Diagnostic value of aldosterone to renin ratio calculated by plasma renin activity or plasma renin concentration in primary aldosteronism: a meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Since the diagnostic value of aldosterone to renin ratio (ARR) calculated by plasma renin concentration (PRC) or plasma renin activity (PRA) is still inconclusive, we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA, so as to provide guidance for clinical diagnosis.@*METHODS@#We searched PubMed, Embase, and Cochrane Library from the establishment of the database to March 2021. We included studies that report the true positive, false positive, true negative, and false negative values for the diagnosis of primary aldosteronism, and we excluded duplicate publications, research without full text, incomplete information, or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.@*RESULTS@#The pooled results showed that ARR (plasma aldosterone concentration [PAC]/PRC) had a sensitivity of 0.82 (95% confidence interval [CI]: 0.78-0.86), a specificity of 0.94 (95% CI: 0.92-0.95), a positive-likelihood ratio (LR) of 12.77 (95% CI: 7.04-23.73), a negative LR of 0.11 (95% CI: 0.07-0.17), and symmetric area under the curve (SAUC) of 0.982, respectively. Furthermore, the diagnostic odds ratio (DOR) of ARR (PAC/PRC) was 180.21. Additionally, the pooled results showed that ARR (PAC/PRA) had a sensitivity of 0.91 (95% CI: 0.86-0.95), a specificity of 0.91 (95% CI: 0.90-0.93), a positive LR of 7.30 (95% CI: 2.99-17.99), a negative LR of 0.10 (95% CI: 0.04-0.26), and SAUC of 0.976, respectively. The DOR of ARR (PAC/PRA) was 155.52. Additionally, we conducted a subgroup analysis for the different thresholds (<35 or ≥35) of PAC/PRC. The results showed that the DOR of the cut-off ≥35 groups was higher than the cut-off <35 groups (DOR = 340.15, 95% CI: 38.32-3019.66; DOR = 116.40, 95% CI = 23.28-581.92).@*CONCLUSIONS@#The research results suggest that the determination of ARR (PAC/PRC) and ARR (PAC/PRA) was all effective screening tools for PA. The diagnostic accuracy and diagnostic value of ARR (PAC/PRC) are higher than ARR (PAC/PRA). In addition, within a certain range, the higher the threshold, the better the diagnostic value.

Study on Quality Standard of Compound Platycodon grandiflorum Antitussive Tablets / 中国药房

OBJECTIVE： To establish the quality standard of Compound Platycodon grandiflorum antitussive tablets. METHODS： TLC was used to identify the P. grandiflorum， Polygala tenuifolia and Glycyrrhiza uralensis qualitatively in Compound P. grandiflorum antitussive tablets. HPLC-ELSD method was used to measure the content of platycodin D in Compound P. grandiflorum antitussive tablets. The determination was performed on Agilent C18 column with mobile phase consisted of acetonitrile-water （26 ∶ 74， V/V） at the flow rate of 1.0 mL/min. ELSD was used with drift tube temperature of 105 ℃， gas flow rate of 3.0 L/min and column temperature at 35 ℃. RESULTS： TLC chromatograms of P. grandiflorum， P. tenuifolia and G. uralensis had clear spots with good separation and no same spot from negative samples. The linear range of platycodin D was 0.421 9- 5.062 8 μg （r＝0.999 9）. The quantitative limit and detection limit were 0.364， 0.109 μg， respectively. RSDs of precision， stability， reproducibility and durability tests were all lower than 3.0％. The recovery rates were 87.32％-91.96％ （RSD＝1.73％，n＝6）. The platycodin D contents of 178 samples ranged from 0.004 to 0.73 mg/tablet. The content of platycodin D in 55 batches （30.9％） of samples was lower than the content limit （0.10 mg/tablet） proposed in this study. CONCLUSIONS： Established method is accurate and reliable， and can be used for the quality control of Compound P. grandiflorum antitussive tablets.

Analysis on the Basic Situation of Medical Service for Inpatients with Mental Illness in Beijing from 2003 to 2015 / 中国卫生经济

Objective:Through the analysis of the basic situation of the medical service of the psychiatric inpatients in Beijing from 2003 to 2015,it provided the basis for rational allocation of mental health resources and reasonable utilization of medical expenses.Methods:Descriptive statistical method was used to analyze the annual discharged patients,average hospitalization days and hospitalization expenses of inpatients with mental illness.Results:The annual discharged patients were increasing gradually.The number of discharged patients increased from 7861 to 24898 during 2003-2015.The annual average growth rate was 10.08％.The average length of stay in hospital since 20ll was lower than before,which were about 40 days in recent years.The average hospitalization expenses per day were also increasing.It increased from 131.04 yuan to 461.02 yuan during 2003-2015.The annual average growth rate was 11.05％.Conclusion:The demand of mental illness patients for hospitalization was gradually increasing.The hospitalization demand of patients with mental illness was increasing.The medical expenses quickly increased.It needed to adjust the payment policy to promote the rational and effective utilization of medical expenses.

