Practice of refined cost management of medical service charging items based on hospital intelligent agent / 中华医院管理杂志

In recent years, public hospitals have been facing pressure from the reform of medical insurance payment methods. It is urgent to strengthen the operation and management of public hospitals. In June 2022, a tertiary public hospital utilized hospital intelligent agents to carry out refined cost management practices for medical service charging projects, sorted out medical service charging projects, designed management paths, and calculated project costs. The hospital conducted refined management on the cost of medical service charging items from three control dimensions of project unit cost with manpower, equipment and consumables, and two comparative directions with horizontal and vertical. The refined cost management practice not only pointted out the direction for global refinement cost control within the hospital, but also reduced the proportion of hospital consumption, which provided reference for improving the level of refined operation and management of public hospital hospitals.

Comparison of image quality based on deep-learning image reconstruction and iterative reconstruction algorithm for dual-energy CT: a phantom and animal-model study / 中华放射学杂志

Objective:To investigate the impact of the deep learning reconstruction algorithm TrueFidelity TM for Gemstone Spectral Imaging (TF-GSI) and the adaptive statistical iterative reconstruction algorithm (ASiR-V, hereinafter referred to as ASiR-V) based on phantom and animal models on the image quality of dual-energy CT images. Methods:GE Revolution Apex CT was used to scan the ACR 464 phantom and a mouse model of gastric cancer with lymph node metastasis ( n=16). TF-GSI and ASiR-V were separately used to reconstruct middle and high-grade images (TF-GSI-M, TF-GSI-H, ASiR-V-50%, and ASiR-V-100%) on the phantom and mouse based on virtual monoenergetic images at 70 keV. The task transfer function (TTF) of bone and acrylic, image noise power spectrum (NPS), and detectability index (d′) of the phantom images were evaluated. One-way ANOVA analysis was used to compare the image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for brain and liver on images of mice. The consistency of the two reconstruction-algorithm images (TF-GSI-H and ASiR-V100%) in the detection of small lesions by two radiologists (A and B) was evaluated using kappa test. Results:In terms of the phantom, the TF-GSI-H group had the best performance in TTF, NPS, and d′. Compared to ASiR-V-100%, the TTF50% of bone and acrylic in the TF-GSI-H group increased by 2.4% and 8.9%, respectively; the NPS peak decreased by 54.1%, compared to ASiR-V-100%; the d′ of bone and acrylic in the TF-GSI-H group relative to ASiR-V-100% increased by 52.7% and 59.5%, respectively. The TF-GSI group had reduced image noise compared to the ASiR-V group, and both SNR and CNR of the two tissues increased, but the differences between the groups were not statistically significant (all P>0.05). The two reconstruction-algorithm images showed good consistency in image evaluation by the two radiologists (A, Kappa=0.875, P<0.001; B, Kappa=0.625, P=0.012). In terms of the detection of micro-metastases in mice, the TF-GSI group outperformed the ASiR-V group (average accuracy: 83.5% vs 71.9%; average sensitivity: 77.8% vs 61.2%; average specificity: 85.7% vs 85.7%). Conclusion:Compared with iterative reconstruction algorithm, the DLIR algorithm showed improved spatial resolution, reduced image noise, and enabled detectability of micro-lesion for images from dual-energy CT.

Exploration of diagnosis-intervention packet cost analysis and refined management based on hospital intelligent agents / 中华医院管理杂志

