Effects of Gravity Loading Countermeasure Garment on Degeneration of Lumbar Intervertebral Disc in Microgravity Environment / 医用生物力学

Objective To analyze the biomechanical effects of gravity loading countermeasure garment on human lumbar intervertebral disc in microgravity environment. Methods Based on CT images of a healthy adult volunteer, the finite element model of L4-5 vertebrae was established. Through the empty load and 400 N axial loading for 4 hours on lumbar finite element model, the biomechanical effect of the non-intervention and gravity loading countermeasure garment were simulated respectively in microgravity environment. Results The central pore pressure, radial displacement and water content of the human lumbar intervertebral disc increased with time in microgravity environment. In the case of wearing gravity loading countermeasure garment, the central pore pressure, axial stress, radial displacement and water content of the lumbar intervertebral disc were reduced after 72 hours of cyclic loading compared with the non-intervention group. Conclusions Wearing gravity loading countermeasure garment can help astronauts to prevent the adverse effects of microgravity on the spine to some extent in microgravity environment.

Relationship between environmental tobacco smoke and lung cancer risk among nonsmokers in China: A meta-analysis / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the environmental tobacco smoke (ETS) and lung cancer by Meta-analysis.</p><p><b>METHODS</b>We used "lung cancer/lung neoplasm", "non-smoking/non-smoker", "China/Chinese", "case-control/case control", "risk factor", "environmental tobacco smoke/passive smoking" as key words, to search papers in databases including Chinese BioMedical Literature (CBM), China National Knowledge Internet (CNKI), Wanfang, Vip Citation Databases (VIP), PubMed and Web of Science databases, and collected the case-control studies on ETS and lung cancer among Chinese non-smokers from January 1999 to December 2013. A total of 129 research papers were collected. RevMan 5.2 software was used to calculate combined odds radio (OR) and 95% CI.</p><p><b>RESULTS</b>Qualified 18 literatures were included, total cases 6 145 and controls 8 132. Consolidated results showed that ETS exposure could increase the risk of lung cancer, combined OR (95% CI) = 1.52 (1.42-1.64). Stratified analysis showed that ETS exposure was found to be significantly associated with an increasing risk of the lung cancer on non-smoking women and men, and combined OR (95% CI) were 1.58 (1.42-1.75) and 1.34 (1.08-1.65), respectively; the ETS exposure from family or the working environment could increase the risk of lung cancer, and combined OR (95% CI) were 1.48 (1.20-1.82) and 1.38 (1.13-1.69) respectively; childhood exposure and adult exposure were no significant statistical significance, and combined OR (95% CI) were 1.37 (0.98-1.91), and 1.34 (0.97-1.85) respectively.</p><p><b>CONCLUSION</b>Environmental tobacco smoke exposure was a significant risk factor of lung cancer among non-smokers in China.</p>

Exploring the transition to DRGs in developing countries: a case study in Shanghai, China

With the success of DRGs [Diagnosis Related Groups] in developing countries, this prospective payment system has been imported into China from the early 21[st] century. However, DRGs has been struggling and has made little progress since [its adoption in] 2004. This study contributes to the debate on how to bridge the pay-for-service [system/scheme] and DRGs [Diagnosis Related Groups] during the transitional period of payment reform in China. From 2008 to 2012, sixty regional general hospitals in Shanghai were divided into three groups according to their economic level, and one hospital was picked from each group randomly. After ranking of morbidity, 22130 patients with hypertension or coronary heart disease were chosen as sample. Using multiple linear regression analysis, the inter relationships between the total medical expenses of the inpatients, and age, gender of the inpatients, length of stay, region and economic level of the hospitals were examined. The main findings were [1] Age, LOS and the economic level of treatment location had a statistically significant impact on patients with hypertension or coronary heart disease. However, gender is only a significant factor to patients with coronary heart disease. The results suggested that age, LOS and the economic level of treatment location should be considered in formulating pricing standards for the hypertension patient group. Besides the above mentioned factors, gender should also be considered in formulating pricing standards for the coronary heart disease patient group. [2] Under the premise of limited resources, developing countries should first narrow down to screen for common and frequently occurring diseases, then study the key factors which affect the treatment cost of the diseases. Simplification of the DRGs standard- setting process based on standardized clinical pathways and accurate costing will greatly increase the efficiency of implementing DRGs in the developing world

