Objective To quantify the right ventricular (RV) function in patients with left heart disease (LHD) related pulmonary hypertension (PH) by two-dimensional speckle tracking imaging (2D-STI),and explore its potential value in diagnosis of reactive PH.Methods Forty healthy volunteers and 65 patients with LHD related PH were enrolled.PH patients were further divided into two subgroups according to pulmonary vascular resistance(PVR):passive PH group and reactive PH group.A complete 2D-STI derived longitudinal strain of RV free wall was performed,and the basal,middle,apical longitudinal peak systolic strain (LS) and RV free wall global LS (RVLSbas,RVLSmid,RVLSapi and RVLSfw) were measured.Results Compared to control group,RVLSbas and RVLSfw in reactive PH group decreased significantly (all P ＜0.05).Compared to passive PH group,RVLSbas and RVLSfw in patients with reactive PH decreased significantly (all P ＜0.05).The differences of RVLSbas and RVLSfw between control group and passive PH group had no statistical significance (all P ＞0.05).No significant differences in etiology and left ventricular ejection fraction (LVEF) were observed between PH subgroups (all P ＞0.05).The area under the ROC curve of RVLSbas in predicting reactive PH was 0.93,the cut-off value was-21.86,and the sensitivity and specificity were 83 ％ and 89 ％,respectively.The area under the ROC curve of RVLSfw was 0.79,the cut-off value was-13.84,and the sensitivity and specificity were 59％ and 89％,respectively.Conclusions 2D-STI can realize quantitative assessment of RV function in patients with LHD related PH.RVLSbas and RVLSfw may have important clinical value in diagnosing patients with reactive PH,and differential diagnosis value between patients with passive PH and patients with reactive PH.

Objective To intelligently adjust the driving force of a remote-controlled drug delivery capsule based on the postural information in intestines,so as to achieve the control of speed and dosage of drug delivery and reduce the energy consuming.Methods A six-axis sensor MPU6050 was used,and its Z axis was coincident with the central axis of the drug delivery capsule so as to made the medicine discharge port pointing to the Z direction.The angular velocities and accelerations of X,Y,Z axes were monitored,transformed to quaternion with built-in digital motion processor,and then converted to Euler angle form.The intelligence adjustment of driving force could be achieved by accessing the real-time attitude angle of the capsule.Results The results of experiments showed that the error between the actual and the attitude angle measured by the sensor was less 1°.Conclusions The intelligent adjustment scheme of driving force of a gastrointestinal remote-controlled drug delivery capsule was designed.The real-time attitude angles of the capsule could be obtained with high spped and precision.This study can provide the theoretical and experimental basis for the intelligent adjustment of the driving force.

AIM:To investigate the effects of eplerenone (Epl) on thyroid hormone (T3) induced myocardial electrical remodeling .METHODS:The ventricles of 1~3 d neonatal rats were digested with 0.125%trypsin and 0.08%collagenase type 2.The cell suspension was replated for 90 min to reduce the proportion of non-myocardial cells.The isola-ted cardiomyocytes were randomly divided into control group , T3 group, Epl group and T3+Epl group.The cardiomyocytes were identified by immunofluorescence staining .The viability of the cardiomyocytes was measured by CCK-8 assay.The ex-pression of Kv1.5, Kv4.3, Cav1.2, connexin 40 (Cx40) and Cx43 at mRNA and protein levels was determined by immu-nofluorescence staining , real-time PCR and Western blot .RESULTS:The results of the cell immunofluorescence labeling conformed that the cultured cells were cardiomyocytes with more than 95%positive staining of sarcomeric α-actinin.Com-pared with control group , the mRNA and protein levels of Kv1.5, Kv4.3, Cav1.2 and Cx40 were increased, but the ex-pression of Cx43 was decreased in T3 group.The mRNA and protein levels of Kv1.5, Kv4.3, Cav1.2 and Cx40 were de-creased, but the expression of Cx43 was increased in Eplerenone group .Compared with T3 group, the mRNA and protein expression levels of Kv1.5, Kv4.3, Cav1.2 and Cx40 were decreased, but the expression of Cx43 was increased in T3+Epl group.CONCLUSION:Eplerenone partly reverses T3-induced myocardial electrical remodeling .

This study was aimed to screen antibacterial agents against 9 pathogenic bacteria from 240 extracts of 60 traditional Chinese medicinals ( TCM ) . And the minimum inhibitory concentration ( MIC ) test was applied on extracts with positive results. The disk diffusion was employed to screen the antibacterial activity preliminar-ily among 240 extracts. The MICs of active extracts were tested by liquid culture method (double dilution method). The results revealed that 104 extracts show antibacterial activity on one or more strains, 20 of them show strong inhibition on three commonly seen bacteria ( MIC < 0 . 2 mg/mL ) . It was concluded that ethanol , acetone and hexane extracts of 11 TCMs including Salvia miltiorrhiza, Cnidium monnieri, Polygonum tinctorium, Taraxacum mongolicum, Morus alba, Glycyrrhiza uralensis, Curcuma longa, Arnebia euchroma, Lobelia chinen-sis , Chrysanthemum indicum and Buddleja officinalis show strong inhibition on Bacillus subtilis , Bacillus cereus , Staphylococcus aureus .