Experience of CHEN Yingloni treating common diseases in Fujian and Taiwan with acupuncture and medication / 中国针灸

With literature of professor CHEN Yinglong such as Medical Notes of Doctor CHEN Yinglongfor Taiwan Compatriots,the'experience of doctor CHEN Yinglong treating common diseases in Fujian and Tai-wan is summarized. The diseases in the paper are constipation, retention of urine, asthma, vec6rdia, bi syndromeinsomnia, thoracic obstruction, pediatric obesity and freckle of face, etc. It is discovered that professor CHENYinglong treated diseases with combination of acupuncture and medication and accurate acupoints according to thefeature of climate in Fujian and Taiwan.

Predicting the risk of hospital-acquired pressure ulcers in intensive care unit patients based on decision tree / 中国实用护理杂志

Objective To explore and evaluate the feasibility and accuracy of applying decision tree methods to predict the risk of hospital-acquired pressure ulcers (HAPUs) in intensive care upit (ICU) patients,and provide a theoretical basis for the prevention of HAPUs in clinical practice.Methods A retrospective design was used to collect 468 patients' records,and all of the patients were hospitalized in ICUs including medical intensive care unit and coronary care unit between October 2011 and October 2013 in a 3 A grade hospital in Guangzhou.The CART algorithm was used to construct the decision tree risk prediction model.The area under the receiver operating curve (AUC),sensitivity and specificity were used to evaluate the predictive validity of the decision tree model compared with the Braden Scale.Results The decision tree model had four stratums and eleven nodes.Six classification rules and three styles of high-risk populations were screened out:(1)age ＞81;(2)age ≤81 combined with fecal incontinence;(3)age ≤81 combined with total Braden score ≤ 13 and diastolic blood pressure ＜ 60mmHg (1 mmHg=0.133 kPa).The AUC of the decision tree model was significantly higher than the Braden Score (Z=2.31,P ＜ 0.05).The sensitivity and specificity of the decision tree model (0.809 and 0.703) were higher than the Braden Score (0.777 and 0.587).Conclusions The decision tree model is an easy and feasible tool to predict the risk of HAPUs in ICU patients,and it can be used to screen high-risk populations.

DRGs in China: development, application and promotion / 中华医院管理杂志

Introducing the progress of DRGs work in Beijing, its application in medical insurance payment, as well as in hospital management and appraisal.Recommendations were made for DRGs development in the country, including unification of DRGs standards nationwide, orchestrated efforts of government departments, and acceleration of DRGs use in payment mode reforms.

Pelvic serous carcinoma of female:a clinicopathogical analysis of 20 cases / 临床与实验病理学杂志

Purpose To study the clinicopathological and immunohistochemical features, carcinogenesis and differential diagnosis of female pelvic serous carcinoma. Methods The clinical data, macroscopic and microscopic features and immunostaining results of 20 patients with pelvic serous carcinoma were studied, and some associated literatures were reviewed. Results 20 cases of PSC aged from 23 to 87, with the mean age being 58. 9. PSC may occur in fallopian tube, ovary and peritoneum, while they were referred to hospital because of abdominal distention, abdominal pain or pelvic mass. The tumor often invasive pelvic organs diffusely when they were diag-nosed, so, the primary site were difficultly determined. Usually, the primary focus of serous carcinoma of fallopian tube is small and easily planted in pelvic. The patients with ovarian serous carcinoma or peritoneal serous carcinoma had serous tubal intraepithelial car-cinoma at the mean time. Conclusions The tubal epithelial cells may be the major source of PSC. About the specimen of PSC, we need check the fallopian tube carefully to determine the primary site, and make differential diagnosis with peritoneal malignant mesothe-lioma and metastatic carcinoma from other sites than pelvic when it diffusely invasive peritoneum.

Adjustment method and application of CMI in hospital medical performance evaluation / 中华医院管理杂志

Objective To analyze the applicability of case mix index (CMI) in medical performance evaluation of different type of hospitals and its calculation method.Methods Standardized adjustment to the CMI value of hospitals according to the CMI of the main disease categories (MDC) of short-term inpatient cases of the city, to align the CMI values of various hospitals with their levels of medical and technical services.Results The said adjustment ensures the CMI value to better represent the levels of such hospitals.Conclusion The adjusted CMI calculation method can provide accurate data support for various hospitals' performance evaluation.

