Objective: To prevent the error of overcharging fees, missing fees and mistaken identity fees, check the inpatient expense rationality with using the self-developed software system. Methods:With extracting data from HIS and other systems, check and audit the inpatient expense, such as billing classification, red account records, logic checks, integrity checks, etc, according to pre-established rules. Results:Using the auditing software can greatly improve the work efficiency and the accuracy of inpatient expense, reduce the incidence of billing dispute issue. Conclusion:This system has valuable reference and be worth generalizing because it can bring the social benefit to hospital.

The purpose of this study was to found a three dimensional anatomical model of normal knees in Chinese and to carry out measurements of the relating parameters with this model. Three dimensional CT scan of 18 normal Chinese (36 knees) were acquired. All the cases were divided into three groups according to the height of each individual (156～165cm, 166～175cm, 176～185cm), with each group consisting of 6 individuals (12 knees). Data of the 6 ipsilateral knees were integrated to create a typical three dimensional anatomical model. Altogether 15 parameters including the linear and the angular indices were measured through this model. The results showed: (1) Most anatomical characteristics of the knee of typical Chinese population could be covered by the 3 D model we established; (2) There were stable positive relationships between different linear parameters and between the linear parameters and the body height; (3) The angular parameters were comparatively independent. This well developed 3 D model could provide a reliable method on the measurements of the knee geometry in Chinese people.

Based on the analysis of the existing medical service process,the paper takespatient centered as the ultimate objective,and transforms the health service process from the view of informatization including smart hospital,regional health and family health processes.The design includes the health service modes of smart hospital,family health and regional health sub-modules,and provides ideas for the achievement of wisdom medical in the future.

OBJECTIVE To investigate the antibiotic resistance status in clinical strains of Staphylococcus aureus (SAU) in Xiangfan and provide scientific evidence for reasonable use of antibiotics. METHODS Retrospective review was performed to analyzed the specimen source and the clinical distribution of 359 strains of SAU. BioMerieux Vitek 32 was used to identify the species of bacteria. Antibiotic susceptibility test was performed by K-B method and drug-resistance results were read according to CLSI2006. RESULTS Isolating rate of methicillin resistant S. aureus (MRSA) arrived at 54.9%. The results of susceptibility test showed that SAU had been resistant to the diverse antibiotics in different degree. The drug sensitivity rate of glycopeptide antibiotics and linezolid were all 100%. CONCLUSIONS The different grade hospitals should practically perform the management of antibiotics to postpone the resistance development and control outbreak and prevalence of nosocomial infections.

Objective To explore biological effects of up-regulated expression of transfected FOLR1 gene on SKOV3 cell lines following action by cisplatin(DDP).Methods Three groups of cells originated from the same SKOV3 cell line were used in this research,including the SKOV3 cell line (blank control),the cell line transfected with lentiviral pWPI plasmid (no-load control) and the cell line transfected with FOLR1 gene via lentiviral pWPI plasmid (experimental group).Next,the mRNA and protein expression of FOLR1 gene in the three groups were detected by reverse transcription (RT)-PCR and western blot,respectively.Methyl thiazolyl tetrazolium (MTT) assay was used to analysis cells growth curve and identify their sensitivity to cisplatin,and their half inhibition concentration (IC5o) values were calculated.Based on the IC50 value (3.6 μg/ml) in the experimental group,different levels of cisplatin concentration (0.5 × IC50,1 × IC50,2 × IC50,respectively) were administered to the three groups of cells,and the inhibition rates,apoptosis rates as well as apoptosis proportion of each group after 24,48,72 hours were further recorded.Finally,the residual cisplatin concentrations in the three group cells acted successively by 1 × IC50 cisplatin for 48 hours were measured by high performance liquid chromatography(HPLC).P value less than 0.05 were defined as statistically significant.Results RT-PCR and western blot detection showed that stable mRNA and protein expression of the FOLR1 gene in the experimental group while the other two groups were not.MTT assay demonstrated that higher cell growth rate,sensitivity to cisplatin(IC50 =3.6 μg/ml) and inhibition rate in the experimental group compared with those in the other two groups (P ＜ 0.05),which showed no significance in intergroup comparison(P ＞ 0.05).Flow cytometry showed apoptosis rates among three groups increased with higher cisplatin concentrations and longer action duration in dosage-time dependent manner (P ＜ 0.05),and the proportion of S phase cells increased with higher cisplatin concentration in dosage-dependent manner (P ＜ 0.05) ; for the same concentration and duration,the experimental group showed significantly different apoptosis rates and S phase cells compared with the other two groups,which demonstrated no significance in intergroup comparison (P ＞ 0.05).After action by cisplatin(3.6 μg/ml) for 48 hours,HPLC showed significantly higher residual cisplatin concentration (2.60±0.21) μg/106 cell counts in experimental group than those in no-load control group (1.49 ±0.12) μg/106 cell counts and blank control group (1.54 ± 0.11)xg/106 cell counts,respectively (P ＜0.05),and the comparison within the latter two groups showed no significance (P ＞ 0.05).Conclusion Up-regulated expression of the transfected FOLR1 gene in SKOV3 cells may be associated with higher sensitivity to cisplatin,residual cisplatin concentration and higher proportion of S phase cells,and tended to inhibit cancer cells growth and induce apoptosis.

