A postoperative in-hospital mortality risk model for elderly patients undergoing cardiac valvular surgery based on LASSO-logistic regression / 中国胸心血管外科临床杂志

@#Objective     To evaluate the risk factors for postoperative in-hospital mortality in elderly patients receiving cardiac valvular surgery, and develop a new prediction models using the least absolute shrinkage and selection operator (LASSO)-logistic regression. Methods     The patients≥65 years who underwent cardiac valvular surgery from 2016 to 2018 were collected from the Chinese Cardiac Surgery Registry (CCSR). The patients who received the surgery from January 2016 to June 2018 were allocated to a training set, and the patients who received the surgery from July to December 2018 were allocated to a testing set. The risk factors for postoperative mortality were analyzed and a LASSO-logistic regression prediction model was developed and compared with the EuroSCOREⅡ. Results     A total of 7 163 patients were collected in this study, including 3 939 males and 3 224 females, with a mean age of 69.8±4.5 years. There were 5 774 patients in the training set and 1 389 patients in the testing set. Overall, the in-hospital mortality was 4.0% (290/7 163). The final LASSO-logistic regression model included 7 risk factors: age, preoperative left ventricular ejection fraction, combined coronary artery bypass grafting, creatinine clearance rate, cardiopulmonary bypass time, New York Heart Association cardiac classification. LASSO-logistic regression had a satisfying discrimination and calibration in both training [area under the curve (AUC)=0.785, 0.627] and testing cohorts (AUC=0.739, 0.642), which was superior to EuroSCOREⅡ. Conclusion     The mortality rate for elderly patients undergoing cardiac valvular surgery is relatively high. LASSO-logistic regression model can predict the risk of in-hospital mortality in elderly patients receiving cardiac valvular surgery.

Effects of miR-141-3p on dorsal root ganglion inflammation and lower limb pain in rats with lumbar disc herniation / 中国组织工程研究

BACKGROUND:Studies have shown that insulin-like growth factor 1/platelet-derived growth factor has an inhibitory effect on fibroblast apoptosis.miR-141-3p in bone marrow stromal cells increases with age and has a relationship with the activation of inflammatory signaling pathways,suggesting that it may be a therapeutic target for lumbar disc herniation. OBJECTIVE:To explore the effects of miR-141-3p on dorsal root ganglion inflammation and lower limb pain in rats with lumbar disc herniation by regulating insulin-like growth factor 1/platelet-derived growth factor. METHODS:Fifty male Sprague-Dawley rats,SPF level,were randomly divided into normal group,model group,miR-NC group,miR-141-3p inhibitor group and miR-141-3p mimics group,with 10 rats in each group.Except for the normal group,animal models of lumbar disc herniation were established in rats by autologous nucleus pulposus transplantation.After successful modeling,rats in the miR-NC,miR-141-3p inhibitor and miR-141-3p mimics groups were injected intrathecally with 10 μL of 20 μmol/L miR-NC,miR-141-3p inhibitor,miR-141-3p mimics,once a day for 28 days,respectively,while those in the normal and model groups were injected with the same volume of saline at the same location at the same time.Paw withdrawal thermal latency threshold was used to evaluate lower limb pain in rats.The mRNA expression of miR-141-3p in dorsal root ganglion tissue was detected by real-time fluorescence quantitative PCR,the levels of inflammatory factors in dorsal root ganglion tissue were detected by ELISA,and the expression of insulin-like growth factor 1/platelet-derived growth factor in dorsal root ganglion tissue was detected by western blot.The correlation between miR-141-3p and insulin-like growth factor 1/platelet-derived growth factor was analyzed. RESULTS AND CONCLUSION:There were no significant differences in all indexes between the miR-NC group and the model group.Paw withdrawal thermal latency threshold was significantly lower in the model group than in the normal group(P＜0.05),significantly lower in the miR-141-3p inhibitor group than the miR-NC group(P＜0.05),and significantly higher in the miR-141-3p mimics group than in the miR-141-3p inhibitor group(P＜0.05).The mRNA expression of miR-141-3p in dorsal root ganglion tissue was significantly lower in the model group than in the normal group(P＜0.05),significantly lower in the miR-141-3p inhibitor group than in the miR-NC group(P＜0.05),and significantly higher in the miR-141-3p mimics group than in the miR-141-3p inhibitor group(P＜0.05).The levels of tumor necrosis factor α,interleukin 1β,and interleukin 1 in dorsal root ganglion tissue were significantly higher in the model group than in the normal group(P＜0.05),significantly higher in the miR-141-3p inhibitor group than in the miR-NC group(P＜0.05),and significantly lower in the miR-141-3p mimics group than in the miR-141-3p inhibitor group(P＜0.05).The protein expressions of insulin-like growth factor 1 and platelet-derived growth factor in dorsal root ganglion tissue were significantly lower in the model group than in the normal group(P＜0.05),significantly lower in the miR-141-3p inhibitor group than in the miR-NC group(P＜0.05),and significantly higher in the miR-141-3p mimics group than in the miR-141-3p inhibitor group(P＜0.05).The expressions of insulin-like growth factor 1 and platelet-derived growth factor showed a positive correlation with miR-141-3p(r=0.904,P＜0.001;r=0.879,P＜0.001).To conclude,miR-141-3p can significantly improve lower limb pain and inhibit inflammation in dorsal root ganglia in rats with lumbar disc herniation,and its mechanism may be related to the promotion of insulin-like growth factor 1/platelet-derived growth factor expression.

