Research progress and thinking on cost accounting of medical service items based on cost equivalent method / 中华医院管理杂志

Through literature research, this paper analyzed the research progress of medical service project cost accounting based on cost equivalent method. According to the calculation mode of cost equivalent value, this method could be divided into two types, namely, equivalent coefficient method and point method. This paper classified and summarized the application status of cost equivalent method in the cost accounting of medical service projects, analyzed the advantages of cost equivalent method, such as being able to consider a variety of cost drivers, concise accounting process and strong operability, discussed the existing problems of this method, and put forward suggestions for further deepening the application of cost equivalent method and strengthening hospital cost accounting, such as strengthening the summary and case publicity of cost equivalent method, reasonably combining and applying various methods, and scientifically and reasonably developing hospital cost accounting information construction, so as to help build a scientific and accurate cost accounting system for medical service project.

Quantifying the Soft Tissue Profile by Two Different Methods in Iraqi Adults: A Comparative Study

Patient’s soft tissue profile plays a prominent role in orthodontic diagnosis and treatment planning, many researchers have defined various facial soft tissue parameters based on lateral cephalometric radiographs by using either anatomic point method or tangent line method, however, these methods differ in the way of constructing straight lines along the soft tissue profile. This study aimed to compare the reliability of the two drawing methods (anatomic point and tangent line method). The sample consists of 100 true lateral cephalometric radiographs of patients with normal occlusion and accepted facial profile aged (18-30) years, ten angular measurements along the soft tissue contour were measured by the 2 drawing methods by 3 orthodontist examiners and analyzed statistically to fined means and standard deviation and to be compared by intra-class correlation coefficient. The results showed the non-significant difference between the measurements of the two drawing methods, and both methods were reliable and consistence in soft tissue profile analysis.

Therapeutic observation on point-toward-point needling at points on the low back regions for residual back pain after percutaneous kyphoplasty / 针灸推拿医学（英文版）

Objective:To observe the effect of point-toward-point needling at points on the low back regions on residual back pain after percutaneous kyphoplasty (PKP),thoracolumbar function and quality of life (QOL) in patients with osteoporotic vertebral compression fracture (OVCF).Methods:A total of 72 patients with OVCF and residual back pain after PKP were included and allocated into a treatment group (n=36) and a control group (n=36) by the random number table.Cases in the control group received salmon calcitonin injection (miacalcic),for 1 mL each time,once a day,and oral intake of calcium carbonate D3 pill,600 mg each time,once a day,whereas cases in the treatment group received point-toward-point needling at points on the low back regions and electroacupuncture (EA) for 30 min each time,once a day and 6 times a week on the basis of the treatment in the control group.Treatment in both groups lasted for 2 weeks.Therapeutic efficacy indicators including visual analog scale (VAS),Oswestry disability index (ODI) and Barthel index (BI) were evaluated before and after treatment and at follow-up visit (1 month after treatment).Results:The total effective rate was 94.4％ and 88.9％ in the treatment group after treatment and at the follow-up visit,respectively,higher than 77.8％ and 69.4％ in the control group,and the between-group differences were statistically significant (both P＜0.05).After treatment and at the follow-up visit,the VAS and ODI scores decreased,and BI scores increased in both groups,and the intra-group differences were statistically significant (all P＜0.05).After treatment and at the follow-up visit,between-group differences of VAS,ODI and BI scores were statistically significant (all P＜0.05).Conclusion:On the basis of conventional medication treatment,point-toward-point needling at points on the low back regions has a good therapeutic effect in relieving residual back pain after PKP,improving thoracolumbar function and QOL,better than conventional medication treatment alone.

Clinical Observation of Fu San Zhen plus Xing Nao Kai Qiao Needling for Urinary Incontinence After Cerebral Infarction / 上海针灸杂志

