Objective To explore the application of auto-regressive integrated moving average (ARIMA) product season model in predicting number of inpatient and hospitalized expense of malignant tumor,and to provide scientific basis for hospital business management.Methods We collected inpatient data of malignant tumor from January 2007 to December 2015 in one hospital for model fitting,and used monthly data 2016 to verify the effect of model prediction.We predicted the number of inpatient and hospitalized expense of malignant tumor in 2017.Results ARIMA (0,1,1) (1,1,0) 12 was the best model for number of inpatient and hospitalized expense of malignant tumor,with prediction fitting errors of 1.1％ and 1.47 ％,respectively.The number of inpatient and hospitalized expense of malignant tumor in 2017 were predicted to be 7631 and 0.336 billion.Conclusion ARIMA product season model can better applied in the predicting of hospital business management.

The Rotating Automatic Drug Delivery Machine is designed to deliver aqueous drugs in hospital pharmacy.It consists of two main parts-mechanical parts and controlling circuit.In the machine the drug tray is rotated in a seperate layer,and its spinning,position fixing and tray stopping is run by one step motor.The microcomputer (MCS-51) used in the controlling cir- cuit makes it easy to simplify the hardware and change iits controlling ways. This machine use first used in our hospital and it has been proved successfal.

Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using Sun’s operation and triple-branched stent graft. Methods According to the operation mode, thirty-three patients with type A aortic dissection were divided into Sun’s operation group (n=22) and triple branches aortic arch stent-graft placement op?eration (triple-branched) group (n=11). Preoperative examinations included cardiac ultrasound, aortic CT angiography (CTA), hepatic and renal functions and blood routine test in all patients. Intraoperative monitoring included the index about cardiopulmonary bypass and blood loss. The perioperative hepatic and renal functions and complications were also recorded. Survival and recovery rates were evaluated by follow-up between two groups of patients. Results There were six periopera?tive death in Sun’s group, and three patients died in triple-branched group. In triple-branched group, the intraoperative blood loss was significantly increased than that in Sun’s group [(3 586.4±2 926.8) mL vs. (2 630.5±1 821.2) mL, P<0.05]. Postoperative echocardiographic examinations revealed that the left ventricular size (LVEDd) and the aortic diameter were decreased while the left ventricular ejection fraction (LVEF) was elevated after surgery in Sun’s group [(50.9±6.9) mm vs. (55.0±7.5) mm,(28.2±1.6) mm vs. (48.8±11.0) mm, 0.620±0.031 vs. 0.469±0.104, P<0.05]. Whereas, only the aortic diame?ter was decreased after surgery in triple-branched group [(28.6±3.9) mm vs. (50.9±9.2) mm, P<0.05]. Kaplan-Meier surviv?al curve showed that five-year survival rate of Sun’s group was similar with that of triple-branched group (Log-rank χ2=0.095,P>0.05). At 5 year after operation, there were no significant differences in the recurrence of new aortic dissection, the incidence of cerebral infarction and mortality between Sun’s group and triple-branched group (P>0.05). Conclusion Sun’s operation can significantly decrease patient’s intraoperative blood loss and improve cardiac function. But its survival rate and long term results need advanced observation.

Objective To compare the effects of different doses of dexmedetomidine on the median effective concentration (EC50) of ropivacaine for epidural block and investigate the appropriate dose.Methods One hundred and twenty ASA Ⅰ patients of both sexes,aged 20-55 yr,weighing 50-75 kg,scheduled for knee arthroscopic operation,were randomly divided into 4 groups (n =30 each):no dexmedetomidine group (group D0),0.25 μg/kg dexmedetomidine group (group D0.25),0.50μg/kg dexmedetomidine group (group D0.50),and 1.00μg/kg dexmedetomidine group (group D1.00).In group D0,ropivacaine 20 ml was injected into epidural space.The ropivacaine-dexmedetomidine mixtures containing 0.25,0.50 and 1.00 μg/kg dexmedetomidine were injected into epidural space in groups D0.25,D1.00 and D0.50 respectively.The volume of mixtures was 20 nl in groups D0.25,D1.00 and D0.50.The initial concentration of ropivacaine was set at 0.40 ％,0.40 ％,0.28 ％ and 0.20 ％ in groups D0,D0.25,D0.50 and D1.00 respectively and then the EC50 was determined by up-and-down technique.The concentration of ropivacaine was increased/decreased by 0.02％ in the next patient.The analgesic effect was assessed using VAS score.VAS score =0 was considered as effective analgesia.The EC50 and 95％ confidence interval (CI) of ropivacaine were calculated using probit method.Adverse effects were recorded.Results The EC50 and 95 ％ CI of ropivacaine was 0.38％ (0.35-0.41)％,0.34％ (0.31-0.36)％,0.22％ (0.20-0.24)％ and 0.14％ (0.12-0.15) ％ in groups D0,D0.25,D0.50 and D1.00 respectively.The EC50 of ropivacaine was decreased gradually in groups D0,D0.25,D0.50 and D1.00 ( P ＜ 0.05).Compared with group D0,the incidonce of hypotension and bradycardia was significantly increased in group D1.00 ( P ＜ 0.05),while no significant change was found in the incidence of adverse effects in groups D0.25 and D0.50 (P ＞ 0.05).Conclusion The appropriate dose of dexmedetomidine for epidural analgesia is 0.50 μg/kg.

