influence of transfection on cells.The expression of SHH gene in the BMMSC was detected by PCR,RT-PCR,Western-blot analyses.Results Through fluorescence inverted microscope,the observed transfection rate was appropriately 30％,PCR showed a obvious increase of SHH expression in transfected cells than that in untransfected cells,and it is quantified by qPCR for appropriately 7 times.Western-blot further demonstrated that the SHH protein expression in transfected cells had a distinct increase.However,it was observed that the exponential phase of BMMSCSHH growth curve delayed.The growth curves of both overlap 12 days after transfection.Conclusions This electroporation method can transfect exogenous SHH gene into BMMSC sufficiently with the effective protein expression in BMMSCSHH.It is the foundation of further research of genetic therapy for ischemic heart disease.

Objective To explore the change of serum osteopontin levels in preoperative and postoperative patients with non-small cell lung cancer (NSCLC) and its clinic significance.Methods The levels of serum osteopontin were detected by ELISA.Results In 88 NSCLC patients,serum osteopontin levels were significantly higher than in benign pulmonary disease and healthy control group(P＜0.05.P＜0.01.respectively) There was no difference between benign pulmonary disease and healthy control group(P＞0.05).Serum osteopontin levels were related to clinical stage and lymph node metastasis,and the levels of serum osteopontin were lower in postoperative patients than in preoperative cases(P＜0.05).For NSCLC.the detection of osteopontin had a sensitivity of 84.1%,a specificity of 92.5%,and an accuracy of 88.1%. Conclusion Increased serum levels of osteopontin may be useful as a helpful clinical biomarker to diagnose earlier,predict prognosis and differentiate from benign pulmonary disease.