Study on the Competition Status and Spatial Correlation of Medical Market in Beijing / 中国医院管理

Objective To analyze the competition status and spatial autocorrelation of Beijing medical market from 2015 to 2019.Methods The Herfindahl-Hirschman Index(HHI)was used to calculate the degree of market competi-tion in 16 districts of Beijing,and the Moran index was used to calculate the spatial autocorrelation of market compe-tition.Results Except for the number of discharged patients,the average HHI of the number of health technicians,the number of beds and the total number of medical visits in 16 medical markets in Beijing from 2015 to 2019 showed a downward trend between 0.2 and 0.4,and the spatial global Moran index of the HHI index was all less than 0,showing a spatial negative correlation with the degree of competition in the medical market.Conclusion The medical market competition in Beijing is strengthened,the competition gap between urban and rural areas is large,and the competition in adjacent markets is mutually exclusive.It is suggested to strengthen the differentiated develop-ment of hospitals,strengthen the balanced layout between regions,and promote the low-competitive market with cross-regional medical association,forming a positive spillover effect.

A four-component combination derived from Huang-Qin Decoction significantly enhances anticancer activity of irinotecan / 中国天然药物

Huang-Qin Decoction (HQD) is a classic prescription for diarrhea in Chinese medicine treatment. Recent studies have demonstrated that HQD and its modified formulation PHY906 could ameliorate irinotecan (CPT-11) induced gastrointestinal (GI) toxicity and enhance its anticancer therapeutic efficacy. Nevertheless, which constituents in HQD are effective is still unclear so far. The study aims to screen out the key bioactive components combination from HQD that could enhance the anticancer effect of CPT-11. First, the potential bioactive constituents were obtained through system pharmacology strategy. Then the bioactivity of each constituent was investigated synthetically from the aspects of NCM460 cell migration, TNF-α release of THP-1-derived macrophage and MTT assay in HCT116 cell. The contribution of each constituent in HQD was evaluated using the bioactive index E

Current status:low dose spiral CT lung screening and pulmonary nodules / 实用肿瘤学杂志

Lung cancer has become one of the most threatening malignant tumors in human life.Its morbidity and mortality rank is the first place in malignant tumors,so it is particularly important to screen for lung cancer.With the widespread use of low-dose CT,the detection rate of pulmonary nodules is increasing,and its research is also in-depth.This article described the status of lung cancer screening,factors of benign and malignant pulmonary nodules.It could provide the basis information for prevention and treatment of the lung cancer and pulmonary nodules.

Specific labeling method in improving mixed placing of medical waste in neonatal intensive care unit / 中国感染控制杂志

Objective To explore the effect of specific labeling method in improving the mixed placing of medical waste in neonatal intensive care unit(NICU).Methods Medical waste classification of 34 trash cans in the NICU of a hospital between July and December 2014 were investigated,July-September was pre-implementation phase of spe-cific labeling,October-December was post-implementation phase,mixed placing of medical waste between pre-and post-implementation phase was compared.Results A total of 504 cases of medical waste classification in NICU were investigated,252 cases respectively in pre-and post-implementation phase,74 cases of mixed placing were found. Mixed placing rates before implementing specific labeling was higher than after implementing (25.40%[64/252]vs 3.97%[10/252],χ2 =46.187,P <0.001 );before implementing specific labeling,57 cases of infectious waste and non-infectious waste were mixed placing,after implementing specific labeling,only 8 cases of infectious waste and non-infectious waste were mixed placing.Mixed placing were mainly performed by trainees for in-service training and interns,accounting for 39.06% before implementing and 50.00% after implementing.Conclusion The specific labeling for standardizing and managing of medical waste can improve the classification of medical waste in NICU, significantly improve the compliance of all kinds of health care workers to the standard handling of medical waste.

