Objective:To analyze the financial auditing method after changing the settlement method of outpatient medical income in hospitals under the background of launching “Jing Yi Tong” business line in public hospitals of Beijing.Methods:It summarized the key point of financing audit in outpatient medical income of hospitals under the settlement mode of “Jing Yi Tong”business,proposed the effective settlement method and suggestions on auditing.Results:Through close financial auditing,it effectively ensure the acuteness and completeness of outpatient medical income of hospitals,prevent the leak and man-made fraud in settlement process.Conclusion:The effective hospital financing audit was the main task for internal control,which played key role on improving hospital financing management level.

OBJECTIVE: To investigate the clinical characteristics of ocular symptoms in patients with allergic rhinitis (AR) and the impact of the ocular symptoms on patients' quality of life. METHOD: AR patients' history and clinical data were collected and analyzed. One hundred cases were extracted from adult patients with and without ocular symptoms in each group and their quality of life were evaluated using rhino-conjunctivitis quality of life questionnaire (RQLQ). RESULT: Totally 1119 cases were collected and 859 cases had ocular symptoms. Of the patients with ocular symptoms, 582 cases were mild, 234 cases were moderate, 43 cases were severe. Eye itching was the most common symptom, followed by tears, hyperemia and swelling. Patients with ocular symptoms had longer disease history than non ocular symptom group (P < 0.05). There was a positive correlation between ocular and nasal symptoms (P < 0.01); patients with ocular symptoms had more severe nasal symptoms than patients without ocular problems; while patients with moderate to severe AR had more severe ocular symptoms than mild AR patients (P < 0.01). Female patients had higher incidence (P < 0.05) and ocular symptoms score (P < 0.05) than male. Children less than 10 years old had a relative lower incidence and score of ocular symptoms. While the incidence and score had an increasing trend for patients older than fifty. There was no difference regarding the type and number of allergen in the patients with and without ocular symptom. Moreover, patients with ocular symptoms had higher scores in the domains of non-nose/eye symptoms, practical problems, ocular symptoms, emotional function and total score in RQLQ than patients without ocular symptom. CONCLUSION It was common for the AR patients to have ocular symptoms, and ocular symptoms had obvious influence on the patients' quality of life. So controlling of the ocular symptoms should not be ignored during the diagnosis and treatment of AR.
Adolescent ; Adult ; Allergens ; Child ; Eye Diseases ; etiology ; Female ; Humans ; Male ; Quality of Life ; Rhinitis, Allergic ; complications ; Rhinitis, Allergic, Perennial ; complications ; Surveys and Questionnaires

Animal medicine is an important part of traditional Chinese medicine with a long application history in China. Systematically understanding the history of the development of animal medicine is of great significance to scientific protection and rational use of animal medicine resources. It has certain guiding significance to protection of wild resources, exploitation of new substitutes, standardization and summary of artificial breeding, and artificial reproduction technology. Taking the development of bezoar as an example, this article expounded the following four aspects:the development history of animal medicine, national animal protection, technical development, and prospect forecast by summarizing the Chinese ancient medical books and consulting the relevant laws and regulations. The entire above are about to offer new ideas for the sustainable development, the development of new medicine resources, and the development of animal medicine related preparation product.

