Yinchuan city began since January 1,201 5 to implement the“Disease scoring settlement under total budget”for hospitalization cost settlement.The new settlement method impels the hospitals to strengthen internal management,strengthen cost control,implement clinical pathway,strengthen the construction of hospital informationization,and standardize the hospital medical information upload.This paper covered the policy background and hospital internal management requirements,as well as hospital response measures,for reference of government healthcare authorities in the formulation of policy specific measures,and for the hospital’s medical insurance management department to adjust management mode and work flow,in order to better respond to and implement the policy.

Objective To characterize 16S rRNA methylase encoding genes associated with aminoglycoaides resistance, gene cassettes of class Ⅰ integrons of the multidrug-resistant Acinetobctcter spp. The sixty one Acinetobacter isolates were collected at the Second Hospital of Shanxi Medical Uni versity from July, 2007 to May, 2008. Methods Species identification was confirmed by sequence analysis of the blaOXA-51-like gene and 16S-23S rRNA gene space-region. Antimierobial susceptibility tests were performed by agar dilution method. 16S rRNA methylaae encoding genes and gene cassettes associated with integrons were amplified by PCR method. Results Among the sixty one strains, there were fifty five of Acinetobacter baumannii, three genospecies 3TU, one 13TU, one Aeinetobaeter ealcoacetieus, and one Aeinetobaeter haemolytieus. Forty eight isolates showed high-level resistance to three aminoglyeosides, including amikaein, tobramyein and gentamicin. The armA gene was found in 47 isolates and all isolates were negative for rmtA, rmtB, rmtC and rmtD genes. The Intl gene was found in 27 isolates. The gene cassettes contained arr-3, accA4,ctacCI ,catB8, aadA1 or dfrA12 genes. According to the PFGE DNA patterns, 5 distinct clones of armA-pasitive strains were identified. Clone A and Clone B were the dominant clones, widely distributed among different divisions. Condnsions 16S rRNA methylase encoding gene (armA) distributed widely in muhidrug-resistant Acinetobacter spp. The armA gene is not located in class Ⅰintegron. The class Ⅰ integron carries multiple resistant genes associated with aminoglycosides and chloramphenieol resistance.PFGE analysis suggests that armA-pesitive strains are widely spread in our hospitaL Effective infection control measure should be conducted in order to control the outbreak of resistant bacteria.

Objective To discuss the efficacy of Compound Anisodine Injection combined with Iodized Lecithin Tablets in treatment of central serous chorioretinopathy.Methods Totally 60 patients with CSC were selected,and divided into two groups randomly.The patients in control group (29 cases) were given Iodized Lecithin Tablets.The patients in observation group (31 cases) were given Iodized Lecithin Tablets and Compound Anisodine Injection.The efficacy of Compound Anisodine Injection combined with Iodized Lecithin Tablets in treatment of central serous chorioretinopathy was evaluated by efficacy,visual acuity,light sensitivity,and adverse reaction during treatment.Results After treatment,the effective rates of observation and control groups were 93.5％ and 79.3％,and the observation group was significantly higher than control group (P ＜ 0.05).There were no statistical significance on visual acuity between two groups.After treatment,rhe visual acuity of two groups was increased and the visual acuity in the observation group was better (P ＜ 0.05).Before treatment,there were no statistical significance on light sensitivity between two groups.After 2 and 4 weeks treatment,the light sensitivity of two groups were increased and the light sensitivity in the observation group was higher (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Compound Anisodine Injection combined with Iodized Lecithin Tablets has a curative effect on central serous chorioretinopathy.It could increase the visual acuity and improve the light sensitivity of eyes with good security.It is worthy of clinical use.

OBJECTIVETo study the effects of continuous cropping obstacles on growth of Rehmannia glutinosa.

METHODThe growth indexes, activity of root ATPase, root activity and mineral nutritional absorption were determined.

RESULTContinuous copping decreased growth rate and declined the size of leaves. Activity of root ATPase and root activity were also inhibited.

CONCLUSIONThe deficiency of source capacity is an important factor to restrain the root development of R. glutinosa with continuous cropping, the decrease of root activity and ATPase activity as well as nutritional stress of potassium and nitrogen are the reasons for the effects of continuous cropping on the growth and development of R. glutinosa.

Absorption ; Adenosine Triphosphatases ; metabolism ; Plant Roots ; enzymology ; growth & development ; metabolism ; Rehmannia ; enzymology ; growth & development ; metabolism ; Stress, Physiological

OBJECTIVETo determine 5 phenolic acids in the soils around rhizosphere of Rehmannia glutinosa in the field under normal rotation and successive cropping.

METHODPhenolic acids related to allelopathy effect in the soils around rhizosphere of R. glutinosa were determined by HPLC.