Health status of senior high school graduates living at urban or suburban areas in Beijing / 中华健康管理学杂志

Objective To compare health status of senior high school graduates living as urban vs suburban areas in Beijing.Methods Wilcoxon rank sun test,Ridit analysis and fuzzy mathematics synthesis were used to evaluate body shape index,physical function index and health defects indicator of 39 982 senior high school graduates in Beijing.Results A total of 9 117 urban boys,9 299 suburban boys,10 380 urban girls and 11 186 suburban girls were studied.For the boys,the urban was superior to the suburban areas in body shape index (Rurt=0.518,Rsub=0.482,P＜0.05) and physical function index (Rurt=0.520,Rsub=0.480,P＜0.05),and the urban was inferior to suburban areas in health defects indicator (Rurb=0.501,Rsub=0.554,P＜0.05) and the composite index (Ruurb=0.484,Rsub=0.516,P＜0.05).For the girls,the urban was superior to the suburban areas in physical function index (Rurb=0.562,Rsob=0.442,P＜0.05),and the urban was inferior to the suburban areas in health defects indicator (Rurb=0.473,Rsub=0.523,P＜0.05).The differences between urban and suburban areas tended to be of no statistical significance in body shape (U=5.79,P＞0.05) and composite index (U=5.73,P＞0.05).In fuzzy mathematics synthesis,the scores of urban boys,suburban boys,urban girls and suburban girls were 68.37,69.13,69.83 and 69.79,respectively.Conclusion Our investigation identified some differences in body shape index,physical function index and health defects indicator among senior high school graduates living at urban vs.suburban areas,although the differences of synthetical health were not statistically significant.

Increasing trend of prevalence of infertility in Beijing / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Infertility is one of the most important and underappreciated reproductive health problems in developing countries. However, epidemiological data in the Chinese population are still sparse. The aim of the present study was to determine the current prevalence and prevalence trend of infertility in Beijing, and to identify the risk factors associated with infertility.</p><p><b>METHODS</b>This cross-sectional study was conducted in Beijing in 2012. A stratified cluster sampling method was used to select 12 448 couples of whom the female partners were born between 1955 and 1985. All subjects were interviewed face to face. Infertility was defined as the failure to achieve a clinical pregnancy after 12 months of regular unprotected sexual intercourse.</p><p><b>RESULTS</b>Of the 12 448 couples, 12 342 (99.1%) answered the questions appropriately. The prevalence of infertility was 4.2% (3.1% as primary and 1.1% as secondary infertility). An increase in the prevalence of infertility according to the age of the female partner was found: 1.3% infertility for married females born in the 1950s and 11.4% for married females born in the 1980s. The increase was found in both urban and suburban areas. In addition, a Logistic regression showed that for the female partner, higher education levels, an older age at first marriage, adverse occupational conditions, mental labor and pre-pregnancy contraception after marriage were all significantly associated with a higher risk of infertility.</p><p><b>CONCLUSION</b>The prevalence of infertility has increased significantly among couples in Beijing, possibly because of an interaction among multiple factors.</p>

The stakeholder analysis of Beijing medical service payment system reform / 中华医院管理杂志

The medical service payment system reform is one of core issues in medical and health system reform.The payment system can directly affect behavior of stakeholders and indirectly affect medical expense,quality of care,efficiency of medical services and efficiency of medical insurance funds.Through behavior analysis of stakeholders in fee for service,DRGs-PPS,global budget,DRGs-PPS is the best payment system that can control the irrational increase of medical expenses and ensure the level of health service and meets interest of stakeholders among three payment systems.In DRGs-PPS,stakeholders continuously make progress in filling in the front sheet of medical records,clinical pathway,construction of information system,cost calculation and restructure costs.

Impacts of Diagnosis Related Groups and Balanced Score-card on inpatient medical services / 中华医院管理杂志

Objective To improve overall value of healthcare industry through setting up critical inpatient medical services strategic plan.Methods Identify major objectives which the local government expects to achieve through strategic map; Standardize inpatient output and assign weight to each group through diagonosis related groups; Translate the objectives of strategic map and result of diagnosis related group to Balanced Score-card; Finally build up strategic map and according action plans.ResultsPreliminarily established 16 objectives、23 measures and 13 tasks in four perspectives including customer,internal work flow,learning and growing and finance.ConclusionThe strategy map and the balanced score-card can help implement full strategic plan of regional inpatient medical services; DRGs is a core management tool of patient-centred service output management; Balanced Score-card is able to realize continuous improvement of Beijing inpatient medical services from macro to micro persoetive.

