Objective Beijing plans to run a DRGs-PPS pilot.Cost estimation of each DRG group needs a set of scientific reasonable standards for inpatient charge category.MethodsResource consumption accounting Classify charge item by practitioners,services,resources; medical consumables are singled out to emphasize the value of medical personnel's services; some of old categories are subdivided in order to be compatible with new categories.Results 19 old charge categories of patient discharge chart turn to 31 new items by dividing medical service into treatment,surgery,nursing,imaging,examination,management,paramedic,pharmacy,etc.ConclusionRegulating the charge categories of services,medical data is more consistent by using the same statistical coverage.Also it accurately present the incoming of all operationstreatment,surgery,nursing,imaging,examination,management,paramedic,pharmacy,etc.It gives government directions of decision-making to adjust the weight of DRG groups.

ObjectiveTo study the special effect of oxytocin and vasopressin mRNA expression by acupuncturing acupoint ST36.Methods78 SD male rats were divided into four groups, acupuncturing ST36 group, acupuncturing para-acupoint ST36 group, bondage group and control group. RT-PCR was used to observe the oxytocin and vasopressin mRNA expression in 2,4,6,8 hours after acupuncture, semi-quantitative result was obtained by using image analysis system.ResultsOxytocin mRNA expression in hypothalamus in 2,4 hours was the statistically significant different in acupuncturing para-acupoint ST36 group contrast with other three groups, while there was not statistically different between all groups on oxytocin mRNA expression in 6,8 hours. Vasopressin mRNA expression in hypothalamus in 2,4,6,8 hours was statistically depressed in acupuncturing acupoint ST36 contrast with other three groups.ConclusionOxytocin mRNA expression in hypothalamus increases for short time after acupuncturing para-acupoint ST36. Vasopressin mRNA expression in hypothalamus decreases for long time after acupuncturing acupoint ST36.

ObjectiveTo investigate effects of electroacupuncture(EA) of Zusanli(ST36) on changes of substance P(SP) mRNA expression in rat brain stem.Methods78 SD rats were evenly randomized into Zuanli-EA group, non-acupoint group, bondage groups(at the end of 2h,4h,6h,8h after 30 minute EA stimulation in each group) and control group. RT-PCR and image processing were used to study the change of SP mRNA level in brain stem.ResultsIn control groups,there was SP expression. An increase of SP mRNA expression was seen in Zusanli group and non-acupoint group comparing with control group at the end of 2h after 30min EA stimulation(P<0.05).There was difference between above two groups at the end of 6h and 8h(P<0.05).ConclusionEA stimulation elicited an accelerated expression of SP gene. Zusanli-EA stimulation can increased this expression, which may constitute one of the mechanisms for gastrointestinal motility and eletroacupuncture analgesia.

Objective:To evaluate the seven existing vaginal birth after cesarean (VBAC)screening tools and to identify additional factors that may predict VBAC or failed trial of labor in China.Methods:In the study,53 patients with 1 previous cesarean delivery who then delivered between January 1,2007 and Novenber 31,2014 were recruited.The average age of the patients was (32.1 ±3.5 )years,the average gestational age was (38.0 ±2.3)weeks.There was no significant difference of the successful group and the failed group in the maternal /neonatal mortality and morbidity,also in the incidence of the postpartum hemorrhage and the postpartum infection.The probability of VBAC was calculated for each participant using 7 prediction models created by Weinstein,Flamm,Grobman,Gonen,Troyer,Smith and Torri.The data were analyzed using t test,rank-sum test,and receiver operating curve analysis. Results:44 trial of labor patients had a vaginal birth after cesarean delivery,and the successful rate was 83%.The scores between the successful group and the failed group had significant difference when eva-luated by Weinstein and Grobman scoring models only.After recalculating the successful rate of VBAC in different score levels according to the references,there was significant difference between the rates of dif-ferent score levels when evaluated by the Weinstein model.The successful rates of different score levels were higher compared to the references (<50%)when evaluated by the Troyer (70%),Gonen (60%),Torri (85.7%)models.The area under the receiver operating characteristic curve of Weinstein prediction model (0.746)and Flamm prediction model (0.723)were more than 0.7,and there was no significant difference between the seven models.Conclusion:Among the seven scoring models,the Weinstein model is more applicable to the population of our country,but a new model more applying to Chinese women still needs to be created.

