Objective To investigate the profit-loss of the hospital's DRGs pilot and its reasons.Methods An investigation of the profit-loss situation of 9 225 cases of a hospital in Beijing,who have been discharged from December 2011 to December 2013 and grouped into 105 DRG pilot groups.Results As shown in the medical records of 9 225 cases,96.54％ are covered by urban employee basic medical insurance,and 3.46％ by urban residents' medical insurance; 78 DRGs groups were recorded as with profit(74.29 ％),while 27 recorded as with a loss(25.71％) ;average length of stay as 9.37 days,average expense per hospitalization per person as 18 032.27 yuan,average quota standard as 17 337.53 yuan,average out-of-pocket cost as 829.47 yuan,average second charge as 2 448.57 yuan,average profit as 2 583.29 yuan,average sum of out-of-pocket payment ratio and second charge ratio as 12.46％.Conclusion The current DRGs pilot model shows the hospital as profit making in general,with no significant impact on the hospital.

Adrenergic beta-Antagonists ; therapeutic use ; Genomics

Blood Pressure ; physiology ; Humans ; Peptidyl-Dipeptidase A

0.05). Conclusions Transcatheter arterial thermochemoembolization combined with hepatic arterial infusion of Tween-80 is an effective and safe method in treating metastatic hepatic carcinoma.

Objective To investigate the dynamic change of T-lymphocyte subsets in the patients of liver cancer treated with intra-arterial hyperthermia chemoembolization (IHCE). Methods Sixteen patients of hepatic cancer were treated with IHCE. One or two weeks before and after the procedure, the blood samples were collected for evaluation of the peripheral blood T-lymphocyte subsets using flow cytometry in 16 cases. The results were compared with those of other 18 patients received routine transcatheter arterial chemoembolization (TACE) during the same period. Results The cases of IHCE group showed that the proportion of CD4 cells was increased and that of CD8 cell was decreased after 2 weeks of the treatment, so that the ratio of CD4 to CD8 was obviously higher than that of the control group (P=0.01). Conclusion The hyperthermia effect of IHCE can further enhance immune function of the patients with liver cancer.

ObjectiveTo observe the curative effect of sensory integration training on children with attention deficit hyperactivity disorder (ADHD).Methods60 ADHD children were randomly divided into trial group and control group with 30 cases in each group. Children in trial group were treated with sensory integration training besides routine medication, and assessed with Scale for Assessment of Attention Sensory Integration after treatment.ResultsAfter treatment, scores of large muscle dis-equilibrium and ill-proprioception increased obviously (P<0.01) ; scores of improper tactile defense and insufficient development of learning ability also increased (P<0.05) compared with pretreatment. The curative effect of trial group was better than that of control group (P<0.05 ).ConclusionOn the basis of medication, sensory integration training can improve the rehabilitation effect of ADHD children.

Objective To compare the control effect on postoperative GER disease between tubular EC stomach esophagus anastomosis and the traditional full stomach esophagus anastomosis.Methods From September 2010 to October 2015 in Bozhou People's Hospital,85 patients diagnosed with esophageal cancer undergoing elective resection were randomly divided into a tubular stomach EC group (45 cases) and total gastrectomy group (40 cases),two patients underwent esophageal resection,wherein the tubular stomach set of rows of tubular esophagus stomach anastomosis,total gastrectomy group underwent conventional full stomach esophagus anastomosis.After the surgery until the patient to return to normal gastrointestinal function uses dynamic monitor its pH 24h esophageal pH monitoring chamber,the other respectively after 1 March using RDQ Scale GER-related symptoms in patients with score,at the same time Statistics after 1 March of the occurrence of GER.Results There were no deaths occurred,and no occurrence of postoperative anastomotic fistula and thoracic gastric emptying dysfunction,etc;the two groups were almost reached full monitoring 24 h,and between groups while monitoring the total time,Li position monitoring time,there was no significant supine monitoring time (P＞0.05);24 h reflux episodes long tubular gastric reflux group and significantly less than the number of total gastrectomy group,the longest duration of reflux and pH value ＜4.00 The cumulative time was significantly shorter in total gastrectomy group,DeMeester scores were significantly lower than the total gastrectomy group,between groups were statistically significant (P＜0.01);postoperative gastric tube 1,March RDQ score and incidence of GER significantly lower than the total gastrectomy group,between groups were statistically significant (P＜0.01 or P＜0.05).Conclusion Tubular stomach esophagus anastomosis compared with conventional full stomach esophagus anastomosis resection of esophageal cancer has a more ideal GER disease control effect,and can provide a reference for the choice of nastomosis ways for patients with esophageal cancer surgery.

Objective To discuss the less invasive stabilization system(LISS)in treatment of fractures around the knee joint.Methods Between February 2002 and December 2005,103 cases of periarticular fractures of knee joint were treated with LISS in our department.There were 58 cases of comminuted distal femoral fracture and 45 cases of comminuted proximal tibia fracture.Follow-ups were conducted once per week during the first four weeks and once per month in the following months to observe whether such complications as loosening of internal fixators and nail breakage would occur.Results All the cases were followed up for a mean time of 16.5 months(range, 6 to 27 months).Loosening and breakage of internal fixation was found in only one case,while others obtained bony union.In fractures of types A and C,the knee range of motion varied from 95?to 145?(average,130?)and 85?to 140?(average,110?)in flexion respectively.HSS score:excellent in 84 cases(81.6%),good in 15 cases (14.6%),fair in three cases(2.9%),and poor in one case(0.9%).Conclusions The LISS can be the best choice for the treatment of periarticular fractures around the knee joint,but we should take care to implant the plate and screws in a proper position and direction and avoid early weight-bearing.In application of the 13-hole plate, large incision should be made to approach the distal tibia for fear of damaging the superficial peroneal nerve.

