Objective To set the cost standards for hospitalization based on the eases of the clinical pathway in order to help set a reasonable ceiling for the expenses of various diseases.Methods The multiple linear regression analysis was applied to find out influencing factors of hospitalization costs of the hysteromyoma.Diagnosis Related Groups(DRGs)ease mix was used to group 1777 hysteromyoma cases.Results The main factors for the expenses,as listed by their influence,were surgical operation or not,disease(s)of concomitance and the amount,adjusted R2 =0.6545.Hysteromyoma patients were divided into four diagnosis related groups; the all coefficient of variation(CV)is as small as 0.068,0.104,0.102,and 0.116 respectively.The hospitalization costs of the hysteromyoma of standard reference value were then calculated.Conclusion The standards interval for hospitalization costs set with DRGs case mix is reasonable and efficient,significantly useful for regulating medical practice and harnessing excessive costs of hospitalization.

Objective: To investigate the adhesive characteristics of two kinds of light-curing resin that was used to bond teeth and orthodontics brackets. Methods: A total of 60 premolar teeth were randomly divided into six groups, and brackets were bonded according to the manufacturers' instructions. In group A1, A2 and A3, the teeth were prepared using 100 ml/L polyacrylic acid, and the brackets were bonded using Fuji Ortho LC. In group B1, B2 and B3, the teeth were using self-etching primer, and the brackets were bonded using Transbond Plus Self Etching Primer (TPSEP). After 30 min and 24 h under room temperature and received cold-heat cycle treatment respectively, bond strength was measured using a testing instrument (2000S, Lloyds Instruments, Fareham, England) at a speed of 1 mm/min, and the residual adhesive was quantified using a stereomicroscope. The adhesive interface was observed by scanning electron microscope. Results: The bond shear strength of TPSEP and Ortho Glass LC are more than 5 MPa. The bond shear strength of TPSEP is stronger than that of Ortho Glass LC after 24 h. However,The adhesive remnant index (ARI)of TPSEP is higher than that of Ortho Glass LC. Conclusion: Transbond Plus Self Etching Primer and Ortho Glass LC can satisfy the clinic need of orthodontics.

砄bjective: To investigate the role of Candida species in burning mouth syndrome (BMS) in a Chinese cohort. Methods: The studied population comprised 52 BMS patients and 37 healthy controls. An oral rinse technique was used to detect the candidal carriage. The isolates were identified using API 20C AUX Candida identification kit.Results: Candida was found in 3 out of 37 of the controls(8.1%) and in 10 out of 52 BMS patients(19.2%). 25 strains of Candida were isolated from the 10 Candida positive BMS cases, 22 out of the 25 strains were Candida albicans while 3 were Candida prarapsilosis . 7 strains of Candida were isolated from the 3 Candida positive controls and all the 7 were Candida albicans . Conclusion: Candida infection may play a role in the development of BMS, especially in the type 1 subtype.

Objective To study the effectiveness and safety of therapeutic mild hypothermia in patients successfully resuscitated from cardiac arrest using a meta-analysis.Methods We searched the MEDLINE (1966-April 2012),OVID (1980 to April 2012),EMBASE (1980 to April 2012),Chinese bio-medical literature & retrieval system (CBM) (1978 to April 2012),Chinese medical current contents (CMCC) (1995 to April 2012),and Chinese medical academic conference (CMAC) (1994 to April 2012).Studies were included (1) the study design was a randomized controlled trial (RCT); (2) the study population included patients successfully resuscitated from cardiac arrest,and received either conventional post-resuscitation care with normothermia or mild hypothermia; (3) the study provided data about good neurologic outcome and survival till hospital discharge.Relative risk (RR) and 95％ corfidence interval (CI) were used to pool the effect.Results The study included four RCTs with a collected total of 417 patients successfully resuscitated from cardiac arrest.Compared to conventional post-resuscitation care with normothermia,patients in the hypothermia group were more likely to have good neurologic outcome (RR =1.43,95％ CI 1.14 ～ 1.80,P =0.002) and were more likely to survive till hospital discharge (RR =1.32,95％ CI 1.08 ～ 1.63,P =0.008).From all over the studies there was no significant difference in reported adverse events between the normothermia and hypothermia group (P ＞ 0.05).There did not exist heterogeneity and publication bias.Conclusions Therapeutic mild hypothermia improves neurologic outcome and survival in patients successfully resuscitated from cardiac arrest.

