From ethics angle analysis of the characteristics of the doctor -patient contradiction in the new peri-od, clear the hospital party committee in the political core position in the construction of a harmonious doctor -pa-tient relationship , and puts forward play the ethical function of the hospital party committee in building a harmoni -ous doctor-patient relationship , finally summarize the hospital party committee in rebuilding the harmonious doctor-patient relationship specific ethical measures , including: strengthening the ethical and moral education , in -depth professional moral education; Hospital ethics committee , and actively promote ethical operation system; To improve medical environment , mobilize the enthusiasm of the party branch;And improve the mechanism of doctor-patient communication , to protect patients′right to know and privacy;The treatment medicine , commercial brib-ery letter-inquiring-and-accusing work mechanism .

Objective To explore the feasibility of He-Ne laser irradiation in promoting orthodontic tooth movement and periodontal remodeling through observing the effect of low power laser on the expression and distribution of matrix metalloproteinases- 9(MMP- 9) during orthodontic tooth movement in rabbit. Methods Thirty rabbits were divided into 1d,3d,5d,7d,14d and 21d groups, each group were given a coil spring connected to the maxillary upper first molar to the upper incisor and fixed bilaterally by a ligature wire and set force to 80g. He-Ne laser irradiation was performed on the right side of the orthodontic tooth, and the left side served as control. Radiation time ranged from 1 day to 5 days, once a day, 15min each time. All of the tissue sections were proceeded with MMP- 9 immunohistochemical staining. MMP- 9 average gray scale in periodontal tissue of the orthodontic teeth was analyzed by a Computer Image Analyzing System. Results The expression level of MMP- 9 increased earlier and lasted for a longer time in the compression and tension area on the side of irradiation by He-Ne laser as compared to those on the control side. There was significant difference between the irradiation side and the control side in terms of the MMP- 9 expression gray scale in the tension zones at 5 and 7 days post-operation, and in the pressure zones at 3,5,7 day post-operation. Conclusion During the movement of orthodontic teeth, local irradiation with He-Ne laser could increase the expression of MMP-9. It was suggested that the irradiation with low power laser accelerate blood vessel and bone remodeling.

Objective:This study aims to ensure the private hospitals development strategy in the background of new healthcare reform and put forward some scientific suggestions to help promote their sustainable development. Methods:The SWOT analysis method was adopted to analyze the private hospitals’ internal strength, weakness, exter-nal opportunity and threats. Results: The results showed a clear property right, advanced management system and other outstanding advantages in the private hospitals. Opportunities like the improved policy environment and people’s medical demand expansion are also very prominent. Meanwhile, the private hospitals development also faces some disadvantages and challenges such as illegal operation, disorder in the market competition, vague orientation, etc. Conclusions:It suggests the strengthening of the personnel and hospital culture construction, adoption of the differen-tiation strategy, improvement of the diagnosis and treatment ability, etc.

Objectives:This study aims to summarize the research progress of multiple-site physician practice to determine further research directions. Methods:Literature on Chinese multiple-site physician practice between 1949 and 2013 was obtained from CNKI, Wan fang database and CQVIP database, the annual volume distribution of se-lected documents was been described and the topics and content of literature cited at least once were summarized through literature content analysis. Results:The volume of literature increased rapidly from 2009, guided by related government policies. Content analysis is insufficient in the research areas of supporting policies, international experi-ences, relevant laws and empirical studies. Suggestions: Further research should focus on multiple-site physician practice policies themselves and supporting policy analysis, international comparisons of multiple-site physician prac-tice systems, studies into relevant laws and regulations and empirical studies based on quantitative methods.

Objective To find a selection method system appropriate for China's essential drug list.Methods Collection and analysis of technical paper literature on essential drug list developement,adjustment technical papers,and literature on evidence-based medicine,pharmacoeconomics evaluation,and medical insurance budget analysis from WHO and other countries.On such basis,a method system for selecting China's essential medicine list can be proposed,with its feasibility analyzed and demonstrated.Results The GRADE assessment proposed by WHO was used to evaluate the efficacy and safety of the drug;the pharmacy economics evaluation is added to assess the economic efficiency;these were aided by the pharmacoeconomics evaluation for a comprehensive evaluation of the pharmacoeconomics of the drug in question,supplementing analysis of the medical insurance,and ensuring its affordability of essential medicine so selected.The theory of this system is well developed,and supporting software ready for application.Examples in Zhejiang Province regarding essential medicine for diabetes have proved this method feasible.Data acquisition constitutes a major roadblock for scientific selection due to barriers against medical insurance data sharing.Conclusions Theoretic basis and method tools are fully available for essential medicine selection,and the selection method system as proposed in this study prove feasible to some extent.Decision makers are recommended to scientifically select the essential drugs,and to encourage data sharing,in order to make the list more scientific and pragmatic.

