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.

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.

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 .

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.

Objective To explore the effect and safety of ice compress combined with early walking training on postoperative rehabilitation in patients with total hip arthroplasty (THA) without drainage. Methods Totally 84 THA patients from Zhejiang Provincial People′s Hospital were recruited in this study during April 2015 to March 2016 by using purposive sampling method. According to the random number table (i.e. hospital ID),the participants were divided into the intervention group (n=42) and the control group (n=42). Patients in the control group received drainage tubes after THA,and started walking training after removing the tubes. However,patients in the intervention group didn′t receive drainage tubes after THA but received ice compress,and started walking training within 24 hours after surgery. The postoperative complications,the pain, swelling degree,hemoglobin change,time of recoving independent walking,activities of daily living (ADL),and average inpatient days of patients in two groups were observed and compared.Results The pain scores within 24 hours and 25-48 hours after surgery for the intervention group were (2.38±1.13) and (1.90±1.06),which were lower than the scores [(3.26±1.38) and (2.41±1.0)] for the control group (t=3.283,2.487;P<0.05). But the pain scores 49-72 hours after surgery had no statistical differences between two groups (t=-1.185;P>0.05). Similarly,there were no differences between two groups in wound swelling and hemoglobin change (t=-1.221,-0.294;P>0.05). The ADL scores one week and two weeks after THA surgery for the intervention group were (70.12±9.96) and (75.00±7.89),which were higher than the scores [(64.52±9.9) and (70.21±9.3)] for the control group (t=2.577,2.588;P<0.05). While the ADL scores that one month after surgery had no statistical differences between two groups (t=-1.185,P>0.05). The time of recoving independent walking in the control group was longer than that in the intervention group [(3.71±1.59) d vs (5.20±2.03) d;t= -3.848;P<0.05]. The average hospitalization time in the intervention group was shorter than that in the control group [(9.29±4.03) d vs (11.07±3.28) d;(t=2.283;P<0.05)]. No complications (e.g. dislocation,infection,and symptomatic deep venous thrombosis) were observed after three months′ follow-up.Conclusions The ice compress combined with early walking training is beneficial for postoperative rehabilitation in THA patients without drainage. It can improve patients′ independent walking function and self-care ability and can accelerate the rehabilitation process.

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.

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.

Emaciation is a common physical condition in clinical practice,often accompanied by symptoms related to"excessive fire in thin people".Insufficient yin-qi is the main physiological and pathological basis of emaciation,and excessive dryness-heat is the secondary manifestation.The disease involves five viscera,with the spleen as the core.The principle of treatment is to nourish yin-qi as the main method,and to dissipate stagnant heat as the auxiliary method.Specifically,it includes two aspects:treating the root cause and treating the symptoms.Treating the root cause should nourish yin-qi to improve the"emaciation"constitution,and treating the symptoms should dissipate stagnant heat to eliminate the"excessive fire"state.The importance of the two should be determined ac-cording to the severity and urgency of the excessive fire.Clinically,the addition and subtraction of medicinal ingredients are made ac-cording to factors such as the urgency of the root cause and symptoms,the state of emaciation and the ability to eat,the degree of defi-ciency or excess of fire-heat,the pathogenesis of the disease,and the season.