Outcomes and clinical prognostic factors for elderly patients with esophageal squamous cell carcinoma treated after definitive chemoradiotherapy / 中国癌症杂志

Background and purpose: With the increase of aging population, elderly patients (age ≥70 years) with esophageal squamous cell carcinoma occurred more and more. However, few studies have focused on elderly esophageal squamous cell carcinoma patients. This study aimed to assess the outcomes and prognostic factors for elderly patients with esophageal squamous cell carcinoma treated after deifnitive chemoradiotherapy. Methods:We retrospectively analyzed 53 patients (age≥70 years) with esophageal squamous cell carcinoma and treated with deifnitive radiotherapy with or without chemotherapy from Fudan University Shanghai Cancer Center from Mar. 2009 to Dec. 2011. Results:Median age was 74 years. Twenty-nine patients underwent radiotherapy, 24 patients underwent radiochemotherapy. 1-, 2-, 3-, and 5- year survival was 62%, 44%, 33% and 19% respectively. Grade 2 and above acute radiation-induced esophageal toxicity and radiation pneumonitis occur rate was 6% and 9% respectively. No treatment-related deaths occurred and no patients experienced any grade 4 and above toxicities. Multivariate analysis identiifed treatment modality, tumor site and smoking history as independent prognostic factors for overall survival. Conclusion:Radiotherapy may be an acceptable treatment option for elderly patients with esophageal squamous cell carcinoma. In appropriately selected patients, concurrent chemotherapy could bring a better overall survival.

Application feasibility of xenogeneic deproteinized cancellous bone scaffold in the treatment of spinal intertransverse fusion / 中国组织工程研究

BACKGROUND:Nowadays, most of the studies regarding tissue engineering bone have mostly focused on critical-size bone defects of the backbone; however, there are less studies and reports on its spinal fusion. OBJECTIVE:To explore the feasibility of xenogeneic deproteinized cancelous bone as bone tissue engineering scaffold in the treatment of spinal intertransverse fusion. METHODS:The cancelous part in the distal femur of adult pigs was obtained to prepare xenogeneic deproteinized cancelous bone. After combined with the recombinant human bone morphogenetic protein, the xenogeneic deproteinized cancelous bone was combined with bone marrow mesenchymal stem cels to prepare tissue engineering bone. Twenty-four goats were obtained to prepare intertransverse bone bed, and randomly divided into two groups: observation and control groups. In the observation group, the tissue engineered bone was implanted into the left side, and the xenogeneic deproteinized cancelous bone of recombinant human bone morphogenetic protein was implanted into the right side. In the control group, the autologous iliac bone was implanted into the left side, and xenogenic deproteinization cancelous bone was implanted into the right side. At the 4th, 8th and 12th weeks after implantation, the fusion segment was obtained for gross observation, X-ray observation, histological observation and biomechanical testing. RESULTS AND CONCLUSION:X-ray films showed that the implant materials from these two groups were fixed wel and reliably. At different time points after implantation, the implant materials from each group were al in good position. There were no purulent and necrotic tissues around the material. Soft tissue ingrow and wraping were present. There were no effusions and necrosis surrounding the implant materials. The imaging and histological performance in the tissue engineering bone group outperformed that in the recombinant human bone morphogenetic protein xenogenic deproteinized cancelous bone group and xenogenic deproteinized cancelous bone group, which was the most close to the autogenous bone. At the 12th week after implantation, the maximum bending load in the tissue engineering bone group was the most close to the autogenous iliac bone group. There was no significant difference between these two groups. These results demonstrate that as bone tissue engineering scaffold, xenogenic deproteinized cancelous bone has a certain application feasibility in the treatment of spinal intertransverse fusion.