Objective To observe the clinical efficacy of Fu San Zhen (acupuncture at three abdominal acupoints) plus Xing Nao Kai Qiao (brain-awakening and orifice-opening) needling in treating urinary incontinence after cerebral infarction. Method Sixty patients with urinary incontinence after cerebral infarction were randomized into an experimental group of 20 cases and a control group of 20 cases. The experimental group was intervened by Fu San Zhen [Qihai (CV6) and bilateral Shuidao (ST28)] plus Xing Nao Kai Qiao needling by selecting Shuigou (GV26), Neiguan (PC6) and Sanyinjiao (SP6). The control group was intervened by ordinary acupuncture [Zhongji (CV3), Qihai (CV6), Shenshu (BL23) and Pangguangshu (BL28)] plus Xing Nao Kai Qiao needling method by selecting Shuigou (GV26), Neiguan (PC6) and Sanyinjiao (SP6). The maximum bladder capacity, residual urine volume and the score of International Consultation on Incontinence Questionnaire Short-form (ICIQ-SF) of the two groups were observed before and after the intervention, and the clinical efficacies were also compared. Result After the intervention, the maximum bladder capacity, residual urine volume and the score of ICIQ-SF were significantly changed in both groups (P<0.01). There were significantly statistical differences in comparing the maximum bladder capacity, residual urine volume and the score of ICIQ-SF between the two groups after the treatment (P<0.01). The total effective rate was 95.0％ in the experimental group versus 75.0％ in the control group, and the difference was statistically significant (P<0.01). Conclusion Fu San Zhen plus Xing Nao Kai Qiao needling can produce a more significant efficacy in treating urinary incontinence compared to ordinary acupuncture plus Xing Nao Kai Qiao needling.

Clinical Study on the Specificities of Needling Manipulation in Point-toward-point Needling at Scalp Acupoints for Acute Stroke / 上海针灸杂志

Objective To observe the efficacy difference between different needling manipulations in treating acute stroke with point-toward-point needling at scalp acupoints, for seeking the optimal treatment protocol. Method Ninety patients with acute stroke were randomized into a manual needling group, an electroacupuncture group, and a needle-retaining group, 30 cases each. In addition to the neurological treatment, the three groups were all given point-toward-point needling from Baihui (GV20) to Taiyang (EX-HN5) on the affected side, respectively with manual twisting, electroacupuncture and needle retaining methods. Before and after 14-day treatment, the Neurological Deficit Score (NDS), level of neuron specific enolase (NSE) and total efficacy were compared among the three groups. Result The NDS dropped significantly in the three groups after the intervention (P<0.05); the manual needling group showed the most significant improvement, better than the electroacupuncture group and needle retaining group. The level of NSE declined significantly in the three groups after the intervention (P<0.05); the decrease in the manual needling group was the most significant compared to that in the electroacupuncture group and needle retaining group. The total effective rate in the manual needling group (90.0%) was significantly higher than that in the electroacupuncture group and needle retaining group (P<0.05). Conclusion Point-toward-point needling at scalp acupoints with manual operation can effectively improve the neurological deficit in stroke patients, and the application of needling manipulations can further enhance the therapeutic efficacy, which is specific.

De la neuroplasticidad a las propuestas aplicadas: estimulación temprana y su implementación en Costa Rica / From Neuroplasticity to Applied Proposals: Early Stimulation and Its Implementation in Costa Rica

Resumen La discusión en torno a la influencia del ambiente sobre la ontogenia ha alimentado la interrogante sobre cuál es el grado en el que, a través de la manipulación del contexto, se modifican las características de los individuos. Actualmente, la evidencia científica desde distintos campos (e.g., Psicología del desarrollo, Neurociencias) describe cómo el ambiente es capaz de modular los procesos del desarrollo y las distintas capacidades del cerebro, así como los mecanismos plásticos que subyacen a dicha modulación. Con base en esta evidencia, distintas aproximaciones metodológicas orientadas a la estimulación temprana (ET) se han propuesto potenciar el desarrollo o remediar problemas que se presentan durante las etapas tempranas del ciclo vital. En este contexto, se brinda una revisión del tema y se ofrece un marco teórico general sobre los antecedentes y sobre los principios que sustentan la estimulación del sistema nervioso (i.e., plasticidad cerebral). Además, a través de una aproximación empírica y un proceso de revisión bibliográfica, se presenta la evidencia disponible de algunos de los métodos de mayor conocimiento/uso en Costa Rica (i.e., Doman- Delacato, Snoezelen®, Point y Bebé Políglota). Al recapitular los alcances y las limitaciones de la ET, se concluye que es necesario sistematizar las experiencias profesionales de forma tal que permitan abrir un debate académico sobre el tema.

Abstract The discussion about environmental influence on ontogeny has fueled the question about how much context manipulation can regulate individuals' characteristics. Today, scientific evidence from different fields (e.g., developmental psychology, neuroscience) describes not only how environment can modulate brain development and function, but also the plastic mechanisms involved. In consequence, different methodological approximations of early stimulation (ES) have arisen, although they are not necessarily based on solid empirical evidence. In this context, a brief approximation to the ES background is provided, as well as a general framework about brain plasticity. In addition, the theoretical and practical perspective of the ES practitioners is also described by detailing the empirical evidence around its most known/used variants in Costa Rica (i.e., Doman-Delacato, Snoezelen®, Point and Bebé políglota). Finally, bringing up the scope and limitations of ES, we conclude that the professional experiences need to be systematized, in order to open an academic debate on the subject.

