Lung cancer, as the highest incidence and mortality in the world, has become a majorkiller of human health. Most patients received chemotherapy to alleviate symptoms and prolong life when they are in the middle and advanced stage of lung cancer. The supplementing Qi and activating blood circulation method of traditional Chinese medicine maybe the breakthrough point for lung cancer. Thus, this paper reviewed the clincial research on the single agent, compound and Chinese patent medicine, which relected the meaning of upplementing Qi and activating blood circulation, for bone marrow suppression caused by lung cancer chemotherapy.

Objective To investigate the psychological experiences of young uremic patients during different periods waiting for renal donor .Methods The phenomenology study method was adopted to conduct the semi-structure interviews in young uremic patients waiting for renal donor .Results The four themes were summarized:(1) having hope at the early stage (0—6 months);(2) ineffective coping at the middle stage(7—12 months);(3)uncertainty at the late stage(13—24 months);(4)serious negative emo-tion(more than 2 years) .Conclusion The young uremic patients patients waiting for renal donors have complex and changeable psychological experience .Medical staff should provide the pertinent professional support for promoting the living quality of patients by aiming at the psychological characteristics in young uremic patients .

Internct has provided abundant resources for teaching,but it also brings two challenges,information overload and knowledge fragmentation.Under the environment of Internct,only by efficient course designs,can teachers deal with these two new challenges,and attract students' attentions and motivate their learning interests.Among teaching designs,the design of teaching ‘opening speech’ is quite important.During the course construction of Epidemiology in China Medical University,design strategies on opening speech were explored;the principles of opening speech design were determined.And the opening speeches were designed and cumulated for the teaching modules of Epidemiology.Furthermore,the skills of opening speech design were summarized.

Objective To study the acute toxicity of ginkgolic acids from Ginkgo biloba sarcotestas against fish.Methods The ginkgolic acid mixture was obtained from Ginkgo biloba sarcotestas.The acute toxicities of the ginkgolic acid mixture against the fry of Cyprinus carpio var.and fry of Carassius auratus were detected.Results LC50 and LC90 of the ginkgolic acid mixture against the fry of Cyprinus carpio var.were 1.805 mg/L and 2.191 mg/L,respectively.LC50 and LC90 of the ginkgolic acid mixture against the fry of Carassius auratus were 1.930 mg/L and 2.217 mg/L,respectively.Conclusions The toxicity of ginkgolic acids against the fry of Cyprinus carpio var.and fry of Carassius auratus is medium.

Objective:The paper aims at developing a method of defining and visualizing the scope of the basic medical insurance pharmacy service, and provides a new way of thinking for the designated pharmacy planning. Methods:Collecting the basic data and information on administrative divisions in the planning area taking equity and efficiency as the guidance, using ArcGIS and its function modules to define and visualize the scope of the medical in-surance pharmacy service. The procedure of issue focus, method improvement, data simulation, expert consultation, methodology perfecting were followed to define and visualize the scope. Results:Forming a whole set of operative pro-cedures of defining and visualizing the scope of the medical insurance pharmacy service based on medical resources allocation standard, and the operation commands and procedures in ArcGIS were clarified. Conclusion:Operating ac-cording to the appropriate method steps, the following can be achieved:(1) The adjacent scope of medical insurance pharmacy service are adjacent to each other but do not overlap or cross;(2) Spatial relations can be clearly and ef-fectively expressed;(3) The shape is flat and regular;(4) The data collected at different times can be comparable in space, providing good prerequisites for medical insurance designated pharmacy planning.

Objective To objectively study the current progress of China Healthcare Improvement Initiative, and its effectiveness and shortcomings for further improvement. Methods Questionnaires were customized by expert consultation and pre-investigation, and distributed by the National Health Commission in April 2018 to the hospitals.Data of 5 469 hospitals were recovered and analyzed with a statistics software for descriptive analysis.Results Implementation progress of the five working systems varied with regions, and rooms of improvement were found in such aspects as outpatient appointment, clinical pathway management and social work system.In 2017, the proportion of outpatient appointments of 5 469 hospitals averaged 19.1%.Progress of the ten major service models also varied, as defects were found in such service models as continuous medical service, intelligent service, and interconnection service.In 2017, only 6.7% of the 5 469 hospitals had put in place hierarchical integrated clinical pathways within their medical alliances.Conclusions Improvement of the medical services calls for not only the efforts of medical institutions themselves, but also top-level design by the local health authorities. In particular, an online information platform should be established for the whole region, to unify the information standards and processes, and corresponding mechanisms and system support are needed.

Walking disorder is the most common sequela in patients with hemiplegia after stroke.More than half of stroke patients can not walk independently after discharge,and still present a gait asymmetry and slow pace,and other abnormalities.Then,the fall risk is increased.With security concerns,patients are more afraid to walk independently and can not complete the walk in community environment.Therefore,gait rehabilitation is considered as the main goal of stroke rehabilitation.Rhythmic auditory stimulation(RAS)is a new rehabilitation method to improve stroke gait.By elucidating the mechanism of RAS and their effects on stroke gait,the aim of this paper is to explore the effective RAS treatment method for hemiplegic patients,so that RAS is not only used in gait training,but also in real-time assessment of gait in any environment for chronic stroke patients.

