Objective:To reveal the behavior characteristics of health delivery system(HDS) and the dynamical mechanism by which HDS promoting population health,so as to provide theoretical and methodological evidences for the decision-making of national macro health system.Methods: The macro model of HDS was constructed by using the theory of complex system and the method of system dynamics.Results: The principle of "high coverage and reasonable quality" was put forward as developmental strategy of national health service.The improvement of population health was taken as the system objective of HDS;meanwhile,HDS was community-centered and city-country integrative.The macro model of HDS was constructed based on the above objectives.Conclusion: Modeling based on system dynamics is effective to reveal the complexity of health delivery system.The HDS complex system model constructed in this article can be used to analyze and interpret the behavior characteristics of HDS and the dynamic mechanism by which HDS promoting population health.

Objective To study the therapeutic effect and significance of Naloxane on the brain function in patients with acute organ phosphorus pesticide poisoning. Methods 106 patients with acute organ phosphorus pesti-cide poisoning were randomly allocated to two groups according to the hospitalized date, the NX group(n=54) and the normal group(n=52). The two groups received the same basic treatment and the dynamic monitor about the changes of the β-EP and MDA levels in each groups, and the NX group was given additional treatment with 0.8 mg Naloxone-intravenous injection every 20 minutes till consciousness recovering or symptoms improved. Results The time of recovering consciousness was (16.71±3.17)h in NX group and (20.84±3.25)h in control group. β-EP and MDA were higher than normal before treatment in all patients (P<0.01), and were significantly reduced after treatment in NX group (P<0.05), the control group had mild change after treatment. Conclusion Relating to the inhibition of oxygen free radicals, Naloxone can reduce time of recovering consciousness and can protect the injured brain of the patients with acute organ phosphorus pesticide poisoning.

To introduce a trend chart electronic nursing record sheet which takes the real-time data acquisition and monitoring module as the core technology, and observes its characteristics and advantages in clinical application. At the same time, it makes a prospect for the information construction of the critical care record. The module can acquire and upload monitoring data of monitor and ventilator in real time, automatically and completely. The data can be extracted according to the setting frequency and uploaded to the hospital information system (HIS). In the corresponding position of the intensive care record Generate dynamic change trends and save the monitoring data in the database, and the data can be stored for a long time. The application of real-time data acquisition module can save indirect nursing time and improve the nursing efficiency, meanwhile, the whole monitoring data is of great significance to the research and medical records analysis.

Objective To investigate the potential factors which have impact on the working space for surgeons in gasless laparoscopic cholecystectomy and to probe into the specifications of gasless surgeries.Methods Clinical data of 49 cases of gasless laparoscopic cholecystectomy between March 2007 and July 2010 were summarized.The impacts of body mass index,bowel preparation and means of anesthesia on operation time and conversion to laparotomy were analyzed.Results For patients with body mass index ≤25and ＞ 25,operation times were (43.0 ± 5.4) min,and (52.8 ± 7.4 ) min,respectively,and rates of conversion to laparotomy were 0/34 and 4/15,respectively.Both indices in the first group were higher.For patients with and without bowel preparation,operation times were (44.5 ± 5.4) min and (46.1 ± 8.0)min,respectively,and rates of conversion to laparotomy were 2/26 and 2/23,respectively.For patients with epidural anesthesia and lumbar/epidural anesthesia,operation times were (46.5 ± 7.9) min and (44.1 ±6.8) min,respectively,and rates of conversion to laparotomy were 2/24 and 2/25,respectively.Conclusions The operation time of gasless laparoscopic cholecystectomy could be affected by many factors,such as body mass index.Gasless operations can be improved by evaluating the conditions of patients correctly and by selecting suitable operation methods,anesthesia means and bowel preparation.

Aim To observe the antiviral function of Radix Notoginseng flavone on a virus infection model caused by COXB_3 virus in vitro and in vivo. Methods To establish an experimental in vitro model of viral myocarditics based on primary culture of myocardial cells of newborn Wistar rats and a Balb/c mouse model of viral myocarditics through intraperitoneal injection. Results In vitro Radix Notoginseng flavone obviously inhibited pathologic change of cultured cardiac cells; it reduced release of enzymes from myocardial cells, and increased the level of interferon in mouse spleen, and inhibited inflammatory cells infiltration among cardiac cells in Balb/c mice infected by COXB_3 virus; survival rate of mice in treated groups increased. Conclusion Radix Notoginseng flavonoe has therapeutic efficacy on viral myocarditis caused by COXB_3 virus.