Clinical Observation of Point-toward-point Acupuncture from Qiuxu (GB40) to Shenmai (BL62) for Post-stroke Ankle Joint Dysfunction / 上海针灸杂志

ObjectiveTo observe the clinical efficacyand safety of the point-toward-point needling respectively from Qiuxu (GB40) to Shenmai (BL62) and from Qiuxu to Zhaohai (KI6) in treating post-stroke ankle joint dysfunction.MethodThirty-six patients with post-stroke ankle dysfunction were randomizedinto a treatment group of 18 cases and a control group of 18 cases. The treatment group was majorly treated with point-toward-point needling from Qiuxu to Shenmai, while the control group was by needling from Qiuxu to Zhaohai.ResultRegarding the spasm intensity of the triceps surae, the change of the Modified Ashworth Scale (MAS) score in the treatment group after treatment was significantly different from that in the control group (P<0.05), and the treatment group was superior to the control group.ConclusionPoint-toward-point needling from Qiuxu to Shenmai is better than that from Qiuxu to Zhaohai in relieving the spasm of triceps surae, and it’s an safe and effective needling method.

Quality Evaluate of Betamethasone Tablet by Establishing a Mathematical Model / 中国药房

OBJECTIVE:To investigate the quality differences of Betamethasone tablet from different enterprises,and provide reference for the eventual establishment of the drug relative quality evaluation system. METHODS:According to the principle and steps of the ideal point method,a mathematical model was established. And the perfect point of the 3 inspection parameters (content,content uniformity and dissolution)of Betamethasone tablet was regarded as the upper limit theoretically,and the permis-sible point as the prescribed minimum in the model. After homogenizing the initial data or ones to be quantifiable were translated in-to evaluation parameters;and the evaluation parameters were calculated by ideal point method to receive comprehensive evaluation results. RESULTS:According to variance analysis,there was no significant difference in the comprehensive evaluation results of Betamethasone tablet from different enterprises(P=0.54>0.05),indicating that the overall quality of Betamehasone tablet was good. CONCLUSIONS:The mathematical model of quality evaluation with different drug has certain feasibility and operability.

Effect of Needling the Meridian Muscle Regions on Lower Limb Spasticity in Spastic Cerebral Palsy / 上海针灸杂志

Objective To observe the clinical efficacy of needling the meridian muscle regions in treating the lower limb spasm in spastic cerebral palsy.Method Eighty patients with spastic cerebral palsy were randomized into a treatment group and a control group, 40 cases in each group. The two groups were both intervened by conventional rehabilitation. Besides, the treatment group was given acupuncture at the meridian muscle regions including Chengshan (BL 57) point and the point 1 cun above the upper margin of the Achilles-tendon attachment, while the control group was given acupuncture majorly at points from the Yangming Meridian of the affected lower limb. The modified Ashworth Scale (MAS), Composite Spasticity Scale (CSS), and Gross Motor Function Measure (GMFM) were evaluated before intervention and after 3 treatment courses.Result The MAS, CSS, and GMFM scores were significantly changed after intervention in both groups (P<0.01). After treatment, the MAS, CSS, and GMFM scores of the treatment group were significantly different from that of the control group (P<0.05).Conclusion Needling the meridian muscle regions can effectively improve the lower limb spasticity in spastic cerebral palsy, and it can help correct clubfoot and enhance the gross motor function.

The role of serum magnesium level in type 2 diabetes mellitus.

Background: Diabetes mellitus is one of the most common metabolic disorder and leading cause of death and disability in the world. The incidence of diabetes is increasing globally and in India. Magnesium depletion has a negative impact on glucose homeostasis and insulin sensitivity in patients with type 2 diabetes. Hypomagnesaemia can lead to development of complications in diabetes. Hence there is need for the study to explore the status of magnesium in type 2 diabetes. Objectives: To estimate and compare the serum magnesium levels in type 2 diabetes patients with age/sex matched non diabetic controls. Methods: A case control study was done in randomly chosen 100 type 2 diabetic patients and 100 non diabetic age/sex matched controls. Estimation of serum magnesium was done by enzymatic end point method. Results: 37% of diabetic patients had low serum magnesium levels (Mg2+ level ≤1.5 mg/dL) and 9 % of controls had low serum magnesium levels. The mean serum magnesium levels were 1.96 ± 0.54 mg/dL and 2.375 ± 0.449 mg/dL in diabetics and controls respectively (P value <0.0001 highly significant). Hypomagnesaemia (Mg2+ level ≤1.5 mg/dL) was correlating with retinopathy (P = 0.041 significant). Conclusion: This study demonstrated that low serum Mg2+ status is common in type 2 diabetes mellitus patients when compared to non-diabetic controls. It may be prudent in clinical practice to periodically monitor plasma Mg2+ concentration in diabetic patients. If plasma Mg2+ is low, an intervention to increase dietary intake of magnesium may be beneficial to prevent the complications.