Analysis of prognostic factors and index model in patients with brain metastases after whole-brain radiotherapy / 中国癌症杂志

Background and purpose: Radiation therapy is still the most primary treatment of brain metastases, and prognosis is affected by many factors. The aim of this study was to identify the prognostic factors and to establish a prognostic index model in patients with brain metastases after whole-brain radiotherapy (WBRT). Methods: We reviewed the clinical date of 140 patients with brain metastases radiotherapy in our hospital from Jan. 2008 to Jul. 2011. The signiifcance of prognostic variables in the survival was resulted from both univariate analysis and multivariate analysis. The prognostic index (PI) was established based on Cox regression analysis and subgrouping values. It was assessed whether recursive partitioning analysis classes (RPA), basic score for brain metastases (BS-BM) and the graded prognostic assessment index (GPA) were related to prognosis. Results:The median survival time was 222 days. The univariate analysis showed that the independent prognostic factors were KPS performance status, number of brain metastases, presence of extracranial metastases, primary tumor status, radiation dose, hemoglobin. The multivariate analysis showed that KPS performance status (P=0.002, Wald=9.700), presence of extracranial metastases (P=0.018, Wald=5.604) and primary tumor status (P=0.001, Wald=10.212) were signiifcantly correlated with overall survival. RPA, BS-BM and GPA were closely related to their prognosis by Log-rank test. In predicting 3 months and 6 months of survival for patients, PI was better than other modes. Conclusion:Our data suggest that the 3 indexes RPA,BS-BM and GPA are valid prognostic index models, but PI model is better.

The effect of Xuebijing injection on B-type natriuretic peptide level of rabbits with acute pulmonary thromboembolism / 中国中西医结合急救杂志

Objective To explore the therapeutic effect and possible mechanisms of Xuebijing injection for treatment of acute pulmonary thromboembolism(APE)in rabbits. Methods Twenty-four New Zealand rabbits with big ears were randomly divided into control group,model group and Xuebijing group(each n=8). The model of APE was performed by re-infusing of autologous blood clots. After the model was established,in the rabbits of the Xuebijing group,Xuebijing injection 1 mL/kg was injected into the ear marginal vein,twice daily for consecutive 7 days. In the model and control groups,the same amount of normal saline was given via the same route. The changes in plasma levels of B-type natriuretic peptide(BNP)were detected by enzyme-linked immunosorbent assay(ELISA) at the time points of 8 hours and 1,3,5,7 days,and after 7 days the lungs of the rabbits were removed for the lung histopathological examination. Results The BNP levels of the model group and Xuebijing group were significantly higher compared with the level of control group at 8 hours after embolization,the model group being the most significant(all P<0.05). On day 3,the BNP levels of the model group and Xuebijing group reached their peaks,and then gradually decreased,but the level of model group was significantly higher than that of Xuebijing group(ng/L:581.1±144.6 vs. 251.5±22.5,P<0.05). On day 7,the BNP level of Xuebijing group fell to the level of the control group(ng/L:78.5±9.4 vs. 50.9±11.5),the level of the model group also decreased,but it was still much higher than that of the Xuebijing group(ng/L:214.1±47.6 vs. 78.5±9.4,P<0.05). Histopathological examination showed Xuebijing could significantly reduce the infarct size with mild inflammatory cell infiltration,but the infarct size of the model group was obviously bigger than that of the Xuebijing group and accompanied by relatively more inflammatory cell infiltration. Conclusion Xuebijing injection can significantly reduce the plasma BNP level of the rabbits with pulmonary embolism,and in the mean time ameliorate the degree of inflammatory infiltration in the lung tissue and infarct.

Resection of the fourth ventricle tumors through lateral wall type of the cerebellomedullary fissure approach under endoscope / 中华显微外科杂志

Objective To investigate the therapeutic effect of the fourth ventricle tumors through lateral wall type of the transcerebellomedullary fissure approach under endoscope.Methods Clinical data of 14 cases with the fourth ventricle lesions were analyzed retrospectively.All the patients were treated by lateral wall type of the transcerebellomedullary fissure approach surgery.The endoscope was used if the lesions develop to the aqueduct and hard to be exposed.Both neurophysiological monitoring and intraoperative ultrasound were used regularly.Results Tumors were totally removed in 12 cases,subtotally in 1,and partially in 1.All the patients were diagnosed in postoperative histopathology,including 4 medulloblastoma,three epidermoid cyst,two ependymoma,two hemangioblastoma,one meningioma,one cavernous hemangioma and 1 astrocytoma.Hypopnea occurred immediate after operation in 1 patient.Ventilatory support was performed by Ventilator,and the respiration was restored 1 day later.Normal cerebrospinal fluid circulation was return in all cases.Neither aggravation of preoperative symptoms nor nuclei injury related complication had been found.The follow-up interval between 3 months to 28 months,one patient was dead with unexplained,and 1 medulloblastoma patient was relapse.Conclusion Lateral wall type of the transeerebellomedullary fissure approach,under endoscope,combined with the usage of neurophysiological monitoring and intraoperative ultrasound,can degrade the surgical related complications such as facial palsy and amblyacousia.