AIM: To establish the method for determing four effective components in Qidan Capsules(total saponin of Radix et Rhizoma Notoginseng,total phenolic acids of Radix et Rhizoma Salviae Miltiorrhizae) by RPHPLC. METHODS: The contents of ginsenoside Rg1、ginsenoside Rb1,notoginsenoside R1 were simultaneously determined by an HPLC system with Lichrospher C18(150 mm ? 4. 6 mm,5 ?m). The mixture of acetonitrile and water was used as the mobile phase and the flow rate was 1. 0 mL/min. The detection wavelength was set at 203 nm. The content of salvianolic acid B was determined by an HPLC system with Lichrospher C18 (150 mm ? 4. 6 mm,5 ?m). The mobile phase was (formic acid-water)-(methanol-acetonitrile) = 62 ∶ 38. Formic acid-water (1 ∶ 59),Methanol-acetonitrile (30 ∶ 10),and the flow rate was 1. 0 mL/min and the detection wavelength was 286 nm. RESULTS: The linear ranges of notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1 and salvianolic acid B were 0. 472 1 - 2. 832 ?g(r = 0. 999 5),1. 734 - 10. 404 ?g (r = 0. 999 9),1. 732 - 10. 392 ?g (r = 0. 999 9),0. 4 - 4. 0 ?g (r = 0. 999 9) respectively. The average recoveries (n = 5) were 100. 32% ,99. 965% , 100. 285% and 101. 4% ,corresponding RSD were 1. 01% ,2. 53% ,2. 46% and 1. 88% respectively. CON-CLUSION: The results indicate that the HPLC method is simple,highly selective and reproducible; thus it can be used in the determination of the four components in Qidan Capsule.

AIM:To investigate the effects of N-acetylcysteine (NAC) on acute lung injury induced by H9N2 swine influenza virus ( SIV) in mice.METHODS: BALB/c mice were used to establish the animal model of acute lung injury by nasal inoculation of H9N2 SIV.The mice were divided into control group (without SIV infection), H9N2 SIV group (inoculation of H9N2 SIV) and NAC group (inoculation of H9N2 SIV plus pretreatment with NAC).The pulmonary edema was evaluated by determining the lung wet weight /dry weight ( W/D) ratio.The pathological changes of the lung tis-sues were observed .The concontrations of TNF-α, IL-1βand IL-6 in bronchoalveolar lavage fluid ( BALF) were meas-ured.The virus titer, T-SOD activity, MPO activity and MDA content in the homogenate of the lung tissues were detected . RESULTS:Treatment with NAC decreased the morality of infected mice , and significantly prolonged the survival time of infected mice .The pathological changes of the lung tissues , the lung W/D ratio and the lung index were relieved when SIV infected the mice treated with NAC .Treatment with NAC significantly decreased the infiltration of inflammatory cells inclu-ding macrophages, lymphocytes and neutrophils in the BALF .The levels of TNF-α, IL-6, IL-1βand MDA and the activity of MPO were also decreased.Treatment with NAC also significantly increased the T-SOD activity.CONCLUSION: The protective effect of NAC on the acute lung injury mouse model is related to suppression of the oxidative stress and inflamma -tory responses .

[ ABSTRACT] AIM:To investigate whether kaempferol protects against acute lung injury induced by swine -origin influenza A H9N2 virus via down-regulation of NF-κB signaling pathway .METHODS:BALB/c mice were used to estab-lish the animal model of acute lung injury by nasal inoculation of swine-origin influenza A H9N2 virus.After the interven-tion with kaempferol , the pulmonary edema was evaluated by determining the lung wet weight /dry weight ( W/D) ratio, the pathological changes of the lung tissues were observed , the concentrations of TNF-α, IL-1βand IL-6 in the bronchoalveolar lavage fluid (BALF) were measured, and superoxide dismutase (SOD) activity, myeloperoxidase (MPO) activity and MDA content in the homogenate of the lung tissues were detected .NF-κB P65 levels were determined by Western blot , and the NF-κB P65 and NF-κB P50 nuclear translocation in the nuclear extracts from mouse lung tissue homogenate was detec-ted by ELISA .RESULTS:Treatment with kaempferol decreased the morality of infected mice , and significantly prolonged the survival time of the infected mice .Kaempferol also relieved the pathological changes of the lung tissues , the lung W/D ratio and the lung index in swine-origin influenza A H9N2 virus-infected mice.Treatment with kaempferol significantly de-creased the infiltration of inflammatory cells including macrophages , lymphocytes and neutrophils in the BALF .The levels of TNF-α, IL-6, IL-1βand MDA and the activity of MPO were also decreased .Treatment with kaempferol also significantly increased the SOD activity .NF-κB P65 levels were decreased , and the NF-κB P65 and NF-κB P50 nuclear translocation in the nuclear extracts from the mouse lung tissue homogenate were also decreased by treatment with kaempferol .CONCLU-SION:The protective effect of kaempferol on the mice with acute lung injury induced by swine -origin influenza A H9N2 vi-rus is related to suppression of the oxidative stress and inflammatory responses by down-regulation of NF-κB signaling path-way.