RESULTThe growth of R. glutinosa under normal rotation was strong. During harvest, the dry weight of the root tube and the volume of the R. glutinosa under normal rotation were 6.02 and 7.71 times of the ones under successive cropping.

CONCLUSIONThe seeding stage and elongating stage are the crucial periods for the autotoxic effect of the R. glutinosa under continuous cropping. During these periods, the content of coumaric acid, 4-hydroxybenzoic acid, syringic acid, and ferulic acid of R. glutinosa under successive cropping are notably negative correlation with the growth of the leaf and root tuber of R. glutinosa under successive cropping. Among them, ferulic acid plays a major role in the restriction effect on R. glutinosa under successive cropping.

Chromatography, High Pressure Liquid ; Coumaric Acids ; analysis ; metabolism ; toxicity ; Gallic Acid ; analogs & derivatives ; analysis ; metabolism ; toxicity ; Hydroxybenzoates ; analysis ; metabolism ; toxicity ; Plant Leaves ; drug effects ; growth & development ; Plant Roots ; drug effects ; growth & development ; Rehmannia ; drug effects ; growth & development ; metabolism ; Soil ; analysis

Objective:To evaluate main performance indexes and application value of a domestic blood nucleic acid test system for blood screening,so as to ensure the safety of blood screening in the system of blood bank.Methods:Twenty samples were selected from Langfang Center Blood Bank in January 2022,and 6703 blood specimens of voluntary blood donors from Langfang Blood Bank between 2022 and 2023 were simultaneously selected.According to the requirements of the"Technical Operating Procedures for Blood Stations(2019 Edition)"and the standard for medical medicine industry"Nucleic Acid Amplification Test Reagents(kits)",the performances of stability,analytical specificity,sensitivity,precision,anti-interference ability and against cross-contamination ability of nucleic acid test system were verified for the analysis of clinical application.Results:The coincidence rate of the nucleic acid test system was 100%for 20 negative plasma samples.The coincidence rates of the sensitivities of Hepatitis B virus deoxyribonucleic acid(HBV DNA),Hepatitis C virus ribonucleic acid(HCV RNA)and Human immunodeficiency virus ribonucleic acid(1+2)(HIV 1+2 RNA)were respectively 100%,and percentages of the coefficient of variation(CV%)of the precision of them were respectively 1.57%,0.75%and 1.49%.When the system conducted nucleic acid test,the hemolytic plasma with a hemoglobin concentration level of 400mg/dl and the blood specimen with triglyceride concentration levels of 3 000 mg/dl did not affect the analysis performances of the standard substances of HBV-DNA(9.0 IU/ml),HCV-RNA(30.0 IU/ml)and HIV-RNA(135.0 IU/ml)of low concentration level.There were not cross-contaminations when 10 positive samples at high concentration(1 000 IU/ml)were cross-lined with 11 negative samples to conduct test.A total of 16(0.24%)reactive specimens were checked out from 6 703 specimens by Nucleic Acid Test(NAT)Technique under mixed mode.Conclusion:Nucleic acid test system must conduct performance verification before it is put into use,so as to ensure the safety of blood screening.The currently domestic nucleic acid test system can meet the requirements of screening blood safety.The performance verification of nucleic acid test system has great value in ensuring the safety of blood screening.

Objective To investigate the clinical, electromyographic and cervical magnetic resonance imaging (MRI) characteristics of Hirayama disease. Methods Fifteen patients with Hirayama disease were observed for special clinical manifestations and underwent electromyographic examination of the bilateral distal upper limb muscles and peripheral nerve conduction velocity. MRI of the neck in neutral and fully flexed positions was performed to identify potential lower cervical cord atrophy and cervical curvature anomalies. Results All the 15 male patients had disease onset during puberty with asymmetric muscular atrophy and weakness of the hands and forearms. Concentric needle electromyography revealed prolonged duration and large amplitude of the motor unit potentials in the compromised distal limb muscles with also increased polyphasic potentials and poor recruitment, involving mainly the C7, C8 and T1 myotomes. In neutral neck position, MRI identified lower cervical cord atrophy in 9 patients, occurring mainly at C5, C6 levels;in fully flexed position, all patients showed forward displacement and flattening of the lower cervical cord, occurring mostly at C6 level. Conclusion Hirayama disease occurs mainly in puberty in young male patients, whose clinical features and electromyographic examination often indicate localized anterior horn anomalies in the lower cervical cord. MRI of the neck in neutral and fully flexed position can provide valuable assistance in the diagnosis of this disease.

OBJECTIVETo investigate the mixed infection and analyze risk factors in children with severe adenovirus pneumonia.

METHODSA retrospective analysis was performed on the clinical data of 756 children with adenovirus pneumonia between June 2009 and June 2011. Pathogens and risk factors were studied in 216 severe cases.