Research on the influence of comprehensive intervention on the quality of life of infants and young children with atopic constitution / 中国基层医药

Objective To investigate the influence of comprehensive intervention on improving the quality of life of idiosyncratic infants and young children.Methods A control study Was conducted on 106 idiosyncratic patients aged 6 months to 1 year with specific genetic background,eczema and wheezing under allergen test and comprehensive intervention via a randomized double-blind method.The onset of symptoms and measurement of immunological function were compared after 18 months.Results Serum IgG and IgA increased(all P＜0.05),wheezing and eczema attacks decreased significantly(all P＜0.01),sleep and emotion also improved significantly in the treatment group after 18 months(all P＜0.05).Milk and eggs were the most common allergen for infants and young children.Conclusion Idiosyncrasy and environmental factors were risk factors for allergic diseases.Early childhood was a critical period influencing the occurrence of allergic diseases in children.Early intervention could reduce the incidence of allergic diseases in children and improve the quality of life of idiosyncratic infants and young children.

Meta-analysis on NRAMP1 gene polymorphisms and tuberculosis susceptibility in East-Asia population / 中华流行病学杂志

<p><b>OBJECTIVE</b>To provide a quantitative summary in estimating the association between polymorphisms of 3 loci in NRAMP1 gene and susceptibility to tuberculosis in East-Asia population by means of meta-analysis.</p><p><b>METHODS</b>We searched databases (MEDLINE, OVID and CBM disc) from January 1995 to May 2005 using "NRAMP1" or "SLC11A1", in combination with "tuberculosis", also performed a manual search of citations from relevant original studies and literature. For each study involved, information was collected concerning the characteristics of the subjects, such as mean age of cases and the size of study. These characteristics were used to evaluate the sources of variation. Summary ORs and corresponding 95% CI were estimated by fixed effects (Mantel-Haenszel) or random effects (DerSimonian and Laird) model. To check for publication bias,a funnel plot, using Egger's linear regression method, was constructed. Cumulative meta-analysis was performed to evaluate whether the summary OR for studies with the polymorphisms of the 3 loci in the NRAMP1 gene was changing along with the accumulation of more data. Chi-square goodness of fit was used to test deviation from Hardy-Weinberg equilibrium.</p><p><b>RESULTS</b>Eight publications, with the number of cases and controls of 1067 and 1084 respectively, were identified and all genotype frequencies were consistent with Hardy-Weinberg equilibrium. The summary ORs for studies with polymorphisms of 3' UTR, D543N and INT4 loci of the NRAMPI gene among the East-Asia population were 1.68(95% CI: 1.31-2.16, P< 0.001), 1.78(95% CI: 1.38-2.30, P< 0.001), 1.56 (95% CI: 0.72- 3.35, P = 0.26), respectively when compared with their corresponding common homozygotes. Publication bias was not found in the studies with the three loci, except for INT4 locus, by Egger linear regression method. The cumulative summary effects ORs were 1.85 (P = 0.02) in 2000, 1.35 (P = 0.12) in 2002,1.64 (P= 0.001) in 2003, and 1.68 (P<0.001) in 2004 for 3'UTR locus, 1.88 (P = 0.001) in 2000,1.65(P = 0.001) in 2002,1.70(P<0.001) in 2003,1.76(P<0.001) in 2004, and 1.78(P<0.001) in 2005 for D543N locus, and 0.88(P = 0:70) in 2002, 2.50(P = 0.41) in 2003, 1.52(P = 0.42) in 2004 and 1.56(P = 0.26) in 2005 for INT4 loucs.</p><p><b>CONCLUSION</b>Polymorphisms at 3' UTR and D543N loci had statistically significant association between the NRAMP1 variants and susceptibility to tuberculosis in the East-Asia descendants, and variant in the INT4 locus failed to show statistically significant association in the East-Asia population.</p>

