Objective To explore the application of clinical pathway in the management of single disease cost. Methods Inpatients with breast cancer from June 2006 to June 2007 were divided into the test group and the control group according to different payment models.Patients in the test group had medical insurance while patients in the control group did not.The general data in the two groups had no statistical difference.The test group were given nursing intervention by clinical pathway while the control group received routine nursing measures. Results The mean inhospital days,mean days waiting for operations and mean inhospital expenses in the test group were shorter or lower than those in the control group (P ＜ 0.05).The mastering degree of health knowledge and the satisfaction degree of patients in the test group were higher than those in the control group (P ＜ 0.05). Conclusions The application of chnical pathway in the single disease cost patients with medical insurance could effectively control the medical expenses and guarantee the quality.So we consider that the application of clinical pathway in single disease cost is applicable.

This article analyzed, organizde, and summarized the specific meaning of yin and yang in Shang Han Lun, holding the idea that Zhongyang in Shang Han Lun contains fluid. YE Tian-shi's Tong Yang Bu Zai Wen Er Zai Li Xiao Bian is derived from Zhong jing method, and is more suitable to be used in damp-heat syndromes, reflecting that YE Tian-shi is not confined to traditional methods, but follows traditional prescriptions and flexible thoughts, which provides references for learning and flexibly applying prescription ideas.

OBJECTIVETo explore the action of pingxiao capsules (PXC) and its significance in the treatment of late stage mammary cancer (LSMC).

METHODSOne hundred and forty-two LSMC patients were randomized into four groups: the two single treated groups treated by endocrinotherapy (ET) alone (n = 27) and by chemotherapy alone (n=44) respectively, and the two PXC combined treated groups treated with PXC plus endocrinotherapy (n=27) or chemotherapy (n=44). The remission rate and progression time (TTP) of disease, the survival time and quality of life (QOL) of patients, and the adverse reaction were compared between the single treated groups and the combined treated groups.

RESULTSThe median progression time was obviously prolonged, and QOL improved in the combined treated groups than those in the single treated groups (P < 0.05), but no significant difference was found in the remission rate or adverse reaction between them.

CONCLUSIONPXC can improve QOL, prolong the progression time in patients of LSMC, and with less adverse reaction. It is worth spreading combination of PXC with chemo- or endocrino-therapy in clinical application for treatment of LSMC patients.

Adult ; Aged ; Antineoplastic Agents, Hormonal ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Paclitaxel ; administration & dosage ; Phytotherapy ; Sepharose ; administration & dosage ; analogs & derivatives ; Tamoxifen ; therapeutic use

OBJECTIVE: To explore the association between the cancer related fatigue and social support in breast cancer patients after chemotherapy. METHODS: According to the uniform inclusive and exclusive criteria, 396 breast cancer patients after chemotherapy were sampled randomly from 4 hospitals in Changsha and investigated on the spot by cancer fatigue scale and social support scale. RESULTS: The levels of social support, subjective support, Objective support, and utilization of support of the breast cancer patients after chemotherapy were 36.63±7.80, 21.05±4.67, 8.45±3.06, and 7.13±2.10, respectively, which were lower than the normal level, with significant difference(P<0.001). There was a negative correlation between each fatigue dimension and social support, subjective support, Objective support, and utilization of support (P<0.05 or P<0.001). CONCLUSION The social support system in patients with breast cancer after chemotherapy is poor. There is a negative correlation between the social support system and cancer related fatigue.
Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Breast Neoplasms ; complications ; drug therapy ; Carcinoma, Ductal, Breast ; drug therapy ; psychology ; China ; Fatigue ; etiology ; psychology ; Female ; Humans ; Middle Aged ; Social Support

Nowadays,oil-pollution of seawater in the world has severely threatened the security of sea entironment.Bioremediation offers one available option for an oil spill response.The aspects as follows are introduced some evolvement of microbial ecology,including new method of survey of microbial diversity without cultivation,new isolated method and the properties of main hydrocarbon degradated strain.But we have little or no understanding of the vast majority of marine bacteria that remain uncultured,and more efforts should be made to improve current methods for isolating oil-degrading or oil-emulsifying bacteria,not only for assessing the fate and effects of the spilled oil,but also for isolating novel bacteria that would be useful for the petroleum industry.