Objective:To investigate the value of quantitative electroencephalography (qEEG) in the evaluation of thrombolytic efficacy in acute cerebral infarction.Methods:A prospective cohort study was conducted. Ninety-four patients with acute cerebral infarction who received intravenous thrombolysis admitted to the department of emergency of Qinhuangdao First Hospital from October 2019 to September 2020 were enrolled. The relative energy values of δ, θ, α and β waves in qEEG before and 2 hours, 24 hours and 7 days after intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis were dynamically monitored, and the power ratio index [DTABR, DTABR = (δ+θ)/(α+β)] was calculated. The National Institutes of Health stroke scale (NIHSS) score was also recorded. The reduction of NIHSS score ≥ 3 or the disappearance of neurological symptoms were regarded as effective thrombolytic therapy. The changes of DTABR before and after thrombolysis in patients with effective and ineffective thrombolysis were analyzed, and the correlation between DTABR and NIHSS score was analyzed by Pearson method.Results:A total of 94 patients were enrolled, including 64 males and 30 females. The average age was (61.71±10.11) years from 36 to 89 years old. Thrombolysis was effective in 57 cases and ineffective in 37 cases. Compared with before thrombolysis, DTABR of the effective group was significantly decreased at 2 hours, 24 hours and 7 days after thrombolysis (left cerebral infarction: 1.87±1.45, 1.59±0.88, 1.58±0.90 vs. 3.82±2.60; right cerebral infarction: 1.55±0.57, 1.41±0.50, 1.35±0.44 vs. 3.20±1.63, all P < 0.05). DTABR did not change or increase significantly at 2 hours, 24 hours and 7 days after thrombolysis compared with before thrombolysis (left cerebral infarction: 3.56±2.57, 3.48±2.19, 3.54±2.50 vs. 3.11±1.62; right cerebral infarction: 5.29±3.93, 5.33±3.94, 5.19±4.52 vs. 4.73±2.43, all P > 0.05). Pearson correlation analysis showed a significant positive correlation between DTABR and NIHSS score in patients with acute cerebral infarction (r = 0.691, P < 0.01).Conclusion:The quantitative index of qEEG, DTABR, can accurately and quickly monitor the process of thrombolysis in acute cerebral infarction, and can effectively evaluate the effect of thrombolysis in patients.

Objective To investigate the relationship between metabolic parameters of 18F-FDG PET-CT and cilinicopathological features of patients with lung squamous cell carcinoma. Methods The study comprised 118 patients with lung squamous cell carcinoma. All patients undergone 18F-FDG PET-CT before surgery. Maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) were measured, and total lesion glycolysis (TLG) was calculated. Relationship between metabolic parameters and clinicopathological factors was analyzed. Results SUVmax, MTV and TLG of 118 primary lesions were 11.93 (3.12-41.46), 27.71 cm3 (0.54-347.10 cm3) and 153.13 (1.65-2219.37), respectively. SUVmax was related to tumor differentiation degree and pleural invasion (χ2= 15.358, P= 0.000; Z= -2.875, P= 0.004); MTV was related to tumor differentiation degree, pleural invasion, vascular invasion and lymphatic metastasis (χ2= 13.341, P= 0.001; Z= -2.855, P= 0.004; Z= -2.683, P= 0.008; Z= -3.951, P= 0.000), TLG was also related to these clinicopathological factors (χ2= 15.609, P= 0.001;Z= -3.901, P= 0.002;Z= -2.311, P=0.021;Z= -3.721, P= 0.000). T stage and TNM stage had positive correlation with all metabolic parameters (r= 0.326, 0.794, 0.732;r= 0.358, 0.718, 0.668; all P< 0.05). And for N stage, SUVmax was no correlative (r=0.125, P=0.107), but MTV and TLG were positively correlative (r=0.399, 0.371, both P< 0.05). According the MTV or TLG and tumor size, patiens were divided into three groups: low-risk group, moderate-risk group and high-risk group. Significant differences were found among the three groups not even in MTV model, but also in TLG model (χ2= 20.800, P= 0.000; χ2= 20.069, P= 0.000). Conclusions Metabolic parameters of lung squamous cell carcinoma primary lesion have good correlation with clinicopathological factors, and can reflect partial characteristics of the tumor pathology in a certain extent. Furthermore, the probability of lymphatic metastasis could be predicted by MTV or TLG combined with tumor size.

To develop a portable medicine coffer for medical support in order to standardize the management of special medicine. The coffer with double-fingerprint cryptography and internal mechanical lock was com-posed of a body and a cap. The coffer had the body made of high-intensity plastics or light alloy, monitor made of high-intensity abrasion-resistant glass as well as rechargeable lithium battery. The coffer eliminated the deficiencies of traditional medicine chest. The portable coffer standardizes the management of special medicine for medical support.