This paper reported some problems in relation to the elderly renal transplant recipients.Before transplantation,hemodialysis,blood transfusion,water and electrolyte balance and corrections of acidosis.and treatment of diseases of the other systems should be emphasized.Method of treating the athe erotic change in the iliacartery during the operation,and selection of immunosuppressants and dosages were discussed.The prevention and treatment of the postoperative pulmonary infection,septicemia,steroid induct ulcerations of gestrointestinal tract and profound hemorrhage,serious diabetes mellitus and hypertensive encephalopathy after transplantation were also discussed in this paper.

Objective To explore the expression and relationship with the clinical pathological features of CD34,CD117,smooth muscle actin(SMA),S -100 protein in gastrointestinal stromal tumor.Methods 60 cases of resection of gastrointestinal stromal tumor specimens were collected,all cases were confirmed by postoperative patholo-gy,explored the expression of CD34,CD117,SMA,S -100 protein expression in gastrointestinal stromal tumor with immunohistochemical method,analyzed the relationship with the clinical pathological features of CD34,CD117,SMA, S -100 protein.Results CD34 positive signal located in the cytoplasm,CD117 positive signal mainly located in cyto-plasm,a few located in the cell membrane,nuclear yellow particles diffuse distribution in cells,SMA and S -100 pro-tein located in the cytoplasm of focal or scattered point positive expression of CD34,CD117,SMA,S -100 protein pos-itive expression rate in gastrointestinal stromal tumor tissue were 88.33% (53 /60),95.00% (57 /60),43.33%(26 /60)and 6.67% (4 /60);CD34 positive expression rate was related to area (χ2 =9.093,P <0.05),S -100 protein positive expression rate related to the histological type (χ2 =10.447,P <0.05).Conclusion CD34,CD117 in gastrointestinal stromal tumor tissue in the positive expression rate is very high,detection jointed with CD34,CD117 can improve the gastrointestinal stromal tumor diagnosis accuracy.

Objectives:This paper at measuring the inequity and its influencing factors of medical care utiliza-tion of elderly aged above 60 ( inclusive) . Methods:data comes from 2013 China Health and Retirement Longitudinal Study ( CHARLS) where the population aged 60 and above was selected as the research object. Concentration index ( CI) and its decomposition or centralized curve was used to measure the inequity of medical care services utilization of the elderly, and then the influencing factors of inequity were analyzed by means of the centralized index. Results:The concentration index for outpatient and inpatient service utilization for the elderly was 0 . 0619 and 0 . 1050 , re-spectively, and the concentration curves were below the absolute fair line. The top 2 factors that showed positive con-tribution to the outpatient service utilization included annual per capita consumption expenditure and the pension a-mount. The top 2 factors that showed negative contribution and larger contribution rate to the outpatient service utiliza-tion included New Rural Cooperative Medical Insurance (NRCMI), and Physical Ability in Daily Life (PADL). The top 2 factors that positively and highly contributed to the inpatient service utilization included the household per capita consumption expenditure and the Urban Employees' Basic Medical Insurance (UEBMI). The top 2 factors that nega-tively contributed to the inpatient service utilization included the New Rural Cooperative Medical Insurance ( NRCMI) and the Physical Ability in Daily Life ( PADL) . The horizontal inequity of outpatient and inpatient service utilization was 0. 0739 and 0. 1339, respectively, indicating that there was unfairness in the use of outpatient and inpatient services among elderly. Conclusion:There is inequity of medical care service utilization among the elderly in China. The economic status contributes the largest part of inequity, meaning that it is unfair to the first contribution factor;while the Needs-based fac-tors and New Rural Cooperative Medical Insurance (NRCMI) showed an inequity, narrowing the unfair gap.

