Objective To analyze the data of percutaneous coronary stent implantation related groups in certain hospi-tal of Beijing,so as to provide data support for promoting CHS-DRG payment reform and provide guidance and reference for its refined management.Methods The case data of local medical insurance patients in Beijing who received percutaneous coronary stent implantation from January 2020 to December 2021 in certain hospital were statistically analyzed,collect the medical insurance settlement information of the selected patients,and analyze the factors that affect their entry into FM19 group settlement.Results There are differences in the factors affecting FM19 inclusion in different reform stages,overtransfer personnel is a new independent factor that interferes with the group settlement in the actual operation stage.Some special operation codes may interfere with cases entering FM19 group due to pri-ority effect among disease groups.Conclusion The grouping settlement conditions of CHS-DRG are more complex,patients with different expense types need to be specifically analyzed according to the current grouping scheme and reimbursement policy.At present,there are relatively few disease groups settled by package for urban residents,and they continue to be affected by the rule of grouping priority.However,it is necessary to fully implement and strengthen the cost control of disease groups for urban employees,and rationally optimize the diagnosis and treat-ment plan to finely control medical costs.

【Objective】 To explore the predictive value of preoperative liver function for massive blood transfusion (MBT) in patients undergoing ascending aorta surgery. 【Methods】 Data from 238 patients undergoing ascending aorta surgery in the Department of Cardiovascular Surgery at The Affiliated Lihuili Hospital of Ningbo University were collected. Preoperative liver function tests were performed for all patients. Based on the perioperative transfusion volumes of red blood cell suspension, patients were divided into the MBT group, non-MBT group, and no blood transfusion (NBT) group. Clinical data during the perioperative period were compared among different groups. Receiver operating characteristic curve (ROC curve) analysis was used to assess the predictive value of liver function indicators for MBT and determine cut-off values. 【Results】 Compared with the non-MBT group and NBT group, the MBT group showed statistically significant differences in preoperative levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), direct bilirubin (DBIL), and serum albumin (SA) (P<0.05). ROC curve analysis revealed that AST had the largest area under the curve (AUC) for predicting MBT, with a value of 0.723. ALT had the highest specificity for predicting MBT at 86.7%, and SA had the highest sensitivity at 89.7%. When AST >28.50 U/L, ALT >40.00 U/L, SA ≤34.55 g/L, and DBIL >4.25 μmol/L, there was a significant increase in the transfusion volume of various blood components and the incidence of MBT. 【Conclusion】 Preoperative liver function indicators (AST, ALT, SA, DBIL) have a moderate predictive value for MBT in patients undergoing ascending aorta surgery.

The purpose of this study was to clone and characterize the ZFP36L1 (zinc finger protein 36-like 1) gene, clarify its expression characteristics, and elucidate its expression patterns in different tissues of goats. Samples of 15 tissues from Jianzhou big-eared goats, including heart, liver, spleen, lung and kidney were collected. Goat ZFP36L1 gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR), then the gene and protein sequence were analyzed by online tools. Quantitative real-time polymerase chain reaction (qPCR) was used to detect the expression level of ZFP36L1 in intramuscular preadipocytes in different tissues and adipocytes of goat at different differentiation stages. The results showed that the length of ZFR36L1 gene was 1 224 bp, and the coding sequence (CDS) region was 1 017 bp, encoding 338 amino acids, which was a non-secretory unstable protein mainly located in nucleus and cytoplasm. Tissue expression profile showed that ZFP36L1 gene was expressed in all selected tissues. In visceral tissues, the small intestine showed the highest expression level (P < 0.01). In muscle tissue, the highest expression level was presented in longissimus dorsi muscle (P < 0.01), whereas the expression level in subcutaneous adipose tissue was significantly higher than that in other tissues (P < 0.01). The results of induced differentiation showed that the expression of this gene was up-regulated during adipogenic differentiation of intramuscular precursor adipocytes (P < 0.01). These data may help to clarify the biological function of the ZFP36L1 gene in goat.
Animals ; Goats/genetics* ; Amino Acid Sequence ; Liver ; Cloning, Molecular

With the steady progress of the rule of law for Internet in China, " Internet+medicine" is drawing greater attention and legislative demand. The enactment of E-commerce Law in early 2019 has provided rich legal connotations of " Internet+" commerce scenario, clarifying its legal subject scope and legal service scope.The authors analyzed the legal system of medical E-commerce, and the legal obligations of medical E-commerce. From the following four aspects of legitimate business conduct, consumer rights protection, platform responsibility and intellectual property protection, the authors held that the current legal regulation of medical E-commerce is plagued by major setbacks as follows.These setbacks include incomplete legislation, low legal ranking, ambiguous subject definition and legal guidance, as well as lack of behavior regulation and unclear legal obligations.In this regard, the state is recommended to advocate the enactment of the Pharmaceutical E-commerce Law, speed up the revision of a series of laws and regulations, and improve the supporting service policies as a whole, so as to strengthen the rule of law regulation of future pharmaceutical E-commerce.

