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Yinchuan is designated as a pilot for " Internet + healthcare " trials. Based on the classification and definition of Internet-based healthcare, the authors introduced the practical exploration of" Internet+healthcare" in Yinchuan, including making policies on the first try, inviting Internet medical enterprises, setting up Internet-based hospitals, providing telemedicine services, adding Internet health services to the insurance list, and establishing an administration platform, among others. Despite the difficulties and challenges such as health information security risks, service quality administration, interests sharing and responsibility attribution, Yinchuan took " Internet+healthcare" as a breakthrough of improving the medical conditions in an underdeveloped area, showing the courage in innovation, and exploring the functions and limits of Internet-based medical enterprises.In conclusion, Yinchuan provided a good reference of " Internet+healthcare" to other parts of our country.
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Objective To study the association between serum testosterone level and insulin resistance (IR) in elderly male hypertensive patients.Methods One hundred and seven elderly male hypertensive patients were divided into IR group (n=44) and IR-free group (n=63).Their total TST level was measured,their FAI and TSI were assayed.The patients were further divided into TST≥14 nmol/L group (n=72) and TST＜14 nmol/L group (n=35).The association between serum testosterone level and IR in elderly male hypertensive patients was analyzed.Results The serum TST level,FAI and TSI were significantly lower in IR group than in IR-free group (12.02±2.66 nmol/L vs 15.98±3.98 nmol/L;20.16％±2.75％ vs 28.53％±4.74％;2.26±0.49 nmol/U vs 3.21±0.55 nmol/U,27.67％±5.49％ vs 25.98％±4.98％;2.95±0.39 nmol/U vs 2.78±0.64 nmol/U,P＜0.05).The FAI and TSI were significantly higher in hypertention grade 1 patients than in hypertension grade 3 patients (P＜0.05).The IR was significantly lower while the serum TST level,FAI and TSI were significantly higher in TST≥14 nmol/L group than in TST＜14 nmol/L group (33.3％ vs 57.1％,P=0.019;18.43±3.41 nmol/L vs 12.15±2.23 nmol/L,P=0.002;32.49％±5.67％ vs 24.57％±6.94％,P=0.036;3.53±0.87 nmol/U vs 2.55±0.62 nmol/U,P=0.016).TST,FAI and TSI were negatively associated with HOMA-IR (r=-0.406,r=-0.469,r=-0.429,P=0.000).Conclusion Low serum TST level is a risk factor for IRin elderly male hypertensive patients.
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Objective To investigate the effects of hyperbaric oxygen (HBO) on ischemia/repeffusion (Ⅰ/R) injury of the small intestine after resuscitation from trauma and hemorrhagic shock (T/HS) in rats in order to elucidate the underlying mechanisms. Method Ninety-six male Wistar rats were randomly divided into four groups with 24 rats in each group. In shock group, rats were operated with induced T/HS. In sham group, rats operated without induced T/HS. In one HBO therapy (HBOT) group, rats with T/HS were treated with HBOT once. In three-HBOT group, rats with T/HS were treated with HBOT thrice. The Animal Care and Use Committee of China Medical University approved all animal protocols. Rats were anesthetized with amobarbital sodium (80 mg/kg, i.p.) at room temperature (25 ℃), the bloed pressure was monitored via polyethylene cannula inserted into the right femoral artery, connecting with the pressure analyzer (Multiparameter Monitor, M3046A, Boebin-gen, Germany). The left jugular vein was cannulated for administering normal saline and for resuscitation. The right carotid artery was cannulated for shedding blood. After operation, the middle part of left thigh of rat was se-lected as a site to be made of trauma by a lump of 2.5 kg iron falling upon from 20 cm height, causing the com-pound fracture of femur and crush injury of muscular tissue, then the damaged thigh was bandaged and fixed. At the same time, the blood was drawing out of fight carotid artery via cannula until the mean arterial was reduced to 30-35 mmHg within 5 minutes. The hypotension was kept constant for 60 minutes by additional drawing small amounts of blood as needed. After 60 minutes of hypotension, the rats were resuscitated by transfusing the shed blood over 5 minutes, followed by 4 -6 mL normal saline in 60 minutes to get the mean artery pressure maintained above 80 mmHg. The resuscitated rats were put into the hyperbaric chamber (10N-750, menoplace chamber, Ningho, China). The pressure inside the chamber was adjusted to 2.5 ATA and the oxygen concentration was higher than 95 %. The set pressure and oxygen concentration were maintained for 60 minutes. When the pressure within the chamber was decreased to 1 ATA, rots were taken out. The rats in one-HBOT group were given one HBO therapy immediately after resuscitation, and the rats in three-HBOT group were given one HBO therapy im-mediately after resuscitation with additional twice HBO therapy within 24 hours ((q 8 h). The one-way ANOVA and Pearson's bivariate methed were used for statistics. Results Twenty-four hours after resuscitation, the levels of lactate, induced nitric oxide synthase (iNOS), nitric oxide (NO), and tumor necrosis factor-α (TNF-α) in in-testinal tissue of rats in both HBOT groups were significantly lower than those in the rats of shock group without HBOT (P < 0.05). The histological injury grading scores of intestinal tissue in both HBOT group was significant lower than that in shock group (P < 0.05). There was positive correlation between the levels of iNOS and NO in intestinal tissue (P < 0.001). All the above-mentioned parameters in the three-HBOT group were better than those in one-HBOT group, but the difference was not significant (P > 0.05). Conclusions HBO decreases the production of inflammatory factors, inhibits the excessive inflammatory reaction to T/HS, and prevents the mucosal barrier of intestine from I/R injury after resuscitation from T/HS.
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Objective To analyze the present situation of technical efficiency in TCM hospitals throughout the country, discuss the influencing factors causing inefficiency and propose corresponding suggestions. Methods The technical efficiency in 60 TCM hospitals in the country was analyzed using the stochastic frontier cost model for panel data and the influencing factors causing inefficiency were discussed using the multiple stepwise regression method. Results The average technical inefficiency was 22.59% and inefficiency showed an upward trend as the areas shifted from the eastern through the middle to the western regions. Five factors, including the utility rate of beds and the proportion of health technicians among the entire hospital staff, were statistically significant so far as the effect on the increase of the overall cost was concerned. Conclusion The stochastic frontier cost model for panel data is the best method for evaluating the technical efficiency in TCM hospitals. On the basis of the above analysis, suggestions for strengthening scientific management, improving the utility rate of resources and reducing unnecessary waste are put forward.