Pachymic acid exerts antitumor activities by modulating the Wnt/β-catenin signaling pathway via targeting PTP1B

@#Objective: To determine the inhibitory effects of pachymic acid on lung adenocarcinoma (LUAD) cells and elucidate its underlying mechanism. Methods: CCK-8, wound healing, Transwell, Western blot, tube formation, and immunofluorescence assays were carried out to measure the effects of various concentrations of pachymic acid on LUAD cell proliferation, metastasis, angiogenesis as well as autophagy. Subsequently, molecular docking technology was used to detect the potential targeted binding association between pachymic acid and protein tyrosine phosphatase 1B (PTP1B). Moreover, PTP1B was overexpressed in A549 cells to detect the specific mechanisms of pachymic acid. Results: Pachymic acid suppressed LUAD cell viability, metastasis as well as angiogenesis while inducing cell autophagy. It also targeted PTP1B and lowered PTP1B expression. However, PTP1B overexpression reversed the effects of pachymic acid on metastasis, angiogenesis, and autophagy as well as the expression of Wnt3a and β-catenin in LUAD cells. Conclusions: Pachymic acid inhibits metastasis and angiogenesis, and promotes autophagy in LUAD cells by modulating the Wnt/ β-catenin signaling pathway via targeting PTP1B.

Establishment of an In-hospital Mortality Risk Model for Elderly Patients Undergoing Cardiac Valvular Surgery Based on Machine Learning / 中国循环杂志

Objectives:To evaluate and predict the risk for in-hospital mortality in elderly patients receiving cardiac valvular surgery preferably,we developed a new prediction model using machine learning. Methods:Clinical data including baseline characteristics,peri-operative data and primary endpoint of 7 163 elderly patients aged 65 years or older undergoing cardiac valvular surgery from January 2016 to December 2018 from 87 hospitals were collected from the Chinese Cardiac Surgery Registry(CCSR).Patients from January 2016 to June 2018 were assigened to the training cohort(n=5 774)and patients from July to December 2018 were assigened to the validation cohort(n=1 389).The primary endpoint was in-hospital mortality.Machine learning algorithms were used to analyze risk factors and develop prediction model. Results:Overall in-hospital mortality was 4.1%.Linear discriminant analysis(LDA),support vector classification(SVC)and logistic regression(LR)models in the training cohort all have high AUCs and low Brier scores,with good discrimination and calibration.In validation cohort,the AUC of LDA,SVC and LR were 0.744,0.744 and 0.746 respectively,which were significantly better than that of 0.642 using the European System for Cardiac Operative Risk Evaluation II(EuroSCORE II)model(P<0.05). Conclusions:The mortality rate for elderly patients undergoing cardiac valvular surgery is relatively high.LDA,SVC and LR can predict the risk for in-hospital mortality in elderly patients receiving cardiac valvular surgery with high accuracy.