Establishing organization of diagnosis related groups and prospective payment system in Beijing / 中华医院管理杂志

Establishing medical service payment system reform organization of diagnosis related groups and prospective payment system(DRGs-PPS) based on the theory of matrix management and learning organization.Firstly joint committee mechanism hasbeen established to guide the implementation of DRGs-PPS with the strong support of Beijing local government; Secondly series of related technical standards and organizational systems including AP-DRGs,AR-DRGs Group,Data Dictionary,ICD Group,International Classification of Surgical Operations Group,Pricing Classification Group,Training Group,Supervision Group,Support Group,Data Validation Group,BJ-DRGs Group have been created to support standard maintenance,project inspection and data analysis; Furthermore,learning organization has been realized by setting up various project groups and the establishment of DRGs-PPS platform help ensure performance evaluation of healtheare institutions and payment system reform.

High throughput screening method of identifying D5 receptor agonist from Chinese herbs / 生物医学工程学杂志

D5 receptor is a subtype of dopamine D1-like receptor, and it plays a functional role in many neurological disorders. Some natural compounds from Chinese herbs, which were shown to have the property as that of receptor agonist, might provide a rich source in search of new candidates for therapeutic use. For exploring this possibility, we developed a cell-based high throughput (HTS) D5 receptor assay to screen the herb-based natural compound library established in our centre. The D5 receptor plasmid (hD5R/pcDNA3.1) and reporter gene plasmid (4 x CRE/TK/Luci/pGL3) were co-transfected into HEK293 cell line. After G418 being selected, the monoclonal cell lines bearing hD5R and the reporter gene were established and used for agonist screening. To optimize the assay condition, the effects of some factors such as cell number per well, incubation time, and the doses of SKF38393 (a potent selective partial D1-like agonist) were examined by using forskolin, a positive compound for cAMP response element. The best condition for this HTS assay included: the cell number at 5 x 10(4)/mL, the dose of forskolin at 5-20 micromol/L, the dose of SKF38393 at 100 nmol/L-100 micromol/L, and the agonist incubation time at 6 -8 h. Thereafter, water extracts from more than 200 Chinese herbs in our library were screened and three of these water extracts showed positive activity, with higher or similar activity as SKF38393. In conclusion, we have established a cell-based HTS assay for D5 receptor agonist screening, and by use of this HTS assay, 3 Chinese herbs maybe contain components exhibiting D5 receptor agonist property. This work provides an alternative vision of how to use herb medicines and a way to develop potential drugs for treatment of neurological disorders.

Application of Low Temperature Hydrogen Peroxide Gas Plasma Sterilization in Dental Handpieces / 中华医院感染学杂志

OBJECTIVE To investigate the application of low temperature hydrogen peroxide gas plasma sterilization in dental handpieces.METHODS Totally 240 pieces dental handpieces were divided into 8 groups in accordance with different ways of oiling and package,sterilized by Johnson STERRAD 100S low temperature hydrogen peroxide gas plasma sterilizer,and then inspected by sterility testing,rotational speed and appearance observation.RESULTS The result of sterility testing of dental handpieces in auto oiling group with 4 types of packages was negative,and the sterilization effect was reliable.After 10 cycles of low temperature hydrogen peroxide gas plasma sterilization,the rotational speed of dental handpieces had no obvious decline and the appearance was quite intact without any corrosion.CONCLUSIONS The sterilization effect is reliable and the damage caused by low temperature hydrogen peroxide gas plasma sterilization on dental handpieces is not found.

Treatment results of different radiotherapy for 763 patients with advanced cervical cancer / 中华放射肿瘤学杂志