Objective:To analyze the cost of diagnosis-intervention packet(DIP) in a certain hospital in 2021 based on hospital intelligent agents, so as to provide feasible ideas for refined management of DIP costs.Methods:On the basis of the construction of the hospital intelligent agent platform and the results of project cost accounting in the early stage, a total of 60 187 cases and 4 860 DIP diseases in the hospital in 2021 were selected as the research objects. The project superposition method was applied to calculate the unit cost of all DIP diseases in the hospital. Based on the results of DIP cost accounting, the ideas and methods of fine management of DIP costs were explored from the perspectives of DIP disease classification, management of all hospital diseases and medical insurance diseases, vertical and horizontal comparative analysis of DIP costs, and management of medical insurance cases and non medical insurance cases under the same DIP disease category.Results:Twenty-two advantageous DIP disease types, 67 key disease types, 1 590 potential disease types, and 3 181 disadvantageous disease types were identified. Introducing medical income as an intermediate indicator facilitated the classification of DIP disease types under medical insurance, 1 072 advantageous disease types, 917 key disease types, 458 potential disease types, and 815 disadvantageous disease types in medical insurance were identified. Through refined accounting, it was found that the average cost of non medical insurance cases under the same DIP disease category was generally higher than that of medical insurance cases, and there were differences in DIP costs at different levels during different time periods.Conclusions:By determining and analyzing the advantages and disadvantages of disease types in the entire hospital, common problems of disease types under the same category can be identified, and targeted control measures can be proposed. By analyzing the two dimensions of medical insurance surplus and medical surplus, the advantages and disadvantages of medical insurance diseases can be quickly determined, providing a lever for the control of medical insurance diseases. The horizontal and vertical comparative analysis of DIP costs, as well as the analysis of medical insurance cases and non medical insurance cases under the same DIP disease category, can provide feasible methods for hospitals to manage DIP costs at multiple levels and dimensions.

Research on early identification indicators for anterior cruciate ligament injury based on knee gait analysis / 中华创伤骨科杂志

Objective:To characterize the knee gait maps of ordinary people, athletes and patients with anterior cruciate ligament (ACL) injury when walking on a level ground in order to identify potential kinematic indicators for early identification of ACL injury.Methods:From December 2021 to March 2022, 39 ordinary college students (normal group) and 39 college athletes (athlete group) were recruited in Southern Medical University, and 26 patients with ACL injury (patient group) were recruited at the Department of Orthopedics, Guangdong Provincial People＇s Hospital. The normal group consisted of 20 males and 19 females with a median age of 19 (18, 21) years; the athlete group consisted of 22 males and 17 females with a median age of 19 (18, 20) years; the patient group consisted of 23 males and 3 females with a median age of 20 (19, 20) years. A portable knee joint motion capture system was used to collect the knee gait maps of the subjects walking at a speed of 3 km/h on a treadmill. The knee varus and valgus angles, internal and external rotation angles, flexion and extension angles during the movement, and anteroposterior, medial-lateral superior-inferior displacements of the tibia relative to the femur were compared between the 3 groups.Results:There was no significant difference in the general data among the 3 groups except for gender, showing they were comparable ( P>0.05). There were significant differences in the varus and valgus angles during the whole gait cycle (1% to 100%), internal and external rotation angles during the weight-bearing response period (9% to 10%), flexion and extension angles during the stance phase and swing phase (1% to 27%, 29% to 100%), anteroposterior displacements during the weight-bearing reaction phase (1% to 3%) and at the end of the swing phase (96% to 98%), superior-inferior displacements at the middle support phase (15% to 19%), the end of the support phase (29% to 33%, 36% to 43%) and the swing phase (68% to 94%), and medial-lateral displacements at the middle stance phase and the middle swing phase (12% to 82%) among the 3 groups ( P<0.05). The maximum varus and valgus angles (-10.89°±4.55°, -12.20°±4.38°) of the subjects in the normal group and the athlete group were significantly greater than those in the patient group (-5.44°±3.72°) ( P<0.05). The medial-lateral displacement at the middle support phase [3.69 (0.13, 7.25) mm] of the subjects in the normal group was significantly larger than those in the athlete group and the patient group [-0.59 (-6.65, 5.24) mm, 0.96 (-1.54, 3.89) mm] ( P<0.05). Conclusions:The gait of college athletes is significantly different from that of ordinary college students and that of patients with ACL injury. Indexes like the varus and valgus angles and the medial-lateral displacement may be used as potential indictors for early identification of ACL injury.