Postoperative subacute static progressive stretch does not increase the risk of distal lower limb venous thromboembolism / 中华创伤杂志(英文版)

PURPOSE@#Static progressive stretch (SPS) can be applied to treat chronic joint stiffness. However, the impacts of subacute application of SPS to the distal lower limbs, where deep vein thrombosis (DVT) is common, on venous thromboembolism remain unclear. This study aims to explore the risk of venous thromboembolism events following subacute application of SPS.@*METHODS@#A retrospective cohort study was conducted on patients diagnosed with DVT following a lower extremity orthopedic surgery before being transferred to the rehabilitation ward from May 2017 to May 2022. Patients with unilateral lower limb comminuted para-articular fractures, transferred to rehabilitation ward for further treatment within 3 weeks after operation, followed up more than 12 weeks since initial manual physiotherapy, and diagnosed DVT by ultrasound before rehabilitation course were included in the study. Patients with polytrauma, without evidence of previous peripheral vascular disease or incompetence, had medication for thrombosis treatment or prophylaxis before the operation, detected with paralysis due to nervous system impairment, infected after operation during the regime, or with acute progression of DVT were excluded. The included patients were randomized to the standard physiotherapy and the SPS integrated groups for observation. Associated DVT and pulmonary embolism data were collected during the physiotherapy course to compare the groups. SSPS 28.0 and GraphPad Prism 9 were used for data processing. A p < 0.05 was set significant difference.@*RESULTS@#In total of 154 patients with DVT participating in this study, 75 of them were treated with additional SPS for postoperative rehabilitation. The participants in the SPS group showed improved range of motion (12.3° ± 6.7°). However, in the SPS group, there was no difference in thrombosis volume between the start and termination (p = 0.106, p = 0.787, respectively), although difference was seen intra-therapy (p < 0.001). Contingency analysis revealed the pulmonary embolism incidence (OR = 0.703) in the SPS group compared to the mean physiotherapy.@*CONCLUSION@#The SPS technique is a safe and reliable option to prevent potential joint stiffness without aggravating the risk of distal DVT for postoperative patients suffering from relevant trauma.

Research progress on the mechanism of valproic acid against glioma / 中国药房

Gliomas are commonly central nervous system tumors. The conventional treatment is surgical resection combined with chemoradiotherapy， but glioma patients often have a poor prognosis. Therefore， there is an urgent need to identify new potential targets in gliomas and develop more effective treatments. Valproic acid has the properties of histone deacetylase inhibitor， which has been proven to have inhibitory effects on various tumors. It is confirmed that valproic acid could promote apoptosis and cell arrest of glioma cells， inhibit cell invasion and glioma stem cells， increase the sensitivity of glioma cells to radiotherapy and chemotherapy by regulating ERK/Akt signaling pathway， Akt/mTOR signaling pathway， and regulating expression levels of RECK， MGMT， Nrf2， PON2， Smad4， GSK3β and other proteins. In addition， valproic acid can also enhance the effectiveness of anticancer drugs by inhibiting the growth of glioma stem cells and inducing their differentiation. In conclusion， valproic acid can inhibit glioma through multiple targeted actions， and may become a new targeted drug for the treatment of glioma.

Construction of a prognostic nomogram based on pathology for long-term survival after radical resection of intrahepatic cholangiocarcinoma / 中华肝胆外科杂志

Objective:To establish and evaluate a nomogram for long-term survival of patients with intrahepatic cholangiocarcinoma (ICC) after radical resection.Methods:The data of ICC patients who underwent radical resection for the first time at Zhongshan Hospital, Fudan University from January 2014 to December 2017 were retrospectively analyzed. Of 167 patients who were enrolled, there were 104 males and 63 females, with the age of (60.3±10.9) years. Tumor tissues were collected for immunohistochemical staining and interpretation. Univariate Cox regression, LASSO regression and multivariate Cox regression were used to analyze influencing factors of postoperative long-term survival after ICC. R software was used to construct a nomogram in predicting ICC prognosis.Results:Cox regression analysis showed that TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression to be independent risk factors associated with poor long-term survival after radical resection. The prognostic nomogram model of ICC was constructed based on these factors. The C-index was 0.821. The nomogram model consistency index had a high degree of prognostic differentiation. The 45° diagonal of the 3-year postoperative calibration curve which represented the actual survival fitted well with the segmented line which represented the predicted survival of the nomogram. The area under the receiver operating characteristic curve of the nomogram model was higher than that of AJCC TNM staging (0.894 vs. 0.803, z=4.10, P<0.001). The nomogram model was more effective in predicting postoperative survival of ICC patients than the TNM staging. Conclusion:TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression were independent risk factors for postoperative survival of ICC. The nomogram model could better evaluate long-term prognosis of ICC patients after radical resection than the traditional TNM staging system.