RESULTSOf the 216 severe cases, 138 (63.9%) were aged from 6 months to 2 years, and 161 (74.5%) developed the disease in the winter and spring; 177 (81.9%) were affected by 1-4 pathogens besides adenovirus, including 74 cases (34.3%) infected with one pathogen as an addition. A total of 334 pathogen strains were identified from the respiratory secretions and sera of the 216 cases. Of them, 163 (48.8%) were bacterial strains, dominated by Gram-negative bacteria (124 strains), 108 (32.3%) were viral strains, and 40 (12.0%) were fungal strains. Multivariate logistic regression analysis indicated that congenital heart disease, congenital airway abnormalities, nutritional anemia, recurrent pulmonary infection, and surgical history were the independent risk factors for severe adenovirus pneumonia in children, with odds ratios of 3.3, 11.1, 7.2, 14.3 and 12.9 respectively (P<0.05).

CONCLUSIONSSevere adenovirus pneumonia is mostly seen in children aged from 6 months to 2 years and occurs frequently in the winter and spring. Many cases are also infected with other pathogens, most commonly Gram-negative bacteria. Congenital heart disease, congenital airway abnormalities, nutritional anemia, recurrent pulmonary infection and surgical history are the independent risk factors for severe adenovirus pneumonia in children.

Adenoviridae Infections ; epidemiology ; etiology ; microbiology ; Child ; Child, Preschool ; Coinfection ; epidemiology ; microbiology ; Female ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Pneumonia, Viral ; microbiology ; Retrospective Studies ; Seasons

The effect of growth and fermentation conditions on the production of catalase by T. aurantiacus WSH 03-01 was investigated in shaking flasks. Catalase activity reached 1594 u/mL when the culture was grown on a complex carbon source containing 20 g/L dextrin and 1% (V/V) ethanol, which was 23% higher than the sum produced on 20 g/L dextrin and 1% (V/V) ethanol, respectively. It was concluded that dextrin might act as a major carbon source in the complex, while ethanol was rather a stimulator than a carbon source. The stimulation effect of ethanol on catalase production was postulated to be two aspects; catalase-dependent alcohol metabolism is activated by acute alcohol, thus more catalase need to be synthesized for that use, named direct induction. As for indirect induction, which may result from little amount of H2O2 generation in process of NADH regeneration in respiratory chain. Peptone was shown to be a favorable nitrogen source for catalase production and its optimum concentration was found to be 10 g/L. Catalase production by T. aurantiacus WSH 03-01 was further improved by optimizing the initial pH, volume of medium in flasks as well as the concentration of external H2O2. Under the optimum culture conditions, the activity of catalase reached 2762 u/mL, which was nearly 6.8 times higher than that of the initiate conditions. Furthermore, the potential application of this novel catalase in the treatment of textile bleaching effluents was evaluated. Thermo-and alkaline stability of this catalase was compared with the commercial available catalases produced from bovine and Aspergillus niger. The crude enzyme from T. aurantiacus WSH 03-01 showed stronger stabilities at (70 degrees C, 80 degrees C, 90 degrees C) and (pH 9.0, pH 10.0, pH 11.0) than the other two types of catalases, indicating a great application potential in the clean production process of textile industry.
Catalase ; metabolism ; Culture Media ; Ethanol ; metabolism ; Fermentation ; Hot Temperature ; Hydrogen-Ion Concentration ; Peptones ; metabolism ; Textile Industry ; Thermoascus ; enzymology ; growth & development

Objective To study the expressions of anaplastic lymphoma kinase (ALK-1) and cytotoxic proteins in primary systemic anaplastic large cell lymphoma (S-ALCL) and their relationship with clinical outcome. Methods 51 S-ALCL cases were collected from Lymphoma Lab of Peking University Health Science Centre & Peking Children's Hospital. The morphologic characteristics were studied under routine microscope, and essential immunohistochemical stainings were performed and reviewed to confirm the diagnosis of S-ALCL. Immunohistochemical stainings for ALK-1 and cytotoxic proteins (TIA-1 & granzyme B) were performed using standard SP method. Patients related clinical data including follow-up materials were collected. Results Survival time of 44 cases with completely clinical follow up materials ranged from 0.5～66months. 36 out of 51 cases(37 %) was positive for ALK-1 protein. While 20 cases out of 47 S-ALCL cases ( 42.55 % ) positive for granzyme B and 22 out of 28 cases (81.48 %) were positive for TIA-1. The prognosis of patients with ALK-1 protein positive and granzyme B negative expression was better, but TIA-1 expression might have nothing to do with clinical outcome (P＞0.05). In addition, multivariate analysis confirmed that ALK-1 protein expression, granzyme B protein expression and Ann-Arbor stage system were possible for prognosis(P＜0.05), Conclusion Expression of ALK-1 and granzyme B protein expression may serve as two independent prognostic predictors in S-ALCL patients.