Effect of SAM junctional tourniquet on respiration when applied in the axilla: A swine model / 中华创伤杂志(英文版)

PURPOSE@#SAM junctional tourniquet (SJT) has been applied to control junctional hemorrhage. However, there is limited information about its safety and efficacy when applied in the axilla. This study aims to investigate the effect of SJT on respiration when used in the axilla in a swine model.@*METHODS@#Eighteen male Yorkshire swines, aged 6-month-old and weighing 55 - 72 kg, were randomized into 3 groups, with 6 in each. An axillary hemorrhage model was established by cutting a 2 mm transverse incision in the axillary artery. Hemorrhagic shock was induced by exsanguinating through the left carotid artery to achieve a controlled volume reduction of 30% of total blood volume. Vascular blocking bands were used to temporarily control axillary hemorrhage before SJT was applied. In Group I, the swine spontaneously breathed, while SJT was applied for 2 h with a pressure of 210 mmHg. In Group II, the swine were mechanically ventilated, and SJT was applied for the same duration and pressure as Group I. In Group III, the swine spontaneously breathed, but the axillary hemorrhage was controlled using vascular blocking bands without SJT compression. The amount of free blood loss was calculated in the axillary wound during the 2 h of hemostasis by SJT application or vascular blocking bands. After then, a temporary vascular shunt was performed in the 3 groups to achieve resuscitation. Pathophysiologic state of each swine was monitored for 1 h with an infusion of 400 mL of autologous whole blood and 500 mL of lactated ringer solution. Tb and T0 represent the time points before and immediate after the 30% volume-controlled hemorrhagic shock, respectively. T30, T60, T90 and T120, denote 30, 60, 90, and 120 min after T0 (hemostasis period), while T150, and T180 denote 150 and 180 min after T0 (resuscitation period). The mean arterial pressure and heart rate were monitored through the right carotid artery catheter. Blood samples were collected at each time point for the analysis of blood gas, complete cell count, serum chemistry, standard coagulation tests, etc., and thromboelastography was conducted subsequently. Movement of the left hemidiaphragm was measured by ultrasonography at Tb and T0 to assess respiration. Data were presented as mean ± standard deviation and analyzed using repeated measures of two-way analysis of variance with pairwise comparisons adjusted using the Bonferroni method. All statistical analyses were processed using GraphPad Prism software.@*RESULTS@#Compared to Tb, a statistically significant increase in the left hemidiaphragm movement at T0 was observed in Groups I and II (both p < 0.001). In Group III, the left hemidiaphragm movement remained unchanged (p = 0.660). Compared to Group I, mechanical ventilation in Group II significantly alleviated the effect of SJT application on the left hemidiaphragm movement (p < 0.001). Blood pressure and heart rate rapidly increased at T0 in all three groups. Respiratory arrest suddenly occurred in Group I after T120, which required immediate manual respiratory assistance. PaO2 in Group I decreased significantly at T120, accompanied by an increase in PaCO2 (both p < 0.001 vs. Groups II and III). Other biochemical metabolic changes were similar among groups. However, in all 3 groups, lactate and potassium increased immediately after 1 min of resuscitation concurrent with a drop in pH. The swine in Group I exhibited the most severe hyperkalemia and metabolic acidosis. The coagulation function test did not show statistically significant differences among three groups at any time point. However, D-dimer levels showed a more than 16-fold increase from T120 to T180 in all groups.@*CONCLUSION@#In the swine model, SJT is effective in controlling axillary hemorrhage during both spontaneous breathing and mechanical ventilation. Mechanical ventilation is found to alleviate the restrictive effect of SJT on thoracic movement without affecting hemostatic efficiency. Therefore, mechanical ventilation could be necessary before SJT removal.