How to make diagnosis related groups payment more feasible in developing countries- a case study in shanghai, China

Given limited health sources, how to make DRGs [Diagnosis Related Groups] more feasible is a big question in developing countries. This study contributes to the debate on how to bridge the pay-for-service and DRGs during the transitional period of payment reform. From 2008 to 2012, 20740 patients with cirrhosis or duodenal ulcer disease were chosen as sample. Using multiple linear regression analysis, the interrelationships between the total medical expenses of the inpatients, and age, gender of the inpatients, length of stay [LOS], region and economic level of the hospitals were examined. The main findings were 1] length of stay [LOS] and the economic level of treatment location had a statistically significant impact on patients with cirrhosis or duodenal ulcer disease. Meanwhile gender is not a significant factor for both of them. 2] Under the premise of limited resources, developing countries should first narrow down to screen for common and frequently occurring diseases, then study the key factors which affect the treatment cost of the diseases. Based on picking out common diseases and their key factors, Simplification of the DRGs setting process will greatly increase the efficiency of implementing DRGs in the developing world

The clinical significance of determining serum paraquat by spectrometry / 中华急诊医学杂志

ObjectiveTo evaluate the reliability and clinical value for detecting paraquat (PQ)concentration in serum by spectrometry. MethodsThe determinations of wave length for detecting serum PQ concentration by ordinary spectrometry and second-derivative spectrometry were carried out. When the second-derivative spectrometry was used for detecting PQ in serum, the linear range and precision for PQ concentration were well defined. The results of serum PQ concentration determined by second-derivative spectrometry and by HPLC (high performance liquid chromatography) were compared in 8 patient with PQ poisoning. A total of 21 patients with acute poisoning after PQ ingestion over 4 hours admitted from October 2008 through September 2010 were retrospectively studied. Patients were divided into two groups as per the serum concentrations more than 1.8 μg/mL or less than that by second-derivative spectrometry on the day of admission. The severity of clinical manifestations between two groups was analyzed with t-test or Fisher's exact probabilities analysis. Results ( 1 ) The absorption peak of 257 nm could not be found by using ordinary spectrometry to detect the PQ concentration in serum. (2) The calibration curve in the 0. 4 ～ 8.0μg/mL range for detecting PQ concentration by second-derivative spectrometry observed the Beer's law (r =0. 996) . The average retrieval rate of PQ was within the range of 95.0％～ 99. 5％ with relative standard deviation (RSD) within 1.35％～ 5.41％ ( n = 6), and the lowest detection limit was 0. 05μg/mL. (3) The results of PQ concentrations from 8 patients with PQ poisoning detected by second-derivative spectrometry were consistent with those of the quantitative determinations by HPLC ( r = 0. 995,P＜0. 01 ) . (4) The survival rate of patients with serum PQ concentration more than 1.8 μg/mL was 22. 2％ ,and the incidences of acidosis, oligouria and pneumomediastium in these patients were 55.6％,55. 6％ and 77.8％, respectively. These clinical manifestations were significantly different from those in patients with serum PQ concentration less than 1.8 μg/mL ( P ＜ 0. 05 ) . Conclusions ( 1 ) It was inappropriate to take 257 nm as the determination wave length for detecting serum PQ concentration by ordinary spectrometry. (2) The method of second-derivative spectrometry was reliable for detecting serum PQ concentration. (3) Serum PQ concentration detected by second derivative spectrometry could be used to predict the severity of clinical manifestations of patients with PQ poisoning and was an important predictive factor for poor prognosis if the serum PQ concentration more than 1.8 μg/mL after PQ ingestion over 4 hours.

Tentative plan for field medical card / 医疗卫生装备

After the introduction of origin and significance of field medical card,this paper mainly analyses the field medical card in such aspects as preferable user,information demand,function demand and structure demand.Moreover,this paper briefly introduces the technologies of two-dimensional barcode,magnetic card,IC card,optical card,radiofrequency identification and blue tooth.The radiofrequency identification technology is feasible.