Objective To compare the blood glucose level and associated hypoglycemia risks between group of insulin glargine combined with repaglinide and group of mixed insulin in the treatment of type 2 diabetes in the elderly. Methods Sixty four type 2 diabetes patients (age≥60 years) with inadequate glyeaemic control by drugs were divided into 2 groups randomly: glargine group (32 cases) and mixed insulin group (32 cases). In glargine group, 32 patients were given repaglinide before breakfast, lunch, supper respectively and injection of glargine hypodermically once at 22 o'clock every night, while the 32 patients in mixed insulin group were injected with the mixed insulin (Novolin 30R) hypodermically before breakfast and supper respectively for 16 weeks. The dose of repaglinide and insulin were adjusted every 3 days according to the level of fasting glucose (FPG)and postprandial glucose (PPG), reaching the aim of FPG less than 7.2 mmol/L and PPG less than 10mmol/L. The blood glucose level and the incidence of hypoglycemia were observed. Results The daily glucose profile and the level of HbAlc of the 2 groups dropped obviously after 16 weeks treatments (all P<0. 05). At the end of the experiment, the PPG of lunch and supper, and the level of HbAlc were markedly lower in glargine group than in mixed insulin group (all P<0. 05), and the body mass index (BMI) increased markedly in mixed insulin group compared with pre-experiment (P<0. 05), but no significant change was found in glargine group (P>0. 05). The incidence of hypoglycemia in glargine group was lower than that in mixed insulin group (2 patients in glargine group, 12 patients in mixed insulin group, P<0.05). Conclusions Both of the mixed insulin and glargine combined with repaglinide have visible effects on controlling the blood glucose, but the latter has better efficacy, lower risk of hypoglycemia and lower increase of BMI than the former.

OBJECTIVE:To optimize the formulation technology of Ibuprofen sustained-release dropping pill and evaluate its in vitro drug-release characteristics. METHODS:Using stearic acid as sustained-release matrix,polyethylene glycol 6000 as imme-diate-release matrix,melting method was used to prepare the Ibuprofen sustained-release dropping pill. Using the comprehensive scores of roundness,weight difference,drug loading rate,in vitro drug-release time as indexes,drug-matrix mass ratio,liquid tem-perature,condensation temperature,dropping distance as factors,orthogonal test was adopted to optimize the formulation technolo-gy,and verification test was conducted. In media of deionized water,hydrochloric acid solution (pH 1.2),phosphate buffer (pH 4.5,6.8),the in vitro drug-release were compared between self-made sustained-release dropping pill and commercially available Ibuprofen sustained-release capsule,which were fitted for former drug-release behavior. RESULTS:The optimal formulation tech-nology was as follows as mass ratio of ibuprofen-polyethylene glycol 6000-stearic acid of 4.0:15.3:0.7,liquid temperature of 83 ℃,condensation temperature of 8 ℃,and dropping distance of 11 cm. The weight difference of prepared 3 batches of Ibupro-fen sustained-release dropping pill was 2.067%(RSD=1.19%),roundness was 96.73%(RSD=0.28%),drug loading rate was 96.31%(RSD=0.19%),cumulative release rate in 12 h was 93.05%(RSD=0.81%). The f2 values of self-made sustained-re-lease dropping pill and commercially available Ibuprofen sustained-release capsule were greater than 50,the former one fitted more into Higucci equation(r=0.9881-0.9972). CONCLUSIONS:The formulation technology of Ibuprofen sustained-release dropping pill is successfully optimized,and in vitro drug-release behavior of prepared sustained-release dropping pill is similar to commercial-ly available Ibuprofen sustained-release capsule.

Background and Purpose:Prostate cancer is one of the most common cancers and the second leading cause of cancer-related death in Europan and North American males.The incidence of prostate cancer has also been increasing during the past few decades in China.It is widely accepted that this heterogeneity,which results from the tumor progression driven largely by genomic instability(genetic and/or epigenetic alterations)of tumor cells in primary tumor,endows specific populations of tumor cells with the unique character needed for invasion,migration,and metastasis colony formation in other organs and only these subpopulations possessing thost character can survive the potentially destructive journey from the primary tumor to the sites of metastases.The purpose of the present study was to explore the genes associated with invasion and metastasis of human prostate cancer cell line PC-3M in nude mice.Methods:After PC-3M cells were inoculated into orthotopic site(prostate) in a male nude mouse for two months,tumor cells were isolated from the primary tumor and lymph node metastasis,separately.Cell invasion and adhesion ability in vitro were first compared between two cells.Then metastasis-related genes differentially expressed between them were analyzed by utilizing cDNA microarray technique.Results:The in vitro cell invasion and adhesion potential of tumor cells from lymph node metastasis was significantly higher than those from primary tumor by 2.5 fold and 1.5 fold,respectively.Metastasis-related genes differentially expressed between those two sublines were identified,all of them were up-regulated in the tumor cells from lymph node metastasis and could be categorilized: 1.genes encoding cellular matrix-degrading proteolytic enzyme including cathepsin and MMP.2.genes encoding transcription factors.3.genes related to heterotypic adhesion of tumor cells.4.genes encoding cell surface receptors.Conclusions:There are significant differences in invasion and adhesion potential between cells from primary tumor and those from lymph node metastasis.Some differentially expressed molecules might be playing pivotal roles in promoting tumor cells to migrate from primary tumors to distant metastases,which may be helpful to elucidate the possible mechanism of metastasis in prostate cancer.

