With performance evaluation management as the stepping stone,the hospital joined the DRGs with the attending in-charge method by means of enforcing the attending in charge practice,DRGs knowledge training,and identifying problems with DRGs grouped data of the attending physician group, in an effort to explore new methods of medical quality control.Two years of practice provide tools of quality control to strengthen the hospital’s fine management.At the same time,it should also be noticed that DRGs merely diversify management means,as the content and form of which still need to constantly be improved in the course.

By using the diagnosis related groups(DRGs) method, we analyze and compare the rationality and feasibility of outcomes and human resources distribution of clinical specialties and health care professionals.It may increase the hospital management levels and feasibility.The introduction of DRGs for the majority of hospital management may enhance the performance evaluation and human resource levels in the hospitals.

BACKGROUND: Diabetic retinopathy is the common complications of diabetes mellitus. Taurine is free aminoacid with the mostly abundant content in retina, and it is the necessary nutrition factor for regeneration and development of retina. Deficiency of taurine will cause structural and functional change of retina.OBJECTIVE: To probe into the effect of taurine on the expression of retinal glial fibrillary acidic protein (GFAP) mRNA DESIGN: A randomized and controlled observation SETTING: Third Military Medical University of Chinese PLA MATERIALS: This experiment was carried out at the Third Military Medical University of Chinese PLA from March 2003 to December 2003.Totally 54 closed group SD rats, with body mass of 250 g, were chosen.The successful diabetic rat model were randomly divided into 6 groups: diabetic group of 1 month, taurine-treated diabetic group of 1 month, diabetic group of 2 months, taurine-treated diabetic group of 2 months, diabetic group of 3 months, taurine-treated diabetic group of 3 months, with 9 rats in each group. Another 15 rats were chosen homeochronously as normal control group.METHODS: The animals were raised in separate cages. They were free to access to food and water, and fasted for 12 hours before experiment. Streptozotocin was used to induce diabetes mellitus .When Tes-Tape showed urine glucose reached more than (+++), and blood glucose concentration of venous blood from tail measured ＞16.7 mmol/L, models were established successfully. Expressions of GFAP mRNA and protein were measured with immunohistochemistry, RT-PCR, Western blotting and other technical methods. The effect of taurine on retinal neurons and glial cells in rats with diabetes mellitus was observed.MAIN OUTCOME MEASURES: Expressions of GFAP mRNA and protein RESULTS: ① Immunohistochemical analysis showed that: When rats suffered from diabetes mellitus for 1 month, taurine can inhibit the immunoreactivity of GFAP. With the elongation of intervention time of taurine, the immunoreactivity of GFAP is weakened. ②RT-PCR detection: Starting from the beginning of 2 months, the expression of GFAPmRNA in diabetic group began to increase; taurine obviously down-regulated the expression of GFAP mRNA. ③ In taurine-treated diabetic group of 3 months,the expression of GFAP was the strongest. When diabetic rats were treated by taurine for 2 months, the expression of GFAP was decreased.CONCLUSION: Taurine can down-regulate the expression of GFAP mR-NA and protein, indicating that it can protect retinal pathological change in rats with diabetes mellitus.

OBJECTIVE To study the in vitro activity of cefepime combined with sulbactam against carbapenem-resistant strains of Acinetobacter spp clinically isolated. METHODS The activity of each drug alone was determined against 24 isolates. Chequerborad synergy testing was then performed against all the isolates. RESULTS The percentage of the FIC index showed 33.3% synergism, 62.5% additive, 4.2% (1/24) indifference, and no antagonism tively. CONCLUSIONS Testing of cefepime and sulbactam combinations revealed synergism and additivity activity against some carbapenem-resistant strains(23/24) of Acinetobacter spp which could be likely to prove beneficial effect for the treatment of infections due to multidrug-resistant strains of Acinetobacter spp.

A survey on clinical knowledge of coronary artery disease (CAD) management in general practitioners (GPs) in Beijing was conducted from March to September,2013.The questionnaire contained 4 cases (stable angina pectoris,post-percutaneous coronary intervention,acute anterior myocardial infarction and acute inferior myocardial infarction) and related clinical questions.Five hundred questionnaires were distributed and 471 valid questionnaires were returned with a recovery rate of 94.2％.The correct rate was 87.3％ and 61.8％ for diagnosis and treatment of emergent events in acute anterior myocardial infarction; however,the correct rate for other knowledge was ranged between 23.4％ and 40.6％.The correct rate increased with the educational levels in 5/11 items(P ＜ 0.01)and increased with the professional titles(P ＜ 0.001)in 3/11 items,which was not associated with the attendance of training or frequency of training attendance.The results indicate that clinical knowledge of CAD management for GPs in Beijing should be improved and the training methods should be focused on the clinical capacity.