Objective To determine the expression of CD24 in colorectal carcinoma, and to explore the relationship between CD24 and the clinicopathological features of colorectal carcinoma.Methods The expression of CD24 in 62 cases of colorectal carcinoma, 47 cases of adenomas, 15 cases of colorectal polyps and 30 cases of the adjacent non-cancerous tissues were observed by immunohistochemical assay.The relationship between CD24 and the clinicopathological features was analyzed.Results The positive rates of CD24 in colorectal carcinoma 72.6％ and adenomas 63.8％ were significantly higher than those in colorectal hyperplastic polyps 13.3％ (x2 =17.83, P =0.00;x2 =11.61, P =0.00) and adjacent non-cancerous tissues 6.7％ (x2 =35.15, P =0.00;x2 =24.64, P =0.00).The expression of CD24 in colorectal carcinoma had a significant correlation with the tumor diameter (x2 =5.48, P =0.02), tumor differentiation (x2 =8.86, P =0.00), Duke staging (x2 =11.47, P =0.00) and lymph node metastasis (x2 =8.92, P =0.00).Conclusion The expression of CD24 is high in colorectal carcinoma, having a significant correlation with the size of tumor, degree of differentiation, Duke stage and lymph node metastasis.

Objective To discuss the potential relationship between endometrial serous carcinoma (ESC) and tubal epithelial lesions by pathologic examination of fallopian tubes with ESC. Methods A total of 30 cases of typical ESC were reexamined and chosen by the pathologist. In each case, bilateral fallopian tubes were submitted to examination of pathologic morphology and immunostaining for p53, annexin Ⅳ(ANX-Ⅳ), human epidermal growth factor receptor 2(HER2)/neu, and high-mobility group protein A2 (HMGA2). Results Fallopian tubal epithelial lesions were found in 15 cases, including 9 cases tubal serous carcinoma, 2 cases serous tubal intraepithelial carcinoma (STIC) and 2 cases epithelial hyperplasia. Both sides of tubal serous carcinoma and STIC were found in 1 case. The results showed the positive expression for p53 in 26(87%)out of 30 endometrial malignant specimens tissues and 9(30%)tubal tissues samples (P>0.05). Twenty-five(83%)endometrial malignant specimens tissues and 6(20%)tubal tissues samples showed the positive expression of ANX-Ⅳ. Twenty-one(70%)endometrial malignant tissues and 7(23%) tubal tissues showed the positive expression of HER2/neu. Twenty-five(83%) endometrial malignant tissues and 6(20%)tubal tissues showed the positive expression of HMGA2. While, there were significant differences among the expression of three proteins between endometrium and the fallopian tube site (all P<0.05). Conclusions STIC may be associated with the occurrence of ESC. The expression of p53 was positively correlated between the fallopian tube and the endometrium. ANX-Ⅳ,HER2/neu and HMGA2 were extensively expressed in ESC.

The nephrotoxicity of Chinese materia medica (CMM) can’t be ignored so that it needs effective monitor and prevention. Recently, the determination of biochemistry and pathology indexes is the most important means of research with low sensitivity and trauma. In recent years, metabolomics has shown broad prospects in CMM nephrotoxicity studies due to its systematic advantages, and also achieved remarkable success. However, large clinical sample studies are still needed to realize the clinical transformation of research results. Thus, the application of metabolomics in the toxicology, assessment biomarkers and mechanism of CMM nephrotoxicity are reviewed in this paper, in order to provide references for further research.

Objective To study the protection effect of acupuncture at acupoint ST 36 in rat with cold-restrainted stress-induced ulcer,and to observe the expression of NOS in hypothalamus and adrenal. Methods Ulcer Index in rats was used to study the protection effect of acupuncture, and and RT-PCR was employed to study the expression of NOS in hypothalamus and adrenal. Images were analyzed with semi-quantitative method. Results The ulcer Index was significantly decreased in rats with stress-induced ulcer by acupuncture as indicated by a comparison with those without acupuncture. The expression of NOS1 in hypothalamus was increased by acupuncture protect stress-induced ulcer. The increased expression of NOS2 was involved in stress-induced ulcer, and acupuncture decreased its expression. The expression of NOS3 in hypothalamus had the similar reaction to NOS2, but the decreased effect of acupuncture was limited. The expression of NOS1 and NOS3 in adrenal were increased by cold stress, only the expression of NOS1 could be repressed with acupuncture. There was no NOS2 expression in adrenal in stress-induced ulcer rats. Conclusion The protection effect in stress-induced ulcer exerted by acupuncture at acupoint ST 36 were mediated by increase of the physiological expression of NOS1 in hypothalamus as well as decrease of the expression of NOS2,NOS3 in hypothalamus and repress of the expression of NOS1 in adsenal.