A bioequivalence study of generic and brand clozapine in schizophrenic patients / 中国临床药理学与治疗学

AIM: To establish a ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method to determination the plasma concentration of clozapine and compare the bioequivalence of a generic clozapine tablet with Clozaril

Identification of traditional Chinese drugs containing active ingredients for treating myocardial infarction and analysis of their therapeutic mechanisms by network pharmacology and molecular docking / 南方医科大学学报

OBJECTIVE@#To identify traditional Chinese drugs that contain active ingredients for treatment of myocardial infarction (MI) and explore their therapeutic mechanisms using network pharmacology and molecular docking technology.@*METHODS@#The TCMSP database was used for screening the traditional Chinese drugs containing active ingredients for treating MI, and the related targets of MI and the candidate drugs were obtained from Genecards, OMIM, PharmGkb and PharmMapper databases. The common target network of the drug targets and disease targets was established using Venny2.1.0 software. GO and KEGG signal pathway enrichment analysis of the common targets was performed, and the protein-protein interaction (PPI) network was constructed for the targets. The targets in the PPI network were analyzed to identify the key targets, for which GO and KEGG pathway enrichment analyses were performed. Molecular docking was performed for the candidate ingredients and the key targets, and a total score ≥6 was used as the criteria for screening the therapeutic ingredients and their docking binding with key targets was verified. A human umbilical vein endothelial cell (HUVEC) model of oxygen-glucose deprivation (OGD) was used to validate the candidate ingredients and the key therapeutic targets for MI by Western blotting.@*RESULTS@#Our analysis identified Salvia miltiorrhiza and Dalbergiae odoriferae as the candidate drugs rich in active ingredients for treatment of MI. These ingredients involved 16 key therapeutic targets for MI, which participated in such biological processes as inflammatory response, angiogenesis, energy metabolism and oxidative stress and the pathways including HIF-1, VEGF, and TNF pathways. Sclareol and PTGS2 in Salvia miltiorrhiza and formononetin and KDR in Dalbergiae odoriferae all had high docking total scores. Western blotting showed that at medium and high doses, sclareol significantly inhibited PTGS2 expression and formononetin promoted KDR expressions in the cell models in a dose-dependent manner (P < 0.05).@*CONCLUSION@#Both Salvia miltiorrhiza and Dalbergiae odoriferae have good therapeutic effects on MI. Sclareol in Salvia miltiorrhiza and formononetin in Dalbergiae odoriferae regulate the expressions of KDR and PTGS2, respectively, to modulate the inflammatory response, angiogenesis, oxidative stress and energy metabolism and thus produce myocardial protective effects.

A Single-Center Analysis of the Use of G-CSF Combined with Plerixafor to Mobilize Peripheral Blood Hematopoietic Stem Cell from Healthy Related Donors in Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

OBJECTIVE@#To study the effect and safety of G-CSF combined with Plerixafor on the mobilization of peripheral blood hematopoietic stem cells from healthy related donors of allogeneic hematopoietic stem cell transplantation (allo-HSCT).@*METHODS@#It was analyzed retrospectively that the data of peripheral blood hematopoietic stem cells from 33 (observation group) related donors mobilized by G-CSF plus Plerixafor in Hebei Yanda Lu Daopei Hospital from April 2019 to April 2021. Bone marrow and peripheral blood hematopoietic stem cells (PBSCs) of these donors were respectively collected on the fourth and fifth day of G-CSF-induced mobilization. Following the administration of Plerixafor on the night of the fifth day, PBSCs were collected on the sixth day once again. 46 donors using "G-CSF only" mobilization method in the same period were randomly selected as the control and respectively analyzed the differences of CD34+ cell counts on the fifth and the sixth day in two groups. And the donors' adverse reaction to Plerixafor in the form of questionnaire was also observed. Then it was compared that the patients who underwent allo-HSCT in "G-CSF+Plerixafor" group and "G-CSF only" group in terms of acute GVHD at grade I-IV or III-IV, CMV reactivation and EBV reactivation.@*RESULTS@#CD34+ cells count (M±Q) among PBSCs collected on the fifth and the sixth day in the observation group were (1.71±1.02)×106/kg and (4.23±2.33)×106/kg, respectively. CD34+ cell counts on the sixth day was significantly higher than that of the fifth day (P<0.001); While the counterparts in the control group were (2.47±1.60)×106/kg and (1.87±1.37)×106/kg, respectively. By statistical analysis, CD34+ cell counts on the sixth day was significantly less than that of the fifth day (P<0.001). The adverse reaction to Plerixafor for the donors in the study were all grade 1 or 2 (mild or moderate) according to CTCAE 5.0 and disappeared in a short time. The patients who underwent allo-HSCT in the "G-CSF+Plerixafor" group and "G-CSF only" group were not statistically significant in terms of acute GVHD at grade I-IV or III-IV, CMV reactivation and EBV reactivation (P>0.1).@*CONCLUSION@#The cell mobilization program of G-CSF combined with Plerixafor is safe and effective for being applied to allo-HSCT. The addition of Plerixafor can significantly increase the number of CD34 postive cells in the PBSC collection. Key words　　; ;

