This paper presented both the theoretical basis and the technical route of the study for health system reform in Shanghai via system monitoring and evaluation.By way of two rounds of expert consultation and joint liaison meetings,the study initially established framework indicators of such based on the following four aspects,including inputs and activities,outputs,outcomes and impact.Also,the study identified 13 grade-2 indicators and 133 grade-3 indicators.Based on the main results of the baseline survey,the paper preliminary analysed the problems and challenges that may be faced in the field of Shanghai health system reform,and proposed suggestions for carrying out monitoring and evaluation of the health system reform respectively on both a research and practical level.

The purpose of this study was to reveal the current situation of health technology transfer in Shanghai hospitals,and to analyze the problems and needs.Questionnaire and interview were adopted for the study.We found that in the past 3 years,the transformation rate of patent technologies at Shanghai Tertiary Hospitals was 5.88％.The transfer routes mainly involves proactive enlist of enterprises by project leader,technology brokerage,exhibitions of patents achievements,friends' recommendation,etc..The main factors impacted the transfer included poorer quality of patent,lacking efficient management,and lacking channels for transfer.In order to improve the transfer of patents,hospitals need to provide information service,technology assessment,project packaging,patents application,consultant,and relevant trainings etc.Other things that could promote health technology transfer are to improve scientific research system,to enhance the quality of scientific achievements,and to develop technology brokerage.

Objective Establishing the scientific research competitiveness evaluation index system of Shanghai hospitals.Methods Delphi method and Analytic Hierarchy Process were applied.Results Thirty-four experts were invited to provide evaluation index and weighted scores.The positive coefficient from two rounds of expert's consultation were 88.24％ and 94％.The expert's opinion of authority coefficient of each indicator's was greater than 0.7.The degrees of coordinative consistency was high.Kendall concordance coefficient was increasing with the increasing of consulting times.After two rounds of Delphi expert consultation,2 level-one indictors,10 level-two indictors and 47 level-three indictors were confirmed.Conclusions After two rounds of Delphi expert consultation,using all objective indicators,an Index System for research competitiveness evaluation in the hospitals in Shanghai has been created and could be used with scientific,objectivity and feasibility.

Objective To investigate the enhancement patterns of hypervascularized breast tumors with real time contrast-enhanced ultrasound (CEUS) and to evaluate the accuracy of CEUS in comparison with power Doppler in the discrimination purpose. Methods CEUS was preoperatively performed in 35 patients with 37 hypervascular breast lesions detected on power Doppler. The patterns of enhancement were analyzed and compared with morphological characteristics of the vessels displayed by power Doppler. Results Considering initial lump enhancement and peripheral flake enhancement as a criterion suggesting malignancy, CEUS showed a sensitivity of 90.9% ,a specificity of 73.3% and an accuracy of 75.70/00. While the morphological characteristics of the vessels demonstrated by power Doppler showed no significant difference between benign and malignant lesions, Conclusions CEUS is more accurate than power Doppler ultrasound in the assessment of blood flow of hypervascular breast tumors and more helpful in the differentiation role.

Objective To compare features between color Doppler flow imaging(CDFI) and contrast-enhanced ultrasonography(CEUS) in the diagnosis of small renal cell carcinoma(SRCC) and investigate the diagnostic value of CEUS. Methods The images of CDFI and CEUS examination were retrospectively analyzed in forty-five SRCC (≤3 cm in diameter) which were confirmed sequentially by operation and pathology. Inner echoes,boundary,dark-ring and color flow of tumors were observed by CDFI. The degree of tumor vascularity was subjectively graded from 0 to Ⅳ. Enhancement patterns and phases on uhrasonography were reviewed, including enhancement start time, peak time, wash-out time and enhancement appearances of SRCC. Results The images were observed as homogeneous or relatively homogeneous (19) and heterogeneous or relatively heterogeneous(26), clear boundaries(37, including 10 with dark-ring) and ill-defined margins(8). The tumor vascularity was showed as grade 0(5) ,grade Ⅰ (6),grade Ⅱ (14),grade Ⅲ (14),grade Ⅳ(6) on CDFI. All lesions were showed mean enhancement start time (13.84±3.80) seconds,peak time (19.49±4.73) seconds,wash-out time (26.91±5.86) seconds respectively on CEUS. All cases were observed as simultaneous wash-in(39) and gradually wash-in(6),hyperechoic(14) and isoechoic(22) and hypoechoic(9) in peak time, simultaneous wash-out (19) and rapidly wahs-out (19) and gradually wahs-out(7). After contrast medium injection, tumors were detected partly non-enhaneement or cellular enhancement (25) and pseudocapsule (20). Conclusions CEUS is effective in improving the sonographic visualization of tumoral vascularity ,internal structure and pseudocapsule. It plays an important role in the diagnosis of SRCC.

Objective To analyze the reliability and validity of an established Research Hospital Competitiveness Evaluation System.Methods To evaluate the research competitiveness of 34 tertiary hospitals and their departments in Shanghai using above system.The reliability and validity of the indicator system were analyzed with the Cronbach's alpha coefficient, and confirmatory factor analysis based on the structural equation model.Results After adjusting for structure of the index system via item parceling, the CFI, MFI, RMSEA AND IFI were 1.000, 1.009, 0.000 and 1.028, the Cronbach's alpha of whole set indicators system was 0.768.Conclusions The results suggested that the measured reliability and validity are both in good degree, survey results can reflect the actual competence of evaluated hospitals.

The biological role of N 6-methyladenine (m 6A) methylation modification has been gradually identified, and it has shown increasing value in tumor. In recent years, with the accumulated explore of epigenetics in RNA modification, many studies have reported that m 6A methylation modification contributes to development and progression of lung cancer. m 6A-related modified regulator has potential application value as a clinical target for diagnosis and treatment of lung cancer.

Objective To investigate the patent technological domain distribution of shanghai health system,and comparative analysis of patent technological hotspots between shanghai health system and enterprises.Methods The study used IPC classification method to conduct quantitative analysis of the distribution of patent technology,co-words analysis and visualization of social network establishment method were adopted to analyze patent technological hot spots.Results Within the A61 category,numbers of authorized patents of shanghai health system in orders are A61B、A61K、A61M and A61F.Further analysis of the highest authorized A61B17 group patent in the highest class A61B found that,compare to enterprises,the degree of coincidence with the high-frequency keywords of the technology hotspots is small,the technical hotspots are scattered,and lack of overall technical arrangement.Conclusions Shanghai health system mainly focused on medical device development.It is lower than that of enterprises regarding to the patent technology market demand matching,technical arrangement of the enterprise is relatively better than the health system,thus,the study suggested enhancing market demand survey,adjusting patent distribution,and broadening the scope of market promotion.