Objective To evaluate the application of a self-designed handy body position scaffold in the fluoroscopy for lower limb surgery.Methods We reviewed the intraoperative X-ray films of 161 patients with lower limb fracture who had undergone intraoperative fluoroscopy using our self-made handy body position scaffold during surgery from October 2013 to May 2017.They were 105 males and 56 females,aged from 10 to 91 years (mean,39.7 years).There were 42 femoral fractures of middle or lower shaft,12 fractures of medial or lateral condyle or tibial plateau,96 tibiofibular fractures,7 ankle fractures and 4 foot fractures.The operation time,intraoperative fluoroscopy time,intraoperative bleeding,rate and time of fracture union,and complications were recorded.Results All the 161 patients completed intraoperative fluoroscopy and radiography uneventfully,indicating that the handy body position scaffold effectively maintained the body position of the affected ipsilateral lower limb.The body position scaffold was slightly deviated due to one overweight (121 kg) patient when the knee joint was flexed 90°,but the fluoroscopy and radiography was completed after adjustment of the C-arm roentgenographic machine.The operation time averaged 71.5 minutes (from 28 to 119 minutes),the X-ray exposure time 9.8 seconds (from 6 to 31 seconds),and the intraoperative bleeding 157.2 mL (from 80 to 500 mL).The 161 patients obtained follow-up for 5 to 22 months (average,14.1 months).The rate of primary union was 97.5％ (157/161).The time for fracture union averaged 8.8 weeks (from 4 to 17 weeks).Fracture nonunion occurred in one case,and delayed union in 3 cases.The final follow-ups revealed normal functional recovery of the affected knees and ankles,but no limb shortening,or no rotational,lateral or anteroposterior angulation deformity.Conclusion In the lower limb surgery,the intraoperative fluoroscopy can be completed better with the aid of our self-designed handy body position scaffold that prevents movement of the affected lower limb and lowers the risk of radiation exposure.

OBJECTIVETo analyze the angiographic features and factors related to the blood supply from right inferior phrenic artery (RIPA) branches in hepatocellular carcinoma (HCC).

METHODSAngiography images of blood supply from RIPA branches and clinical data from patients with HCC who had undergone tmnscatheter arterial chemoembolization in our hospital between 2009 and 2013 were collected for retrospective analysis. Angiographic features of the RIPA branches were assessed for correlation between treatment number, growth pattern, size, tumor location, and rates of blood supplying RIPA branches. Statistical analyses were carried out using chi-square test, t-test, Fisher's exact test and rank sum test.

RESULTSThe 140 patients included in the analysis were grouped according to primary HCC (n=63; group A) and recurrent HCC (n=77; group B) and no statistically significant differences were found between the two groups for incidence of each nutrient branch or total number of nutrient branches. In group A, tumor size was associated with number of nutrient branches (P=0.047). There were 32 cases with HCC lesions in the bare area of the liver, and among those 26 of the cases were supplied by the posterior branch of RIPA. Each branch of RIPA showed greater firequency for particular blood supply areas; the anterior branch (n=55) and lateral branch (n=98) fed tumor lesions in segments 7 and 8, the posterior branch (n=98) fed tumor lesions in segments 6 and 7, and the supra-renal branch (n=10) fed tumor lesions in segment 6. The diaphragmatic branch always fed HCC partly located in segments 4 and 8 (n=17). Unique features were present on the digitally subtracted angiography (DSA) image for each nutrient branch and may be useful for distinguishing in clinical examination.

CONCLUSIONCases of primary HCC and recurrent HCC are not distinguishable by incidence of each nutrient branch or total numbers of the nutrient branches. However, tumor size is related to the number of RIPA nutrient branches, and each RIPA nutrient branch shows a dominant preference for certain blood supply areas, with unique features on DSA.