OBJECTIVE:To establish the essential medicine bidding evaluation model and improve the scientificity and effec-tiveness of essential medicine bidding and procurement. METHODS:Combined with the main objective of essential medicine cen-tralized bidding and procurement,a criteria bidding evaluation index system for essential medicine was established,and a bidding evaluation model for essential medicine was built based on fuzzy group decision making and the feasibility was verified by exam-ples. RESULTS:The essential medicine evaluation model based on fuzzy evaluation and group decision making was established, and empirical analysis for Atorvastatin Calcium tablet was used to show the feasibility of evaluation model. CONCLUSIONS:The essential medicine evaluation model based on fuzzy group decision making can scientifically and effectively accomplish a compre-hensive evaluation of pharmaceutical enterprises,which builds the foundation for promoting the transparency of essential medicine bidding and procurement work and reducing the economic burden for the patients.

OBJECTIVE:To provide reference for replenishing and perfecting essential medicine selection method in China. METHODS:According to the requirements of essential medicine selection,based on the actual situation,target function and restraint conditions for essential medicine selection could be determined by the knapsack theory and the essential medicine selection model could be built. The feasibility of established model was analyzed by an sample. RESULTS:The objective function of estab-lished model was Min∑CjXj,the minimum cost of all the selected essential medicines. Other constraints included covered range of disease,ADR,contraindications,attentions,dosage forms and specifications. Nine kinds of common oral hypoglycemic drugs were selected as candidate drugs,from which glipizide,gliclazide,metformin and repaglinide were chosen as the essential hypogly-cemic medicines with the proposed model. CONCLUSIONS:Established essential medicine selection model based on knapsack the-ory is scientifical,objective and with strong practicality.

Pancreatic cancer is a highly malignant tumor,the incidence is increasing year by year globally.Due to concealed pathogenesis of which and rapid progress,only 25％ of the patients could receive operation.Adjuvant therapy has become the important methods of improving the prognosis of patients with pancreatic cancer,including chemotherapy and radiotherapy.In recent years,some prospective clinical trials have promoted the development of the adjuvant therapy.New controversy and consensus appear in the treatment of pancreatic cancer.This article reviewed the progress of chemotherapy and radiotherapy for pancreatic cancer based on adjuvant therapy and neo-adjuvant therapy for unresectable metastatic pancreatic cancer and locally advanced pancreatic cancer.

Objective:To realize the hospital charging interface integration and sharing by using Web Service based system integration technology for resolving the problems the length of the shortcomings of low efficiency of payment and settlement in hospital.Methods: Using a service-oriented (SOA) open and loose coupling architecture, all agreements provide application services for XML-based standards. It can realize the integration of charging and making price and payment accurately, conveniently and quickly.Results: The integration platform based on Web service can apply complex heterogeneous system, support custom adapter connection, reduce the coupling between the module and improve the versatility of system data.Conclusion: The system is safe and reliable, and has a good sharing compatibility features. It can be able to upgrade and functions expansion. The application of integration technology will greatly improve the medical staff's working efficiency, provide convenience of patients, and reduce the hospital operation maintenance cost.

Objective: To deal with disaster relief, military exercises and sudden accident of scene forces medical rescue mission, aimed at laying cable network for each rescue mission deployment of manpower cost and the high cost of shortcomings, puts forward the use of wireless communication technology applications include construction of network system. Methods:Local wireless communication network is set up that around vehicular mobile medical information data center. Uses the eLTE broadband cluster technology as the local LAN carrying, through the deployment of LTE CPE device will be LTE signal into a wi-fi signal, for CPE surrounding wi-fi access equipment. Results:Single cluster station and don't need to cable connection between CPE, communicate through wireless LTE signal. IT equipment for medical use by wireless router or wireless module (department) wireless network access to the nearest tents, thus the whole battlefield rescue center by means of wireless local LAN connectivity was realized. Conclusion:the application of the wireless communication technology, the overall ascension of our medical and health unit in medical treatment activity ability, the cost of laying cable network was minimized.