Objective To investigate the effects of human milk fortifier(HMF)addition at different time points on the growth,development and the incidence of complications in very low birth weight(VLBW)infants.Methods A total of 93 VLBW infants admitted into Neonatal Intensive Care Unit of Tianjin Central Hospital of Obste-trics and Gynecology from January to September 2015 with more than 80％of total milk intake during hospitalization,excluding those who had severe asphyxia or abandoned treatment and died,were collected.The included cases were divided into 2 groups by using completely randomized grouping method,early fortification group(n=48)and delayed fortification group(n=45)adding HMF with the enteral intake of 50 mL/(kg·d)and 100 mL/(kg·d),respectively.The outcomes included growth development and the incidence of complications during hospitalization.Then,t test and chi-square test of independent samples were used for statistical analysis.Results There was significant difference in the weight growth rate between the 2 groups,and the growth rate of early fortification group and delayed fortification group were(15.4±2.4)g/(kg·d)and(13.6±2.3)g/(kg·d),respectively(t=3.043,P=0.004).There was no significant difference in height growth rate,head circumference growth rate,weight at 34 weeks postmenstrual age,time of recovering birth weight and parenteral nutrition,hospitalization duration,body weight,body length,head circumference at discharge and the incidence of extrauterine growth retardation between the 2 groups(all P>0.05).There was no statistical difference in incidence of feeding intolerance,necrotizing enterocolitis,nosocomial infection,retinopathy of prematurity,bronchopulmonary dysplasia between the 2 groups(all P>0.05).Conclusions HMF with enteral intake of 50 mL/(kg·d)contributes to weight gain rate in VLBW infants during hospitalization,but not to the increase in the incidence of complications.

Objective To investigate the changes of CA125 between primary cytoreductive surgery and interval debulking surgery for prediction the rate of optimal interval cytoreductive surgery and prediction the recurrence and the prognosis in patients with epithelial ovarian cancer.Methods A total of 39 cases with suboptimal primary cytoreductive surgery admitted from Jan.1996 to Jan.2009 were retrospectively analyzed.The median age of patients was 56 years( range:41 -68 years).Based on the changes in CA125level between primary cytoreductive surgery and interval debulking surgery,all cases were divided into four groups,group A (CA125 reduced to normal after primary cytoreductive surgery,n=6),group B (CA125reduced to normal after 1 - 2 cycles of chemotherapy,n =11 ),group C ( CA125 reduced to normal after 3 -4 cycles of chemotherapy,n =14),and group D ( CA125 did not reduced to normal after the chemotherapy,n =8 ), and all received platinum-based chemotherapy.The response to chemotherapy evaluated by pathological examination versus CA125 level,and recurrence and prognoses were also analyzed.Results ( 1 )The rate of optimal interval cytoreductive surgery in group A,B,C and D were 6/6,8/11,9/14 and 2/8respectively,in which there were statistically different between group A or B and group D (P ＜0.05).(2)The clinical benefit rates evaluated by the pathological examination in group A,B,C and D were 4/6,4/11,5/14 and 0,respectively and there were statistically different between group A and group D (P =0.030).( 3 ) There was significant difference in the recurrence rate between group A and group D (3/6 vs.8/8,P =0.024),while there were not significant differences between group B or C and group D ( all P ＞ 0.05 ).The rate of drug-resistant recurrence in group A,B,C and D were 1/6,3/11,5/14 and 7/8,respectively,in which there were significant differences between group A,B or C and group D ( all P ＜ 0.05 ). ( 4 ) The median progression-free survival (PFS) for patients in group A,B,C and D were 32,10,18 and 3 months,respectively,in which there were significant differences in the PFS between group A,B or C and group D (P =0.012,P =0.003,P =0.032 ).The median overall survival (OS) were 44,45,44 and 16 months,respectively.There were significant differences in the OS between group A,B or C and group D ( P =0.022,P =0.004,P =0.000 ).Conclusion The change of CA125 between primary cytoreductive surgery and interval debulking surgery may be predict the recurrence type and the prognosis in patients with epithelial ovarian cancer.