Diagnostic efficiency of CT enterography comprehensive score combined with spectral imaging for Crohn's disease in active phase / 中国医师杂志

Objective:To explore the diagnostic efficiency of CT enterography (CTE) comprehensive score combined with spectral imaging for Crohn's disease (CD) in active phase.Methods:A retrospective analysis was performed on the case data of 87 CD patients who were admitted to the First People's Hospital of Chenzhou from October 2018 to October 2020. According to CD activity index (CDAI), they were divided into active phase group ( n=58) and remission phase group ( n=29). The results of CTE and spectral imaging in both groups were collected. The diagnostic value of CTE comprehensive score combined with spectral imaging for CD in active phase was analyzed. Multiple linear stepwise regression analysis was used to analyze the independent related factors affecting the active phase of CD. Receiver operating characteristic (ROC) curve was used to predict the area under curve (AUC), sensitivity, specificity and cutoff value of CTE comprehensive score combined with energy spectrum imaging (intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase) in active phase of CD. Results:The probability of comb sign, intestinal stenosis or expansion and target sign in CTE of patients with active CD was significantly higher than that in patients with remission CD, the probability of fat sign was significantly lower than that in patients with remission CD, and the CTE comprehensive score was significantly higher than that in patients with remission CD ( P<0.05). Multiple linear stepwise regression analysis showed that the thickness of intestinal wall, uniform enhancement of intestinal wall and iodine concentration in portal phase were independent related factors affecting the active phase of CD ( P<0.05). ROC curve analysis showed that AUC of CTE comprehensive score combined with intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase for predicting CD in active phase was 0.953, higher than 0.869, 0.907, 0.914 and 0.913 of single index. The cut-off values of CTE comprehensive score, intestinal wall thickness and iodine concentration in portal phase were 6.0 points, 0.89 cm and 2.68 mg/ml, respectively. There was no homogeneous enhancement of intestinal wall in spectral imaging. Conclusions:CTE comprehensive score combined with intestinal wall thickness, intestinal wall enhancement and iodine concentration in portal phase can more accurately determine CD in active phase, which provide a new quantitative diagnostic reference.

Analysis on epidemiological characteristics of hand foot mouth disease and the influence of meteorological factors on its incidence in Beijing / 公共卫生与预防医学

Objective To study the epidemic characteristics of hand foot mouth disease (HFMD) and the influence of meteorological factors on the incidence of HFMD in Beijing from 2010 to 2019, and to provide scientific evidence for the warning, prediction, prevention and control of HFMD. Methods Descriptive statistical analysis was conducted to analyze the epidemic characteristics of HFMD in Beijing from 2010 to 2019 using R4.0.2 software, and the relationship between meteorological factors such as daily average temperature, daily average relative humidity, daily average precipitation, daily average air pressure, and daily average wind speed and HFMD incidence from 2015 to 2019 was analyzed by using distribution lag nonlinear model. Results In 2010-2019, a total of 324 864 HFMD cases were reported in Beijing, with an average incidence rate of 155.10/100,000. May to July was the annual peak of HFMD. The average daily temperature, relative humidity and precipitation were positively correlated with the incidence of HFMD (Rs=0.66, 0.45 and 0.24, P=0.0000, 0.0000 and 0.0000, respectively). The average daily wind speed and pressure were negatively correlated with the incidence of HFMD (Rs=-0.14 and -0.3, P=2.22×10-9 and 0.0000, respectively). The RR was the highest when the air temperature was 25℃ and at the lag of 10 day, which was 1.41 (95%CI:1.12-1.77). Humid weather conditions were the risk factors of HFMD, and the influence time was relatively long. The RR was the highest when the relative humidity was 84.5% and the lag was 15 days, which was 1.51 (95%CI:1.34-1.70). When daily average wind speed was 3m/s, and the lag was 14 days, the RR was the highest, which was 1.22 (95%CI:0.86-1.73). The RR was the highest when the daily average pressure was 842.5 hPa and the lag was 5 day, which was 1.20 (95%CI:0.66-2.07). When the daily average precipitation was 166.5 mm and the lag was 7 days, the RR was the highest, which was 4.37 (95%CI:1.61-11.84). When the above meteorological conditions were met, the risk of HFMD was the highest. Conclusion Meteorological factors such as daily average temperature, daily average relative humidity, daily average precipitation, daily average pressure and daily average wind speed are closely related to the incidence of HFMD, which is nonlinear and has certain lag. It can be used to predict the risk and epidemic intensity of HFMD, and to provide a scientific basis for the prevention and control, early warning, and prediction of infectious diseases.