Acute hyperextension spinal cord injury in children: A retrospective study / 中华骨科杂志

Objective:To summarize the clinical characteristics and prognosis of acute hyperextension spinal cord injury (SCI) in children, and to provide some recommendations for the treatment and prevention of this disease.Methods:Reviewed the data of children of SCI after sustained or repeated hyperextension of the spine at Wuhan Union Hospital and Wuhan Children's Hospital from September 2010 to September 2020. According to the American Spinal Injury Association impairment scale (AIS grade), the patients were divided into complete SCI group and incomplete SCI group. The age, symptoms and evolution after injury, neurological level of injury, imaging data, laboratory examination data, prognosis and complications of the two groups were analyzed. Retrospectively summarize the characteristics of this type of injury.Results:Forty-four cases of acute hyperextension SCI in children were included. Their age ranged from 3 to 10 years old, 95% of them were under 8 years old and 95% of them were female. There was no significant difference in age at injury and time of dance training between children with complete SCI and incomplete SCI. Back and leg pain, lower limb weakness or paresthesia, and rapidly progress to complete or incomplete SCI in a short period were typical symptoms. All blood test results anddiagnostic analysis of cerebrospinal fluid were unremarkable or negative. There was no fracture or dislocation in the whole spine. Magnetic resonance imaging showed a longitudinally extended intramedullary high-intensity signal in the thoracolumbar spinal cord. Complete SCI accounted for 60% of all cases, and the prognosis was poor with spinal cord atrophy and various complications.Conclusion:Children younger than 10 years old after sustained or repeated hyperextension of the spine may suffer acute hyperextension SCI. Children with complete SCI have poor prognosis and serious complications. Therefore, prevention of this type of injury is the best strategy.

Management of non-compressible torso hemorrhage: An update / 中华创伤杂志(英文版)

With the widespread adoption of advanced tourniquets, the mortality rate of limb wound hemorrhage has decreased significantly, and non-compressible torso hemorrhage has gradually occupied the leading position of potentially preventable death, both in military and civilian circumstances. With the emergence of novel hemostatic devices and materials, strategies for the management of non-compressible torso hemorrhage have changed significantly. This review summarizes the current treatment strategies and types of equipment for non-compressible torso hemorrhage and suggests future research directions, hoping to provide a comprehensive review for the medical personnel and researchers engaging in this field.

Carrier-free nanoparticles based on self-assembly of active ingredients from Chinese medicine / 药学学报

Traditional Chinese medicine has a long history, unique system and perfect technology, which has been used to prevent or treat a variety of diseases in the form of compound medicine. Recently, some of the active ingredients from Chinese medicine were found to have self-assembly properties, mainly through non-covalent interactions, including π-π stacking, electrostatic interaction, hydrogen bond and coordination interactions, etc. Carrier-free nanoparticles based on self-assembly of active ingredients from Chinese medicine could not only improve the solubility of insoluble active ingredients, but also the bioavailability. As nanocarriers, the natural active ingredients could exert synergistic therapeutic effects. The strategy of self-assembly without carrier is safer and almost non-toxic compared to the commonly used nanocarriers. In addition, some ingredients from Chinese medicine could coordinate with metal ions to form stable nanoparticles, which could be applied to photothermal therapy. In this paper, we summarized and analyzed the recent achievements of carrier-free nanoparticles based on self-assembly of active ingredients from Chinese medicine, and briefly outlined the future development of this kind of nanomedicine.