Legumain, also called asparaginyl endopeptidase, is one new member of the cysteine protease C13 family and plays various roles in human. In recent years, studies have displayed that Legumain is over expressed in a variety of tumors types and promotes the proliferation of tumor cells, tumor invasion and metastasis as well as angiogenesis through varied mechanisms. Further investigation of Legumain will be helpful to elucidate the pathogenesis and progression mechanism of malignant tumors and provide new molecular for targeted therapy of tumors.

Objective To simulate the process of thrombus removal from the open-type stent retrievers, so as to provide theoretical references for the design and clinical application of the open-type stent retrievers. Methods Finite element models of the open-type stent retrievers with 3,4,5 supporting units (K3,K4,K5), the crimping tools, simulated vessels and simulated thrombus (three types) were established. Radial displacement load was applied on the crimping tool until the stent was crimped to 0.5 mm, and the maximum principal strain (MPS) peak and radial force (RF)of the stent were analyzed. When displacement of the crimping tool was restored, the stent self-expanded and contacted with blood vessels, and MPS of the stent and von Mises stress (VMS) of blood vessels were analyzed. Axial displacement was applied to proximal end of the stents to allow the stent to drive the clots to migrate, and the blood vessel VMS and withdrawal force of the stents (the ability to capture thrombus) were analyzed. ResultsThe MPS peaks for 3 types of stent retrievers during crimping process were 6.94%, 8.30% and 5.48%, which were all smaller than the 12% fracture limit. When the outer diameter of the stent was 3 mm (equal to the inner diameter of blood vessels), the K4 stent had the largest RF. The results of self-expanding release process showed that the larger the number of support units, the greater the VMS of blood vessels. At the stage of thrombus migration and removal,the VMS of blood vessels was generally small and concentrated on the thrombus. The withdrawal force of the stent reached the maximum at the initial stage of thrombus migration and removal, then gradually decreased. The peak withdrawal force of the K4 stent was larger than that of the K5 and K3 stent. Conclusions Although the MPS and VMS for 3 types of open-type stent retrievers were within the safe range, the K4 stent showed better performance in RF and withdrawal force with the three types of thrombus. The research findings can provide the analysis methods and ideas for optimizing the open-type stent retrievers, to avoid clinical complications such as vascular injury and improve safety and effectiveness of the stent retrievers.

Objective:To investigate the medical narrative competence of pediatric staff, and analyze its influencing factors and correlation with psychological resilience, and to discuss strategies to improve narrative competence.Methods:From January 11 to February 25, 2022, by convenience sampling, we sampled pediatric personnel and those on refresher training at Children's Hospital, Zhejiang University School of Medicine for a questionnaire survey involving general information, the narrative competence scale, and the 14-item resilience scale. With the use of SPSS 26.0, the narrative competence of different populations was compared, and factors affecting narrative competence were determined through Pearson correlation analysis and multiple regression analysis.Results:A total of 361 valid questionnaires were included in this study, and there was significant differences in the narrative competence score between different ages, professional titles, working years, income levels, and whether they wrote parallel charts ( P<0.05). The total score of narrative competence of pediatric staffs was (147.13±18.76), and positively correlated with the total resilience score and the score of each dimension ( P≤0.001). The regression analysis showed that writing parallel charts and resilience could explain 53.10% of the variation in narrative competence ( P<0.001). Conclusions:Pediatric staff's narrative competence is at low or intermediate levels. Parallel chart writing and resilience training can improve narrative competence and promote a harmonious doctor-patient relationship.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.