The diagnosis and therapy of borderline resectable pancreatic cancer are foci in clinical research.We summarized the status of research on neoadjuvant therapy and discussed the safety and effectiveness of combined vascular resection in borderline resectable pancreatic cancer.We discussed the scope of surgical resection,and evaluated the prognostic markers of post-resectional surgery.

Objective:To study the clinical application of laparoscopic combined with multi-video debridement in treatment of complicated infectious pancreatic necrosis (CIPN).Methods:The clinical data of 34 patients with CIPN who were treated at the Department of General Surgery, Xuanwu Hospital, Capital Medical University from August 2017 to December 2019 were retrospectively studied. Based on the different video methods used, these patients were divided into 3 groups: the laparoscopic combined with intraoperative ultrasound group, the laparoscopic combined with choledochoscopy group and the laparoscopic group. The number of operations, operation time, blood loss, postoperative complication rates, mortality rates and total length of hospital stay were compared.Results:There were 13 patients in the laparoscopic combined with intraoperative ultrasound group, with age of (56.4±13.4) years. There were 7 patients in the laparoscopic combined with choledochoscopy group, with age of (48.0±8.4) years. There were 14 patients in the laparoscopic group with age of (51.4±15.6) years. The number of operations of the laparoscopic combined with intraoperative ultrasound group, the laparoscopic combined with choledochoscopy group and the laparoscopic group were (2.2±1.1), (1.6±0.8), (2.9±1.4), respectively. The number of operations of the laparoscopic combined with choledochoscopy group were significantly less than that of the laparoscopic group ( P<0.05), but there were no significant differences among the other groups ( P>0.05). The operation time of the laparoscopic combined with intraoperative ultrasound group, the laparoscopic combined with choledochoscopy group and the laparoscopic group were (70.5±22.9) min, (65.7±19.9) min, (51.5±15.4) min, respectively. The operation time of the laparoscopic combined with intraoperative ultrasound group was significantly longer than that of the laparoscopic group ( P<0.05), but there were no significant differences among the other groups ( P>0.05). There were no differences in blood loss, postoperative complication rate, mortality rates and total lengths of hospital stay among the three groups ( P>0.05). Conclusion:Laparoscopic combined with multi-video debridement after making full use of the advantages of each of the video methods, can be used to improve treatment outcomes of patients with CIPN.

OBJECTIVETo explore the clinical effects of Dynesys system combined with posterior lumbar interbody fusion (PLIF) in treating multiple lumbar degenerative disease.

METHODSThe clinical data of 46 patients with multiple lumbar degenerative diseases treated by Dynesys system combined with PLIF from September 2010 to May 2013 were retrospectively analyzed. There were 17 males and 29 females, aged from 38 to 68 years old with an average of (56.38±11.63) years. Operation section was in L2-L5 of 16 patients (6 with fusion of L4,5 and 10 with fusion of L4,5,L5S1) and in L3-S1 of 30 patients (11 with fusion of L5S1 and 19 with fusion of L4,5,L5S1). Patients were followed up for three times: postoperative 3 months, 1 year and final follow-up. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at final follow-up. Range of motion (ROM) and disc height index (DHI) were recorded.

RESULTSAll patients were followed up from 16 to 48 months with the mean of (23.23±7.34) months. At third follow-up after operation, ODI and VAS of lumbago and leg pain were significant improved than that of preoperative (P<0.01). DHI of fusion segment was significantly increased than that of preoperative (P<0.05). There was no significant difference in adjacent non-fusion segment between preoperative and postoperative (P>0.05). Postoperative ROM of fusion and non-fusion segments were obviously decreased than that of preoperative. There was no significant difference in ROM of upper adjacent non-fusion segment between 3 months and 1 year after operation (P>0.05), but at final follow-up, the ROM was increased (P<0.05).