Objective To construct the eukaryotic vector that expressing hepatitis B virus (HBV) S and the single fragment of variety chain (ScFv) of monoclonal antiboy against cytotoxic Tlymphocyte-associated antigen-4 (CTLA-4) and to analyze the immunological activity of recombinant S-ScFv protein.Methods The oringially constructed pSect2/ScFv4F10 and pSect2/S were double enzyme digested by Sfi I and Hind Ⅲ,respectively.Then the HBV S gene was cloned into the pSect2/ScFv4F10 vector.The pSect2/ScFv4F10 and pSect2/S-ScFv4F10 were expressed in Chinese hamster ovary (CHO) cells,and the expressed proteins were verified through sodium dodecyl sulfatepolyacrylamide gelelectrophoresis(SDS-PAGE)andWesternblotting.Afterultrafiltration concentration and affinity chromatography,the biological affinity of the expressed ScFv4F10 and S-ScFv4F10 proteins were examined by competitive enzyme-linked immunosorbent assay (ELISA) and surface plasmon resonance (SPR) technology.The comparison between groups was done by One-way ANOVA.ResultsThe eukaryotic expression vector of pSect2/S-ScFv4F10was successfully constructed,and relative molecular mass of the expressed protein of S-ScFv4 F10 was about 52 000 that analyzed by SDS-PAGE and Western blotting.With the fixed concentration of 4F10-mAb against CTLA-4,the A570 value of the mixed reaction with purified CTLA-4 antigen gradually increased with the decrease of ScFc fusion protein proportion; when the molar ratio of ScFv,S-ScFv4F10∶4F10=2∶1,the competitiveinhibitionratesagainst 4F10conjugatedantigenwere72.6％and64.5％,respectively.The affinity constants of association kinetics for CTLA-4 mAb,ScFv4F10 and S-ScFv4F10 with CTLA-4 antigen were 7.29 × 108 mol/L,9.52 × 106 mol/L and 2.04 × 106 mol/L,respectively,and the dissociation constants of KD were 1.40 × 10-9 mol/L,1.05 × 10-7 mol/L and 4.91 × 10-7 mol/L,respectively.ConclusionsThe eukaryotic expression vector of pSect2/S-ScFv4F10is successfully constructed,and the recombinant protein of S-ScFv4 F10 has a fairly high affinity with CTLA-4 antigen.

Objective To investigate the effects of different tidal volumes and positive end expiratory pressures on cell apoptosis in lung tissue of rats with acute lung injury.Methods Forty healthy male Sprague-Dawley rats were randomly(random number)divided into five groups,namely low tidal volume group(LV,VT 8 mL/kg),high tidal volume group(HV,VT 30 mL/kg),low tidal volume group with PEEP 2cmH2O(LV2P,VT 8 mL/kg,PEEP 2 cmH2O),low tidal volume group and PEEP 5cmH2O (LV5P,VT 8 mL/kg,PEEP 5 cmH2O)and low tidal volume group and PEEP 8 cmH2O(LV8P,VT 8 mL/kg,PEEP 8 cmH2O).After intravenous administration of oleic acid(OA,0.1 mL/kg),the rat model of acute lung injury was made.Mechanical ventilation was employed in rats of the experiment groups.Rats were sacrificed and their whole lungs were taken after mechanical ventilation for 2 hours.The transferase d-UTP end labeling assay(TUNEL)was used to define the extent and distribution of apoptotic cells in bronchus and lung tissues.The level of caspase-3 protein was determined by immunohistochemistry.Results The apoptotic cells on both alveolar septum and bronchial epithelium obviously increased with high level of caaspase-3 protein in HV group.The number of apoptotic cells obviously decreased with decrease in caspase-3 protein after PEEP ventilation.These changes were more significant in LV5P than those in other groups(P ＜ 0.01).Conclusions The mechanical ventilation with low tidal volume and PEEP produces protective effects on lung from injury.The cell apoptosis plays an important role in the course of VILI.