Therapeutic Observation of Micro-invasive Point-toward-point Thread-embedding for Post-stroke Shoulder-hand Syndrome / 上海针灸杂志

Objective To observe the clinical efficacy of micro-invasive point-through-point thread-embedding in treating acute stage of post-stroke shoulder-hand syndrome. Method Sixty patients were randomized into a treatment group and a control group, 30 in each group. Patients in the treatment group were intervened by micro-invasive point-through-point thread-embedding in addition to rehabilitation training, while patients in the control group were by rehabilitation training alone. Before treatment and after 4-week treatments, Visual Analogue Scale (VAS) was used to estimate shoulder pain, modified Barthel Index (MBI) to detect the activities of daily life, and Fugl-Meyer Assessment Scale to measure the motor function of upper limb. Result Before treatment, there were no significant differences in comparing the involved indexes between the two groups (P>0.05), and the indexes were significantly improved after intervention in both groups (P<0.05). Conclusion Micro-invasive point-through-point thread-embedding can reduce pain intensity, improve the activities of daily life and motor function of upper limb of patients in acute stage of post-stroke shoulder-hand syndrome.

Numerical simulation on response of human spine with different bone mineral density to landing impact / 医用生物力学

Objective To study the effect of bone mineral density (BMD) change on response of human spine to landing impact by numerical simulation. Methods The three-dimensional material point model of human head skull, cervical vertebrae, thoracic, lumbar vertebra, pelvis, ligament and disc was constructed from the computed tomography (CT) scanned images, and they were attached together as a human spine model and placed on the backrest of the chair, which was constructed by the MPM3D program. The acceleration loading was applied on the back rest of the chair to simulate the landing impact loading when the human spine model was laid on the back of the chair. The different responses of human spine to landing impact were simulated by changing the BMD and the corresponding elastic modulus. Results The general risk of injury γ value of normal BMD was 1.589 3, and when the BMD was reduced by 2%, 4%, 6%, 8%, 10%, respectively, γ values were 1.608 6, 1.634 7, 1.641 0, 1.662 5, 1.680 5, correspondingly. Conclusions Under the same landing impact loading, the smaller the bone mineral density, the larger the response of human spine to landing impact loading, and human body is more vulnerable to injuries.

The clinical value of using a four-point method to measure joint angles / 中华物理医学与康复杂志

Objective To study the clinical value of using a four-point method (FP) in measuring joint angles.Method Methods Twenty-five subjects without knee dysfunction were studied.Every knee joint was tested in extension,below 90° of flexion and above 90° of flexion with the traditional three-point method (TP) and the new four-point method.X-rays were taken as a gold standard measurement.The reliability and validity were analyzed using Bland-Altman plots,which can yield 95% limits of agreement (LOA).Results (1) The joint axis centers moved with changes in joint angle.(2) The 95% LOA of inter-tester reliability was (-5.0,2.7) with the FP and (-6.5,4.4) with the TP.The 95% LOAs of intra-tester reliability were (-3.6,4.0) for tester A and (-4.1,4.8) for tester B with the FP,while (-5.0,6.4) for tester A and (-6.1,5.8) for tester B with the TP.(3) The 95% LOAs in the three positions were (3.5,2.6) in extension,(-3.3,3.6) in mild flexion and (-1.9,5.7) in greater flexion with the FP,and ( 6.8,1.1),(-4.0,7.1) and (0,8.5) with the TP.Conclusions The FP gives better reliability and validity than the TP in joint angle measurement.