Objective To evaluate the clinical value of different radiotherapy protocols in the treatment of advanced cervical cancer. Methods From 1976 to 2006,763 patients with stage Ⅲ cervical cancer(722 with squamous cell carcinoma and 41 with adenocarcinoma)were treated by radiotherapy in our hospital. 113 patients were treated by two-field whole pelvic irradiation in conventional fractionation plus brachytherapy (CF group), 44 by four-field whole pelvic irradiation in accelerated hyperfractionation plus brachytherapy( AHF group), and 606 by concomitant four-field unconventional fractionation radiotherapy and brachytherapy(FRT group). Sixty-one patients were treated by radiotherapy and chemotherapy. Among 350 patients who had complete data, the short-term efficacy and toxicities were compared. Results For patients in CF,AHF and FRT groups, the 3-year overall survival rates (OS) were 65.7%, 66.8% and 44.3%, respectively (P=0.000), and the 5-year OS were 65.7 % ,66.8 % and 36.3 %, respectively (P=0.000). The 10-year OS were 43.3% and 31.9% in CF and FRT groups(P=0.200). For squamous cell carcinoma,the OS was higher of patients with chemotherapy than those without. In 350 patients who had complete data,the local control rates of CF, AHF and FRT groups were 83.0% ,93.2% and 86.1%, respectively(X2=2.70, P=0.259);AHF group had the lowest side effect rate, especially skin reaction (9.1%,X2=20.25,P=0.002) ;CF group had the lowest acute bone marrow suppression rate(X2=25.95,P=0.000);for squamous cell carcinoma, the OS was higher in patients with chemotherapy than those without;the acute bone marrow and intestinal toxicities were more in patients with chemotherapy than those without. Conclusions CF and AHF groups have similar 5-year OS of patients with advanced cervical cancer. AHF group has less toxicities, shorter treatment course and a trend of better local control. Concurrent chemoradiation could improve survival and local control of the patients with advanced squamous cell cervical cancer while increase the side effects. The individual condition should be considered to choose the treatment protocol.

Improved Compliance with Recommended Infection Control Procedures among Beijing Dentists in 2000 vs 2005 / 中华医院感染学杂志

OBJECTIVE To investigate changes in Beijing dentists′ infection control(IC) practices in 2000 vs 2005.METHODS Data from questionaires of 647 dentists in 2000 and 592 dentists in 2005 were compared by using descriptive statistics and Person′s ?2.RESULTS Their response rates were 95.00%(2000) and 93.00%(2005).There were improvements in 2005 vs 2000 in reports of routine use of gloves(94.59% vs 73.31%);masks(56.78% vs 13.94%);and protective gown(38.87% vs 14.51%);change of gloves after each patient(93.47% vs 63.25%);vaccination for hepatitis B virus(HBV)(73.60% vs 32.66%);autoclave sterilization of dental handpieces after each patient(95.07% vs 41.24%);flushing waterlines after each use(70.78% vs 42.01%);and high-volume suction(44.92% vs 11.19%).CONCLUSIONS The compliance with recommended infection control procedures among Beijing dentists is improving in 2005 vs 2000.More education and inspection is needed to develop the infection control practices in dental health care settings.

Research on healthcare management of pregnant women in transient population in Beijing / 中华医院管理杂志

Objective To establish the healthcare management mode for pregnant women adapting to the characteristics of transient population which can safeguard the maternal and infant health or reduce the maternal mortality rate and prenatal mortality rate. Methods Five suburban communities of Chaoyang District, Haidian District and Fengtai District of Beijing were chosen as intervention group, which received systemic healthcare management of pregnant women in transient population, another five suburban communities were selected as control group. Results Both maternal mortality rate and prenatal mortality rate in intervention group were lower than those in control group. To evaluate the effect of systemic healthcare for pregnant women, an average of four antenatal clinic visits were completed in intervention group and eight visits in control group. There was no statistical difference in occurrence of maternal complications, newborn weight and occurrence rate of neonatal asphyxia between two groups. The expense of hospital vaginal delivery was no more than 1000 yuan in intervention group and more than 1000 yuan in control group, while the outcomes of mothers and neonates in two groups had no significant difference. Conclusion The systemic healthcare and community management mode for pregnant women in transient population can safeguard the maternal and infant health with scientific, practical, and replica-ble significances.

Psychological Reaction and Nursing Countermeasures of the Senile Patients in Department of Endodontics / 中国医学伦理学

Senile patients take a big part in the whole population of patients in endodontic department.This article analyzes psychological state of senile patients in endodontic department from the view of medical ethics and studies corresponding nursing countermeasures so as to find a good cooperation of doctors,nurses and patients and improve treatment effect.Suggested countermeasures are as follows.a.Improve the comprehensive quality of nursing staff.b.Respect and cherish senile patients,and meet their reasonable requests.c.Establish high moral responsibility and correct values of ethics and morality.d.Pay attention to the mutual communication between nurses and patients and psychological support.f.Recognize the importance of health education to senile patients before,in and after medical treatment.

A Review of Multisensory Deficit of Unilateral Neglect / 中国临床心理学杂志

We have known that neglect can often be multisensory.This paper reviewed auditory disturbances accompanied by visual neglect.Patients with visual neglect often show deficits in localisation of contralesional single sounds,particularly in the presence of an ipsilesional competitor.Auditory and visual aspects of neglect often correlate in their severity.Recent neuroimaging findings in the normal brain showed that the brain regions damaged in neglect patients might contain multimodal representations of space.