Objective To study the hotspots and frontiers in research of medical big data using CiteSpace.Methods The papers on medical big data covered in Web of Science were analyzed using bibliometrics in combination with CiteSpace.Results The achievements in research of medical big data have rapidly increased since 2012.The nodes in research of big data, system, care, medicine and personalized medicine were bigger.The burst value in research of quality, children and mapreduce was higher.Conclusion The number of current researches in medical big data is greater in medical big data technology, precision medicine, medical and health big data management, medical big data privacy while mapreduce, ontology and hadoop are the frontiers and future trend in research of medical big data.

Medical big data, an important strategic source of basic data for a country, will be applied in precision clinical diagnosis and treatment, decision-making support, disease monitoring, early warning and management, and public health service. The application of medical big data technology in our country is to be improved at pres-ent. How to realize the smooth transition of traditional medical data to a big data system and the added value of data by data mining and analyzing is an important problem needing to be solved immediately. The key functions, inclu-ding the general frame work and data center frame work of medical big data application information system, were thus planned and designed in this paper by constructing the regional application technology and engineering labora-tory for medical big data.

Objective To analyze the hot spots and frontiers in domestic and foreign precision medicine with CiteSpace. Methods The CNKI and WOS-covered papers on precision medicine were analyzed by bibliometrics combined with CiteSpace. Results Domestic precision medicine got off in 1992 and scholars became interested in it from 2010 . Foreign precision medicine started in 1985 and studies on it increased rapidly from 2006 . The node of precision medicine was the largest in China with a rather high value of gene mutation, US president Barack Obama ( precision medicine program) , personalized medicine, gene chip, genomics and pharmacogenomics whereas the node of personalized medicine, cancer and breast cancer was the largest with a rather high value of precision medi-cine, pharmacogenomics and pharmacogenetics. Conclusion The number of domestic and foreign papers on US president Barack Obama ( precision medicine program) is rapidly increased and pharmacogenomics is their common frontier. However, cancer is highly concerned in foreign countries.

Objective Establish an objective and fair evaluation index system for the implementation effectiveness of the National Major New Drug Development Program of China.Methods Based on literature review and Delphi method,the framework of the evaluation index system was built and analytic hierarchy process was applied to determine the priority of each indicator of the system.The objectiveness and validness of the results were assured by determining expert activeness coefficient,authority coefficient,indicator rationality,and by applying consistency check.Results A targeted and systematic evaluation index system was constructed for the National Major New Drug Development Program,and through expert consultation and analytic hierarchy process,the factor of product result was considered of the highest weight of 39.03％,followed by technical result,theoretical result and organization and management result.The evaluation index system suggested that product result and technical result are two relatively more significant factors to be considered during evaluation.Conclu sion After consultation on expert opinions,the evaluation index system for the National Major New Drug Development Program was constructed with each factor been assigned with a scientific and rational weight,and this will provide a guideline for the decision making of program administrators and evaluation practice.

Eubhorbia neriifolia L. is a plant of Euphorbia family.Five known lignans were isolated from the aerial parts of E. neriifolia L. by silica gel for column chromatography and preparative high-performance liquid chromatography (HPLC).Their potential antitumor activities were evaluated in vitro.Compound 2 exhibited proliferation inhibition and cytotoxicity against esophageal squamous cancer cells, especially KYSE-410 and KYSE-450 cells.Further analyses showed that compound 2 could significantly induce apoptosis through the activation of caspase 3/9 and down-regulation of the Bcl-2/Bax protein ratio.These results suggested that compound 2 had a significant inhibitory effect on the esophageal squamous cancer cells, especially KYSE-410, which deserves further research as a potential antitumor agent.