Systematic analysis of drug dispensing errors and preventive measures in outpatient pharmacies / 药学实践杂志

Objective To understand the current situation of dispensing errors and effective prevention and control measures in outpatient pharmacies in domestic hospitals, in order to further improve the quality of drug dispensing. Methods The Chinese journal database was retrieved from 2015 to 2020 for the literature on the dispensing errors of outpatient pharmacies and the continuous improvement of the quality after the measures were taken in secondary and tertiary hospitals. Results Of the 146 literatures retrieved, 13 were included in the analysis (11 in tertiary hospitals and 2 in secondary hospitals). Before the improvement, the median of the drug dispensing error rate was 5.1‰, and after the improvement it was 1.1‰. Before and after the improvement, the types of drug dispensing errors were mainly quantity errors (52.5% vs. 51.3%), variety errors (28.3% vs. 28.7%), specifications and dosage forms errors (6.2% vs. 6.7%), and labeling errors (2.1% vs. 2.9%). The improvement measures taken for the reasons of dispensing errors have a high overlap rate, and they are concentrated in two aspects: personnel factors and drug factors. Conclusion The use of continuous quality improvement tools in hospital outpatient pharmacy to control and prevent dispensing errors is still a hotspot of current research. The composition of the types of errors after improvement has basically not changed. The implemen-tation of standardized operating procedures and other continuous improvement comprehensive measures can effectively reduce the incidence of dispensing errors, and contribute to the implementation of the “Expert Consensus on Medication Error Management in China”.

Mechanism of BCL2L2-PABPN1 expression induced by sodium arsenite and its metabolites in 16HBE cells / 中国职业医学

@#Objective - - （BCL2L2）- （ ） To investigate the differential expression of the fusion gene BCL 2 like protein 2 poly A （PABPN1） （ ） binding protein nuclear 1 induced by sodium arsenite SA and its methylated metabolites in 16HBE cells and the Methods ） ， related mechanism. i The 16HBE cells exposed to SA at concentrations of 1.5 3.0 and 4.5 µmol/L were set as -， - - low medium and high dose arsenic exposure groups. The 16HBE cells exposed to 4.5 µmol/L monomethylarsonic acid （ ）， （ ） ， MMA dimethylarsonic acid DMA and SA were set as MMA group DMA group and SA group. The 16HBE cells without ， BCL2L2-PABPN1 toxic stimulation were set as control group. After the cells were cultured for 48 hours the expression of was - （ - ） ） （ ） detected by quantitative real time polymerase chain reaction qRT PCR . ii Two small interfering RNA siRNA silencing 基金项目：国家自然科学基金（ ）； 年云南省科技厅昆明医科大学应用基础研究联合专项面上项目 82160607 2021 （ ） 202101AY070001-054 作者简介：施雅（ —），女，在读大学本科生，主要从事劳动卫生与环境卫生学研究；尹锦瑶（ —），女，在读劳动卫生与环境卫 2001 1995 生学硕士研究生，主要从事劳动卫生与环境卫生学研究；施雅和尹锦瑶为共同第一作者 通讯作者：何越峰教授，博士研究生导师，- ： E mail heyuefeng@kmmu.edu.cn中国职业医学 年 月第 卷第 期 ， ， ， · · 2022 10 49 5 Chin Occup Med October 2022 Vol.49 No.5 523 BCL2L2-PABPN1， - fragments were designed and transfected into 16HBE cells to knockdown which were set as siRNA 1 group - - BCL2L2-PABPN1 and siRNA 2 group. Non transfected control group without knockdown of transfection was set up. After ， BCL2L2-PABPN1 - culturing for 48 hours the expression level of in the three groups of cells was detected by qRT PCR. The cell - survival rate and early apoptosis rate were detected by MTS method and JC 1 mitochondrial membrane potential detection ， （ ） ， method respectively. The apoptosis was detected by Hoechest33342/propidium iodide PI double staining and the expression - Results ） level of P53 signaling pathway related proteins was detected by Western blotting. i The relative expression of BCL2L2-PABPN1 （P ） BCL2L2- in 16HBE cells increased with the increasing SA doses <0.01 . The relative expression of PABPN1 - ， - - in high dose arsenic exposure was higher than that in control group low dose and medium dose arsenic exposure （ P ） BCL2L2-PABPN1 ， groups all <0.05 . The relative expression of in SA group was higher than those in control group MMA （ P ） BCL2L2-PABPN1 group and DMA group all <0.05 . The relative expression of showed no significant difference between ， （ P ） ） BCL2L2-PABPN1 control group MMA group and DMA group all >0.05 . ii The relative expression levels of and cell - - - （ P ） survival rate in siRNA 1 group and siRNA 2 group were lower than those in non transfected control group all <0.05 . ， （P ） However there was no significant difference in the early apoptosis rate among the three groups >0.05 . The results of - Hoechest33342/PI double staining showed that the number of nuclear shrinkage and early apoptotic cells in siRNA 1 group and - - ， - siRNA 2 group was higher than that in non transfected control group. The relative protein expression levels of P53 phospho ， - - ， - - （ P ） p53 BCL 2 associated death promoter P21 and cytochrome C in siRNA 1 group and siRNA 2 group were higher all <0.05 , - - P and the relative protein expression levels of P53 up regulated modulator of apoptosis were lower (all <0.05), when compared - Conclusion with the non transfected control group. SA may block the apoptosis of 16HBE cells by inducing the expression of BCL2L2-PABPN1 fusion gene . The mechanism may be related to the activation of P53 signaling pathway. The SA methylated BCL2L2-PABPN1 BCL2L2-PABPN1 - metabolites MMD and DMA had no effect on the expression of . may affect anti apoptosis BCL2L2 PABPN1 through affecting the synergistic effect of and genes.

