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.

OBJECTIVE To learn the condition of nosocomial infection in our hospital,and enforce the prevention and therapy of nosocomial infection.METHODS A total of 8413 inpatients of our hospital in 2006 monitored prospectively and investigated retrospectively.RESULTS A total of 188 patients suffered from nosocomial infection.The rate of infection was 2.23%.The sites of infection were mainly in respiratory tract(30.30%),skin soft tissue(28.79%),gastrointestinal trackt(14.14%) and operative infection(10.10%).The pathogenic bacteria of hospital infection were mainly G+ bacteria(58.14%).CONCLUSIONS Analyzing the risk factors of nosocomial infection,monitoring the pathogens,aseptic manipulation,strictly proper antibiotics usage,and protecting the susceptible population in hospital,all the measures are effective to reduce nosocomial infection.

Objective To analyze the clinical effect of intravascular intervention for treating the severe stenosis of bilateral renal arteries (BRASS).Methods A total of 40 patients with BRASS admitted in Fuwai Hospital from September 2008 to December 2010 were retrospectively analyzed.These patients,23 males and 17 females,aged from 21 to 76 years with average age of (59.75 ± 17.59) years,with luminal narrowing over 70％ in bilateral renal arteries,met the criteria of BRASS evidenced by angiography of renal arteries,and were subjected to renal artery interventional therapy. The etiological factors included arteriosclerosis (34 cases),Takayasu arteritis (3 cases) and congenital fibromuscular dysplasia (3 cases).After percutaneous endovascular intervention,the therapeutic effects were evaluated by lowering the systemic blood pressure and serum creatinine level in 12-month follow-up in average after operation. The data were analyzed with SPSS 13.0 statistical software.ResultsAmong the 80 reual arteries in 40 patients,18 arteries were treated with percutaneous transluminal balloon angioplasty (PTBA),while the other 62 arteries were treated with percutaneous transluminal renal artery stenting (PTRAS).Mter endovascular intervention,the mean systolic blood pressure decreased from ( 165.0 ± 27.0) mm Hg to ( 135.7 ± 25.3 ) mm Hg on the second day after operation ( P ＜ 0.01 ) ; and the mean diastolic blood pressure decreased from ( 88.9 ±15.1 ) mm Hg to (74.8 ± 13.2) mm Hg on the second day after operation ( P ＜ 0.01 ).Accordingly,the kinds of anti-hypertension drug used decreased from ( 3.1 ± 0.9 ) to ( 2.3 ± 1.2) ( P ＜ 0.01 ).Only one patient died suddenly 3 months after intervention,and one died of acute myocardial infarction 7 months after operation.The other 38 patients were followed up for 12 months.At last,the mean systolic blood pressure of patients decreased from ( 165.0 ±27.0) mm Hg to ( 133.53 ± 15.94) mm Hg and the mean diastolic blood pressure decreased from (88.9 ± 15.1 ) mm Hg to (77.37 ± 13.47 )mm Hg. Of all 38 patients,2 were cured (5.3％),27 were improved (71.1％) and 9 failed to treatment (23.7％).Of all 38 patients,76.4％ got hypertension lowered.Moreover,renal function (Scr) was improved in 2 patients (6.3％ ),steady in 21 patients ( 65.6％ ),declined in 9 patients ( 28.1％ ) resulted in azotemia stage.Of 38 patients,71.9％ patients got overall benefit from endovascular intervention in respect of renal function improved.Conclusions The procedure of PTBA or PTRAS offered a minimally invasive,relatively safe and effective technique for BRASS patients to decrease blood pressure and stabilize renal function.