Production of carboxylic acids by metabolically engineered Yarrowia lipolytica: a review / 生物工程学报

Yarrowia lipolytica is a non-conventional yeast with unique physiological and metabolic characteristics. It is suitable for production of various products due to its natural ability to utilize a variety of inexpensive carbon sources, excellent tolerance to low pH, and strong ability to secrete metabolites. Currently, Y. lipolytica has been demonstrated to produce a wide range of carboxylic acids with high efficiency. This article summarized the progress in engineering Y. lipolytica to produce various carboxylic acids by using metabolic engineering and synthetic biology approaches. The current bottlenecks and solutions for high-level production of carboxylic acids by engineered Y. lipolytica were also discussed, with the aim to provide useful information for relevant studies in this field.

Systematic Review of Chinese Medicine in Improving Sperm Quality in Animal Experiments Based on Structure and Function of Sertoli Cells / 中国实验方剂学杂志

ObjectiveTo systematically review the intervention effect of Chinese medicine on the structure and function of testicular Sertoli cells in animal models of impaired spermatogenesis. MethodThe databases， such as China National Knowledge Infrastructure （CNKI），VIP，Wanfang Data，EMbase，and Pubmed，were searched for experimental studies on the effect of Chinese medicine on the structure and function of testicular Sertoli cells in animal models with impaired spermatogenesis. The included studies were evaluated for risks of bias，and the outcome indicators were analyzed with RevMan and Stata software. ResultThirty studies were included，involving 37 randomized controlled trials （RCTs）. As indicated by the Meta-analysis results， compared with the model group，Chinese medicine increased sperm density（SMD=2.42，95% confidence interval（CI）［1.47，3.37］，P<0.000 01）， promoted sperm motility（SMD=2.35，95%CI ［1.70， 2.99］，P<0.000 01）， up-regulated the protein and mRNA levels of Vimentin （related to Sertoli cell cytoskeleton）， elevated the levels of Occludin and Claudin-11 （related to tight junction of blood-testis barrier）， boosted the levels of β-catenin and N-cadherin （related to adherens junction of blood-testis barrier）， raised the level of connexin 43 （Cx43， related to gap junction of blood-testis barrier）， improved the function of Sertoli cells， increased the serum content of Inhibin B （INHB）， and up-regulated the levels of testicular follicle-stimulating hormone receptor （FSHR）， INHB mRNA， androgen-binding protein （ABP） mRNA， transferrin（TF），stem cell factor（SCF），SCF mRNA，glial cell line-derived neurotrophic factor （GDNF），GDNF mRNA，bone morphogenetic protein 4（BMP4），and BMP4 mRNA （P<0.05）. ConclusionChinese medicine can effectively increase sperm density and motility of animal models of impaired spermatogenesis，and improve the structure and function of testicular Sertoli cells. However，affected by the quality of the included studies，the above conclusion needs to be further verified by relevant high-quality studies.

Nucleolar protein 6 promotes cell proliferation and acts as a potential novel prognostic marker for hepatocellular carcinoma / 中华医学杂志(英文版)

BACKGROUND@#Nucleolar protein 6 (NOL6) is a nucleolar RNA-associated protein that is highly conserved between species. It has been proved to be associated with the prognosis of liver cancer. However, the underlying mechanism has not been fully established. This study aimed to assess the relationship between NOL6 and liver cancer prognosis.@*METHODS@#We constructed an NOL6-short hairpin RNA (shRNA)-expressing lentivirus. Through viral transfection, cell growth assay and fluorescence-activated cell sorting, we evaluated the effect of shRNA-mediated NOL6 knockdown on the proliferation, colony formation, and apoptosis of hepatocellular carcinoma (HCC) cells. The relationship between NOL6 expression and HCC patient survival has been established through bioinformatics analysis. We also explored the downstream molecular regulatory network of NOL6 in HCC by performing an Ingenuity Pathway Analysis in the database.@*RESULTS@#Increased NOL6 expression was detected in HCC cells compared to normal controls; HCC patients with high NOL6 expression had poorer prognoses than those with low expression. NOL6 knockdown inhibited HCC cell proliferation, apoptosis, and colony formation. Also, MAPK8, CEBPA, and FOSL1 were selected as potential downstream genes of NOL6.@*CONCLUSIONS@#NOL6 up-regulates HCC cell proliferation and affects downstream expression of related genes. Moreover, NOL6 is considered to be associated with poor prognosis in HCC patients.