Utility of procalcitonin, human neutrophil lipocalin and neutrophil CD64 in early diagnosis of bacterial infection / 中国感染与化疗杂志

Objective To examine the expression levels of procalcitonin (PCT),neutrophils apolipoprotein (human neutrophil lipocalin,HNL) and neutrophil CD64 (CD64) in the blood of patients with bacterial infection and investigate their utility in early diagnosis and treatment of bacterial infection.Methods A total of 210 patients with confirmed infection who were treated in hospital from February 2013 to May 2017 were enrolled.The patients were classified into bacterial infection group (105 cases) and viral infection group (105 cases).Additionally,a cohort of 80 healthy subjects were randomly selected from health checkup during the same period as the control group.PCT and HNL were determined on the UPT up-converting phosphor microbial immunity analyzer provided by Beijing Hotgen Biotech Company.BD FACS calibur flow cytometer was used to measure and calculate CD64 percentage.Results The levels of PCT,HNL,CD64 and WBC were compared between bacterial infection group,viral infection group and control group.The between-group difference was statistically significant (P＜0.05).The CD64 and WBC levels were significantly different between viral infection group and control group (P＜0.05),but the PCT and HNL levels were not different significantly between viral infection group and control group (P＞0.05).The area under the ROC curve of PCT,namely AUC PCT,was 0.855,and AUC (HNL) was 0.930,AUC (CD64) 0.928,and AUC (WBC) 0.729.The cutoff value of PCT,HNL and CD64 for diagnosis of bacterial infections was ＞0.79 ng/mL,＞87.43 ng/mL,and ＞9.01％,respectively.Conclusions Bacterial infection is associated with elevated levels of PCT,HNL and CD64,which can be used in early diagnosis of bacterial infections.HNL may provide the highest diagnostic value.

Design and application of special gowns for critical patients / 现代临床护理

Objective To explore the effect of newly-designed gowns for critical patients. Methods Two hundred critical patients hospitalized for more than 3 days in the intensive care unit of our hospital during February 2013 to February 2015 were divided into the control group and observation group equally according to their odd or even registration number. The control group wore conventional dresses for patients (including a shirt and a pant) and the patients in the latter group were newly-designed gowns. The two groups were compared in terms of comfort, nursing manpower, nursing stuff and security. Result The observation group was significantly superior to the control group in terms of comfort, nursing manpower, nursing stuff and security (P<0.05). Conclusions The newly-designed gowns for critical patients can improve the comfort degree and save nursing manpower and stuff. It allows convenience in treatment and nursing.

Comprehensive evaluation of community health services in Shanghai / 中华医院管理杂志

The study introduced the general evaluation indicator system for community health services in Shanghai and its characteristics,analyzing the results of the comprehensive evaluation from the aspects of regions and institutions.From six aspects of financial input,human resource construction, operation mechanism,family doctor system,information system construction and the application of the comprehensive evaluation results,the paper recommended on deepening the reform of community health services.

Investigation on reference intervals of blood lipids four indexes in healthy population in Hengshui city / 国际检验医学杂志

Objective To establish the reference intervals of total cholesterol (TC),triglyceride (TG),high density lipoprotein (HDL-C)and low density lipoprotein (LDL-C)in the healthy population in Hengshui region.Methods 16 403 healthy individuals were collected from the various counties and cities in this region and detected the above 4 blood lipid indexes (TC,TG,HDL-C, LDL-C)by adopting the automatic biochemical analyzer.The subjects were grouped according to different genders and ages and the detection results were performed the statistical analysis.Results TC 3.17-7.20 mmol/L;TG 0.08-3.16 mmol/L;HDL-C 0.94-2.30 mmol/L;LDL-C 1 .14 -4.59 mmol/L.Conclusion The differences of blood lipid detection results exist in males and fe-males in Hengshui region,the results are different among different age groups,it is suggested that different genders and different age groups should establish their own normal reference intervals in order to provide the diagnostic basis for clinic.

Reference intervals of 3 indicators of renal function test for the healthy adults in Hengshui City / 国际检验医学杂志

Objective To establish the reference interval of serum urea nitrogen (BUN) ,creatinine(Cr) ,uric acid(UA) for the healthy adults of Hengshui City .Methods 16 403 cases of healthy adults of different areas in the city were enrolled in the study .By using automatic biochemical analyzer ,3 kidney function indicators(BUN ,Cr ,UA) were determined .According to different sex and age groups ,statistical analysis was performed .Results The reference intervals of 3 kidney function indicators for healthy people in Hengshui City were as follows ,BUN :2 .75-7 .05 mmol/L for male and 2 .24-6 .58 mmol/L for female;Cr:49 .69-87 .96 μmol/L for male and 35 .82-72 .22 μmol/L for female;UA :209 .51 -500 .06 μmol/L for male and 146 .25 -389 .69 μmol/L for female . Conclusion The reference intervals established could basically reflect the concentrations of 3 kidney function indicators for the healthy adults in Hengshui City ,which could provide a reference .