Clinical effects of tranexamic acid in arthroscope for femoroacetabular impingement / 中国骨伤

OBJECTIVE@#To evaluate the clinical effects of tranexamic acid in arthroscope for femoroacetabular impingement.@*METHODS@#Totally 34 patients (34 hips) with femoroacetabular impingement underwent hip arthroscopy from June 2016 to December 2018, were randomly divided into two groups named as tranexamic acid group and control group, 17 patients in each group. In TXA group, there were 10 males and 7 females, aged from 20 to 49 years old with an average of (32.1±7.6) years old;15 mg/kg TXA was intravenous drops before operation incision performed at 10 min. In control group, there were 11 males and 6 females, aged from 20 to 49 years old with an average of (30.9±6.2) years old;100 ml normal saline was intravenous drops before operation incision performed at 10 min. Introopertaive and total bloodloss between two groups were compared. Visual analogue scale (VAS) at 3 and 7 days after opertaion were used to evaluate pain relief of hip joint. Modified Harris Hip Score(mHHS) of hip joint at 3, 6, 9 and 12 weeks after oeprtaion were applied to evaluate clinical effects.@*RESULTS@#All patients were obtained follow up over 12 weeks. Incision healed well without infection and deep vein thrombosis. There were no statistical difference in opertaion time bewteen two groups(@*CONCLUSION@#Preoperative application of tranexamic acid could effectively reduce blood loss in arthroscopy for femoroacetabular impingement, thereby improving surgical field of vision, reducing difficulty of surgical operation, which could promote early and rapid rehabilitation of hip function.

Synergistic effects of autophagy/mitophagy inhibitors and magnolol promote apoptosis and antitumor efficacy

Mitochondria as a signaling platform play crucial roles in deciding cell fate. Many classic anticancer agents are known to trigger cell death through induction of mitochondrial damage. Mitophagy, one selective autophagy, is the key mitochondrial quality control that effectively removes damaged mitochondria. However, the precise roles of mitophagy in tumorigenesis and anticancer agent treatment remain largely unclear. Here, we examined the functional implication of mitophagy in the anticancer properties of magnolol, a natural product isolated from herbal

Establishing a model of femoral head necrosis by alcohol burning in Cyan-Shank Partridge Chicken: A feasibility analysis / 中国组织工程研究