Objective To analyze the management experience of Swedish medical research funding,and provide reference for further rationalization of medical research investment management in China.Methods Literature research method,descriptive statistics and other methods were used to systematically sort out the source of Swedish medical research funding,and specifically analyze the capital investment and distribution in medical fields in the past ten years.Results The Swedish government 's budget in the UO9 (health,medical and social care) field is steadily increasing.The annual average budget accounts for 7.14％ of the total government budget.There are scientific management methods for fund allocation.The appropriation projects are mainly divided into three main directions including public health categories,health care and social care.Conclusions Taking into account of the problems existing in the investment and distribution of medical research funds in China,this paper proposes to explore the capital investment mode suitable for China's national conditions,enhance the targeted investment of funds in medicine,and establish a scientific and efficient fund investment management mechanism.

Objective:To investigate the cost-effectiveness of Helicobacter pylori ( H. pylori) antimicrobial susceptibility testing-guided therapy versus an effective empiric modified bismuth quadruple therapy for first-line H. pylori treatment. Methods:This cost-effectiveness analysis was based on the data from a multicenter prospective randomized controlled clinical trial (NCT02935010), which included 382 patients with H. pylori infection. Among them, 286 cases were in the antimicrobial susceptibility testing group, which were diagnosed by biopsy under endoscopy. And according to the results of antimicrobial susceptibility testing of H. pylori, patients were treated with triple or quadruple therapy of eradicating H. pylori for 14 days. A total of 96 patients were in empirical therapy group, which were diagnosed by biopsy under endoscopy (96 cases, endoscopy empirical group), who were treated with 14-day empiric bismuth quadruple therapy. At the same time, based on the patients of empirical group, a simulated 13C-urea breath test (UBT) empirical group (UBT empirical group) was set up (96 cases, H. pylori infection was first diagnosed by 13C-UBT examination) and in the cost accounting the expenses related to endoscopy, biopsy and drug sensitivity test were removed and the expense of 13C-UBT was added. The information of patients of endoscopy empirical group was kept. Taking the eradication rate of H. pylori as an effectiveness indicator, the cost, cost-effective ratio (CER), incremental cost-effective ratio (ICER) among antimicrobial susceptibility testing group, endoscopy empirical group and UBT empirical group were compared by intention-to-treat (ITT) analysis and per-protocol (PP) analysis. Sensitivity analysis was conducted based on the results of ITT analysis to evaluate the reliability of the research results. Results:The results of ITT analysis indicated that the cost of antimicrobial susceptibility testing group, endoscopy empirical group and UBT empirical group were (1 747.41±149.30), 1 032.71 and 657.71 Yuan, respectively. The cost of antimicrobial susceptibility testing group was (714.70±149.30) and (1 089.70±149.30) Yuan higher than that of the endoscopy empirical therapy group and UBT empirical therapy group, respectively. The CER of antimicrobial susceptibility testing group, endoscopy empirical group and UBT empirical group were (19.08±1.49), 12.09 and 7.70 Yuan/%, respectively. ICER of antimicrobial susceptibility testing group was (115.27±1.49) and (175.76±1.49) Yuan /% in comparison with the endoscopy empirical group and the UBT empirical therapy group. Compared with that of empirical group, the ICER of antimicrobial susceptibility testing group was more likely to be affected by H. pylori eradication rate and the cost of antimicrobial susceptibility testing. When the H. pylori eradication rate decreased in the empirical group, the ICER of the antimicrobial susceptibility testing group also decreased; when the H. pylori eradication rate increased in antimicrobial susceptibility testing group, the ICER decreased, and vice versa. When the cost of antimicrobial susceptibility test was upregulated or downregulated by 20%, for every 1% increase in the eradication rate of H. pylori in comparison with that of the endoscopy empirical group, the cost of the antimicrobial susceptibility testing group increased by 99.15 and 131.40 Yuan; in comparison with that of the UBT empirical group, the cost of the antimicrobial susceptibility testing group increased by 159.63 and 191.89 Yuan. Conclusions:For patients diagnosed with H. pylori infection by 13C-UBT and without indications for endoscopy examination, the empirical quadruple therapy is the first choice. For patients intended to do endoscopy to confirm H. pylori infection, with additional affordability of 115.27 Yuan for every 1% increase in the eradication rate of H. pylori, antimicrobial susceptibility testing can be conducted and personalized. H. pylori eradication therapy can be carried out based on the results of antimicrobial susceptibility test. Reduced cost of the antimicrobial susceptibility test will be more conductive to the promotion of personalized treatment after antimicrobial susceptibility test.