Relationship between socioeconomic status and the prevalence of cardiovascular disease among retired residents living in a community,Shanghai / 中华流行病学杂志

Objective To explore the relationship between socioeconomic status and the risk factors of cardiovascular diseases in retirees from a community in Shanghai. Methods Observational study involved 9 943 retirees aged 50 and over in Shanghai. Both single factor and multi-factor analyses methods were used to describe the correlation between factors as:educational level,marital status,annual household income and risk of hypertension,coronary heart disease,stroke etc. A new defined compound index was used to assess the relevance of socioeconomic status on the risk of cardiovascular diseases,based on logistic regression model. Results After adjusted for age,the risk of cardiovascular diseases in these retirees was influenced by socioeconomic status. In general, opponent correlations in education levels and prevalence of hypertension were found between female and male. Compared with those having received college or higher education,the risk of hypertension increased in females when the education level declined,with OR as 1.08(95%CI:0.89-1.30). For those having had senior high school junior high school or elementary education,the risks of hypertension were 1.26(95%CI:1.05-1.51),1.34(95%CI:1.08-1.65),0.72(95%CI:0.59-0.87),0.78 (95%CI:0.64-0.94),and 0.70(95%CI:0.52-0.92)for males,respectively. The risk of cardiovascular diseases increased with annual household income. Compared with high level of socioeconomic status, lower socioeconomic status might decline the risk of cardiovascular diseases in males by approximately 30%,with OR for medium being 0.72(95%CI:0.61-0.84)and for lower ones it was 0.70(95%CI:0.57-0.87). However,similar correlations were not found in females. No significant relationship was found between marital status and the prevalence of cardiovascular diseases in this study. Conclusion The risks of cardiovascular diseases varied with different socioeconomic status, indicating that tailored interventions should be conducted in different socioeconomic groups.

Relationship between socioeconomic status and the prevalence of cardiovascular disease among retired residents living in a community,Shanghai / 中华流行病学杂志

Objective To explore the relationship between socioeconomic status and the risk factors of cardiovascular diseases in retirees from a community in Shanghai. Methods Observational study involved 9 943 retirees aged 50 and over in Shanghai. Both single factor and multi-factor analyses methods were used to describe the correlation between factors as:educational level,marital status,annual household income and risk of hypertension,coronary heart disease,stroke etc. A new defined compound index was used to assess the relevance of socioeconomic status on the risk of cardiovascular diseases,based on logistic regression model. Results After adjusted for age,the risk of cardiovascular diseases in these retirees was influenced by socioeconomic status. In general, opponent correlations in education levels and prevalence of hypertension were found between female and male. Compared with those having received college or higher education,the risk of hypertension increased in females when the education level declined,with OR as 1.08(95%CI:0.89-1.30). For those having had senior high school junior high school or elementary education,the risks of hypertension were 1.26(95%CI:1.05-1.51),1.34(95%CI:1.08-1.65),0.72(95%CI:0.59-0.87),0.78 (95%CI:0.64-0.94),and 0.70(95%CI:0.52-0.92)for males,respectively. The risk of cardiovascular diseases increased with annual household income. Compared with high level of socioeconomic status, lower socioeconomic status might decline the risk of cardiovascular diseases in males by approximately 30%,with OR for medium being 0.72(95%CI:0.61-0.84)and for lower ones it was 0.70(95%CI:0.57-0.87). However,similar correlations were not found in females. No significant relationship was found between marital status and the prevalence of cardiovascular diseases in this study. Conclusion The risks of cardiovascular diseases varied with different socioeconomic status, indicating that tailored interventions should be conducted in different socioeconomic groups.

Progress and bottlenecks of family doctor system in Shanghai / 中国卫生政策研究

Shanghai began to strengthen the community health service system in 1997 , and had officially en-tered the period of “connotation construction” with the core policy of family doctor system in 2011 after the period of“service framework and network establishment” and“operational mechanism reform”. Through summarizing the poli-cy files related the family doctor system and based on 2013 report on monitoring and evaluation of family doctor system in Shanghai, the paper presented the progress of the system from aspects of system coverage, signature relationship, service mode and operational mechanism, and analyzed the development bottlenecks of the system from aspects of the policy itself, service principal, service supervision and service objects. Finally, the paper proposed some suggestions in order to give some references for further development of national general practitioner system.