Protective effect of fistular onion bulb extract on myocardial ischemia / reperfusion injury / 解剖学报

Objective To explore the effects of fistular onion bulb extract (FOB) on myocardial ischemia / reperfusion (I / R) injury and possible regulation mechanism. Methods The left anterior descending (LAD) artery of 36 adult rat heart was ligated for 30 minutes and subsequently released for 120 minutes to establish the I / R injury model in vivo. Cultured neonatal rat cardiomyocytes were subjected to 6 hours of hypoxia followed by 18 hours of reoxygenation to establish the hypoxia / reoxygenation (H / R) model in vitro. The rats or cardiomyocytes were randomly divided into the control group, I / R group (or H / R group) and FOB pretreatment+I / R group (or H / R group). The left ventricular (LV) function was measured using PowerLab multichannel physiological recorder; the infarct size was detected by 2, 3, 5-triphenyl tetrazolium chlorid(TTC) staining. The apoptosis rate was detected by flow cytometry, Western blotting and Real-time PCR were used to detect the expression of apoptosis-related proteins and mRNA (Bcl-2, Bax and Caspase-3); Immunofluorescence was used to detect the expression of cytochrome C (Cyt-C). Results In the animal experiments, compared with the control group, the left ventricular systolic and diastolic functions were deteriorated (P<0. 05); compared with the I / R group, the pretreatment of FOB significantly improved the left ventricular systolic and diastolic function, and decreased the infarct size (P<0. 05). In cultured cardiomyocytes, compared with the control group, the apoptosis rate was significantly increased (P<0. 01), the protein and mRNA expression of Bcl-2 decreased, meanwhile the expression of Bax, Caspase-3 and Cyt-C increased in the H / R group (P< 0. 05); Compared with the H / R group, the pretreatment of FOB significantly reduced the apoptosis rate (P < 0. 05), increased the protein and mRNA expression of Bcl-2, at the same time, decreased the expression of Bax, Caspase-3 and Cyt-C(P<0. 05). Conclusion Fistular onion bulb extract has the protective effect on myocardial ischemia / reperfusion injury, and its possible mechanism is to reduce cardiomyocyte apoptosis through mitochondrial pathway.

MRI presentation and pathogenesis of tennis legs / 中华放射学杂志

Objective To evaluate the imaging features of MRI of tennis legs and to explore the pathogenesis of tennis legs. Methods A retrospective analysis was made on the MRI images of 38 patients with tennis legs which met the criteria and were clinically diagnosed in our hospital from May 2014 to June 2018. All patients underwent non?enhanced MRI. Coronal T1WI、T2WI fast spin echo (TSE) and transverse proton density weighted imaging (PDWI) were performed. The signs of fluid collection between gastrocnemius muscle (GM) and soleus muscle (SM),muscle and tendon injuries, superficial vein dilatation of calf were observed and recorded. Results Coronal T1WI, T2WI TSE and transverse PDWI sequences showed 30 (75.0%) places fluid collection (hematoma or effusion) between medial head of the gastrocnemius muscle (MCM) and SM, 11 (27.5%) places fluid collection (hematoma or effusion) between lateral head of gastrocnemius muscle(LGM)and SM,7 (17.5%) places fluid collection (hematoma or effusion) in MGM and 2 (5.0%) placesin SM. There were 17 (42.5%) places that hematoma or effusion spread around the fascia of the lower leg. The diameter and thickness of hematoma or effusion are about 1.7-22.3 cm and 0.2-3.5 cm, respectively. Rupture of the GM was seen in 37 (92.5%) places,including 37 places rupture of the MGM at the myotendinous junction, 15 places rupture of the LGM at the myotendinous junction, 24 places tendonrupture of MGM,3 places tendon rupture of MGM and LGM,and 2 places tendon rupture of LGM. The maximum diameter of tendon rupture was 1.2-27.0 mm. The muscle rupture of MGM was seen in one place, and muscle rupture of MGM and LGM was seen in one place at the same time. Rupture of the SM was seen in 15 (37.5%) places, including 15 places rupture of the SM at the myotendinous junction, 2 places muscle rupture of SM, 6 places tendonrupture of SM. The maximum diameter of tendon rupture was 2.5-14.9 mm. Rupture of plantaris tendon (PT) was seen in 4 (10.0%) places. Superficial vein dilatation was seen in 3 (7.5%) places. Conclusion This study shows that the rupture of the MGM at the myotendinous junction and the tendon is the main responsibility of tennis leg.