Agerelated changes in Alzheimer’s disease-like pathology in male APP/PS1/Tau triple transgenic mice / 中风与神经疾病杂志

@#Objective Immunohistochemical methods were used to observe the age-related changes of Alzheimer’s disease-related pathology in the hippocampus and sensory cortex in male APP/PS1/Tau triple transgenic mice aged 2-15 months.Methods Male 3xTg-AD mice were randomly divided into 7 groups according to the age of 2，4，6，8，10，12 and 15 months，with 3 mice in each group as the experimental group；age-matched male C5B7L/6J mice Randomly divided into 7 groups according to the age of 2，4，6，8，10，12 and 15 months，with 3 mice in each group as a control group. The immunohistochemical method was used to detect the pathological age-related changes in the hippocampus and sensory cortex of each mouse brain tissue with age，closely related to Alzheimer’s disease，including Aβ，phosphorylated tau，transgenic products of human tau P301L mutant，astrogliosis，neuron markers.Results Compared with C5B7L/6J mice，the intensity of immunostaining of Aβ cells（6E10），p-tau（AT8，Ser202/Thr205） and tau（HT7） astrocytes（GFAP） in APP/PS1/Tau triple transgenic mice is significantly enhanced，P<0.0001.The hippocampus and sensory cortex of male APP/PS1/Tau triple transgenic mice aged 2-15 months did not have obvious amyloid plaque deposition. The staining degree of Aβ cells in the CA1 area of the hippocampus gradually increased at the age of 8 months，and the staining degree of the sensory cortex remained unchanged，P<0.05. The staining degree of Tau (HT7) in the CA1 area has weak staining at 2 to 6 months of ageand the staining degree remained stable from 6 months to 15 months；The degree of staining in the sensory cortex increased from 2 to 4 months old，and the degree of staining remained stable at 4 to 15 months，P<0.05.The phosphorylation of AT8 in CA1 area began to increase at 6 months，and the phosphorylation of sensory cortex began to increase at 12 months，P<0.05.Astrocytes（GFAP） in CA1 area and sensory cortex area gradually increase in reactivity from 2 months to 15 months. The number of mature neuron markers（NEUN） in CA1 area gradually decreased from 2 months to 6 months，and was stable from 6 months to 15 months. The number of NEUN in CA-3 area gradually decreased from 2 months to 15 months，P<0.05.Conclusion 3xTg-AD mice show a clear interaction between age and phenotype development，which makes it an important tool for studying the role of aging in disease pathogenesis.

Current Research Status of Aptamer-mediated Liposome Targeted Delivery of Antitumor Drugs / 中国实验方剂学杂志

Tumor has become the second most serious disease that threatens human health and life. Treating with chemical drugs (referred to as chemotherapy) is the most basic treatment, but most chemotherapeutic drugs cause damage to normal tissues. It is a difficult problem in the field of biomedical research that how to deliver anti-tumor drugs more efficiently, increase the concentration of drugs in tumor tissues, enhance the anti-tumor effect, and decrease the drug distribution in normal tissues to weaken the damage to normal tissues. In order to achieve the goals of accurate delivery of anti-tumor drugs and synergism and attenuation, the researchers used systematic evolution of ligands by exponential enrichment technology (SELEX technology) to screen aptamers that can specifically target tumor markers or tumor cells, and designed the novel liposome targeting drug delivery system with aptamers as targeting molecules (ligands). This paper briefly introduced nucleic acid aptamer technology and common tumor markers, and reviewed the research advances on the antitumor effect of aptamer-liposome drug delivery system. It will provide references for the selection of appropriate tumor markers as targets and the application of aptamer technology in the research and development of high-efficiency and low-toxicity liposome targeting agents of anti-tumor traditional Chinese medicine. Meanwhile, it is of great significance for promoting the application of aptamer technology in targeted drug delivery systems.