CONCLUSIONThe preliminary clinical results of the Dynesys system combined with PLIF in the treatment of multiple lumbar degenerative diseases are satisfactory. It can be determined in fusion or non-fusion according to the individual needs and can reserve the some intervertebral motion, prevent the early degeneration of adjacent segments. However, its long-term clinical efficacy should be verified with long time.

Humans ; Lumbar Vertebrae ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Spinal Diseases ; physiopathology ; surgery ; Spinal Fusion ; methods ; Visual Analog Scale

Objective To investigate the effect of Zidan decoction containing serum on endometrial receptivity in uterine immunity environment,and then to discuss if it's effect on endometrial receptivity through its controlling the expression of cell factors which related to endometrial receptivity.Methods Mice's endometrium tissue samples and uterine Natural Killer (UNK) cells were obtained from pregnant mice on gd 4.5 days and gd 12.5 days.After endometrial glandular epithelial cells,endometrial stromal cells and UNK cells were separated through primary culture,epithelial cells and endometrial stromal cells at rate of 1 ∶ 1 a certain concentration UNK were mixed together and highly purified-cultured.Different concentrations of Zidan decoction was acted on the culture solution.FBS,black and aspirin control group were setup for contrast.The expression of LIF and VEGF which influenced by Zidan decoction in the immunity environment was assayed by Realtime-PCR.Results The expression of LIF and VEGF was significantly increased in the immunity environment of uterine (in 10％ Zidan decoction group,10％ aspirin group and 10％ blank control group:LIF was 2.10±0.20,1.98±0.14,0.90±0.05 separately,and VEGF was 3.17±0.31,2.52±0.09,0.92±0.06respectively,P＜0.05).Conclusion Zidan decoction could improve endometrial receptivity by increasing the expression of cell factor which related to endometrial receptivity with the help ofUNK paracrine.

Objective To investigate the relationship between heart rate variability and type 2 diabetes mellitus(T2DM)in Kirgiz and Han,to understand the differences between ethnic groups,at the same time to provide effective method for type 2 diabetic autonomic neuropathy.Methods 24 -h Holter recording was performed in 1 46 individuals.75 cases of T2DMconfirmed by glycolated hemoglobin(HbA1 c)were selected as observation group, Kirgiz 40 people,Han 35 people.While 71 subjects without T2DM were chosen as control group,Kirgiz 34 people, Han 37 people.The HRV indices,including standard deviation (SD)for the time between normal -to -normal complexes in the entire 24 h electrocardiographic recording(SDNN),the average of SD for the time between normal -to -normal intervals for each 5 min period(SDNN5),the percentage of adjacent RR intervals 50 ms apart(PNN50), normal RR intervals divided by RR intervals derived from the triangle index(TRIA),SD of the average normal -to -normal intervals for each 5 min period (SDANN)and root -mean square of differences of successive RR intervals (RMSSD)were compared between these groups.Results There were no significant differences in age,gender, education level and smoking between Kirgiz and Han patients.The differences were statistically significant in SDNN, SDNN5,PNN50,SDANN,TRIA(t =3.392,P =0.001 ;t =3.652,P =0.001 ;t =3.826,P =0.001 ;t =3.235,P =0.002;t =2.378,P =0.02)between patients with or without T2DMin Kirgiz population.In contrast,the mean square root of SDNN,SDNN5,PNN50,TRIA,RMSSD(t =3.498,P =0.001 ;t =3.41 4,P =0.001 ;t =2.1 05,P =0.039;t =2.1 02,P =0.039;t =3.41 3,P =0.001 )were statistically significant in Han population between T2DM patients and nondiabetic patients.There was no deference between Han and Kirgiz patients without T2DM in HRV,whereas the TRIA(t =2.887,P =0.005 )had significant difference in T2DM patients between Han and Kirgiz population. Conclusion The HRV is significantly reduced in the T2DMpatients,especially the Kirgiz.The HRV analysis using 24h Holter is a noninvasive technology to detect the T2DM.