Objective To explore the method of the major hospital indexes examination using clinical pathway as an opportunity.Methods Based on the material of our hospital from 2008 to 2010,reference the data of the same level hospital in Xinjiang Uygur Autonomous Region,we set the benchmark and formulated the examination standard of three examination indexes:average length of stay (ALOS),average hospitalization expense and drug proportion.Meanwhile,we took the subentry incentives to give the corresponding reward to clinical departments according to the decreases rate compared with the benchmark monthly.Results ALOS,average hospitalization expense and drug proportion of department and the whole hospital were obviously decreased compared with the same period last year,and the differences were statistically significant (Medical system:t =27.479,14.462,11.362,all P ＜ 0.01 ; Surgical system:t =18.944,16.029,12.071,all P ＜ 0.01).Conclusion After using the examination methods and combining clinical pathway,the effects are obvious,which can effectively shorten ALOS,reduce average hospitalization expense and drug proportion,so as to relieve the patients' economic burden.

Objective To analyze the principal components and trends of total health expenditure from 1995 to 2011 in Xinjiang,in order to put forward policy recommendations to improve health financing.Methods Calculating the total health expenditure in Xinjiang using the financing source method,and analyzing the calculation results.Results Total health expenditure increase in Xinjiang averaged 14.75％ from 1995 to 2011.The total health expenditure in Xinjiang and per capita health expenses maintained a growing trend,and the level of financing was higher than regional economic development,but the health consumption elasticity coefficient was unstable; Residents' individual health burden was gradually decreasing,the health expenses of financing structure were relatively reasonable; Urban and rural residents health care spending grew faster than the per capita income,and the proportion in people's living consumption was found rising.Conclusion It is recommended to continue with the health reform,make full use the policy of strategic health support to Xinjiang,promote primary health service equity,develop economy and improve the urban and rural income,strengthen social health care security systems,tighten macro-control and curb the fast rising trend of health expenses.

Objective To optimize conditions for extraction of alkaloids from Evodia rutaecarpa by means of 732 cation exchange resin and performe its anti-breast cancer bioactivity.Methods The optimum processing route on extraction of alkaloids from Evodia rutaecarpa was investigated by means of 732 cation exchange resin.The performance of 732 cation exchange resin was compared with tranditonal process ( aqueous extraction-ethanol precipitation in extraction-purification process).The alkaloid reagent-potassium mercuric iodide test and MTT test were performed on the crudes.Results Compared with traditional purification process, it was much better to use 732 cation exchange resin approach for extraction of alkaloids from Evodia rutaecarp with high yield(16.81%) The best eluent should be saturated brine with excellent purification.No obvious correlations were found between the toxin of breast cancer cell and concentration of total alkaloids.When the concentration of total alkaloids was 50μmol/mL, cellular survival rate was 68%afterward 24 h.When the concentration of total alkaloids comes to 100 μmol/mL and 150 μmol/mL, cellular survival rates were slightly decreased by 66% and 60%.Conclusion 732 cation exchange resin performes much higher than traditional process in purification of total alkaloids extracted from Evodia rutaecarpa.Simultaneously, the extracted total alkaloids showe remarkable inhibition in breast cancer cell.

Objective To design and evaluate a new type of acromion & clavicle anatomic plate with combinatorial hinge more suitable for acromioclavicular joint dislocation and distal clavicular fracture.Methods The new type of acromion & clavicle anatomic plate with combinatorial hinge we had designed was used in 21 patients (21 shoulders) who were treated for acromioclavicular joint dislocation or distal clavicular fracture from October 2016 to April 2017 at Department Ⅰ of Orthopaedics,The 2nd People's Hospital of Lu'an.They were 15 men and 6 women,aged from 24 to 63 years(average,41.5 ±4.2 years).Of the 14 cases of acromioclavicular joint dislocation,7 were type Ⅲ,5 type Ⅳ and 2 type Ⅴ,according to the Rockwood classification;all the 7 distal clavicular fractures were Neer type Ⅱ.They were all treated by open reduction and internal fixation with our self-designed acromion & clavicle plate with combinatorial hinge.They were followed up at the outpatients department at 3 weeks,3,6,12 and 15 months postoperatively for evaluation of their shoulder functions by Constant-Murley score,changes in coracoclavicular clearance before and after operation and loss of coracoclavicular clearance after removal of internal fixation by X-ray.Results All the 21 patients were effectively followed up for 15 to 20 months (average,18 months).As for their Constant-Murley scores,preoperation (49.7±4.9) ＜3 weekspostoperation (57.6±5.9) ＜3 monthspostoperation (83.2±5.7) ＜6 months postoperation (90.4 ±4.0) ＜ 12 months postoperation (94.3 ±4.2) ＜ 15 months postoperation (98.1 ±4.2),with significant differences between different time points (P ＜ 0.05).The postoperative coracoclavicular clearances at different time points were all significantly decreased than the preoperative value (P ＜ 0.05).With the aid of our new type of acromion & clavicle anatomic plate,the shoulder functions of the patients were gradually improved,the postoperative acromioclavicular joint and reduction of the distal clavicular fracture were stable,and no re-dislocation occurred after removal of internal fixation.Conclusion Our new handy type of acromion & clavicle anatomic plate with combinatorial hinge can provide more effective internal fixation for acromioclavicular joint dislocation and clavicular distal fracture,facilitating functional recovery of the shoulder.

Objective:To evaluate modified Lanza score (MLS) of gastric mucosa for predicting the prognosis of geriatric patients with sepsis.Methods:Data of 50 patients with sepsis, who were over 60 years old and underwent gastroscopy for suspected gastrointestinal bleeding in the Department of Geriatric Critical Care Medicine of Guangdong Provincial People's Hospital from January 2019 to April 2022, were retrospectively analyzed. Patients were divided into the death group ( n=32) and the survival group ( n=18) according to their regression within 28 days after gastroscopy. Their gastric mucosa was scored by using MLS system, and the mortality of patients with MLS≥1 was calculated, then the patients were further divided into 2 groups, MLS=0-2 ( n=23, less than 2 regions of lesions ) and MLS=3-5 ( n=27, two or more regions of lesions). The relationship between MLS and acute physiology and chronic health status evaluation (APACHE) Ⅱ score, risk factor of death and mortality in each group were compared. The correlation between MLS and mortality was analyzed. The influence of geriatric sepsis risk factors affecting the prognosis of patients within 28 days were analyzed by using logistic regression. Results:Among the 50 geriatric patients with sepsis, those with gastric mucosal lesions, i.e., MLS ≥1, accounted for 68.00% (34/50), including 84.38% (27/32) patients with MLS≥1 in the death group, which was significantly higher than the 38.89% (7/18) patients with MLS≥1 in the survival group ( χ 2=10.593, P<0.001). Patients with MLS=3-5 had significantly higher APACHE Ⅱ scores (26.09±6.47 VS 18.57±7.66, t=3.527, P=0.001) and higher mortality [85.19% (23/27) VS 39.13% (9/23), χ 2=11.434, P=0.001] compared with MLS=0-2. Correlation analysis showed a significant correlation between MLS and mortality ( r=0.886, P=0.019). Multivariate logistic regression analysis showed that MLS=4-5 was an independent risk factor for death in geriatric patients with sepsis ( OR=17.055, 95% CI: 1.387-209.744, P=0.027). Conclusion:MLS presents high sensitivity in predicting 28-day outcomes for geriatric patients with sepsis. Two or more than 2 regions of gastric mucosal lesions can significantly increase the risk of death in geriatric patients with sepsis.