Clinical characteristics and genetic analysis of two cases of pseudohypoparathyroidism type Ⅰa with early-onset skin nodules as the diagnostic clue / 中华皮肤科杂志

Clinical features of and genetic mutations in two cases of pseudohypoparathyroidism type Ⅰ a(PHP Ⅰ a) with early-onset skin nodules were analyzed.Both of the two patients were males,and their ages at onset were 2 and 3 months respectively.They both presented with early-onset skin nodules as the main clinical manifestation,and were clinically characterized by a round face,short neck and early obesity.Histopathological examination of skin lesions showed subcutaneous ectopic osteogenesis in both patients.The first patient had low blood calcium,high blood phosphorus,high parathyroid hormone (PTH),and gene sequencing showed a heterozygous mutation c.399delT causing a T base deletion at position 399 in exon 5 of the GNAS gene.The second patient had normal blood calcium and phosphorus levels as well as normal PTH levels at early stage,and gene sequencing showed a heterozygous mutation c.939delT causing a T base deletion at position 939 in exon 9 of the GNAS gene.The blood PTH level was found to increase in the second patient after 1-year follow-up.Both the patients were confirmedly diagnosed with PHP Ⅰa.After treatment with vitamin D3,no new skin nodules occurred,and the blood calcium and phosphorus levels returned to normal.

Effect of Taraxerol in Inducing Autophagy in Breast Cancer Cells via mTOR Signaling Pathway / 中国实验方剂学杂志

Objective: To investigate the effect of taraxerol on autophagy of breast cancer MCF-7 cells in vitro, and explore the related mechanisms. Method: The effect of various doses of taraxerol (12.5, 25, 50, 100, 200 μmol·L-1) on proliferation of MCF-7 cells was detected by methye thiazolye telrazlium (MTT) assay. The autophagy-inducing effect of taraxerol was observed by acridine orange staining, transmission electron microscope (TEM) and immunofluorescence. The expressions of autophagy-related proteins and the changes of mammalian target of rapamycin (mTOR) signaling pathway were determined by Western blot analysis. Result: The viability of MCF-7 cells was significantly inhibited by taraxerol. Acridine orange staining indicated that the acidic lysosomes increased significantly after treatment with taraxerol in MCF-7 cells. The autophagic structure in the treated group was observed by TEM. Immunofluorescence showed that the expression of microtubule-associated protein 1 light chain 3 (LC3) in the cells of the drug group was increased. Western blot demonstrated that the protein expressions of LC3-Ⅱ and Beclin-1 were increased in taraxerol-treated MCF-7 cells (PP-1 taraxerol group, combination group (taraxerol + 3-methyladenine, 3-MA) showed the down-regulation of LC3-Ⅱ in the MCF-7 cells (PPPConclusion: Taraxerol can induce autophagy in MCF-7 cells, which may be related to the inhibition of mTOR signaling pathway.

Applications of health technology assessment in value-based management of total health expenditure / 中华医院管理杂志

Unreasonable growth of total health expenditure at various extent has been found to be prevalent among many countries for a long time. Thus how to deal with this global public health challenge has become a hot topic among the consumers, providers, and payers alike. Echoing the global trend of value-based healthcare, value-based management of total health expenditure could be a direction of cost containment in the future. Through promoting the rational development of healthcare industry, assisting the decision-making of health insurance authority, improving health authority′s supervision of health technology allocation and utilization, maximizing resource utilization efficiency at hospitals, standardizing physician practices, guiding patients′ medication preferences and behaviors, health technology assessment could mobilize stakeholders′participation in the value-based management of total health expenditure and serve as an important decision-making tool to optimize the allocation and utilization of scarce health resources, reducing and avoiding waste in healthcare sector, and promoting high-value and sustainable development of total health expenditure.

Applications of health technology assessment in value-based management of total health expenditure / 中华医院管理杂志

Unreasonable growth of total health expenditure at various extent has been found to be prevalent among many countries for a long time. Thus how to deal with this global public health challenge has become a hot topic among the consumers, providers, and payers alike. Echoing the global trend of value-based healthcare, value-based management of total health expenditure could be a direction of cost containment in the future. Through promoting the rational development of healthcare industry, assisting the decision-making of health insurance authority, improving health authority′s supervision of health technology allocation and utilization, maximizing resource utilization efficiency at hospitals, standardizing physician practices, guiding patients′ medication preferences and behaviors, health technology assessment could mobilize stakeholders′ participation in the value-based management of total health expenditure and serve as an important decision-making tool to optimize the allocation and utilization of scarce health resources, reducing and avoiding waste in healthcare sector, and promoting high-value and sustainable development of total health expenditure.

Application of humanities curriculum by narrative-based instruction in training of graduate students in oncology / 中华医学教育探索杂志

In recent years,the application of humanities curricula has gained increasing attention gradually in Chinese medical education.For graduate students in oncology who have just been exposed to the actual clinical work,it is extremely important to develop the comprehensive abilities of physician-patient communication,humanistic care and self psychological dredging.Since 2012,we have conducted humanities curriculum by narrative-based instruction for the clinical intern graduate students in oncology at the department of surgical oncology in the First Affiliated Hospital of Xi'an Jiaotong University,and a good teaching result has been gained.This kind of humanities curricula based on open discussion could be an effective way to improve physician-patient communication ability and reduce the clinical psychology pressure for the graduate students in oncology.