BACKGROUND: To date, the pathological mechanism of femoral head necrosis is still unclear, and the existing experimental animal models of femoral head necrosis all have shortcomings. OBJECTIVE: To establish a simple, reliable and stable animal model of femoral head necrosis in a Cyan-Shank Partridge Chicken, with similar biomechanical characteristics to human beings. METHODS: Twenty-four adult young Cyan-Shank Partridge Chickens were randomly divided into experimental group and control group (n=12 per group). One side of the femoral head was randomly selected for operation, and the other side was untreated (untreated group). In the experimental group, alcohol was used to burn the bone tissue in the drilled hole followed by implantation of the original bone. In the control group, the original bone was directly re-implanted after drilling. X-ray and CT scan examinations were performed 1 month after operation. The femoral head was then dissected for general observation, microCT observation and pathological staining. The study protocol was approved by the Animal Ethic Committee of Xuzhou Medical University in China (approval No. AEC2018-020). RESULTS AND CONCLUSION: All the Cyan-Shank Partridge Chickens were alive without wrongful death. They could walk upright with no obvious claudication at 1-3 days after operation. X-ray and CT results revealed collapse of the femoral head with unclear trabecular bone in the experimental group. General observation indicated that the femoral head was collapsed with no smooth surface in the experimental group. MicroCT results showed significantly reduced number of bone trabeculae and significantly increased trabecular thickness, trabecular spacing and bone volume fraction in the experimental group as compared with the control and untreated groups (P < 0.05). Pathological staining showed that there was no obvious necrosis but similar shape of the femoral head in the control and untreated groups, but the number of subchondral vessels was less in the control group than the untreated group. However, the cells arranged disorderly and obvious necrosis such as empty lacuna was observed in the experimental group. To conclude, the use of alcohol to burn the bone tissue of the femoral head of the Cyan-Shank Partridge Chicken can be used to establish a typical animal model of femoral head necrosis, which has similar pathological characteristics of human femoral head necrosis.

Cosmetic injectiion technology and risk management / 中华整形外科杂志

In recent years, injection cosmetic has been favored and sought after by more and more cosmetic surgery patients.Injection cosmetic technique is used widely, botulinum toxin type A injection has been turned into the first place of all injection cosmetic treatment projects, the use of hyaluronic acid occupied the first place of filling materials.There are numerous researches on applies anatomy, technical operation and matters needing attention related to botulinum toxin and hyaluronic acid injection.However, serions complications still occur from time to time, so how to manage the risk? Trying to minimize the risk and maximize the effect is an important issue in the field of injection cosmetic.By reviewing the literature, this paper intends to review the relevant clinical problems.

Analysis of the design ideas for "One community health center, One district hospital and One municipal hospital" contract service mechanism of family doctor in Shanghai and its barrier a-nalysis during implementation / 中国卫生政策研究

Shanghai is the earliest city in China for starting family doctor system at national level. It has actively explored the contract service mechanism between residents and family doctors. It has developed from "soft contract signing of guiding residents to understand, contact and gradually accept family doctor services" to the " main and close contracting using the comprehensive service from medical institutions". This paper systematically analyzed the implementation status in " one community health center, one district hospital and one municipal hospital (1 + 1 + 1)" contractservice system of family doctor in Shanghai from the aspects of adjustment background, design ideas, progress and obstacles of the policy. Based on the analysis of barriers to the policyimplementation, some suggestions were put forward including the improvement of the contract service system in order to increase the number and build the capacity of general practitioners, and the optimization of the existing payment distribution systems.