Objective To investigate the effect of mild therapeutic hypothermia for different lengths of time on cerebral edema and hypoxia-inducible factor 1 α (HIF-1α),vascular endothelial growth factor (VEGF) expressions following intracerebral hemorrhage (ICH) so as to explore possible mechanism for better application of mild hypothermia.Methods ICH models were made in rats by stereotaxically injecting autologous artery blood into right caudate nucleus.Forty male Sprague-Dawley (SD) rats were randomly (random number) divided into 5 groups (n =8 each):sham-operated (sham),normothermic (NT),hypothermic-1 hour (MH1),hypothermic-2 hours (MH2),hypothermic-4 hours (MH3).Normothermic and sham-operated animals were kept at (37.0-± 0.2) ℃ of body temperature.Animals in the hypothermic groups received immediately and rapid cooling after ICH and kept at (33.0 ± 0.5) ℃ of body temperature for 1,2 and 4 hours respectively.Rats were sacrificed at 48 hours after cerebral hemorrhage.Then brain water content and BBB permeability were determined.Quantitative real-time PCR and Western blot were used to analyze the expression of HIF-1α and VEGF.Results The content of brain water,Evans blue concentration in brain,and the mRNA expression and protein levels of HIF-1α and VEGF were noticeably higher in NT group than those in sham group (P ＜0.01).There were statistically significant difference in the expression of HIF-lα mRNA and protein but little difference in other indicators between MH1 group and NT group.Compared with NT group,MH2 group and MH3 group brought about an improvement in BBB permeability and remarkable down-regulation of protein levels and expression of HIF-1 α and VEGF mRNA,whereas there were no statistically significant difference in expression of indicators between the two groups.Conclusions Mild therapeutic hypothermia induced rapidly and immediately after ICH could limit the development of brain edema in rats by down-regulating expression and protein levels of HIF-1 α mRNA,and in turn suppressing the evaluation of VEGF mRNA and protein expression.The brain edema was effectively reduced in animals treated with hypothermia for 2 hours' or 4 hours ' duration with little difference in magnitude of reduction in brain edema between these two modalities of hypothermia.

BackgroundThe morphological examination of macular disease is very important information for the early diagnosis.Spectral domain optical coherence tomography (SD-OCT) is a gold criteria in the diagnosis of macular diseases,but its clinical application is limited in the eyes with refractive medium opacity.The resolution ratio of conventional B-scan sonography is unsatisfactory.20 MHz B-scan sonography may be a new approach to maculopathy.ObjectiveThis study was to evaluate the clinical value of 20 MHz B-scan ultrasound by comparing morphological changes of different maculopathies observed by 20 MHz ultrasound and spectral-domain OCT.MethodsA prospective study was designed.51 eyes of 51 patients with macular diseases who were determined by Tianjin Medical University Eye Center were enrolled in this study.Spectral-domain OCT was used to image the macular area,and then the 20 MHz B-scan ultrasound was used to examine the same eye to assess the value of 20 MHz B-scan ultrasound diagnosis.The macular diseases were typed according to the OCT manifestation.The characteristics of 20 MHz ultrasound for the same maculopathy were analyzed.All the patients subscribe the informed consent before the study.ResultsIn 10 eyes with macular hole determined by spectral-domain OCT,shallow dome-shaped lesion with central hollow was exhibited on the ultrasound image.The macular edema,retinal neuroepithelium layer detachment and retinoschisis were found in 16 eyes,6 eyes and 4 eyes by spectral-domain OCT,but the 20 M Hz B-Scan ultrasound presented with the focal belt-shaped elevation with non-echo zone below.In contrast,in 15 eyes of retinal pigment epithelium detachment in OCT,spectral-domain OCT showed stronger and thicker belt-shaped echo.Conclusions20 MHz B-scan ultrasound has certain value in the diagnosis and differentiation for several common maculopathies.Although it is not accurate as OCT in recognizing diseases,it could play an important role in refractive media opacity eye.

Objective To analyze the relationship between daytime sleepiness and oxygen desaturation in the male eldcrly with obstructive sleep apnea /hyponea syndrome (OSAHS).Methods 147 male elderly (aged 60-80 years) with OSAHS in our sleep laboratory from March 2008 to February 2011 were divided into daytime sleepiness and daytime non-sleepiness groups. Epworth sleeping scale (ESS) and polysomnography (PSG) were employed to detect the degree of sleepiness.Oxygen desaturation were evaluated by oxygen desaturation index (ODI),average and minimum blood oxygen,time percentage of 90％ oxygen desaturation (CT90). Resulls There were significant differences between the two groups in body mass index (BMI) (t=4.157),ODI (t=-10.063),average (t=5.800) and minimum (U=916) blood oxygen,CT90(U=887)and apnca/hypopneaindex (AHI) (t =-11.361) (all P＜0.001).ESS scores were related with desaturation parameters of ODI,average and minimum blood oxygen and CT90 (r=0.683,-0.450,-0.583,0.507,all P＜0.001).ODI was correlated with average and minimum blood oxygen and CT00 (r=-0.628,-0.763,0.689,all P＜0.001).Among parameters of oxygen desaturation,only ODI had influence on ESS scores (odds ratio=1.11,95％CI:1.07 1.15),The sensitivity and specificity predicting daytime sleepiness at ODI ≥23 times/h were about 79.2％ and 84.3％,respectively.Conclusions Daytime sleepiness is associated with oxygen desaturaion and may be predicted by ODI through which average and minimum blood oxygen and CT00 are related with daytime sleepiness in the male elderly with OSAHS.