Objectives To understand essential basis data availability for implementation of cost accounting in TCM hospitals. Methods Costs of a total of 1588 TCM hospitals were investigated by conducting the baseline survey via questionnaires in 2013. Results Departmental basic data (including ratio of office staff and entire staff, ratio of outpatient and inpatient departments in clinical department), and construction data for housing were well accessible, while utility fee and internal service data were not. Conclusion ①Public TCM hospitals need to improve and specify the basic cost data. ②Differences exit among different types and levels of hospitals in the availability of data. ③There are still difficulties in carrying out cost accounting in public TCM hospitals, which needs strong supports from all relevant departments.

Objective To assess systematically the effect of problem-based learning (PBL) versus traditional methods in nursing students.Methods Relative literature was searched by computer at home and abroad.according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software,and literature selection and repetition were used according to the Note Express software.Results A total of 9 studies of randomized controlled or not randomized controlled trial were brought into the study by random effects model.A total of 1 187 were collected into the study,574 in the experimental group and 613 in the control group.According to subgroup analysis showed by measurement scale,problem-based learning (PBL) can significantly improve the critical thinking ability of nursing students.The results had high stability and reliability.Conclusions PBL teaching method can significantly improve the critical thinking ability of nursing students,and provide a better learning method for clinical teachers and students,which is worthy of further promotion.

Many factors,especially perinatal asphyxia,can lead to varying degrees of hypoxia brain injury in fetus or newborns within perinatal period.So far,the mechanisms of neonatal cerebral damage caused by hypoxia during the perinatal period have not been clearly demonstrated,and there have no effective drugs or therapeutic methods to improve hypoxia-induced cerebral damage.This review focuses on the recent progress of zebrafish as a model organism of using in research of hypoxia brain injury,including the anatomic and behavior basis,model making,research strategies and the advantages of neurotrophic drug screening.The application of zebrish in the research of neonatal hypoxic brain injury is promising,and may provide a new tool as research in finding out the therapy strategies of hypoxic-ischemic encephalopathy.

Purpose To investigate the expression of Wnt-1 and β-catenin protein in cervical squamous cell carcinomas ( CSCC) and their relationship with invasion and lymph node metastasis. Methods Expression of Wnt-1 and β-catenin protein were examined on immunohistochemistry containing 78 specimens of CSCC and 30 specimens of normal cervical tissues. Results The positive rates of Wnt-1 and β-catenin protein in normal cervical tissues were 20.0% and 10.0% respectively. The positive rates of Wnt-1 andβ-cate-nin protein in CSCC were 56.4%, and 74.4% respectively. There was a significant difference between the two groups (P<0.001). The positive rates of Wnt-1 andβ-catenin protein in 33 cases with lymph node metastasis of CSCC were 72.7% and 90.9% respective-ly. The positive rates of Wnt-1 andβ-catenin protein in 45 cases with no lymph node metastasis of CSCC were 44.4% and 62.2% re-spectively. The expression of Wnt-1 andβ-catenin protein was significantly related with grades of tumors and depth of invasion and FI-GO stages (P<0.05), and there was no significantly difference between the expression of Wnt-1 andβ-catenin protein and CSCC pa-tients age (P>0.05). Spearman analysis showed that the expression of Wnt-1 protein was positive related to the expression ofβ-cate-nin protein (rs =0.490, P<0.001). Conclusion The abnormal expression of Wnt-1 and β-catenin may be involved in initiation, development, invasion, and metastasis of CSCC, and it is suggested that Wnt-1 and β-catenin be considered as potential markers for invasion, metastasis, and prognosis.