Objective:To investigate the effect of thermal conductivity on the apical sealing ability of different dental gutta-percha cones during the warm vertical condensation obturation.Methods:Four kinds of dental gutta-percha cones were used in this study:Bio-GP points (BP,B&L,Korea),large-tapered gutta-percha (DP,DENTSPLY,America),PROTAPER Universal gutta-percha points (DPP,DENTSPLY,America) and mtwo gutta-percha points (VP,VDW,Germany).Volume differences method was used to determine the main components and the thermal conductivity determinator was used to measure the thermal conductivity of these dental gutta-percha cones.Furthermore,20 cones randomly selected from each kind of dental gutta-percha cones.And 10 cones of each dental gutta-percha cones,which were cut out the part of 4 mm in length from the apical end,were heated (200 ℃) from the upper end without compression,and the temperature of the gutta perchacones surface was monitored in time by the infrared thermal imager during the whole heating process.In addition,the rest of the 10 cones of each dental gutta-percha cones were used to obturate the root canal in the transparent root canal resin model using warm vertical condensation technique.The cross-sectional surface was observed by stereomicroscope (× 40) at 1 mm and 3 mm from the working length and the gutta-percha obturation area proportion was measured and analyzed.The data were analyzed by one-way ANOVA.Results:The proportion of inorganic fillers (80.90％ ± 1.14 ％) (P ＜ 0.05) and the thermal conductivity (2.247 ± 0.002)of DP was siguificantly higher than BP (79.28％ ± 3.88％,1.179 ± 0.003),DPP (68.46％ 5.09％,0.604 ±0.001),VP (78.86％ ± 1.87％,1.150 ±0.001) (P ＜0.05).During the thermal obturation without compression at the setting temperature (200 ℃),DP could achieve 65 ℃ beyond 1 mm from the heating point,and BP,DPP and VP only reached 65 ℃ within 1 mm.After warm vertical condensation obturation,all the groups showed increased gutta-percha obturation area proportion.At the position of WL-3,DP (96.89％ ±0.03％) showed significantly higher proportion of gutta-percha obturation area than BP (95.47％ ±0.06％),DPP (95.21％ ±0.03％) and VP (95.15％ ±0.03％) (P ＜ 0.05).Conclusion:DP contains more inorganic fillers,possesses higher thermal conductivity,and leads a better apical sealing ability than BP,DPP and VP at the position of WL-3 during warm vertical condensation obturation.

Objective:To investigate the antibacterial effect of different self-etching adhesive systems against Streptococcus mutans (S.mutans).Methods:Six reagents ClearfilTM SE Bond primer (SP), ClearfilTM SE Bond adhesive (SA),ClearfilTM Protect Bond primer (PP),which contained antibacterial monomer methacryloyloxydodecylpyridinium bromide (MDPB),ClearfilTM Protect Bond adhesive (PA), positive control chlorhexidine acetate [CHX,1% (mass fraction )],and negative control phosphate buffer solution (PBS)were selected.They were mixed with S.mutans for 30 s respectively,then colony-forming units (CFU)were counted after incubated for 48 h on brain heart infusion (BHI)agar medium. The 6 reagents were applied to the sterile paper discs,and distributed onto the BHI agar medium with S. mutans and incubated for 24 h,then the inhibition zones were observed.CHX,PBS,PP,and SP were added on the dentin with artificial caries induced by S.mutans and kept for 30 s,then confocal laser scanning microscope (CLSM)was used to observe the live and dead bacteria after staining.The ratio of live to dead bacteria was calculated.PP+PA and SP+SA were applied on the dentin according to the manual and light cured.S.mutans were incubated on the samples for 2 h,ultrasonically treated and in-cubated on BHI agar medium for 48 h,then CFU was counted.The data were analyzed by non-parametric analysis and one-way ANOVA.Results:Compared with PBS,the PP,SP,PA,SA and CHX showed the antibacterial effect on free S.mutans (P<0.05 );SP and PP showed stronger antibacterial effect than PA,SA and CHX (P<0.05).CHX,SP and PP presented inhibition zones,while PBS,SA and PA did not.Compared with PBS,the CHX,SP and PP could lower the ratio of the live to dead bacteria significantly (P<0.05).Cured self-etching adhesive systems did not show any antibacterial effect on the free S.mutans.Conclusion:The primer of self-etching adhesives ClearfilTM SE Bond and ClearfilTM Pro-tect Bond showed significant antibacterial effect on free and attached S.mutans.The adhesive only showed antibacterial effect on free S.mutans before light-cured polymerization.After being cured,the self-etching adhesive systems did not show antibacterial effect anymore.