Comparison of the bronchodilation curve in patients with COPD or asthma / 中国实用内科杂志

Objective To set up bronchodilation curve in patients with chronic obstructive pulmonary disease(COPD)or asthma and investigate the features of large and small airways dilation.Methods Pulmonary functions of 44 COPD and 68 asthma patients were determined before and after inhaling Formoterol.Results The curves of FEV1 and FVC rose at 15 minutes after inhaling Formoterol and then declined at 120 minutes post-formoterol in patients with COPD.The curves of FEV1/FVC and FEF75 presented as a wave form,and the curves of FEF50 and FEF75/25 rose at 30 minutes and declined after 30 minutes.The fitting quadr-curves model equations for FEV1,FVC and FEF50 over time were statistically significant(P

Importance and methods of the medical imaging short-term training for clinical medical interns / 中华医学教育探索杂志

Through analysis of the current situation of clinical medical interns and combining the teaching features of the medical imaging,we explored the importance and methods of the medical imaging short-term training to improve the clinical teaching quality and the intern's comprehensive quality.

Autologous bone-marrow mononuclear cells transplantation in experimental acute myocardial infarction / 中国康复理论与实践

@#ObjectiveTo investigate the survival and differentiation of autologous bone-marrow mononuclear cell (ABM-MNCs) after transplanted to infarcted area and border area, and the effect of ABM-MNC on the cardiac function.Methods40 male big-ear Japanese rabbits were divided randomly into the transplanted group and control group with 20 animals in each group. Acute myocardial infarction model was made by ligating left anterior descending artery. 7 days later, Brdu labeled ABM-MNCs were injected into myocardium in the transplanted group, while the control rabbits were injected with saline. Six weeks later, tests of histology and immunohistochemistry were performed.ResultsViable cells labeled with Brdu can be identified in the infarcted area, and myocytes and endothelial cells labeled with Brdu can also be found in the border area, these cells demonstrated myogenic differentiation with the expression of α-actin by immunostaining. While, no cells labeled with Brdu were found in the control group. Moreover, the vessel density of the transplanted group in the borders of the infarction was higher than the control group (P<0.05), but there was no difference in infarcted area between two groups (P>0.05).At the 6 weeks after experiment, the cardiac function was improved in both groups, but there was a significant difference between two groups (P<0.05).ConclusionABM-MNCs injected into the infarcted myocardium can survive in both the infarcted and border areas, and differentiate into endothelial cells and other cells which are able to obtain the characters of myocytes, and increase the vessel density in border area, improve the cardiac function.

To Strengthen Information Analysis and Evaluation Competency——On the Education of Information Literacy of Medical Students / 中华医学教育探索杂志

As society develops,it has become one of the important goals of higher medical personnel training to cultivate medical students' information literacy.After explaining the definition of information literacy,this paper discussed the importance of information analysis and evaluation in information literacy education.

Comparison on Characteristics of Tumor Recurrence of Hepatocellular Carcinoma after Liver Transplantation and Hepatectomy / 中国普外基础与临床杂志

Objective To explore the different characteristics of tumor recurrence after liver transplantation (LT)and hepatectomy(HC)in patients with hepatocellular carcinoma(HCC).Methods The literatures about tumor recurrence of HCC after LT and HC were reviewed and their characteristics were compared.Results There are distinctions of recurrence rates,time,common sites between the recurred tumors after LT and HC,and their correlation factors and mechanisms of recurrence are also different.Conclusion Preventive measures should be strengthened and treatments should be more targeted according to the different characteristics of tumor recurrence after LT and HC to improve postoperative life quality and increase the survival rate.