Medical insurance system plays a key role in China's social security system.In the social insurance system,medical insurance features the widest coverage and the most complex in mechanism,while China' s medical insurance system itself is found with many setbacks.This paper probed into such risks found in the county-level medical insurance system as excessive cost growth causing overpayment of the medical insurance fund and poor supervision of the fund.On such basis,the authors recommended such policy changes as payment reform,and enhanced supervision over the fund,the demand side,and the government,in an effort to optimize China' s medical insurance system for theoretical and decision reference of other county-level hospitals in their reforms.

Objective: To investigate the prevalence and influencing factors of chronic diseases among adult residents in Hunan Province, so as to provide insights into management of chronic diseases. Methods: Permanent residents at ages of 18 years and older were sampled using a multi-stage random sampling method in Hunan Province from April to June, 2021, and participants' demographics, smoking, alcohol consumption, sleep quality and development of chronic diseases were collected using questionnaire surveys. The prevalence of chronic diseases was estimated and standardized by the seventh national population census data. In addition, the factors affecting the prevalence of chronic diseases were identified using a multivariable logistic regression model. Results: A total of qualified 9 469 adult residents were enrolled, including 4 678 men (49.40%) and 4 791 women (50.60%), with a mean age of (59.37±14.14) years. The overall prevalence and standardized prevalence rates of chronic diseases were 50.84% and 38.44%, respectively, and the prevalence and standardized prevalence rates of hypertension, protrusion of intervertebral disc and diabetes were 18.66% and 15.06%, 6.31% and 5.28%, and 4.44% and 4.18%, respectively. Multivariable logistic regression analysis revealed that women (OR=1.252, 95%CI: 1.131-1.386), age (45 years-, OR=3.699, 95%CI: 3.104-4.407; 60 years and older, OR=9.255, 95%CI: 7.743-11.064), unmarried/divorced/widowed (OR=1.170, 95%CI: 1.036-1.321), educational level (junior high school, OR=0.730, 95%CI: 0.653-0.816; high school/technical secondary school, OR=0.710, 95%CI: 0.609-0.827; diploma and above, OR=0.586, 95%CI: 0.454-0.758), monthly household income (3 000 yuan-, OR=0.846, 95%CI: 0.759-0.943; 6 000 yuan-, OR=0.819, 95%CI: 0.710-0.943; 10 000 yuan and higher, OR=0.790, 95%CI: 0.657-0.950), smoking (OR=1.528, 95%CI: 1.363-1.713), insomnia (OR=2.637, 95%CI: 2.271-3.063) statistically correlated with the development of chronic diseases. Conclusion The prevalence of chronic diseases was 50.84% among adult residents in Hunan Province in 2021, and hypertension was the predominant chronic disease. Women, the middle-aged and elderly residents, residents with a low educational level and residents with low incomes are at a high risk of developing chronic diseases.

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 observe and evaluate the clinical efficacy and safety of Xiaoerzhili syrup in attention deficit/hyperactivity disorder(ADHD) in children.Methods This study was performed by a multicenter self-controlled clinical observation trial.A total of 1 833 children with ADHD selected from 18 clinical centers from June 2013 to December 2015 were treated by Xiaoerzhili syrup for 6 months,and the clinical efficacy and safety were evaluated.Chinese Version of ADHD Rating Scale-Ⅳ-Parent(ADHDRS-Ⅳ-P) and Clinical Global Impression (CGI) were used to evaluate the clinical efficacy,and the registration form of side reaction and the questionnaire of drug safety grade were used to assess the safety.Results Compared with the scores before treatment,the total scores of ADHDRS-Ⅳ-P,attention deficit subscale scores and hyperactivity impulsivity subscale scores decreased with statistically significant differences after treatment with Xiaoerzhili syrup in the total ADHD group,male ADHD group,female ADHD group,mild ADHD group,moderate ADHD group and severe ADHD group(all P ＜0.01).The statistically significant differences in the total scores of ADHDRS-Ⅳ-P,attention deficit subscale score and hyperactivity impulsivity subscale scores were not found in different gender before and after treatment (all P ＞ 0.05).According to the results of CGI-Ⅰ,the proportion of "improved obviously" and above were 80.98％ (1 379 cases),79.95％ (1 089 cases) and 85.05％ (290 cases),in the total poptlation group,male group and female group,respectively.The side effects of drugs were found in six male cases.After treatment,safety problems were not found in the analysis of the safety evaluation.Conclusion Xiaoerzhili syrup treatment is effective in children with ADHD treatment,and security problems are not found.

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.

Animals ; Cell Adhesion Molecules ; metabolism ; Colonic Neoplasms ; pathology ; Female ; Humans ; Liver Neoplasms ; secondary ; Protein-Serine-Threonine Kinases ; Proto-Oncogene Proteins ; metabolism