This article is aimed to establish the method of quality standards for highland barley Monascus.Microscopic and TLC were adopted to identify Araliataibaiensis. Referring the relevant method in Chinese Pharmacopoeia (2010 edition) for the determination of its moisture, total ash, acid insoluble ash and extracts,lovastatin in acid and lactone form was determined using high performance liquid chromatography. The characteristics of highland barley Monascus in microscopic and TLC were obvious and specific. The contents in barley red yeast are: water 6.04%-8.78%, total ash 2.15%-2.92%, acid insoluble ash 0.23%-0.29%, water extracts 27.99%-30.17%; alcohol extracts 14.12%-18.51%. The ranges of lovastatin in acid and lactone form are 0.11%-0.29% and 0.02%-0.08%, respectively. The established method is simple, accurate, reliable and duplicable, and can be used to control the quality of highland barley Monascus.

The aim of this study was to conduct the preparation and pharmaceutical characterization of a new type of terbinafine hydrochloride bioadhesive film-forming gel. The viscosity of the gel of(13 299±51)mPa ·s, pH of 3. 50±0. 50, and the shearing viscosity of(196±4)g/cm2 was found. This new gel turned out to be a layer of solid film on the application site in a very short time. The remaining solid ratio of the resulting film was estimated to be(50. 74±2. 81)%; the tensile strength was(1. 17±0. 21)MPa; and the breaking elongation was(21. 42±3. 24)%. In vitro release behavior of terbinafine hydrochloride from the film was investigated according to the paddle over disk method in ChP2010. Terbinafine hydrochloride released continuously for 10 h from the film. Improved Franz type diffusion cells were used in vitro transdermal studies by the application of excised minipigs skins. No penetration of drug into the receptor medium across the skin existed and so it could imply the safety for local application. It was found that(93. 05±5. 66)% of drug stayed on the skin surface while(1. 15±0. 85)% entered into the skin, which was beneficial for the treatment of superficial skin fungal infection.

Objective To explore the relationship of HBV genotypes and the age of patients,the positive ratio of HBV e antigen (HBeAg),DNA load in serum of patients,and its clinical significance.Methods We tested HBV B and C genotypes in 344 Zhejiang patients with hepatitis B,compared their clinical differences.Enzyme linked immune sorbent assay(ELISA) was used to test the HBeAg;HBV DNA copies was detected by time fluorescence quantitative PCR.Make comprehensive analysis of these indexes.Results Among the 344 Zhejiang HBV patients,113 patients (32.8％),217 patients (63.1％) and 14 patients (4.1％) were infected by HBV genotype genotype B,C and B + C,respectively.Positive ratio of HBeAg and HBV DNA in genotype C were higher than that of genotype B(P ＜0.01).The ratio of high level virus load(HBV DNA ＞ 105 copies/ml) in genotype C patients was higher than that in genotype B patients (P ＜ 0.01).Conclusion Genotype C is the major genotype in Zhejiang province.Genotypes are associated with the age of patients,positive ratio of HBeAg,DNA load in serum of patients.

OBJECTIVE: To improve effectiveness of diagnosis and therapy in patients with tracheobronchial specific foreign body. METHOD: Fourty-six cases with specific foreign bodies in the trachea and bronchi, admitted from March 1998 to June 2006, were analyzed retrospectively. RESULT: Forty-one of 46 the specific foreign bodies were successfully removed through bronchoscopy. Three cases were removed by chest surgery. Two cases were died. CONCLUSION Suitable surgical instrument should be well selected and the best operation should be applied according to different conditions of the foreign bodies. Rigid bronchoscopy for removal of specific foreign bodies under general anesthesia is a main measure presently.
Adolescent ; Adult ; Aged ; Bronchi ; Bronchoscopy ; Child ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Trachea ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the diagnosis and treatment of neurinoma of the head and neck. METHOD: The clinical data of 33 patients with neurinoma of the head and neck, from 1980 to 2004, were retrospectively reviewed and analysed. RESULT: The tumors of all the cases were totally resected. Thirty of thirty-three cases have been followed up. Twenty-seven cases were fully recovered without any serious complication. One case with malignant tumor were died. The other 2 cases were died of other diseases. CONCLUSION Tumor resection is still the most effective treatment available for patients with neurilemmomas of the head and neck. Resection of tumor should be performed as soon as possible with careful protection of the function of the nerve. Extensive resection should be performed to treat malignant tumors.
Adolescent ; Adult ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Neurilemmoma ; surgery ; Retrospective Studies ; Young Adult

OBJECTIVE To find out the clinic air disinfectant effect and the damage to human body between air aerosol sprayer of hydrogen peroxide and peracetic acid. METHODS New ninety eight sickrooms were randomly disported into two groups. The group of using peracetic acid was a control one. Then the clinic air disinfectant effect and the damage between two groups were observed. RESULTS After thirty minutes, to sample through flat exposure method. The total number of bacteria of two groups reached the third grade of environment eligible standard without pathogenic bacteria being checked. Hydrogen peroxide had not obvious mucous membrane stimulation and hypersusceptible reaction to human body. But peracetic acid had mucous membrane stimulation and hypersusceptible reaction to human body. CONCLUSIONS The air disinfection using aerosol sprayer is still an available method when there are no person in new sickrooms or extended sickrooms. At present, some chemical disinfectant methods that have strong poisonous reactions and pollute environment, such as peracetic acid, have been restricted to be used because of thrill, toxicity to human body and causticity to goods. But the method of dynamic air disinfectant machine that can be used in the situation of ventilation, dust catching, decontaminating, and ultraviolet irradiation, at the same time having someone has became a new idea of air disinfection.