Objective To investigate the clinical feature,diagnosis and therapy of isolated Langerhans cell histiocytosis(histiocytosis X) with unusual localization.Methods A case of isolated Langerhans cell histiocytosis of the infundibulum was reported.The endocrinic tests,imaging,immunohistochemical and pathological examinations of this case were detected.Through literature review,the pathological and clinical feature,diagnosis,therapy of isolated Langerhans cell histiocytosis of the infundibulum were overviewed.Results Magnetic resonance imaging(MRI) of the brain showed a 9 mm homogeneously enhancing mass in the region of the infundibulum.No other lesion was found in other organ systems.The patient underwent an occupying lesion resection of the infundibulum via right pterion approach.Langerhans cell histiocytosis was diagnosed through pathologic analysis.She was on hormone replacement therapy and close follow-up visit postoperatively.Conclusion Isolated Langerhans cell histiocytosis of the infundibulum in adult is extremely rare.Understanding of this disease should be improved to avert misdiagnosing.

Achieving the millennium development goals and world peace and development are closely linked objectives, and WHO having been made great achievements and progress in the health sector through its related ob -jectives.All health-related millennium development goals such as maternal and child health , HIV/AIDS prevention and control , malaria and tuberculosis , safe drinking water and sanitation , and foreign medical assistance had been basically reached in China .This success was mainly due to the government attention and commitment , legal protec-tion, health information technology-informatization, effective projects and measures , but there are still differences in health status between regions and population groups , and increasing needs of health services quality improvement and chronic diseases control and prevention should be paid great attention in the future .

Data mining technology is called into play to comb and excavate data in the hospital information system(HIS)for the purposes of hospital management and patient safety.Data tables in the electronic medical record system were effectively remodeled as necessary.These measures help build a medical quality surveillance system which is based on the electronic medical record system,with such functions as real-time monitoring and pre-warning.The control framework consists the critical cases control system,surgery and invasive operation control system,overall control system,and TCM strengths application control system.

Objective To explore the clinical value of real‐time elastography in evaluating rabbit carotid vulnerable plaque . Methods Thirty male New Zealand rabbits ( weighted from 2 .0 to 3 .0 kg) were all fed with high cholesterol diet for one week before balloon injury of their right common carotid arteries . Then they were categorized randomly into two groups which were continued fed by high cholesterol diet for 6 and 12 weeks ,respectively . Ultrasound and real‐time elastography of their right common carotid arteries were applied after their anesthesia by ear marginal vein . Strains of the carotid plaques were measured and analyzed statistically by two independent experienced sonographers . All the rabbits were sacrificed by air embolism method after all the examinations . The atherosclerotic rabbit common carotid lesions were dissected ,fixed for pathologic examination , and graded according to the standard of American Heart Association ( AHA) ,which were compared with the real‐time elastography findings . Results Real‐time elastography had well repeatability between different operators . Consistency between elastography and the AHA pathology was quite good ,with the Cohen′s kappa= 0 .803 (95% CI 0 .669 to 0 .938) . Strains of different regions in a plaque had statistically significant difference ( P <0 .000 1) . By using strain higher than 0 .37% ,the sensitivity and specificity of detecting a lipid core were 88 .0% and 81 .6% ,and area under ROC curve was 0 .902 (95% CI 0 .810 -0 .959 , P < 0 .0001) . Conclusions Real‐time elastography can display the inner elastic characteristics of the rabbit carotid plaques ,and may help evaluate the grading of a plaque . The strain value may help detect a necrotic core ,thereby help evaluate the stability of a plaque .

We analyzed the data of application and funding projects of the National Natural Science Foundation of China (NSFC) during 2010-2016 in the field of burns and plastic surgery and summarized the NSFC funding pattern, the research hotspots, and weaknesses in this field. The NSFC has funded 460 projects in the field of burns and plastic surgery, with total funding of RMB 227.96 million. The scientific issues involved in the funding projects include orthotherapy against malformations, wound repair, basic research of burns, skin grafting, scars prevention, and regeneration of hair follicle and sweat glands. The research techniques involved in the funding projects are diversified. NSFC plays an important role in the scientific research and talents training in the field of burns and plastic surgery.

Objective:To evaluate and compare the inpatient medical services of secondary public and private general hospitals by using disease risk adjustment model, and to explore the application of disease risk adjustment model in medical service evaluation of different ownership hospitals.Methods:Based on 1 032 865 front pages of medical records in Chengdu in 2017 and 2018, a regression model with mortality, average length of stay, total hospitalization expenses, medical service fees, drug costs and surgical consumables costs as dependent variables and related influencing factors as independent variables was established by using disease management intelligent analytic and evaluation system. The risk adjusted case mix index(ACMI) was calculated. The mortality, average length of stay, hospitalization expenses and other indicators were predicted. The ratio of observed value to expected value(O/E value) of each index in public and private secondary general hospitals was obtained and compared.Results:The ACMI value of secondary public general hospital was 4.63, slightly higher than that of private hospitals(4.55). The technical difficulty and resource consumption of the public hospitals were slightly higher than that of the private hospitals.From the O/E value, the management of disease mortality, medical service fees and inpatient drug costs of secondary public hospitals was generally good, and the O/E values of hospitalization expenses of each secondary private general hospital were quite different, and there was a possibility that the costs were unreasonable. The O/E value of surgical consumables cost in secondary public general hospital was 1.54, and there was room for improvement in cost management.Conclusions:The disease risk adjustment model fully considers the characteristics of different types and severity of diseases in different institutions, which can not be simply compared. Based on individual cases, it realizes the comparability of different ownership hospitals, and provides a new means for the evaluation of medical service ability and quality.