Afferent Pathways ; anatomy & histology ; Animals ; Female ; Ganglia, Spinal ; anatomy & histology ; Neurons, Afferent ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; innervation

OBJECTIVE To learn the condition of nosocomial infection of lower respiratory tract,so as to take effective measures to prevent and control it. METHODS A total of 10351 inpatients of our hospital from Mar 2007 to Mar 2008 were monitored prospectively and investigated retrospectively. RESULTS Of 234 nosocomial infection events,the lower respiratory tract infection occupied 80 events which the infection rate was the highest (34.19%) and mainly happened in internal medicine (33.75%) and neurosurgery (25.0%) departments. The pathogenic bacteria of hospital infection were mainly G-bacteria (50.94%). CONCLUSIONS The primary affection should be actively treated with strictly aseptic manipulation,reasonable application of antibiotics and strengthening disinfection and management of wards. All the measures are effective,to prevent the lower respiratory tract infection.

Objective To investigate the expression of P2X7 receptor (P2X7R) and the effect of P2X7R agonist 2'-3'-O-(4-benzoyl-benzoyl) ethane adenosine triphosphate three amine salt (BzATP) on cell growth and apoptosis in non-small cell lung cancer A549 cells,and to explore the related mechanism.Methods The expression of P2X7R in A549 cells was detected by immunofluorescence.Cells were treated with different concentrations (150,300,600 μmol/L) of BzATP.Cells untreated with BzATP were used as control group.3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2H-tetrazolium bromide (MTF) assay and Hoest33342 staining were respectively used to detect cell viability and apoptosis.Enzyme-linked immunosorbent assay (ELISA) was uesd to detect the concentration of tumor necrosis factor-α (TNF-α) of cell culture supernatants.The expressions of nuclear factor-κB (NF-κB) p65,inhibitor of α of NF-κB (IκBα) and the phosphorylation of inhibitor of α of NF-κB (phospho-IκBα) were detected by Western blotting.Results P2X7R was expressed on the cell membrane of A549 cells.Survival rate of A549 cell was significantly decreased with the concentrations of BzATP at 300 and 600 μmol/L [(67.87 ± 8.98) ％,(44.73 ± 6.92) ％],compared with the control group (98.60 ± 1.44) ％,the differences were statistically significant (t =4.481,P =0.027;t =3.920,P =0.038).BzATP promoted apoptosis,and increased the concentration of TNF-α of supernatant at 300 and 600 μmol/L [(57.35 ±6.41) pg/ml,(78.63 ± 11.33) pg/ml],compared with the control group (42.56 ±0.37) pg/ml,the differences were statistically significant (t =6.410,P =0.035;t =11.330,P =0.005).In addation,the expressions of NF-κB p65 and IκBα were respectively downregulated and upregulated by BzATP,while the expression of phospho-IκBα was not significantly altered.Conclusion P2X7R is expressed on A549 cell membrane.BzATP can inhibit cell proliferation and induce the apoptosis of A549 cells,and the mechanism of action may be related to promoting the release of TNF-α and inhibition of NF-κB pathway.

Objective To summarize the clinical characteristics of 15 cases of Poland's syndrome and to explore the suitable treatment strategies. Methods A retrospective study of 15 adult patients with Poland's syndrome was conducted and the related literature was reviewed. According to the development of pectoralis muscles and breast, chest deformities were classified into 2 grades: mild and severe. Mild form was limited to absence of partial pectoralis major muscle, with variable hypoplasia of other minor components (such as the size of breast and the size and position of the nipple-areola complex), leading to a mild chest wall asymmetry. Severe form was characterized by absence or severe hypoplasia of the pectoralis major muscle and mammary gland with an evident chest wall asymmetry. Combined with gender, adult patients were divided into 4 types: female mild, female severe, male mild, and male severe. Each type had its own treatment strategies based on its anatomic features: silicone implant insertion for female mild type;latissimus dorsi muscular flap transposition and silicone implant insertion for female severe type;fat injection for male mild type;latissimus dorsi muscular flap transposition for male severe type of the patients. From 2003 to 2008, 15 adult cases were admitted to our ward, aged from 16 to 34 years.The case number of each type was 6, 6, 2 and 1, respectively. One severe female patients rejected any surgical interventions;the others were all treated as the above. Results Follow-up periods ranged from 6 months to 4 years. This series had got satisfactory results with good breast symmetry and natural texture. All the latissimus dorsi muscular flaps survived well. No postoperative complications, such as implant capsular contracture or implant displacement, were observed. Conclusion The manifestations of Poland's syndrome are extremely varied. This classification method is simple but useful, which could effectively direct the individualized treatment for the complete and adequate rehabilitation. Latissimus dorsi muscular flap, pedicled or free transplanted, pulsing silicone implant in females, are the first choices for severe chest deformations of this syndrome.