Development experiences of integrated healthcare in England:A case in Oxfordshire / 中国卫生政策研究

An integration of British healthcare and social services has been underway in recent years, and a typical methodology has been formed in the process of regional explorations . Using qualitative research methods of on-site observation and in-depth interviews, the paper studies the Care Programme Approach ( CPA) system of mental health and emergency multidisciplinary teams of Oxfordshire, a typical case of the integrated healthcare system re-forms in the British healthcare system. England’s integrated healthcare reforms have placed primary care and commu-nity health services at the center of the healthcare system and have included social services within the system. The ex-periences of multidisciplinary teams, integrated care pathways, personalized care planning and patient involvement and independence from the reforms are worthy subjects of study for China’s own healthcare delivery system reforms.

Private medical institutions in China:Policy review and analysis / 中国卫生政策研究

The evolution of China’s policy on private medical institutions has been ongoing, and a comprehen-sive policy system has been established. In this paper, we review the development history and summarize the main policy points in terms of planning, approval, financial input, supervision and administration, support and incentives. We analyze current policy barriers from three levels:1 ) policy ideas, consensus on the function and role of private medical institutions have not reached, which may influence the corresponding policy making and implementation;(2) policy design, multiple policy bottlenecks still exist, such as lack of flexibility, poor convergence, vague stand-ards and other aspects; 3 ) policy implementation, the health planning polices and equal treatment polices haven’t been carried out, and there are many hidden obstacles. To solve these problems, we recommend that further attention be paid to the importance of private medical institutions;the running mode should be chosen properly; the develop-ment space should be expanded;the classified management policy should be improved; and the supervision and ex-amination of policy implementation on local governments should be intensified.

Development condition of private non-profit medical institutions / 中国卫生政策研究

Although private hospitals are generally encountering development difficulties, some private non-profit medical institutions thrived in the medical market. These hospitals have rich experiences in terms of manage-ment system, operation mechanism, and competition methods. In this paper, we summarize the experiences of those well-functioning private non-profit hospitals and analyze the essential conditions for developing private non-profit med-ical institutions. These conditions include meeting local health market needs, ensuring that the hospital management system and operation mechanism result in high-quality health services, ensuring hospital development meets local health plans ( in order to obtain policy support) , ensuring the goal of the hospital is public welfare and that the hospital has strong financial support, obtaining certain social and political capital, and ensuring high-quality managers and staff.

Relationship between socioeconomic status and the prevalence of cardiovascular disease among retired residents living in a community, Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the relationship between socioeconomic status and the risk factors of cardiovascular diseases in retirees from a community in Shanghai.</p><p><b>METHODS</b>Observational study involved 9 943 retirees aged 50 and over in Shanghai. Both single factor and multi-factor analyses methods were used to describe the correlation between factors as:educational level, marital status, annual household income and risk of hypertension, coronary heart disease, stroke etc. A new defined compound index was used to assess the relevance of socioeconomic status on the risk of cardiovascular diseases, based on logistic regression model.</p><p><b>RESULTS</b>After adjusted for age, the risk of cardiovascular diseases in these retirees was influenced by socioeconomic status. In general, opponent correlations in education levels and prevalence of hypertension were found between female and male. Compared with those having received college or higher education, the risk of hypertension increased in females when the education level declined, with OR as 1.08 (95% CI:0.89-1.30). For those having had senior high school junior high school or elementary education, the risks of hypertension were 1.26 (95%CI:1.05-1.51), 1.34 (95%CI:1.08-1.65), 0.72 (95%CI:0.59-0.87),0.78 (95%CI:0.64-0.94), and 0.70 (95%CI:0.52-0.92) for males, respectively. The risk of cardiovascular diseases increased with annual household income. Compared with high level of socioeconomic status, lower socioeconomic status might decline the risk of cardiovascular diseases in males by approximately 30%, with OR for medium being 0.72 (95%CI:0.61-0.84) and for lower ones it was 0.70 (95% CI:0.57-0.87). However, similar correlations were not found in females. No significant relationship was found between marital status and the prevalence of cardiovascular diseases in this study.</p><p><b>CONCLUSION</b>The risks of cardiovascular diseases varied with different socioeconomic status, indicating that tailored interventions should be conducted in different socioeconomic groups.</p>

Preparative isolation and purification of 12,13-dihydroxyeuparin from Radix Eupatorii Chinensis by high-speed counter-current chromatography / 药物分析学报

An efficient method for the isolation and purification of 12,13-dihydroxyeuparin from Radix Eupatorii Chinensis by high speed counter-current chromatography (HSCCC) was established in this paper.The ether extracts of Radix Eupatorii Chinensis were purified by HSCCC with a solvent system of hexyl hydride ethyl acetate-methanol-water (1∶2∶1∶2,v/v/v/v).The upper phase was used as the stationary phase and the lower phase as the mobile phase.About 8.4 mg of 12,13-dihydroxyeuparin was obtained from 200 mg of ether extracts from Radix Eupatorii Chinensis in one-step HSCCC separation,with the purity of 96.71％,as determined by HPLC.After methanolwater recrystallization,the purity of 12,13-dihydroxyeuparin reached 99.83％.Such a simple and effective method was fairly useful to prepare pure compound as reference substances for related study on Radix Eupatorii Chinensis.