This paper summarized Professor ZHOU Zhongying's experience in differentiating and treating hepatitis and liver cirrhosis from deficiency and excess. It is considered that the pathogenesis of hepatitis and liver cirrhosis belongs to deficiency in root and excess in branch， with depletion of liver， spleen and kidney as the root， and constraint and bind of damp-heat and stasis toxin as the branch. Moreover， mutual cause and promotion between deficiency and excess leads to the disease. For general principle of treatment， it is recommended to clear and transform pathogenic excess， supplement deficiency and rectify the healthy qi. In the early stage of hepatitis and cirrhosis， excess pathogen hyperactivity is the main manifestation， which can be treated by clearing and transforming damp-heat and stasis toxin， supplemented by regulating spleen and stomach， with modified Yinchenhao Decoction （茵陈蒿汤） and Biejiajian Pill （鳖甲煎丸）. In the middle and late stages， cases with deficiency-excess complex were more common， which should be treated by clearing damp-heat and stasis toxin， regulating and supplementing liver-spleen-kidney， using medicinals with the function of clearing heat and dispelling damp， dissolving stasis and resolving toxins to treat the branch. Moreover， Liujunzi Decoction （六君子汤）， Yiguan Decoction （一贯煎）plus Erzhi Pill （二至丸） and Buzhong Yiqi Decoction （补中益气汤） modifications are suggested respectively in correspondence to the different kinds of root deficiency including irregular liver and spleen， liver and kidney yin deficiency， and liver-spleen-kidney deficiency.

Objective To explore the iodine nutritional status of all people after the practice of new standard of edible iodized salt, to assess whether the new standard of edible iodized salt can satisfy the iodine nutrition need in different populations, and to provide a scientific basis for supplementation of iodine. Methods Before and after the implementation of new salt iodine concentration, in 2009 and 2015, a contrastive study was performed in 1 243 people(including 402 children aged 8 to 10 years,408 adults aged 18 to 45 years,211 pregnant women and 222 lactating women) who lived in urban and rural areas of Wuwei City. Random urine samples were collected to measure the urinary iodine in all populations and household salt samples were collected. Urinary iodine was detected by arsenic cerium catalytic spectrophotometry(WS/T 107-2006).The iodine level in salt was determined by direct titration(GB/T 13025.7-2012).Results Before and after the implementation of new iodine salt standard, the coverage of adequately iodized salt was consistently higher than 94%, the qualified rate of iodized salt was consistently higher than 96%,the median of iodized salt was reduced from 31.0 mg/kg to 26.9 mg/kg;the medians of urinary iodine of children aged 8 to 10 years, adults, pregnant and breastfeeding women were reduced from 290.84, 225.52,200.42 and 180.65 μg/L to 187.37,174.96,159.99 and 152.88 μg/L;the ratios of urinary iodine which was less than 100 μg/L in children aged 8 to 10 years, adults and breastfeeding women were risen from 5.15% (10/194), 12.57% (24/191) and 16.19% (17/105) to 10.58% (22/208), 15.81% (34/215) and 33.33% (39/117); the ratio of urinary iodine which was less than 150 μg/L in pregnant women was risen from 39.78%(37/93)to 43.22%(51/118);the ratios of urinary iodine between 100 and 200 μg/L in children aged 8 to 10 years and adults were risen from 15.46% (30/194) and 30.37% (58/191) to 44.23% (92/208) and 43.26% (93/215); the ratios of urinary iodine greater than 300 μg/L in children aged 8 - 10, adults, pregnant and breastfeeding women were reduced from 47.94%(93/194),34.55%(66/191),29.76%(26/93)and 28.57% (30/105) to 17.31% (36/208), 19.07% (41/215), 16.95% (20/118) and 11.97% (14/117). Conclusion After the implementation of new salt iodine concentration standard,the iodine nutrition level has decreased in all groups and better suited for children aged 8 to 10 years and adults,but the risk of iodine deficiency is increased in pregnant and breastfeeding women.

Objective: To study new ways and tools for assessing the inpatient disease management and improving refined management of the hospital. Methods: By using homepages of medical records of the patients discharged from 21 tertiary general hospitals in a city in 2016, we completed the modeling and predicted value calculation within each DRGs with the Disease Management Intelligent Analytic & Evaluation System (DMIAES System). Results: 2 192 predication models were built, to compute the theoretic values of the mortality rate, length of stay, medical fee, medical service fee, and drug cost of each inpatient. Such values were compared with the observed results to gain the O/E index. If O/E is less than 1, it indicates that the inpatient′s disease management is good and better than expected. On the other hand, O/E index greater than 1 indicates poorer disease management than expected and rooms of further improvement. With the help of O/E index, we made multidimensional comparisons assessment and analysis of different hospitals, clinical disciplines, diseases and doctors. Conclusions The DMIAES System can take risk factors of inpatients′ outcomes into account, assessing the major indicators of inpatient outcomes by means of big data and modelling. This approach proves effective in enabling administrators and doctors to rapidly analyze problems for identifying solutions and enhancing management, thus having great potential in hospital management, supervision and assessment.