Predictors related to condom use behaviors based on the theory of planned behavior among female sex workers / 中华疾病控制杂志

Objective To identify predictors related to condom use in different tiered female sex workers (FSWs) in Hubei Province. Methods A cross-sectional study was conducted in Hubei Province in 2015 to investigate 816 eligible FSWs by using a multistage sampling method. All data were collected by using a structured questionnaire with scales on condom use, which was designed based on the theory of planned behavior (TPB). A structural equation model (SEM) was used to identify predictors of condom use in the different tiered FSWs. Results It showed that low-tier FSWs used less condom than higher-tier FSWs in commercial sexual behaviors of the last time and during the last month(P<0.001). The TPB scores were significantly different in different tiered FSWs. The scores of PBC in low-tier FSWs were lower than those in higher-tier FSWs (11.43±2.86 vs 12.06±2.87, respectively, P=0.002); But the scores of behavioral intentions were higher than those in higher-tier FSWs (5.47±1.11 vs 5.20±1.15, respectively, P=0.001). The PBC was the major factor related to condom use in low-tier FSWs (effect coefficient=0.55, P<0.001), while the behavioral intention was the major factor related to condom use in higher-tier FSWs (effect coefficient=0.33, P<0.001). Behavioral attitude was the major factor of intention to use condoms for both low-tier (effect coefficient=0.49, P<0.001) and higher-tier FSWs (effect coefficient=0.42, P<0.001). Conclusions Changing the attitude to condom use in FSWs is an important measure to promote the behavior intention. Condom promotion interventions should focus on the perceived behavioral control in low-tier FSWs, and promote the behavior intention in higher-tier FSWs.

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review / 中华创伤杂志(英文版)

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

Effect of retension sutures on abdominal pressure after abdominal surgery / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To evaluate the effect of retention sutures on abdominal pressure and postoperative prognosis in abdominal surgery patients.</p><p><b>METHODS</b>This prospective cohort study included patients who were admitted to Daping Hospital from May 15, 2014 to October 11, 2014. A total of 57 patients were enrolled, including 18 patients in the "U" type retention suture group, 17 patients in the intermittent retention suture group, and 22 patients in non-retention suture group. The demographic data, clinical data and risk factors for abdominal wound dehiscence were recorded. The bladder pressure (IVP) was monitored preoperatively, intraoperatively, and four days postoperatively. Additionally, the incidence of abdominal wound dehiscence and infection 14 days after the operation was recorded.</p><p><b>RESULTS</b>During the operation, the IVP decreased and then increased; it was at its lowest 1 h after the start of the operation (5.3 mmHg ± 3.2 mmHg) and peaked after tension-reducing (8.8 mmHg ± 4.0 mmHg). The IVP values in the "U" type retention suture group and intermittent retention suture group were higher than in the non-retention suture group 4 days after operation (p < 0.005). The Visual Analogue Scale (VAS) pain scores were 3.9 ± 2.2, 3.8 ± 2.0, and 3.0 ± 1.0 in the retention suture group, intermittent retention suture group and non-retention suture group, respectively. The VAS pain scores in the "U" type tension-reducing group and intermittent tension-reducing group were higher than in the non-tension-reducing group (p < 0.005).</p><p><b>CONCLUSION</b>Although retention sutures may reduce the incidence of postoperative wound dehiscence in abdominal surgery patients, they can increase the IVP and postoperative pain.</p>

Current trauma care system and trauma care training in China / 中华创伤杂志(英文版)

Trauma is a life-threatening "modern disease". The outcomes could only be optimized by cost-efficient and prompt trauma care, which embarks on the improvement of essential capacities and conceptual revolution in addition to the disruptive innovation of the trauma care system. According to experiences from the developed countries, systematic trauma care training is the cornerstone of the generalization and the improvement on the trauma care, such as the Advance Trauma Life Support (ATLS). Currently, the pre-hospital emergency medical services (EMS) has been one of the essential elements of infrastructure of health services in China, which is also fundamental to the trauma care system. Hereby, the China Trauma Care Training (CTCT) with independent intellectual property rights has been initiated and launched by the Chinese Trauma Surgeon Association to extend the up-to-date concepts and techniques in the field of trauma care as well to reinforce the generally well-accepted standardized protocols in the practices. This article reviews the current status of the trauma care system as well as the trauma care training.