Clinical characteristics of refractory Mycoplasma pneumoniae pneumonia in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To provide a basis for early diagnosis and treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children by comparing the clinical characteristics of RMPP and general Mycoplasma pneumoniae pneumonia (MPP).</p><p><b>METHODS</b>Children with MPP hospitalized between October 2015 and December 2016 were selected as study subjects. According to the diagnostic criteria, children were divided into RMPP group (n=152) and MPP group (n=551). The differences between the two groups in the basic situation, clinical manifestations, infection parameters and myocardial enzymes were compared.</p><p><b>RESULTS</b>There were no significant differences in gender and age between the RMPP and MPP groups (P>0.05). The peak temperature in the RMPP group was significantly higher than that in the MPP group on the first day of admission (P<0.01). The percentage of children with augmentation in the RMPP group was lower than that in the MPP group (P=0.009). The percentage of neutrophils [Ne(%)] and serum procalcitonin (PCT) levels in the RMPP group were both higher than those in the MPP group (P<0.05), while the percentage of lymphocytes was significantly lower in the RMPP group (P<0.05). The serum levels of aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in the RMPP group were also higher than those in the MPP group (P<0.05). Binary logistic regression analysis showed that the peak temperature and LDH were closely related to RMPP in children (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of the peak temperature and LDH for the diagnosis of RMPP was 0.647 and 0.637 respectively. In children ≤2 years old, when the threshold value of LDH was 400 U/L, the diagnostic sensitivity was 52.63% and the specificity was 54.84%. In children above 2 years old, when the threshold value of LDH was 335 U/L, the diagnostic sensitivity was 69.92% and the specificity was 51.55%.</p><p><b>CONCLUSIONS</b>The children with RMPP have a high fever in the early stage. Meanwhile there are abnormal laboratory test results in these children. Elevated serum LDH levels have a high clinical value of early diagnosis of RMPP, especially in children above 2 years.</p>

A review of brief cognitive behavioral therapy in application to depressive disorder / 中国心理卫生杂志

Brief Cognitive Behavior Therapy (BCBT) may solve the problem of technology promotion in traditional cognitive behavior therapy,with high cost-effectiveness,so in recent years,BCBT has been popularized and developed in western medical institutions.The existing researches on the treatment of depression with BCBT are still less and limited,and the research design and quality should be further improved.

Problems and Countermeasures of Comprehensive Budget Management in Community Health Center / 中国卫生经济

In recent years,Shanghai is exploring the implementation ot comprehensive budget management in community nealtn center,but facing some problems in process:the budget management model is still not unified,"separation between revenue and expenditure" policy is not really implemented,the financial subsidies is not combined with performance appraisal.Meanwhile within the center,the personnel funds are approved by public sector,the operation funds are not standardized,and project funds are relatively chaotic.It is recommended to carry out cost accounting of community health center,clarify expenditure,introduce standardized workload in community health center to promote budgeting scientifically,strengthen the information construction to make budget implementation assessment,and establish a performance appraisal linked to the government subsidy mechanism.

Development and validation of an HPLC-MS/MS analytical method for quantitative analysis of TCBA-TPQ, a novel anticancer makaluvamine analog, and application in a pharmacokinetic study in rats / 中国天然药物

We have recently designed and synthesized several novel iminoquinone anticancer agents that have entered preclinical development for the treatment of human cancers. Herein we developed and validated a quantitative HPLC-MS/MS analytical method for one of the lead novel anticancer makaluvamine analog, TCBA-TPQ, and conducted a pharmacokinetic study in laboratory rats. Our results indicated that the HPLC-MS/MS method was precise, accurate, and specific. Using this method, we carried out in vitro and in vivo evaluations of the pharmacological properties of TCBA-TPQ and plasma pharmacokinetics in rats. Our results provide a basis for future preclinical and clinical development of this promising anticancer marine analog.

Distribution of pathogenic microorganisms and its relationship with clinical features in children with community-acquired pneumonia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the distribution of pathogenic microorganisms in different genders, age groups and seasons in children with community-acquired pneumonia (CAP) and the relationship between the distribution of pathogenic microorganisms and clinical features.</p><p><b>METHODS</b>A total of 1,155 children with CAP were enrolled, among whom there were 670 boys and 485 girls, with a mean age of 3.1±2.8 years (range: one month to 14 years). Indirect immunofluorescence assay, particle agglutination test, enzyme-linked immunosorbent assay, colloidal gold method. and bacterial culture were applied to determine common respiratory pathogenic microorganisms in sputum, throat swabs, blood samples, bronchoalveolar lavage fluid, and urine.</p><p><b>RESULTS</b>A total of 758 specimens (65.63%) were tested positive by pathogen detection. The top three dominant pathogens were Mycoplasma pneumoniae (MP, 43.64%), bacteria (15.12%), and respiratory syncytial virus (RSV, 9.26%), and the rate of mixed infection was 16.02%. The rates of MP infection between boys and girls with CAP were different (40.8% vs 47.6%; P<0.05). The MP detection rate was the highest in the age group of 6-14 years (77.4%) and the lowest in children younger than 1 year (11.2%), while the detection rates of bacteria and RSV were the highest in children younger than 1 year (21.2% and 17.2%, respectively). The MP detection rate was significantly higher in summer and autumn than in winter and spring, while the detection rates of bacteria and RSV in summer and autumn were significantly lower than those in winter and spring. Among children who were MP positive, fever, chills, cough, crackles were more likely to appear; children with RSV infection were more likely to have wheezes; children with bacterial infection were less likely to have cough. Serum levels of C-reactive protein and procalcitonin were associated with bacterial infection (OR=1.747 and 1.418, respectively; both P<0.05).</p><p><b>CONCLUSIONS</b>MP plays a more and more important role in the pathogenic microorganisms of CAP in children. Prevalence and outbreaks of MP infection among children should be alerted in summer and autumn. There are differences in the detection rate of various pathogenic microorganisms in CAP children with various age groups. The clinical features of children with CAP caused by different pathogenic microorganisms are different.</p>