The effects of family doctors' contracting servics on the integration of medical care and prevention / 中国卫生政策研究

Objectives:To analyze the effectsof family doctor contracting service on the integration of medical care and prevention and its mechanism. Methods:Based on the representative sampling, 541 family doctors from seven districts were surveyed, and focus group and personal interviews were conducted withfamily doctors and other relevant informants. Descriptive statistical analysis was mainly used to analyze quantitative data and NVIVO 9. 0 was used for encoded qualitative data. Results ; Different contracted service models have different effects on medical protection on medical care and prevention. The contractingservice with the family doctor is helpful to facilitate the integration of medical care and preventive treatment ; the signing service that helps the team members to get effective incentives and personal paid contracts can help promote the combination of medical defense and preventive treatment ; whereby the service content includes basic medical treatment. Moreover, signing a family doctor contract with public health services can also help promote medical integration. Suggestions :Family doctor contracting services should implement team and individual contracted services. Designing a comprehensive service package that integrates basic public health service projects and basic medical and personalized health management services should be prioritized to reflect the concept of covered medical care and preventive treatment. A new approach to explore the path of integration of basic public health and medical insurance fundsshould be found to strengthen the combination of medical and preventive measures, and promote the transformation of general practitioners from service gatekeepers to health gatekeepers.

Analysis of the financing policy of integrating NCMS and URBMI:Based on the perspective of equity / 中国卫生政策研究

Objectives:This paper intends to analyze the financing policies of integrating NCMS and URBMI in terms of equity. Methods:Data on the financing of NCMS and URBMI from 2008 to 2015 were collected from the China health statistics yearbook (2009—2012) the China health and Family Planning Statistics yearbook(2013—2016),the National Handbook of NCMS Information(2008—2015),the China human resources and social security statistics year-book (2009—2016),and the China social security yearbook(2009—2015)."Ability to pay"approach was introduced to measure the inequity in health financing of medical insurance for urban and rural residents. The proportion of indi-vidual contributions as to NCMS and URBMI as a percentage of the per capita disposable income was used as an actual indicator to analyze the equity in health financing between rural and urban residents. Results:The URBMI had a finan-cing mechanism that was similar to that used by NCMS in that public finance accounted for more than three quarters of the pooling funds,and the individual contribution accounts for less than? of the per capita contribution amount. The scale of financing for NCMS was less than 5% of the per capita net income of rural residents and less than 2% of the per capita disposable income of urban residents for URBMI. Individual contributions to the NCMS and URBMI funds were less than 1% of their disposable and net incomes. The disparities in health financing between urban and rural resi-dents in China was not improved as expected with the introduction of NCMS and URBMI. Conclusions:The proportion of individual contributions to the URBMI and NCMS funds were small in terms of contributors'incomes. The equal financing per capita for URBMI and NCMS masks the inequality of urban and rural residents in the financing of medical insurance.

Current situation of human resources of parasitic disease control and pre-vention organizations in Henan Province / 中国血吸虫病防治杂志

Objective To understand the current status of human resources of parasitic disease control and prevention orga-nizations in Henan Province,so as to provide the reference for promoting the integrative ability of the prevention and control of parasitic diseases in Henan Province.Methods The questionnaires were designed and the method of census was adopted.The information,such as the amounts,majors,education background,technical titles,working years,and turnover in each parasit-ic disease control and prevention organization was collected by the centers for disease control and prevention(CDCs)at all lev-els.The data were descriptively analyzed.Results Totally 179 CDCs were investigated,in which only 19.0%(34/179)had the independent parasitic diseases control institution(department).There were only 258 full-time staffs working on parasitic disease control and prevention in the whole province,in which only 61.9%(159/258)were health professionals.Those with junior col-lege degree or below in the health professionals accounted for 60.3%(96/159).Most of them(42.1%)had over 20 years of expe-rience,but 57.9%(92/159)of their technical post titles were at primary level or below. Conclusions The proportion of the health professionals is low in the parasitic disease control and prevention organizations in Henan Province.The human resource construction for parasitic disease control and prevention at all levels should be strengthened.