OBJECTIVETo explore several numerical methods of ordinal variable in one-way ordinal contingency table and their interrelationship, and to compare corresponding statistical analysis methods such as Ridit analysis and rank sum test.

METHODSFormula deduction was based on five simplified grading approaches including rank_r(i), ridit_r(i), ridit_r(ci), ridit_r(mi), and table scores. Practical data set was verified by SAS8.2 in clinical practice (to test the effect of Shiwei solution in treatment for chronic tracheitis).

RESULTSBecause of the linear relationship of rank_r(i) = N ridit_r(i) + 1/2 = N ridit_r(ci) = (N + 1) ridit_r(mi), the exact chi2 values in Ridit analysis based on ridit_r(i), ridit_r(ci), and ridit_r(mi), were completely the same, and they were equivalent to the Kruskal-Wallis H test. Traditional Ridit analysis was based on ridit_r(i), and its corresponding chi2 value calculated with an approximate variance (1/12) was conservative. The exact chi2 test of Ridit analysis should be used when comparing multiple groups in the clinical researches because of its special merits such as distribution of mean ridit value on (0,1) and clear graph expression. The exact chi2 test of Ridit analysis can be output directly by proc freq of SAS8.2 with ridit and modridit option (SCORES =).

CONCLUSIONThe exact chi2 test of Ridit analysis is equivalent to the Kruskal-Wallis H test, and should be used when comparing multiple groups in the clinical researches.

Biomedical Research ; methods ; Statistics as Topic ; Statistics, Nonparametric

OBJECTIVEThe purpose of this study was to investigate the distribution of collagen I, II , X, alkaline phosphatase (ALP) and their roles during initiation of condylar cartilage of the fetal mouse.

METHODSCoronary sections of mandible of mouse embryo aged from 14th to 18th day were studied under light microscope after stained by immunohistochemical method with antibody of types I, II, X collagen and ALP.

RESULTSOn the 14th day of mouse embryo, it was found that mesenchymal cells condensation continuous with the periosteum. Type I collagen and ALP were positive behind the terminal of the ossifying mandibular periosteum where future condylar will form. On the 15th day, positive staining for types I, II collagen was found in mesenchymal cells around hypertrophic cells and type X collagen was detected in hypertrophic cells. ALP was positive in both mesenchymal cells and hypertrophic cells. On the 16th day, type I collagen was observed from periosteal osteogenic cells and mesenchymal cells of the fibrous cell layer to the upper hypertrophic cell layer while Type II collagen was restricted from the lower polymorphic cell layer to the bottom of the hypertropic cell layer. Type X collagen was positive in the hypertrophic cell layer. ALP was positive in periosteal osteogenic cells and hypertrophic chondral cells, but not in the polymorphic cell layer.

CONCLUSIONDevelopment of condylar cartilage is different from that of limb bone. Types I, II, X collagen are expressed in the condylar chondrocyte on the early stage of endochondral ossification. The histology evidence supports the conjecture that condylar cartilage is derived from differentiated mesenchymal cells of the preperiosteum or periosteum of the mandible where ALP is positively expressed.

Alkaline Phosphatase ; Animals ; Cartilage ; Cell Differentiation ; Chondrocytes ; Collagen ; Collagen Type I ; Mandible ; Mandibular Condyle ; Mice ; Osteogenesis

OBJECTIVETo evaluate a model of temporomandibular disorders established by transzygomatic arch traction of the mandibular ramus in rabbits.

METHODSFifteen adult New Zealand rabbits were subjected to traction in the postero-superior direction unilaterally using elastic force and six rabbits used as the control. Histopathologic change of the disc, joint space and cartilage was observed through Hematoxylin and Eosin staining.

RESULTSAnterior disc displacement or disc deformity in four experimental rabbits was observed on the traction side 2 weeks after operation. At 4 weeks, fibrous adhesions in joint compartment were found in five experimental rabbits. The condyles or articular eminences of some experimental rabbits showed irregularities on the cartilage surface. In the 6 th week, bad disc deformity in four rabbits and severe fibrous adhesions in five rabbits was observed on the traction side, and subchondralbone and calcified cartilage became irregular. In control group, All articular structures were normal.