BACKGROUND: Metal-on-metal hip surface arthroplasty has improved the abradability for hip joint prosthesis and has the characteristics of normal biological stress transfer.OBJECTIVE: To observe the long-term state of hip-joint function of patients who underwent metal-on-metal hip surface arthroplasty.DESIGN: Follow-up study for cases.SETTING: Department of Orthopaedics, Jiangsu Provincial Corps Hospital of the Chinese People's Armed Police Force; Department of Orthopaedics, Affiliated Hospital of Nantong University.PARTICIPANTS: Eighteen cases (23 hips) who underwent a metal-on-metal hip surface arthroplastyprocedure in the Department of Orthopaedics, Jiangsu Provincial Corps Hospital of the Chinese People's Armed Police Force, and Department of Orthopaedics, Affiliated Hospital of Nantong University between September 2004 and July 2005 were recruited in this study. All cases, aged 28 to 54 years, include 11 males and 7 females. According to the classification of etiology, there were 13 cases of osteonecrosis(16 hips),3 cases of osteoarthritis( 4 hips ),1 case of congenital hip dysplasia (2 hips) and 1 case of posterior trauma arthritis(1 hip ). All cases applied the Conserve Plus resurfacing prosthesis (manufactured by Wright Medical Technology, USA), of which the pattern number of acetabular cup (press-fit depth: 1-2 mm) ranged from 38 mm to 56 mm in the inner diameter and from 44 mm to 62 mm in the outer diameter and that of femoral head cup ranged from 38 mm to 56 mm in the outer diameter. Preoperatively all patients signed the informed consent for the surgery, and the application of this technique also gave the approval of the Ethics Committee of the hospital.METHODS: ①After the epidural and lumbar combination anesthesia was satisfactory, the coxacava was exposed at first and the suitable size acetabular cup coated by hydroxyapatite ceramic was selected to be implanted, to be tightened and to be fixed by press-fit referring to the anatomical position. Subsequently to install the femoral head prosthesis, femoral cup was laid on the ready caput femoris and impacted by the presser to make the metal cup paste close-up with sclerotin when the concocted bone cement was overlaid on the prefabricated caput femoris surface and internal surface of prosthesis. Further, short-term of femoral cup should be kept the conformity with axial ray of the femoral neck. ②Patients were allowed to make the function exercise such as initiative stretch and contract of quadriceps muscle of thigh, passive motion of the knee joint and initiative motion of the knee joint under the non-weight loading on bed. Then they were encouraged to walk with two walking sticks two weeks after operation, progressing to get out of the two walking sticks six weeks postoperatively. All affected extremities were fixated with T-shaped tabula shoes in the abduction position after operation. ③All patients were reviewed with taking the anteroposterior radiographs of pelvis, evaluation of the clinically curative effect on the procedure of metal-on-metal hip surface arthroplasty and biocompatibility between the prosthesis and the host one year and two years after operation. Moreover, Harris score was assessed for all affected hips preoperatively, one year and two years postoperatively.MAIN OUTCOME MEASURES: ①The clinically curative effect on metal on metal hip surface arthroplasty; ②Biocompatibility;③The Harris score for the affected hips; ④The pain status of hip after operation.RESULTS: Eighteen cases were all brought into the outcome analysis at last.①The curative effect on the metal-on-metal hip surface arthroplasty: The femoral component of one case had a varus deformation of 10°six weeks after operation, but such complications as component loosening and femoral neck fractures, etc. Did not occur during the coming follow-up. The locations of rest prosthesis were satisfactory. Substantial radiolucencies were found at the rim of acetabular component (1 and 2 zone) in two hips, respectively one and two years after operation. But there was no evidence of radiolucencies around the short-stem of femoral component.②Biocompatibility: No patients were found to have obvious reactions including renal toxicity, pyretogen and rejection. No radiograph showed signs of loosening, dislocation, heterotopic bone formation, femoral neck narrowing, femoral head necrosis and prosthesis fixation failure, etc.③Harris score for the affected hips: The Harris score of all disease hips was improved from the mean 46 preoperatively to 85 one year after operation to 93 two years postoperatively. Of these,15 hips were excellent(> 90),6 hips good (80-89), and 2 hips fair(70–79).④The pain status of hip after operation: Two patients complained of slight pain, one patient of moderate pain, and no cases of severe pain happened.CONCLUSION: The long-term outcome for hip disease patients who undergo metal-on-metal hip surface arthroplasty is satisfactory.

Objective To ev aluate clinical results of selective anterior corpectomy combined with segmental discectomv and fusion for multilevel cervical myelopathv andits related factors.Methods Twenty-five patients of multilevel cervical myelopathv with 3 or 4 consecutive segments were treated with selective anterior corpectomy combinedwith segmental discectomy and fusion.The clinical results were evaluated by the parameters including improvement of Japanese Orthopaedic Association (JOA)score postoperatively,fusion rate,and the degree of spinal canal decompression and range of motion of the cervical spine.Results JOA score were improved from 9.5±1.3 pre-operatively to 13.8±0.8(P＜0.01)6 months post operation and 1 3.6±0.9(P＜0.05)atthe final follow-up.Bony fusion was verified by X-ray and 3D-CT scan 1 2 months post operation and final follow-up.Moreover,the degree of decompression of the spinal canal was also remarkable.The range of motion of the cervical spine after operation decreased significantly(P＜0.05).Conclusion Selective anterior corpectomy combined with segmental discectomy and fusion was an alternative choice for the surgical treatment of multilevel cervical myelopathy.