Simultaneous determination of 12, 13-dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture by high performance liquid chromatography / 药物分析学报

A reversed phase high performance liquid chromatography （HPLC） method was established for the simultaneous determination of 12, 13-dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture. A Grace Apollo Cl8 column （250 mm × 4.6 mm, 5 μm） was used as the stationary phase and the mobile phase was composed of acetonitrile and aqueous phosphoric acid （0.2%, v/v）. Gradient elution was carried out at the flow rate of 1.0 mL/min and the column temperature was 30 ℃. An ultraviolet （UV） detector was used with a selected wavelength of 240 nm. Calibration curves were linear within the concentration range of 4.6-45.75 μg/mL for 12, 13-dihydroxyeuparin （r〉0.9999） and 106.9-1068.9μg/mL for glycyrrhizic acid （r〉0.9999）, respectively. Recoveries were 102.18% for 12, 13-dihydroxyeuparin and 101.17% for glycyrrhizic acid. The method developed could be applied to the simultaneous determination of 12, 13- dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture.

The overall progress and challenges of Shanghai health care for the last 30 years since reform and opening up / 中华医院管理杂志

Marked by the Third Plenary Session of the Eleventh Central Committee of the CPC, Shanghai health care started a journey of reform and opening up as with other sectors. This essay reviews various stages Shanghai health care experienced and the achievements for the last 30 years since reform and opening up, and analyzes the challenges Shanghai health care faces currently. On this basis, the essay summaries the experiences and lessons learned from Shanghai health care reform and development.

Simultaneous determination of 12, 13-dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture by high performance liquid chromatography / 药物分析学报

A reversed phase high performance liquid chromatography (HPLC) method was established for the simultaneous determination of 12,13-dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture.A Grace Apollo C18 column (250 mm× 4.6 mm,5 μm) was used as the stationary phase and the mobile phase was composed of acetonitrile and aqueous phosphoric acid (0.2％,v/v).Gradient elution was carried out at the flow rate of 1.0 mL/min and the column temperature was 30 ℃.An ultraviolet (UV) detector was used with a selected wavelength of 240 nm.Calibration curves were linear within the concentration range of 4.6-45.75 μg/mL for 12,13-dihydroxyeuparin (r＞0.9999) and 106.9-1068.9μg/mL for glycyrrhizic acid (r＞0.9999),respectively.Recoveries were 102.18 ％ for 12,13-dihydroxyeuparin and 101.17％ for glycyrrhizic acid.The method developed could be applied to the simultaneous determination of 12,13-dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture.

On Key issues of Public Hospitals Reform / 中华医院管理杂志

Public hospital reform pilots have been initiated recently and it is necessary to clarify some key issues. To this end, thispaper touches upon six fundamental issues, discussing the generality and value for the existence of public hospitals, differences between reforms of public hospital and those of state-owned enterprise, the public financing for and regulation on public hospitals, relationship with the private sector, as well as service and function positioning of public hospitals.

Preparation of Electrochemical Sensor for Salicylic Acid Based on Molecular Imprinted Film / 分析化学

Molecular imprinted film modified glassy carbon electrode was prepared by electrochemical polymerization of pyrrole with the cyclic voltammetry in the presence of template molecular, salicylic acid. The template molecules were removed from the modified electrode surface by over-oxidized at 1.3V in the solution of 0.2 mol/L Na2HPO4 for 10 min. The modified electrodes can effectively promote electrochemical oxidation process of salicylic acid in the surface of electrode and avoid interference of structural similar substance such as benzoic acid. Cyclic voltammetry was employed in the electrochemical measurements. The experimental results show that the optimum acidity of background solution is pH 6.86 and the optimum incubation is 10 min. The linear response curve was obtained from 1.0×10-6 mol/L to 2.0×10-3 mol/L, with the detection limit of 8.0×10-7 mol/L. The imprinted electrode has been applied to the analysis of salicylic acid in the simulated samples with recovery rates ranging from 94.6% to 103.4%.