CONCLUSIONSA animal model of temporomandibular disorders can be established by transzygomatic arch traction of the mandible.

Animals ; Disease Models, Animal ; Mandible ; pathology ; Rabbits ; Temporomandibular Joint Disorders ; Traction ; Zygoma

OBJECTIVETo investigate the balance function of the patients with unilateral vestibular hypofunction (UVH) by timed balance tests and static posturography (SPG).

METHODSSixty-five subjects with UVH and 92 healthy subjects were taken the timed balance tests under differential stance including (1) standard Romberg test, (2) feet apart stance test, (3) tandem and (4) unilateral standing tests with eyes open and eyes closed. The average timing that subjects kept balance before falling in each standing conditions was recorded by stopwatch as the timed result. The body sway velocity during the test (1) and (2) were also recorded by the SPG.

RESULTSThe timed results of the tandem and unilateral standing with eyes open and eyes closed in the UVH group were decreased (P < 0.001) compared with the control group. The body sway velocity of the standard Romberg test and foot apart stance with eyes open was not different between the UVH group and control group (P-value was 0.118 and 0.110 for the two tests respectively), and the difference was significant in the eyes closed condition (P < 0.001). For the two groups, the body sway velocity of foot apart standing was decreased than that of the standard Romberg test with eyes open and eyes closed (P < 0.05 or P < 0.001). Significant correlations were not found between the timed results and sway velocity results in both two groups respectively (P > 0.05).

CONCLUSIONSAccording to clinical assessment of balance function in UVH, the tandem and unilateral stance test could provide the additional information about the upright stance to the SPG measurement. The effect of foot position on the results of SPG should been considered in clinic.

Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Neurologic Examination ; Postural Balance ; Vestibular Diseases ; physiopathology

Objective To explore the protective effect of nicorandil combined with rosuvastatin on myocardial tissue in patients who underwent percutaneous coronary intervention (PCI).Methods A total of 68 patients with coronary heart diseases (CHD) who underwent PCI were randomly divided into control group (36 cases) and treatment group (32 cases).The control group was treated with rosuvastatin 10 mg once daily for 3 d before PCI.The treatment group was given nicorandil 5 mg three times daily for 3 d before PCI on the basis of control group.Levels of serum high-sensitive troponin T (hs-cTnT),high-sensitive C-reactive protein (hs-CRP),tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10)were measured before PCI and 24,48 h after PCI.Results The markedly effective rates in treatment group and control group were 78.13％ (25/32),52.78％ (19/36),with significant difference (P ＜ 0.05).Before PCI,the levels of hs-cTnT in the treatment group and control group were (36.56 ± 15.35),(30.29 ± 13.67) pg · mL-1,hs-CRP were (3.67 ± 1.24),(3.53 ± 1.32) mg · L-1,TNF-α were (6.54 ± 2.42),(6.76 ±2.15)pg · mL-1,IL-10 were(6.87 ± 1.92),(7.02 ± 1.85)pg · mL-1.At 24 h after PCI,the levels of hs-cTnTwere(71.25 ± 17.87),(82.65 ± 18.34)pg · mL-1,hs-CRP were(9.48 ±2.35),(13.56 ±3.52) mg · L-1,TNF-α were(8.72 ± 2.26),(10.65 ± 3.16) pg· mL-1,IL-10 were (13.55 ± 4.51),(11.21 ± 3.54) pg · mL-1 At 48 h after PCI,the levels of hs-cTnT were(60.56 ± 15.64),(73.54 ± 16.51)pg · mL-1,hs-CRP were(6.62±1.98),(10.24±2.84)mg· L-1,TNF-α were(7.56±1.86),(8.86±1.95)pg· mL-1,IL-10 were(11.16 ± 3.28),(9.76 ± 3.11) pg · mL-1,and the differences of all the parameters above between the two groups were statistically significant (P ＜ 0.05).No adverse drug reactions were found in both groups.Conclusion Nicorandil combined with rosuvastatin before PCI is able to reduce inflammatory factors,improve the level of IL-10 and alleviate myocardial injury,with high safety profile.