Opportune time and method of reconstruction of penile defects caused by devastating electrical burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the timing and suitable method of reconstructing penile defects caused by devastating electrical burn.</p><p><b>METHODS</b>Thirteen patients with penile defects after devastating electrical burn, hospitalized from September 1998 to August 2013, were included in this study. After the necrotic tissues in the wounds were removed by dressing changes, a local or a hinge-like flap constructed from scrotum or abdominal wall, a prelaminated hinge-like flap from forearm, or a free forearm flap was selected, according to the injury degree of the penis, for the repair of the defect or reconstruction of penis respectively.</p><p><b>RESULTS</b>The flaps survived and the wounds healed well in 2 patients repaired with local flaps from scrotum or abdominal wall. Urethritis occurred in 2 patients 6 to 9 months after the transplantation of hinge-like flaps from scrotum, and they were cured by appropriate drugs. Functions of urination and erection of penis were recovered in these 4 patients. All flaps survived in the 5 patients repaired with hinge-like flaps from abdominal wall or prelaminated flaps from forearm. The wounds in 2 patients healed; wound dehiscence occurred in the other 3 patients in different degrees, and they healed after suturing for 2 or 3 times. The function of erection of penis recovered in these 5 patients, but with discontinuity of urinary stream during urination. Among them, 3 married patients enjoyed satisfactory sexual life. All free forearm flaps survived and the wounds healed well in 4 patients. Urinary fistula occurred in 1 patient, and it was repaired by a secondary operation. These 4 patients experienced normal urination function, but only 2 patients in whom corpus spongiosum partially remained retained the function of erection of penis to certain degree. All these 4 patients could not perform normal sexual intercourse. All patients were followed up for 6 to 13 months after surgery. Under ordinary state, the length of penis was 5.9-9.3 cm, and the circumference of penis was 8.4-10.0 cm. Wound scar was not obvious in all cases. Nine patients reported a restricted erection.</p><p><b>CONCLUSIONS</b>Penile defect caused by devastating electrical burn should be repaired with a suitable flap after necrotic tissues are removed with dressing change. To repair affected penis with necrosis of a small part of cavernous body and/or corpus spongiosum, or combined with urethra defects, local flaps from scrotum or abdominal wall or hinge-like flap from scrotum should be employed. To repair those with necrosis of a large part or the whole of corpus spongiosum combined with urethra defects, hinge-like skin flaps from abdominal wall or prelaminated flaps from forearm should be employed. In patients with necrosis of a large part of cavernous body and corpus spongiosum combined with urethra defect, or total loss of penis, free forearm flaps should be employed to reconstruct penis.</p>

Application of novel silicon bioinert perforated chambers in tissue-engineering of cartilage in vivo / 中华医学美学美容杂志