Objective:To analyze the efficacy and relevant indicators of efficacy prediction of immunosuppre-ssive therapy (IST) that was composed of rabbit anti-human thymocyte immunoglobulin (rATG) and cyclosporine A (CsA) to treat acquired aplastic anemia (AA) in children.Methods:Retrospective analysis of the clinical data from 89 cases of children who were diagnosed with acquired AA and applied IST in Children′s Hospital of the First Affiliated Hospital of Zhengzhou University from January 1, 2012 to November 30, 2016 were collected.Patients were followed up for 2 years.Clinical features, curative effect and relevant indicators of efficacy prediction were analyzed retrospectively.Results:Among the 89 children with acquired AA, there were 27 cases of very severe AA(vSAA), 48 cases of severe AA(SAA) and 14 cases of transfusion-dependent non-severe AA(NSAA), with the median age of 7 years old.There was no significant difference in the curative effect among vSAA, SAA and transfusion dependent NSAA at different follow-up time nodes ( P>0.05). The recurrence rate of acquired AA was 4.49%(4/89 cases) and the median recurrence time was 18 months.The clonal evolution of acquired AA was 2.24%(2/89 cases). In multi-factor analysis, at the 6 th month of IST treatment, the newly diagnosed children displayed increased CD4 +/CD8 + ratio and early treatment response to granulocyte colony stimulating factor (G-CSF), indicating that the children responded well to the treatment of IST. Conclusions:Combined with CsA, the IST of rATG is a safe and effective method for the treatment of acquired AA in children.The higher CD4 +/CD8 + ratio and early treatment response of G-CSF are good predictors of treatment response to immunosuppressive therapy at 6 months, respectively.

Objective:To develop a verification platform based on Monte Carlo (MC) for independent dose verification of volumetric modulated arc therapy (VMAT) plans.Methods:The head model including collimator of Varian TrueBeam linear accelerator was constructed by using EGSnrc/BEAMnrc, and the independent dose verification platform for the patients’ VMAT plans was built based on the head model and an in-house code. The percent depth dose (PDD) curves and off-axis ratios for different field sizes, the dose distribution of two irregular fields and three VMAT plans of the head and neck, chest, and pelvis were simulated using the platform. The simulated results of the PDD curves and the off-axis ratios of different field sizes were compared with the blue water measurement results. The difference between the irregular fields and the actual ArcCHECK measurements was also investigated. Besides, the differences among the MC simulated dose, TPS calculated dose and the ArcCHECK measured dose were analyzed by several methods, such as γ analysis and dose-volume histogram to verify whether the platform could be independently employed for dose verification.Results:The MC simulated results of PDD curves and off-axis ratios from 4 cm×4 cm to 40 cm×40 cm were in good agreement with the measured results. And the γ passing rates between the MC simulation and the ArcCHECK measurement for the irregular fields were above 98.1% and 99.1% for 3%/2 mm and 3%/3 mm, respectively. For VMAT plans of three patients, the γ results between the MC simulated dose and ArcCHECK measured dose were better than 93.8% and 95.9% under the criteria of 3%/2 mm and 3%/3 mm respectively. At the same time, the γ passing rates of nasopharyngeal, lung, and rectal cancers were 95.2%, 98.6% and 98.9% based on 3D γ analysis using TPS calculated dose and MC simulated dose under the criteria of 3%/3 mm; the passing rates of these three were 90.3%, 95.1% and 96.7% for 3%/2 mm, respectively.Conclusions:The simulation results of the MC-based verification platform developed in this study show a good agreement with the actual measurement results, and the simulation results are closer to the real dose distribution using the patients’ data. The preliminary results demonstrate that the platform can be used for accurate independent dose verification of VMAT plans.

OBJECTIVE:To explore losses and gains (L&G) and L&G ratio induced by Essential Medicine System in a county. METHODS:By choosing a county in western China as sample area,field investigation was used to collect outpatient and inpatient visits,outpatient and inpatient income,drug income,total length of stay and medical insurance reimbursement criteria in primary medical institutions (township health centers,village health rooms) of the county during 2009-2015. By setting the year 2009 as the baseline year,the drug cost reimbursed by medical insurance was simulated and calculated when Essential Medicine System were not implemented;L&G and L&G ratio of medical insurance were calculated by comparing with actual drug cost reimbursed by medical insurance. RESULTS:The year 2012,in which the sample county fully implemented the Essential Medicine System was the turning year. Medical insurance funds lost in primary medical institutions of the county during 2010-2011(lost 437000,915000 yuan,respectively),but gained during 2012 to 2015(gained 199000,494000,858000,1290000 yuan, respectively);the L&G ratio increased from -0.67％ to 1.21％. For reimbursed outpatient drug cost and inpatient cost,L&G of medical insurance were different. For reimbursed drug cost of village health room and township health center,L&G of medical insurance were also different. CONCLUSIONS:The implementation of Essential Medicine System benefits to medical insurance within the county and Medical insurance funds can be saved.