Objectives To access the bacteriology in patients with sepsis due to biliary tract infection to provide a basis for empirical selection of proper antibiotic treatment.Methods This is a single-center retrospective study on 214 patients with biliary tract infection admitted from August 2014 to July 2016 to the surgical intensive care units (ICU) of The First Affiliated Hospital of Sun Yat-sen University.To study the demographic information,sequential organ failure assessment (SOFA),usage of antibiotics before ICU and duration of ICU were analyzed.Bile,peritoneal drainage and blood samples were collected.Results 47 septic shock patients and 25 septic patients due to biliary tract infection were enrolled in the trial.The two groups (the shock group vs.the sepsis group) had a significant difference in the duration of ICU stay [(6.4 ± 4.6) d vs.(2.3 ± 1.8) d,P ＜ 0.05].48 strains of pathogens were isolated from the bile samples.The major pathogens were Escherichia coli (E.coli) (n =23,47.9％),Enterococcus faecalis (n =8,16.7％) and Enterococcus faecium (n =2,4.2％).80 strains of pathogens were isolated from the peritoneal drainage culture samples.E.coli,pseudomonas aeruginosa,and Klebsiella pneumoniae ranked the top 3 species,accounting for 26.3％,11.3％ and 7.5％,respectively.The sensitivity of E.coli isolated from bile to amikacin,imipenem and panipenem were all over 90.0％.Conclusions E.coli was the principal gram-negative bacterium in biliary infection induced sepsis.Early administration of carbapenemes may reduce the occurrence of septic shock in these patients.

Gene-edited mice are the most ideal laboratory animals for studying human gene functions, exploring disease mechanisms, and developing new drugs. Strain resulting from low fertility, aging, illness, etc. can cause irreversible losses to scientific research, so strain rescues of genetically engineering mice require different measures accordingly. Meanwhile, cost control is another key point when a specific technology is applied. First of all, when the only remaining gene-edited mouse in reproductive age suddenly dies, the dead male mouse can be rescued by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), while the female mouse can be saved by ovarian transplantation, etc. Secondly, due to aging or diseases, mice can be saved through IVF-embryo transfer (ET) and unilateral epididymal tail assisted reproduction. Thirdly, round sperm injection (ROSI) and ovarian transplantation can be used to save endangered mice before sexual maturity with poor life status. This paper reviews rescue techniques of common endangered mice and their applications, which provides a reference for relevant practitioners to better maintain gene-edited mouse strains.

Objective The study aims to optimize the conditions for constructing orthotopic nude mouse models of liver cancer by injecting human liver tumor cell lines and to explore appropriate timings for drug administration. Methods Human hepatocellular carcinoma Hep3B and hepatoblastoma HepG2 cell lines, which stably expressing the luciferase reporter gene (LUC), were selected. The linear correlation between the luciferase luminescence intensity and the number of liver tumor cells was analyzed using a Small Animal In Vivo Imaging system to verify the luminescent efficiency of the human liver tumor cells. Different concentrations (8×10⁶, 2.4×10⁷, 7.2×10⁷ cells/mL) and resuspension media (PBS, Matrigel) of human liver tumor cell suspensions HepG2-LUC and Hep3B-LUC were orthotopically inoculated into the liver lobes of 5-week-old female BALB/c nude mice (12 groups, 7 mice each) to construct human liver tumor nude mouse orthotopic cancer models. Every 7 days, the weights of mice were recorded, and the growth of orthotopic tumors was monitored using the Small Animal In Vivo Imaging system. On day 35 post-cell inoculation, mouse livers were dissected, and pathological slices were prepared for HE staining to observe histopathological changes in liver tissues. Results The luminescence intensity of human liver tumor cell lines was positively correlated with the number of cells (R²=0.983 1, R²=0.970 5), indicating their suitability for orthotopic model construction. Successful modeling was achieved in the high-concentration groups of HepG2-LUC, the low-, medium-, and high-concentration groups of HepG2-LUC+Matrigel, the medium- and high-concentration groups of Hep3B-LUC, and the low-, medium-, and high-concentration groups of Hep3B-LUC+Matrigel. For both HepG2-LUC+Matrigel and Hep3B-LUC+Matrigel groups, mice in the high-concentration groups exhibited significantly reduced body weight compared to the low- and medium-concentration groups (both with P<0.05). The luminescence intensity of successfully modeled mice increased exponentially over time (R²>0.950 0), and reached a minimum of 1.0×10⁷ p/(s·cm²·sr) by day 14 post-transplantation. Mice in the low- and medium-concentration groups of HepG2-LUC and the low-concentration group of Hep3B-LUC showed no significant pathological changes, while the other groups exhibited evident liver tumors and hepatocyte lesions. Conclusion For the HepG2-LUC cell line, the recommended injection volume is 50 µL with a cell density of 2.4×10⁷ cells/mL, resuspended with Matrigel, followed by drug administration or prognostic measures on day 7 post-modeling. For the Hep3B-LUC cell line, the recommended injection volume is 50 µL with a cell density of 7.2×10⁷ cells/mL, not resuspended with Matrigel, with administration or prognostic measures on day 14 post-modeling.