Objective To explore the potential applications of a chamber for in vivo tissue engineering,and to establish a novel model for in vivo tissue-engineered cartilage.Methods Auricular chondrocytes were isolated,cultured and identified from the ears cartilages of New Zealand white rab bits; rabbit auricular chondrocytes(RACs) were seeded into the scaffolds:(1) RACs were seeded into collagen gel scaffold; (2) RACs were seeded into PLGA/collagen gel scaffold in vitro,and the compos ites were placed into the chambers and implanted in the donor rabbit.As control groups,the composites were implanted directly subcutaneously in the donor rabbit without using chambers,and the contents were harvested at 8 weeks after implantation.Gross examination,histologic and immunohistochemical staining and RT-PCR test were performed to evaluate the harvested contents.Results Under the same conditions inside the chambers,the contents formed into new cartilage-like tissue by histo logical and immunohistochemical staining and RT-PCR.In contrast,in the control groups without chambers displayed vascular invasion and inflammatory reaction in the subcutaneous layer of skin,which eventually led to fibrous tissue or absorption.Conclusions Cartilage is successfully constructed in an immunocompetent animal model using a bioinert perforated chamber.This method is effective in creating a relatively favorable environment for cartilage regeneration,which may provide a valuable reference for the clinical application of tissue regeneration.

Value of ultrasound detection of calcification in the diagnosis of thyroid carcinoma / 中华普通外科杂志

ObjectiveTo investigate the clinical value of sonographic detection for calcification in diagnosis of thyroid carcinoma.MethodsClinical data of 3924 thyroid disease patients examined by ultrasonography and pathology at First Hospital of China Medical University were retrospectively reviewed to investigate the relationship between calcification, microcalcification, macrocalcification and peripheral calcification with thyroid carcinoma,the relationship between solitary nodule with calcification and multiple nodules with calcification with thyroid carcinoma and the relationship between calcification with thyroid carcinoma in different age groups. ResultsThe incidences of calcification,microcalcification in malignant and benign thyroid patients were 32.05％,6.50％ and 80.07％,51.53％,the incidences of calcification and microcalcification were significantly higher in malignant group than in benign group (P ＜ 0.01 ).The incidence of carcinoma in solitary nodules with calcification was 53.33％ while it was 22.2％ in multiple nodule group,the incidence of carcinoma in solitary nodules with calcification was significantly higher than that in multiple nodules (P ＜ 0.01 ).The incidence of carcinoma in solitary nodules with microcalcification was 74.1％ while in multiple nodule group it was 47.9％,the incidence of carcinoma in solitary nodules with microcalcification was significantly higher than that in multiple nodules ( P ＜ 0.01 ).The incidence of carcinoma younger than 70 years of age with caicification in different age groups was significantly different (P ＜ 0.05).In 40 and younger age group,the incidence of carcinoma with microcaicification was higher than that in over 44 years group (P ＜ 0.01 ).ConclusionsCalcification or microcalcification is considered to be a risk factor of thyroid carcinoma.Solitary nodules with calcification or microcalcification found in younger patients were more likely to coexist with thyroid carcinoma.

Evaluation of the therapeutic effect of anesthetic sleeping balance for treatment of chronic insomnia / 中华神经医学杂志

Objective To evaluate the effect of anesthetic sleeping balance for treatment of chronic insomnia. Methods Twenty-four patients with chronic insomnia were treated with anesthetic sleeping balance on a voluntary basis with written informed consent. Polysomnographic (PSG) recordings were conducted and the scores of Leeds Sleep Evaluation Questionnaire (LSEQ) were measured before and after the therapy. Results Twenty-two of these patients showed an increase in the LSEQ score of over 100 after the therapy, with a total response rate of 92%. The therapy resulted in significant improvements in the sleep latency, sleep quality, alertness and behavioral integrity on the following morning and the total scores (P<0.05). PSG recording suggested increased total sleep duration, decreased sleep interruption frequency and shortened duration of wakefulness after the therapy, showing significant differences from the status before the therapy (P<0.05). Significant favorable changes also occurred in sleep architecture after the therapy, manifested by decreased S1% and increased S3%, S4% and percentage of rapid eye movement time. Conclusion Anesthetic sleeping balance may help minimize the sleep debt in patients with chronic insomnia and has also good effect in improving the sleep architecture in patients with refractory chronic insomnia.