Effects of components in Biqi Capsulae prescription compatibility on activities of cytochrome P450 in vivo / 中草药

Objective: To investigate and evaluate the effect of components in Biqi Capsulae prescription compatibility on activities of cytochrome P450 (CYP450) in vivo. Methods: A new "Cocktail" one point method has been established, including five probes of Phenacetin, Tolbutamide, mephenytoin, Dextromethorphan, and midazolam. An LC-MS/MS analytical method has been established to determine the above five probes and their corresponding metabolites to analyze and evaluate the potential in vivo induction and (or) inhibition of components from Biqi Capsulae on the above five CYP450 in rats. Results: Biqi Capsulae prescription has compatibility based on CYP450. Compared with blank group, groups of "principal + assistant", "principal + mediator", "principal + assistant + complement", "principal + assistant + mediator", "principal + complement + mediator", and whole Biqi Capsulae could significantly induce the activity of CYP1A2. Moreover, groups of "principal + assistant", "principal + assistant + complement", "principal + assistant + mediator", and whole Biqi Capsulae could significantly induce the activity of CYP2C9. Conclusion: Biqi Capsulae prescription has significant compatibility based on CYP450. These results provide the important information and establish good foundation for further investigation on scientificalness and safety of Biqi Capsulae prescription compatibility.

Clinical observation on two kinds of epidural anesthesia methods for vaginal total hysterectomy / 中国医师进修杂志

Objective To compare the effect of epidural anesthesia on vaginal total hysterectomy.Methods Eighty patients with vaginal total hysterectomy were selected and randomly divided into group Ⅰ(40 cases)and groupⅡ(40 cases).The patients of group Ⅰ were punctured with two-point method to the first tube of epidural in L1-2 and to the tail tube in L3-4 The patients of group Ⅱwere punctured with one-point method to the first tube of epidural in L2-3.Observed the level of anesthesia,induction period and anesthetic effect of all patients.Results The upper bound level of anesthesia was higher in group Ⅰthan that in group Ⅱ(P＜0.05),the induction period Wag shorter in group Ⅰthan that in groupⅡ(P＜0.05).The anesthetic effect Wag better in group Ⅰ(92.5%,37/40)than that in group Ⅱ(70.0%,28/40)(P＜0.05).There were significant difference in maintain time,dose of boost and total between group Ⅰand groupⅡ(P＜0.05).Conclusion Two-point method of epidural anesthesia is better for vaginal total hysterectomy,as it can provide rapidly and completely anesthetic effects.

Influence of Scalp Point-through-point Acupuncture on 200 kDa Neurofilament Protein in Rats with Acute Cerebral Infarction / 针灸推拿医学（英文版）

Objective: To investigate the effect of scalp point-through-point acupuncture on 200 kDa neurofilament protein (NF-200) in rats with acute cerebral infarction and explore its mechanism on nerve plasticity in cerebral infarction rats. Methods: Healthy male Wistar rats were randomly allocated to sham operation (Group A), model (Group B) and acupuncture (Group C) groups. A rat middle cerebral artery occlusion (MCAO) model of cerebral ischemia was made. NF-200 mRNA was measured by reverse transcriptase polymerase chain reaction (RT-PCR) in each group on the 7th, 14th and 28th days. Results: The cerebral expression of NF-200 in group C was significantly different from those in groups A and B (P＜0.05); there was a significant difference between groups C and B or A at different time windows (P＜0.01),indicating that scalp point-through-point acupuncture could improve the cerebral expression of NF-200. Conclusion: Scalp point-through-point acupuncture can improve neural function,promote the recovery of limb function and increase the expression of NF-200 after cerebral ischemia, exerting a regulative effect on neuronal plasticity in the brain.

Acupuncture and Moxibustion Treatment of 150 Cases of Peripheral Facial Paralysis in Different Stages / 针灸推拿医学（英文版）

Moxibustion was used in predominance in acute stage. Shallow needling technique plus electricstimulation was used in the restoration stage. Comprehensive therapy of acupuncture and massage was used in the sequels stage. 21 cases were cured in the acute stage. 101 cases were cured in the restoration stage.10 cases were cured in the sequels stage. The results indicate that the restoration stage is a key moment for treatment of peripheral facial paralysis.

Acupuncture Treatment of 106 Cases of Peripheral Facial Paralysis in Different Stages / 针灸推拿医学（英文版）

In the treatment of facial paralysis in the acute stage and restoration stage by shallow needling technique and penetrating needling technique respectively, totally 106 cases, the effective rate is respectively 98.6% and 83.9%, indicating that the curative rate is high if early treatment is given.

Treatment of 57 Headache Cases by Needling Point Xingjian (LR 2) Through Taichong(LR 3) / 针灸推拿医学（英文版）

Needling point Xingjian (LR 2 ) through Taichong (LR 3) was used as main therapy to treat 57 headache cases by syndromic differentiation, which was compared with the treatment of another 60 cases with conventional points. The curative rate was 100% and 91.7% separately in one of the two groups. There was a significant difference in curative effect (P ＜0.01 ). The effect of the point-through-point method was superior to that of the conventional point method.