Objective To explore the status quo of workplace bullying and job satisfaction among clinical nurses, and to explore the mediating effect of peer support among nurses in the relationship between the above two elements.Methods By convenience sampling, from November 2015 to April 2016, 207 clinical nurses in a comprehensive classⅢ grade A hospital in Fuzhou, were selected and surveyed by a questionnaire on general information, a peer support scale, the negative acts questionnaire-revised (NAQ-R), and job satisfaction scale for nurses. Correlation analysis and regression analysis were conducted to the data collected.Results Workplace bullying was significantly negatively related with peer support among nurses(r=-0.395,P<0.01), and job satisfaction (r=-0.338,P<0.01). Peer support among nurses was positively correlated with job satisfaction (r=0.611, P<0.01). Among nurses, peer support was the mediating variable between workplace bullying and job satisfaction. After introduction of peer support among nurses, influence of workplace bullying on job satisfaction was statistically meaningless (β=-0.148,t=-1.716,P>0.05).Conclusions In the relationship between workplace bullying and job satisfaction, peer support among nurses plays a role as a full mediation. Nursing managers should actively introduce the idea of peer support among nurses, lower workplace bullying, and improve job satisfaction among nurses.

Objective:To preliminary explore the changes in blood system in pyrrolizidine alkaloids (PAs)-related liver damage.Methods:General situation, liver function, biochemical blood test, routine blood test, coagulation function markers, etc., of 77 cases with drug-induced liver damage admitted to the Zhongshan Hospital Affiliated to Fudan University from 2012 to 2019 were retrospectively analyzed. Patients’ were divided into PA group, other traditional Chinese medicine group and Western medicine group according to their medication history. Simultaneously, the changes in liver function were observed in the established mice model of monocrotaline-induced liver damage. Liver tissues HE staining and blood routine indexes were observed.Results:24 cases received PA, 24 cases received other traditional Chinese medicine, and 29 cases received western medicine. Alanine aminotransferase was lower in PA group than the other two groups ( P < 0.05), and the total bilirubin and direct bilirubin were significantly lower than the other traditional Chinese medicine group ( P < 0.05). The peripheral platelet count of the PA group was (84.11 ± 26.91) ×10 9/L, which was significantly lower than the lower limit of normal, and had statistically significant difference with other traditional Chinese medicine and western medicine group ( P < 0.01). Thrombocytocrit, mean platelet volume and platelet indices of PA group were statistically different from the other two groups ( P < 0.05). The D-dimer level in patients with PA group was (2.62 ± 1.93) mg/L, which was higher than the upper limit of normal, and significantly higher than the D-dimer level of the other two groups of patients ( P < 0.01). Meanwhile, prothrombin time was longer in PA group than that of the other two groups ( P < 0.01), and platelets count were decreased significantly in the mouse model of monocrotaline-induced liver damage after alanine aminotransferase and aspartate aminotransferase elevation ( P < 0.01). Conclusion:PA-related liver damage has lower peripheral platelet counts, and the peripheral platelet counts of these patients are lower than other types of drug-induced liver damage. In addition, increased D-dimer in patients with PA-related liver damage indicate a potential risk of thrombosis.

Objective The paper aims to analyze the effectiveness and problems of health personnel construction in China since 2012,provide reference for promoting the construction of health professionals.Methods Using national data from China health statistics yearbook,adopted the methods of descriptive statistics and literature research and so forth.Results The construction of health personnel has been continuously strengthened in China,the structure and distribution of health personnel have been further optimized,the medical service capabilities have been improved.However,there are still inappropriate or imbalanced situations.Conclusions The construction of key personnel such as primary health personnel and urgently needed personnel need to be further strengthened;promote the construction of health service personnel to meet new health needs;continue to improve the construction of high-level and management personnel to play a leading role.