Child ; Chronic Disease ; Guidelines as Topic ; Humans ; Kidney Diseases ; therapy ; Kidney Failure, Chronic ; Nutritional Support ; Renal Insufficiency, Chronic

Based on the related theories of physician behavior analysis, summarize and discuss the incentives mechanism of supplier payment on physician behavior and its inner mechanism, provide theoretical supports and political suggestions for further analysis on payment reform.

Objective: To judge the return to scale of inefficient decision-making unit(DMU)on data envelopment analysis(DEA). Methods: On the basis of return to scale method of classical DEA decision-making unit. Through comparing the same input of efficient and inefficient DMU, increase the quantities of output of inefficient DMU(the inverse of efficiency value), taking this point as the area of inefficient technique unit return to scale. Results: Taking the county-level hospitals of Chinese Medicine as examples, it is found that there are no clear judgment on the return of scale of inefficient hospitals, after adjustment, there are 4 inefficient hospitals are classified into increasing return to scale stage and decreasing return to scale stage, which embody obvious characteristics of insufficient output. Conclusion: The return to scale is important information to evaluate the efficiency of medical institutions which is the reason leading to inefficiency medical institutions.

To discuss the influences of government health input on the efficiency of hospital operation. Methods:Taking 16 county-level hospitals in Ningxia as samples, using DEA and DEA-malmqutist indicator method to calculate the technical efficiency scores from 2000 to 2012, then analyze the compositions of technique efficiency(TE) , using Tobit regression to analyze the relationship between government budget health expenditure and medical institution efficiency. Results: The Ningxia governmental health budget expenditure is growing almost 3 times from 2000 to 2012 and the average TE is 0.82-0.94. In the 16 county-level hospitals, the TFP of 6 hospitals (37.5%) was less than 1, and the minimum was 0.82; while the TFP of 10 hospitals (62.5%) were more than 1, the max was 1.699. For the 6 hospitals of which TFP was less than 1, the reason for negative growth of TFP was contributed to the slow technique change, the pure efficiency or small scale. The regression result of TOBIT showed that the government health expenditure increases 1 000 units, the efficiency of medical institutions will increase 0.0031. Conclusion: The relationship between the governmental expenditure and medical institutions is positive, but the technical efficiency of medical institutions expenditure was the result of multiple factors.

Objective To explore the effects of different degrees of hypoxia-ischemia(HI)on neuronal apoptosis and astrocyte proliferation in neonatal rats.Methods A total of 72 rat pups aged 7 days were randomly divided into 3 groups(n=24 each group):sham operated group,mild HI group,and severe HI group.The rats were subjected to right carotid artery occlusion and exposed to a hypoxic gas mixture (8% oxygen and 92% nitrogen)for 40 minutes at 34.5℃ in mild HI group and for 65 minutes at 35.5℃ in severe HI group.The expression of glial fibrillary acidic protein(GFAP)was detected by immunohistochemistry,and TUNEL method was performed to observe the proliferation of astrocytes and the neuronal apoptosis.Results Compared with sham operated group,the number of GFAP-positive cells signifiantly increased throughout the cortex and white matter in the ischemic hemisphere 48 hours(P＜0.01)and 1 week(P＜0.05)after mild HI,and in some areas the increase continued until week 4(P＜0.05).The number of GFAP-positive astrocytes in the cortex and white matter was signficantly higher in severe HI group than in mild HI group(P＜0.05)and sham operated group(P＜0.01)48 hours and 1 week after severe HI,but the increase was not detectable at week 4.Compared with sham operated group,the number of TUNEL-positive cells in the subcortical white matter in the ischemic hemisphere signficantly increased in mild HI group 48 hours,1 week,and 4 weeks following a mild HI insult(P＜0.05),but no signficant difference in the number of TUNEL-positive cells in the cortex was found.Following a severe HI insult,the number of TUNEL-positive cells in the cortex and white matter in the ischemic hemisphere significantly increased at 48 hours(P＜0.01),and in peri-infarct regions the number of TUNEL-positive cells increased until weeks 1 and 4(P＜0.05).Conclusion Mild HI causes neuronal apoptosis mainly in subcortical white matter and prolonged proliferation of astrocytes.Severe HI is associated with widespread neuronal apoptosis in the ischemic hemisphere,and the proliferation of astrocytes is rapid and prominent after severe HI.

The diagnostic criteria of lupus nephritis(LN) of children in China is the same as the foreign countries′.There is no consolidated therapy for LN.They treat LN patients with more kinds and dosage of drugs.The management of LN should be based on the clinical features,renal histology and the tolerance of the drugs of LN patients.

Objective To investigate the clinical curative effect of combined treatment of mometasone furoate nasal spray, loratadine, health education on children with allergic rhinitis and effects on IL-10 and IL-17. Methods 50 children with allergic rhinitis in our hospital from January 2015 to December 2016 were selected,and according to the different treatment methods divided into observation group and control group,25 cases in each groups.The control group were treated with loratadine, observation group with mometasone furoate nasal spray of loratadine + + health education treatment; we observed the two groups before and after treatment in children with nasal symptoms score, IL-10 and IL-17 and the incidence of adverse reactions, and the relevant data for comparative analysis. Results Mometasone furoate nasal spray of loratadine + + Health Education (observation group) the effect of treatment of children with allergic nasal is better than loratadine (control group) treatment, symptoms to improve the situation, IL-10 and IL-17 are better than the control group, the difference was statistically significant (P<0.05); two groups children with adverse reaction rate comparison, the difference was not statistically significant. Conclusion Children with allergic rhinitis selection of mometasone furoate nasal spray + loratadine + health education treatment effect significantly, can effectively improve the symptoms, IL-10 and IL-17, and will not increase the incidence of adverse reactions, it is worthy of clinical application.

As a safe and noninvasive therapy, repetitive transcranial magnetic stimulation (rTMS) and theta burst stimulation (TBS) are used to change the cortical excitability, and induce or enhance neural plasticity, which can promote the recovery of motor function after stroke. This paper summarized the individual treatment of rTMS on motor function of stroke patients, the advantages of TBS compared with rTMS, and the mechanisms and clinical application of TBS.

This article summarized the mechanism of traditional Chinese medicine treatment for lung cancer in recent years. Related literatures were from the immune regulation, inhibiting growth and metastasis of lung cancer cells and promoting apoptosis and reversing drug resistance. Review showed that traditional Chinese integrated with western medicine for lung cancer has gradually become the consensus of clinical practioners.