Current Situation of and Reflection on Western Rural Education / 中华医学教育探索杂志

This article mainly expounded the actuality,the importance and the improving way of enhancing the western rural education.

Multi-slices spiral CT perfusion imaging evaluating of microvessel density in maxillofacial tumors / 中华放射学杂志

Objective To evaluate the relationship between Multi-slices spiral(MSCT) perfusion and microvessel density (MVD) in maxillofacial tumors. Methods Thirty-one cases of maxillofacial tumors were studied with MSCT perfusion imaging before operation. The time-density curve, perfusion, time to peak(TTP), and Peak enhancement imaging (PEI) of tumors were calculated. MVD of the tumors was measured with immuno-histochemical method by means of detecting factor Ⅷ in all the histologic specimens. Relativity analysis was carried between MSCT perfusion imaging parameters, perfusion curve types and MVD. Results MVD of maxillofacial tumors were higher than normal tissue. MVD remarkably correlated with malignancy of the tumors. Perfusion and time to peak (TTP) correlated well with MVD(t=7.09,4.10, P0.05). Significant difference of MVD in three types of perfusion curve was found(F=8.09,P

CT Measurement of Great Blood Vessels of Thorax in Middle and Old-aged Residents of Sea-level and High Altitude / 实用放射学杂志

Objective The diffferences of the cardiovasular transverse between sea-level and high altitude residents was analysed, by measuring thoracic great vessels diameter with CT scanning .Methods 100 cases residents of high altitude and 100 cases sea-level residents were scaned by CT in lung, and the cardiovascular and pulmonary arterial diameter were measured .Results In high altitude groupe the average transverse diameter(ATD) of aortic arch was (2.59?0.30)cm but in control groupe, ATD was (2.73?0.40)cm. The ATD of right pulmonary veins in high altitude was (1.00?0.30)cm but that of control was(1.19?0.34)cm. The ATD of left subpulmonary arteries in high altitude groupe was (1.30?0.28)cm and that of control was (1.2?0.43)cm.Conclusion The transverse diameter(TD)of pulmonary arteries was larger than those of the control . The TD of great arteries of systemic circuit and pulmonary veins were larger in sea-level residents than those of residents of high altitude.

Effects of Pentabrominated Diphenyl Ethers on Histological Structure and Function of Thyroid of Rats / 环境与健康杂志

Objective To observe the effects of pentabrominated diphenyl ether (BED-99) on the histological structure and function of the thyroid of rats. Methods Forty SPF, SD rats aged 4 weeks, were randomly divided into 4 groups according to the body weight,10 in each group. The rats were treated with BED-99 at the doses of 30 mg/kg,60 mg/kg,120 mg/kg,respectively, through gavage. The rats in the control group were received the equal volume of corn oil. The levels of serum hormone were determined,the change of histopathology,histochemistry and follicular cells ultramicroscopic structure were observed at 15 days of exposure to BED-99. Results Serum levels of thyroxin (FT4),triiodothyronine (FT3),decreased gradually with dose increase at 15 days of exposure to BED-99.However,thyroid stimulating hormone (TSH) levels increased. The thyroid follicular epithelium hyperplasia was aggravated gradually with dose increase. Proliferating cell nuclear antigen (PCNA) positive cells increased constantly with dose increase. The activities of thyroperoxidase (TPO) and succinate dehydrogenase (SDH) of the treated rats increased significantly compared with the controls,and appeared color darkened. The rough endoplasmic reticulum of the thyroid follicular cells changed to saccate under the electron microscope,whereas nucleolus,cell membrane and mitochondria were not injured. Conclusion BDE-99 may damage the histological structure and function of the thyroid, the mechanism may be that BDE-99 down-regulates the thyroglobulin synthesis and then induces thyroxin level decrease which causes an increase of TSH through feedback.