A machine learning model based on initial gut microbiome data for predicting changes of Bifidobacterium after prebiotics consumption / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of prebiotics supplementation for 9 days on gut microbiota structure and function and establish a machine learning model based on the initial gut microbiota data for predicting the variation of Bifidobacterium after prebiotic intake.</p><p><b>METHODS</b>With a randomized double-blind self-controlled design, 35 healthy volunteers were asked to consume fructo-oligosaccharides (FOS) or galacto-oligosaccharides (GOS) for 9 days (16 g per day). 16S rRNA gene high-throughput sequencing was performed to investigate the changes of gut microbiota after prebiotics intake. PICRUSt was used to infer the differences between the functional modules of the bacterial communities. Random forest model based on the initial gut microbiota data was used to identify the changes in Bifidobacterium after 5 days of prebiotic intake and then to build a continuous index to predict the changes of Bifidobacterium. The data of fecal samples collected after 9 days of GOS intervention were used to validate the model.</p><p><b>RESULTS</b>Fecal samples analysis with QIIME revealed that FOS intervention for 5 days reduced the intestinal flora alpha diversity, which rebounded on day 9; in GOS group, gut microbiota alpha diversity decreased progressively during the intervention. Neither FOS nor GOS supplement caused significant changes in β diversity of gut microbiota. The area under the curve (AUC) of the prediction model was 89.6%. The continuous index could successfully predict the changes in Bifidobacterium (R=0.45, P=0.01), and the prediction accuracy was verified by the validation model (R=0.62, P=0.01).</p><p><b>CONCLUSION</b>Short-term prebiotics intervention can significantly decrease α-diversity of the intestinal flora. The machine learning model based on initial gut microbiota data can accurately predict the changes in Bifidobacterium, which sheds light on personalized nutrition intervention and precise modulation of the intestinal flora.</p>

Study on Cost Estimation of Free Family Planning Technical Services / 中国卫生经济

Objective:To calculate the average full cost and average direct cost of the 13 items of free family planning technical services,and provide references for the settlement standard of free family planning technical service project during the period of "two children policy".Methods:Questionnaire survey,ladder allocation method and time coefficient distribution method.Results:Among the 13 items of free family planning technical service,the highest cost was the tubal recanalization(full cost wasl 719.38 yuan,direct cost was 1 381.36 yuan),followed by tubal ligation and the cost of the operation(full cost was 974.76 yuan,direct cost was 786.75 yuan),the lowest was the contraceptive ring and pregnancy situation(full cost was 37.62 yuan,direct cost was 30.37 yuan);free family planning technical service items constituted the details,laboratory tests costed the most time and the number of participants in the operation was the largest.The current settlement standard of Sichuan compensated the actual cost of less than one-third.Conclusion:Maternal and child health institutions should improve efficiency,control too much inspection,strengthen cost management.The government should promptly adjust the relevant settlement standards to make up the actual costs.

Effect Analysis of Hospital Expenses after Calling off Drug - addition and Price Adjustment of Medical Service in Public Hospitals / 现代医院

Objective To provide advice and basis for further reform of the medical service price by analyzing the effect on hospital expenses after calling off drug-addition and price adjustment of medical service in public hospitals at the end of 2016. Methods Comparing the changes of hospital expenses based on the data of hospital expenses before and after the implementation of the price reform policy in a provincial public hospital in Sichuan. Results After canceling the drug-addition and adjustment of medical service price, whether in the whole hospital, in the surgical department or in the non-operative department, the average cost of drugs for discharged patients has been reduced, the average costs of surgical operation and anesthesia has been increased, the ratio of change remains consistent with the policy adjustment range, the composition of drug charges and bed fee has been decreased and the proportion of drugs still ranks first in the composition ratio. Conclusion Canceling the drug-addition and price adjustment of medical service have a significant effect on hospital expenses. The adjustment of medical service price reflects the technical value of medical staff.