Objective To observe the effect of the optimized formulas of extracts of Radix Astragali and Radix Angelicae Sinensis on the survival status of the idiopathic pulmonary fibrosis (IPF) mice,and on the expression levels of transforming growth factor-β (TGF-β) and vascular endothelial growth factor(VEGF),so as to optimize the therapeutic regimen and to explore the therapeutic mechanism.Methods One hundred and five SPF ICR male mice were randomly divided into normal group,model group and 5 Chinese medicine treatment groups (group 1,2,3,4,5 of the optimized formula of Radix Astragali and Radix Angelicae Sinensis extracts).The mice in the model group and the 5 treatment groups were intratracheally injected with bleomycin (5 mg/kg) to induce the pulmonary fibrosis model.On day 21,the lung tissues were taken out for the test.Hydroxyproline content was detected by alkaline hydrolysis method,and morphological changes of lung tissues were observed by hematoxylineosin (HE) staining and Mallory's staining methods.The expression levels of TGF-β and VEGF were detected by polymerase chain reaction (PCR).Results The HE staining and Mallory's staining results showed that the pulmonary fibrosis in the 5 treatment groups was relieved as compared with that in the model group,especially in the group 1,and the alveolar structure recovered better.The 21-day overall death rate in the treatment groups were lower than those in the model group,and group 1 and group 5 had the lowest rates,the difference being statistically significant (P＜ 0.05).Compared with the model group,the content of hydroxyproline in the lung tissues of the treatment groups were decreased to some degrees,and there was significant difference (P ＜ 0.05 or P ＜ 0.01).The expression levels of TGF-β and VEGF in model group were higher than those in normal group,but were deceased in the treatment groups to some degrees,except TGF-β expression in group 5,and the difference was significant(P ＜ 0.05 or P ＜ 0.01).Conclusion When the contents of Radix Astragali water-extract and Radix Angelicae Sinensis alcohol-extract were predominated,the extract formula exerts certain effects on decreasing hydroxyproline content in the lung tissues,inhibiting the expression levels of TGF-β and VEGF,and relieving the degree of pulmonary fibrosis in IPF mice.

The experience of various countries proves that the hierarchical diagnosis and treatment model can lead to reasonable resources allocation and utilization, however, the waste of China''s disordered treatment model has not been estimated.Nowadays, it is very important to establish a hierarchical diagnosis and treatment system during China''s healthcare system reform.Therefore, it is necessary to estimate the benefit the reform may bring.We take Zhejiang Province as an example, and adopted the system dynamics model to build the health delivery system, to emulate the hierarchical diagnosis and treatment model and the disordered model, and to evaluate the benefit.Results showed that if first option at the primary health institutions increased 10%, it could save 0.251 billion yuan, and if increased 15%, it could save 0.39 billion yuan.If the first option at the primary health institution reached 72.35% and the treatment in county reached 90%, the outpatient in tertiary hospital could reduce by 13 million, and those in primary healthcare institutions could increase by 74 million yuan.The direct healthcare cost could reduce 3.016 billion Yuan.

Objective:This study aims to explore recent developments in DEA-based hospital efficiency studies in China, so as to provide reference for further research in DEA-based hospital efficiency. Methods:In this study, a 30-year retrospective systematic review is conducted for the classification of 85 hospital efficiency studies that have been published in China with DEA. The characteristics are summarized and compared with those of international liter-ature according to the selection of input and output indicators to evaluate the normalization of studies in China. Re-sults:The classification reveals several problems existing in DEA-based hospital efficiency studies in China, such as too few studies on hospital allocation efficiency, the application of simple classical models, imprecise selection of in-put-output indicators, inappropriate application of monetary variables as output indicators, etc. Conclusions and sug-gestions:The normalization and rationality of DEA methods applied in China’s hospital efficiency research need to be improved, so as to shorten the gap between China and the international world. Chinese researchers should pay more attention to studying the latest international research findings, so as to scientifically select input and output indicators. In depth analysis of methods and application conditions should be conducted so as to improve the normalization and science of China’s hospital efficiency research.

In this paper, an adaptive notch filter based on QRD-LS algorithm for power line interference in ECG is researched. It can automatically eliminate the power line interference in order to improve the signal-to-interference ratio. Furthermore, QLD-LS algorithm, which is recursive least-squares minimization using systolic arrays, is employed to adjust the weight vector. Compared with the adaptive notch filter based on LMS (least mean square) algorithm, it has good robustness. Simulation examples confirm the results. QRD-LS adaptive notch filter has better performance in comparison with LMS method.
Algorithms ; Artifacts ; Electrocardiography ; methods ; Humans ; Signal Processing, Computer-Assisted ; instrumentation

Objective:With Diagnosis related groups(DRG)indicator introduced into the hospital efficiency evaluation, to analyze the adjustment effect of DRG on the efficiency value, and to compare the similarities and differences between the DEA efficiency value and the DRG efficiency indicator.Methods:The DRG pilot data in 2017 and 2018 of tertiary hospitals in Hubei province and related data from other reports were collected. Indicators including the actual number of beds, the number of employees, the actual total bed days occupied, and medical income were used as input indicators, and total admissions, number of discharges, weight of DRG and number of DRG groups were used as output indicators. 7 models were constructed using different indicator combinations. The efficiency of the hospital was calculated by the Bootstrap-DEA efficiency evaluation method. The relationship between hospital attributes and efficiency was analyzed by a generalized linear model.Results:There was an abnormal phenomenon that the higher the hospital level, the lower the efficiency in the efficiency value calculated by the traditional method. The efficiency values of county hospitals, city hospitals and provincial hospitals were 0.83, 0.74 and 0.71, respectively( P<0.01). DRG weight and group number were used as output for DEA analysis, and the efficiency values of county hospitals, city hospitals, and provincial hospitals were 0.95, 0.95 and 0.96( P=0.20)respectively. The DRG efficiency indications of county hospitals, city hospitals and provincial hospitals were 1.42, 1.11, 1.00 respectively( P<0.01). The higher the level, the lower the efficiency, while the efficiency values calculated by DEA were 0.84, 0.82, 0.86, respectively( P=0.58). Conclusions:The efficiency value calculated by the traditional method presents a systematic bias, which could be corrected effectively when DEA analysis using DRG weights is used as output indicator. The results developed new ideas of efficiency analysis for hospitals practicing DRG management.