For long-term application of the rotary pumps, it is necessary to solve the problems of bearing wear and thrombosis along the bearing. Currently, many investigators choose the magnetic bearing to realize zero-friction and no contact between the rotor and stator; the former avoids the mechanical wear and the latter eliminates the possibility of thrombus formation. We tried and found that it is difficult to apply a magnetic bearing to rotary pump without disturbing its simplicity, reliability and implantable; therefore, we have developed a much simpler and much more creative approach to achieving the same results. Instead of the sliding bearing, a rolling bearing has been devised for the pump; its friction is about 1/15 of the sliding bearing. Furthermore, a wear-proof material of ultra-high-molecular weight polythene has been adopted in making the rollers, their anti-wear property in 8 times better than that of metal. Thereby, the service life of the bearing has extended to several years. For preventing the thrombus formation along the bearing, the impeller reciprocation axially as the impeller changes its rotating speed periodically to produce a pulsatile flow. The reciprocation is a result of the effects of a magnetic force between the motor rotor and stator, and a hydraulic force between the blood flow and the impeller. Similar to piston pump, the oscillating impeller can make the blood in and out of the bearing, resulting in wash-out once a circle. This is obviously beneficial to preventing thrombosis along the bearing and in the pump. The endurance tests with saline of this novel pump demonstrated a durability of the device. It promises to be able to assist the circulation of the patients permanently and to be able to replace the heart transplantation in the future.
Heart-Assist Devices ; Magnetics ; instrumentation ; Prosthesis Design ; Thrombosis ; prevention & control

Actins ; metabolism ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; metabolism ; pathology ; Cell Differentiation ; Female ; Humans ; Immunohistochemistry ; Keratin-7 ; metabolism ; Keratin-8 ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Sarcoma ; metabolism ; pathology ; Vimentin ; metabolism

Magnetic bearing has no mechanical contact between the rotor and stator. And a rotary pump with magnetic bearing has therefore no mechanical wear and thrombosis due to bearing. The available magnetic bearings, however, are devised with electric magnets, need complicated control and remarkable energy consumption. Resultantly, it is difficult to apply an electric magnetic bearing to rotary pump without disturbing its simplicity, implantability and reliability. The authors have developed a levitated impeller pump merely with permanent magnets. The rotor is supported by permanent magnetic forces radially. On one side of the rotor, the impeller is fixed; and on the other side of the rotor, the driven magnets are mounted. Opposite to this driven magnets, a driving motor coil with iron corn magnets is fastened to the motor axis. Thereafter, the motor drives the rotor via a rotating magnetic field. By laboratory tests with saline, if the rotor stands still or rotates under 4,000 rpm, the rotor has one-point contact axially with the driving motor coil. The contacting point is located in the center of the rotor. As the rotating speed increases gradually to more than 4,000 rpm, the rotor will detache from the stator axially. Then the rotor will be fully levitated. Since the axial levitation is produced by hydraulic force and the driven magnets have a gyro-effect, the rotor rotates very steadly during levitation. As a left ventricular assist device, the pump works in a rotating speed range of 5,000-8,000 rpm, the levitation of the impeller hence is ensured by practical use of the pump.
Equipment Design ; Heart-Assist Devices ; Magnetics ; instrumentation