Covered in the paper are reform efforts made by the hospital on the HIS system amid the pilot programs total prepaid and mcdicine-drug separation trials in Beijing.Findings of the programs revealed defects of the HIS system,for example measures for refusal of payment of non-compliance items,and real-time reimbursement for patients.In view of these setbacks,the hospital made further attempts to the system in such aspects of the fundamental maintenance,rational drug usage and new problems,for the purpose of successful completion of the pilot programs at the hospital.Discussions were also made as to how to adapt the HIS system to total prepaid and the separation reforms,aiming at helping those not yet initiated with the reforms,and the information sharing of patient diagnosis/treatment records and social insurance payment at all hospitals in Beijing.

Nurses often face ethical dilemmas in clinical practice,originating from nurses themselves,nursing measures,and nursing management as well.Only by correctly recognizing and analyzing the causes of ethical dilemmas in nursing care,can help nurses get out of the ethical dilemmas and make reasonable ethical decisions in nursing care.

Objective To study the clinical significance of the novel tumor marker Cytokerantin?19?fragment( CYFRA 21?1) of peripheral blood in patients with esophageal cancer. Methods The CYFRA 21?1 level in peripheral blood of 72 patients with benign tumor of esophagus or reflux esophagitis and 60 patients with esophageal cancer was examined before and 7 days after operation by enzyme?linked immuno sorbent assay ( ELISA) . At the same time, patients with esophageal cancer were followed up for 3 years, and the level of CYFRA21?1 was examined. Results (1)Before the operation,the level of CYFRA 21?1 was 0-3. 30 μg/L in 51. 67%( 31/60 ) of the patients with esophageal cancer, higher than that of the control group ( 16. 67%(12/72),χ2=3. 88,P<0. 05). (2)Before the operation,the level of CYFRA21?1 in patients with esophageal cancer,stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ were (3. 27±0. 33) μg/L and (4. 88±1. 21) μg/L,and of the control group was (2. 24±1. 17) μg/L. The levle of CYFRA21?1 in patients with esophageal cancer,stage Ⅰ,Ⅱ andⅢ,Ⅳ were significantly higher than that of the control group( t=2. 37,2. 00,P<0. 05) . ( 3) On the 7th day after operation,the level of CYFRA21?1 was (2. 26±1. 16) μg/L,and the difference was not significant compared with the control group(t=0. 95,P>0. 05). The level of CYFRA21?1 with the palliative resection of esophageal cancer was (3. 31±0. 66) μg/L,and the difference was significant compared with the control group(t=4. 33,P<0. 05) . ( 4 ) After 3 years of follow?up, the factors affecting the survival rate of esophageal cancer were as following:the pathologic stages of tumor(OR 4. 423,95%CI 1. 943-4. 972,P<0. 05),types of operation(OR 0. 023,95%CI 0. 012-0. 036,P<0. 05),the level of CYFRA21?1 before operation(OR 6. 798,95%CI 4. 328-8. 105,P<0. 05),and the decreased level of CYFRA21?1 after operation(OR 0. 117,95%CI 0. 074-0. 202,P<0. 05) . ( 5) During the follow?up period,the level of CYFRA21?1 in patients with local recurrence and distant metastasis of esophageal carcinoma was (7. 97±0. 44) μg/L,significantly more than that of the control group(t=5. 11,P <0. 05) . Conclusion CYFRA21?1 is a useful tumor marker in the positive rate of preoperative diagnosis of esophageal cancer, postoperative monitoring of recurrence, distant metastasis and prediction of prognosis.

Network examination and learning has become the main form of test and training for nurses, doctors and pharmacists in the field of medicine and health. The system design of Jsp+Servlet+Extjs 4.1+Tomcat server+Mysql database implements the simulation training and learning function of the medical qualification examination by system positioning , functional development and hierarchical construction . Question bank should be developed and optimized according to the examination syllabus and achievement analysis. Test sites, examples, difficulties and so on have been developed into micro courses. With the sup-port of the system, the micro courses and examination questions have been linked together to achieve the organic integration of examination and guidance. This kind of examination system based on network and on-line learning has good compatibility and strong pertinence. It can be perfected according to the application of learning end.

Aim Toexploretheinhibitioneffectof triptolide on nasopharynx cancer, and the mechanism. Methods Theinhibitionofcellproliferationwasde-tected by MTT assay;the cell apoptosis was analyzed by flow cytometry with propidium iodide staining. The ex-pressions of glucose regulated protein 78 ( GRP-78 ) , Akt and pAkt in cells were examined by Western blot;the effect of triptolide on reactive oxygen species ( ROS) accumulation was detected by ROS Fluorescent Probe-DHE.Results MTTassayshowedthatthe growth of nasopharynx cancer was inhibited by triptol-ide , and the inhibition occurred in a dose and time-de-pendent manner following triptolide treatment in CNE-2Z nasopharynx cancer cells. Propidium iodide staining revealed that the apoptosis of CNE-2 Z cells was in-duced remarkably by triptolide. After CNE-2Z cells treated with 25, 50,100 nmol·L-1 of triptolide for 24 h, the apoptosis rate was 14%,26. 9% and 34. 4% re-spectively. Western blot experiment showed that the expression of GRP-78 had no significant change follow-ing triptolide treatment in CNE-2 Z nasopharynx cancer cells for 24 h, but the expression and the phosphoryla-tion level of Akt were strikingly decreased. The experi-ment of ROS uncovered that CNE-2 Z nasopharynx cancer cells increased generation of ROS after treat-ment with triptolide for 4 hours, and acted cells in a dosedependentmanner.Conclusions Triptolidecan inhibit the growth of CNE-2 Z nasopharynx cancer cells in a dose and time-dependent maner. The mechanism may be related with the point that triptolide can induce oxidative stress, incease ROS, inhibit the expression and the phosphorylation level of Akt,then promote the apoptosis of CNE-2Z cells.

