Objective:To explore grouping methods of subdividing adjacent diagnosis related groups(DRGs) by introducing patient clinical complexity level(PCCL) principle and provide references for exploring DRG grouping method in line with context in China.Methods:Clinical complexity level of each complication was assigned by clinicians.PCCL model was selected to calculate the scores of clinical complexity cases.Each adjacent DRG was subdivided into DRG groups by classification and regression trees(CART) model.The rank-sum test was applied to test the statistical significances of the grouping results.Results:9 surgical adjacent DRGs were subdivided into 18 DRG groups.There were statistical significances in the differences of hospitalization expenses and length of stay among different DRG groups in each adjacent group.Conclusion:PCCL model showed high performance in DRG subdivision.The unification of the quality of medical records and coding were the key factors to ensure the reasonable grouping results.

OBJECTIVE: To research the effect and mechanism of ethyl acetate extract from Kadsura longipedunculata Finet et Gagnep. METHODS: The 70 SD male rats were randomly divided into 7 groups: normal control group, model group, tripterginum glycosides(TG) group, dexamethasone(DXM) group, ethyl acetate extract from Kadsura longipedunculata Finet et Gagnep. low, medium and high dosage groups(0.063, 0.126, 0.252 g·kg-1·d-1), the CIA(collagen induced arthritis) model of rats was adopted. Under 28 days intragastric administration, the rats' state, weight, degree of paw swelling, arthritis index and pathological changes of ankle joints were observed. Their serologic contents of interleukin 1β(IL-1β), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α) were examined by means of ELISA, and the expression of NF-κB p65 mRNA in joint synovial tissues were tested via quantitative Real-time PCR method. RESULTS: The ethyl acetate extract from Kadsura longipedunculata Finet et Gagnep. is found obviously effective in inhibiting CIA rats' paw swelling, decreasing serologic content of IL-1β, IL-6, and TNF-α, as well as the expression of NF-κB p65 mRNA in synovial tissues.Its effect is dosage-related, and stronger than that of TG, weaker than that of DXM. CONCLUSION: Kadsura longipedunculata Finet et Gagnep. is, to some extent, effective against RA, the mechanism of which is related to the transcription of NF-κB p65.

To bring up teaching quality of health service management and students' integrated ability,the author advanced his thoughts and opinions for teaching reform in teaching contents,teaching methods,examination modes and teachers ability based on the characteristics of health service management and combined with teaching practice.

Objective To observe the effect of Ningxia aqueous extracts of fruitless lycium sprout (AEFLS) on cardiomyo cyte antioxidation and apoptosis-related protein expression in aging mice.Methods The natural aging C57BL/6J mice with 13 months old were randomly divided into aged control group,AEFLS low dose group (AEFLS1),AEFLS middle dose group (AEFLS2)and AEFLS high dose group(AEFLS3).The AEFLS1,AEFLS2 and AEFLS3 groups were respectively given with 5,10,20 mg/kg AEFLS gavage,while the aged control group was given with the normal saline gavage,for continuous8 weeks.The xan thine oxidase assay and thiobarbituric acid method were used for the determination of SOD and MDA in heart tissues.Western-blot and immunohistochemical method were used to detect the expressions of Bcl-2,Bax and Capase-3 in heart tissue.Results Compared with the aged control group,the MDA level in the AEFLS2 and AEFLS3 groups was decreased,while the SOD activity was increased,the difference was statistically significant (P＜0.01).The Western-blot result showed that compared with the aged control group,the optical density value of Bcl-2 in the AEFLS2 and AEFLS3 groups was increased,but the optical density values of Bax and Capase-3 were decreased (P＜0.01);the immunohistochemical results showed that compared with the aged control group,the immunopositive(IP) expressions of Bcl-2 protein in heart tissues in the AEFLS2 and AEFLS3 groups were increased (P＜0.01),while the IP expressions of Bax and Capase-3 were decreased (P＜0.01).Conclusion Middle and high doses of AEFLS can increase the antioxidative ability of myocardial tissue,up-regulates the Bcl-2 expression,down-regulates the Bax and Capase-3 expressions and plays anti-cardiomyocyte apoptotic role.

No abstract available.
Angiotensin II* ; Angiotensins* ; Hydrocortisone* ; Insulin*