Clinical observation on treatment of advanced malignant tumor with Zilongjin Tablets / 中草药

Objective To observe the clinical curative effect and adverse reaction of Zilongjin Tablets in the treatment of advanced malignant tumor. Methods Fifty-three patients were treated with Zilongjin Tablets orally in the treatment group based on routine treatment, while 52 patients in the control group were treated only with conventional treatment. Each group was treated for two courses (28 d). Results The clinical response cases of stable disease in the short-term efficacy of the treatment group were more than that in the control group (P < 0.05). In the meanwhile, the life quality improvement was better than that of the control group (P < 0.01). Conclusion Zilongjin Tablets showed a better curative effect in the treatment of advanced malignant neoplasms without obvious adverse reaction.

Damage control resuscitation of massive hemorrhage: The key to saving the combat casualties / 解放军医学杂志

Combat casualties can be divided into two types,i.e.,non-survivable (NS) and potentially survivable (PS).According to the data of US army,massive hemorrhage constituted 90.98％ of the potentially survivable casualties,and the most important thing to improve the ability of casualty care is hemorrhage control.In this article,the strategies and techniques of damage control resuscitation like surgical hemorrhage control techniques of non-compressive hemorrhage (NCH) in torso and junctional area,the damage control identification of the injured,field transfusion process and fresh whole blood infusion in tactical level and emergency phase were comprehensively illustrated.

Comparative study of automatic breast volume scanner and MRI in the diagnosis of breast masses / 中华超声影像学杂志

Objective To compare the value of automatic breast volume scanner (ABVS) with enhanced magnetic resonance imaging(MRI) in the diagnosis of breast masses.Methods Seventy-four patients with 80 breast masses underwent preoperative ultrasound examinations including ABVS and MRI.The values of ABVS and MRI in the diagnosis of breast masses were comparatively analyzed.Results Among the 80 breast masses that were surgically removed,37 masses were benign and 43 masses were malignant.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ABVSin the diagnosis of breast malignant masses were 94.6％,79.1％,86.3％,79.5％ and 94.4％,respectively,those of MRI were 94.6 ％,86.0 ％,90.0 ％,85.4 ％ and 94.9 ％,respectively,and those of the combination of ABVS and MRI were 94.6％,93.0％,93.8％,92.1％,and 95.2％,respectively.The sensitivity and specificity were not significant difference between ABVS and MRI in the diagnosis of breast malignant masses(P ＞0.05).The specificity of the combination ABVS and MRI in the diagnosis of breast malignant masses were significantly higher than that of ABVS (x2 =4.17,P =0.04).The sensitivity,specificity and accuracy of convergence sign in the diagnosis of breast malignant masses were 64.9 ％,97.7 ％ and 82.5 ％,respectively.Conclusions ABVS and MRI are both valuable in the diagnosis of breast masses,and the combination of ABVS and MRI is the most valuable due to high specificity.

Research on the medical service pricing policy in China′s ongoing healthcare reform / 中华医院管理杂志

Objective To analyze the medical service pricing policy of 30 provinces and autonomous regions in China and recommend on problems and challenges, for reference of medical service pricing reform in the future.Methods Literature review and policy analysis were used for summary and performance appraisal of medical service pricing of China.Results Most of the areas surveyed followed the step-by-step approach to gradually adjust pricing, while a few areas completed it in a one-time adjustment manner.2015 witnessed most areas, up to 20 (66.67%), in price adjustment;their price adjustments focused on price reduction of large-scale medical equipment inspection fees and some medical tests.On the other hand, prices of diagnosis, nursing care, and treatment which are labor-intensive were increased.Conclusions Specifications of medical services are improving, yet there exist great gaps in the convergence of medical insurance.It is advisable to expedite the convergence of the new version specifications, to achieve value regression and dynamic price adjustment of medical services.