Objective To compare the two kinds of purification method for purifying recombinant human cardiac troponin I(cT-nI)to obtain the stable cTnI and promote the study of cTnI diagnosis standardization.Methods The cTnI inclusion body was ob-tained by the ultrasonic broken engineering,after washing by 2% Tritonx-100,2M urea,dissolved in 8M urea,then purified by the column refolding on CM-FF and the dilution refolding respectively.The cTnI yields were compared between the two kinds of meth-od and the stability at 4 ℃,20 ℃,-80 ℃ and on the freeze-dried condition was compared.Then the purification method to effi-ciently obtain the stable cTnI was established.Results The protein about 2 mg and 1.4 mg could be obtained by CM-FF on the col-umn refolding and the dilution refolding from 0.1 g of wet inclusion body,respectively.The former method had the short cycle and high efficiency.The cTnI purified by the column refolding on CM-FF was more stable at 4 ℃,20 ℃,-80 ℃ and on the freeze-dried condition.Conclusion The column refolding on CM-FF is more stable and highly efficient in purification of cTnI than the dilution refolding.

Objective This paper expounds the present situation of the construction and probes into the development path of the medical characteristic disciplines,so as to provide guidance for the development of the characteristic disciplines of local medical colleges and universities.Methods According to the general characteristics of the discipline construction of the local medical colleges and universities,through the analysis of the current situation of the objective development and the restriction of the bottleneck,to analyze the new methods and new ways for the development of the characteristic disciplines in local medical colleges and universities.Results Medical characteristic disciplineconstruction should pursue sustainable development,mining subject characteristics;concise direction of research,enhance the level of scientific research;focus on academic exchanges,build talent echelon;integrate all kinds of resources,construction of subject group;building performance evaluation,pioneering achievement innovation.Conclusions Local educational institutions and medical colleges and universities should fully understand the importance of characteristic disciplines to meet the needs of local development and create brand culture.The characteristic disciplines with prominent advantages,reasonable structure and sustainable development should be established.

OBJECTIVE:To establish the quality standard for Mian medicine Indigofera stachyoides. METHODS:Medicinal properties and microscopic characteristics were identified;TLC was used for the qualitative identification;HPLC was conducted for content determination of epicatechin and 2α,3α-epoxy-5,7,3′,4′-tetra-hydroxy-flavan-(4β→8)-epicatechin(reference A):the col-umn was Comatex TM C18 with mobile phase of acetonitrile- water at a flow rate of 1.0 ml/min,and detection wavelength was 210 nm,column temperature was 30 ℃,injection volume was 5 μl. RESULTS:It showed clear microscopic identification map. I. stachyoides TLC had clear spots and well separated. The linear range was 0.274 5-4.392 0 μg (r=0.999 6) for epicatechin,and 0.103 0-1.648 3 μg for reference A(r=0.999 4),RSDs of precision,stability and reproducibility tests were lower than 3%,recov-eries were 99.76%-104.82%(RSD=2.42%,n=6) and 97.98%-104.99%(RSD=2.75%,n=6) respectively. CONCLUSIONS:The established standard can be used for the quality control of I. stachyoides.

Background and objective Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) show promising therapeutic effects in patients with advanced non-small cell lung cancer (NSCLC). However, despite an initial response to TKIs treatment among responsive patients, most inevitably acquire resistance atfer a progression-free period of about 10 months. hTe percentage of T790M in TKI acquired-resistant patients in most studies is around 50%. hTe aim of this study is to assess the effects of the sequential administration of triptolide and getfinib on cell proliferation and apoptosis of lung adenocarcinoma cell H1975. Methods A MTT assay was used to measure cell proliferation. hTe potency of the sequential ad-ministration of triptolide and getfinib were determined by isobolograms and combination index (CI). Cell apoptosis and cycle distribution were detected by lfow cytometry. hTe Hoechst 33258 method was used to observe the apoptotic morphology. Chemical colorimetric luminescence was used to measure the caspase activity. Results hTe results of isobolograms and CI showed that the sequential administration of triptolide following getfinib remarkably inhibited cell proliferation and cell apop-tosis compared with other sequential administration models. hTe cycle distribution results indicated that sequential triptolide administration following getfinib blocked the cells in the G2/M phase but not in the G0/G1 phase. hTe activation of the Cas-pase-9/Caspase-3 cascade was mainly involved in the apoptotic pathway of lung adenocarcinoma cell H1975 in all sequential administration models. Conclusion hTe triptolide administration following getfinib might be a new therapeutic strategy for lung cancer with T790M mutation atfer having EGFR-TKIs resistance.

Visual prostheses have the potential to restore partial vision for the blinds. The stimulating electrodes generate reproducible phosphenes. Still limited by the low resolution vision used in visual prostheses nowadays, it is important to optimize the image processing strategies in order to deliver better visual information to the patients. This paper presents a review of the current research progress on the image processing strategies based on visual attention models under simulated prosthetic vision and related psychophysics.
Computer Simulation ; Image Processing, Computer-Assisted ; methods ; Visual Prosthesis