Objective To investigate the clinical features and prognostic factors in children with idi-opathic pulmonary arterial hypertension(IPAH). Methods The data of children with IPAH diagnosed in Beijing Children′s Hospital from January 2006 to December 2015 were collected. The cases were divided into survival group and death group according to the prognosis. The risk factors influencing prognosis in children with IPAH were identified by Logistic regression analysis. Results Total 26 patients were enrolled in this study,and 17 of them survived and 9 of them were dead. IPAH was found to be more common in school-age children. The average age of the patients was(6. 6 ± 3. 6)years and the male to female ratio was 1. 17∶1. All of the children had the symptoms with decreased activity tolerance and fatigue. The incidence of syncope and dyspnea and edema of lower extremity were 34. 6%,23. 1%. Accentuated pulmonic second sound(P2) was detected in 92. 3% of patients during physical examination, which was also the most common sign. About 50. 0% patients were functional class Ⅲ-Ⅳ. Echocardiography showed that all childrens′ mean pulmonary artery systolic pressure(PASP) was(79. 0 ± 20. 3) mmHg(1 mmHg=0. 133 kPa) and 16 of them with right ventricular dilatation. Electrocardiogram with ST-T changes and right ventricular high voltage were common. The average plasma level of brain natriuretic peptide(BNP) in all cases was(870. 4 ± 720. 9) pg/ml. The single factor analysis illustrated that syncope(OR=26. 25,95%CI 3. 04 -226. 60,P=0. 003),heart func-tional class Ⅲ-Ⅳ(OR=19. 199,95%CI 1. 88 -196. 53, P=0. 0128), PASP≥70 mmHg(OR =9. 936, 95%CI 1. 81-∞,P=0. 005),BNP≥850 pg/ml(OR=59. 991,95%CI 4. 69-767. 62,P=0. 002) indica-ted the worse outcome. Conclusion IPAH in children is rare and the prognosis is poor. Syncope, cardiac function grade,PASP and the levels of BNP are the main important factors affecting the prognosis of children with IPAH. BNP has important clinical significance for the evaluation of IPAH and the prognosis of the disease.

ObjectiveTo evaluate the safety and superiority of dressings and bandage compression method for patients after percutaneous coronary intervention through femoral artery.MethodsA total of 648 patients who received percutaneous coronary intervention through femoral artery were randomly divided into three groups: the modified group (224 cases), the routine group (213 cases) and the haemostat group (211 cases), they each adopted modified dressings and bandage compression method, the traditional oppression hemostatic method, and arterial oppression with hemostat method. The unarmed oppression time, expenditure, braking time, and complications were observed and analyzed statistically.ResultsThere was no significant difference in braking time and local vascular complications of the three groups. Compared with the routine group, the modified group reduced the unarmed oppression time and the medical staffs workload; compared with the hemostat group, it reduced the expenditure.ConclusionsImproved dressings and bandage compression method can reduce the unarmed oppression time and expenditure, it is an ideal local hemostasis method for patients undergoing percutaneous coronary intervention through femoral artery, and is worthy of clinical application.

OBJECTIVETo consummate the standard of macroscopic syndrome differentiation for diagnosis of dampness syndrome in patients with chronic gastritis (CG), based on the essentials of syndrome differentiation in TCM diagnostics and combined with the multivariant mathematical statistic method. And try to find out the methods and approaches for establishing standard for TCM syndrome differentiation.

METHODSClinical investigation on CG patients was carried out adopting clinical epidemiological method.

RESULTSThe meaningful symptoms for making diagnosis of Pi-Wei damp-heat syndrome in frequency order, were red tongue with yellow and greasy fur, sticky and greasy sensation in mouth, brown urine, constipation, dry stool, flushed face and ponderous extremities. Those for Pi deficiency with damp retention syndrome were swollen tongue with teeth-print, greasy fur, sticky and greasy sensation in mouth, tastelessness, and poor appetite.

CONCLUSIONBy combining the integrative medical theory with multivariant statistic method, the meaningful essentials for diagnosis of dampness syndrome can be screened out.

Adult ; Chronic Disease ; Diagnosis, Differential ; Female ; Gastritis ; diagnosis ; Humans ; Logistic Models ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Reference Standards

As the dominant antigens, early secreted antigenic target 6 (ESAT6, E6) and culture filtrate protein 10 (CFP10, C10) had once been the focus of tuberculosis (TB) vaccine due to their capability of inducing strong cell immune response in the host. They are also endowed with promising future of prevention against and diagnosis of TB. In this review, we systematically introduce recent research progress of E6 and C10, especially in structure-function, biological characteristics, protein expression and secretion, host immunity and vaccine development, and the prospects of their application are also discussed.
Antigens, Bacterial ; chemistry ; genetics ; immunology ; Bacterial Proteins ; chemistry ; genetics ; immunology ; Humans ; Immunodominant Epitopes ; immunology ; Molecular Biology ; Peptide Fragments ; chemistry ; genetics ; immunology ; Tuberculosis Vaccines ; genetics ; immunology ; Vaccines, DNA ; immunology

Objective To evaluate the follow-up results of patients with cervical intraepithelial neoplasia Ⅲ(CIN Ⅲ)after surgical treatment.Methods A retrospective analysis of consecutive patients with CIN Ⅲ after surgical treatment between Jan 1st,1999 and Jun 30 th,2004 was performed.The follow- ups of the patients after surgical treatment were assessed.Results In the follow-up of patients with CINⅢ after surgical treatment,the rate of abnormal cytology was 9.3%.The rate of follow-up was higher in patients with cervical conization than in patients with initial hysterectomy and in patients of the oncological group than of the non-oncological group.The rate of follow-up was lower in patients over 40 years old.There was no difference in the residential areas of the patients.Conclusions Cytological follow-up of patients with CINⅢ after operation is varied.The rate of follow-up is lower in patients over 40 years old,in patients having initial hysterectomy and in patients of the non-oncological group.The rate of follow-up is associated with the knowledge about CIN of both surgeons and patients.