Objective To find out about the financing mix of various hospitals and the changes in effects in the period of economic transition. Methods An investigation was made into the employment of funds and the efficiency and performance of 45 hospitals in the two provinces of Shandong and Henan by means of sampling and review. Results From 1987 to 1999, the proportion of government subsidies in the total income of each of the 45 hospitals was on the decrease, with that in hospitals at the county level and above dropping on the average from 24 7% to 8 0%, while the proportion of patients payments and income from pharmaceuticals was on the increase. At the same time, the productivity and social efficiency of the 45 hospitals all showed a tendency towards decrease. Except for township public health centers, hospitals of the other three kinds all witnessed an increase in their economic vitality. Conclusion Patients payments and income from pharmaceuticals have become the main sources of hospital financing. While attention ought to be paid to economic benefits, it is imperative to properly readjust health policies and improve the productivity of hospitals and the social efficiency of health services.

Objective To study comprehensive nursing meassures for small area of diabetic foot ulcer. Methods A total of 58 patients with small area of diabetic foot ulcer in our department were divided into two groups.The comprehensive nursing group (CN group,30 cases) adopted comprehensive nursing and treatment as follows, surgical dcbridement, infrared radiation of wound surface,sprinkling of growth factors(bFGF and rhEGF),covered by hydrocolloid dressing(Algoplaque).The control group(28cases) received hydropathic compress with 0.5% povidone iodine or 5% furacillin solution.Wound heal-ing progreasion,average healing time and the positive rate of wound germiculture of the two groups were observed. Results The average healing time of the CN group was (29.6±9.4)d,which was shorter than that of the control group,( 39.2±13.5 )d, P < 0.05. Statistical difference existed in the positive rate of wound germiculture at the 7th day and the 14th day between the two groups (P < 0.05). Conclusions Routine medical treatment and general nursing measures plus surgical debridement,infrared radiation of wound sur-face,sprinkling of growth factors and hydrocolloid dressing possess facilitative healing effect for small area of diabetic foot ulcer.

OBJECTIVE: To present the surgical outcomes of advanced epithelial ovarian cancer (AEOC) since the implementation of a personalized approach and to validate multiple predictive models for R0 resection. METHODS: Personalized strategies included: 1) Non-invasive model: preoperative clinico-radiological assessment according to Suidan criteria with a predictive score for all individuals. Patients with a score 0–2 were recommended for primary debulking surgery (PDS, group A), or otherwise were counseled on the choices of PDS, neoadjuvant chemotherapy (NAC, group B) or staging laparoscopy (S-LPS). 2) Minimally invasive model: S-LPS with a predictive index value (PIV) according to Fagotti. Individuals with a PIV < 8 underwent PDS (group C) or otherwise received NAC (group D). Intraoperative assessment (with Eisenkop, peritoneal cancer index [PCI], and Aletti scores) and surgical results were prospectively collected. RESULTS: Between September 2015 and August 2017, 161 pathologically confirmed epithelial ovarian cancer patients were included. A total of 52 (32.3%) patients had a predictive score of 0–2, and 109 (67.7%) patients had a score ≥ 3. Among these individuals, 41 (25.5%) patients received S-LPS. Finally, 110 (68.3%) patients underwent PDS (A+C), and 51 (31.7%) patients received NAC (B+D). The R0 resection rates in PDS and NAC patients were 56.4% and 60.8%, respectively. The area under the curve (AUC) of Suidan criteria was 0.548 for group (A+C). The AUC of Fagotti score was 0.702 for group C. The AUC of Eisenkop, PCI, and Aletti scores were 0.808, 0.797, and 0.524, respectively. CONCLUSION: The Suidan criteria were not effective in these AEOC patients. S-LPS was helpful in decision-making for PDS and should be endorsed in the future.
Area Under Curve ; Cohort Studies* ; Drug Therapy ; Humans ; Laparoscopy ; Ovarian Neoplasms* ; Prospective Studies* ; Research Design ; Triage*

In order to standardize the clinical diagnosis and treatment of upper airway cough syndrome (UACS) for children in China, Dongzhimen Hospital of Beijing University of Chinese Medicine and Affiliated Hospital of Liaoning University of Traditional Chinese Medicine initiated the development of this Traditional Chinese Medicine Diagnosis and Treatment Guidelines for Children with Upper Airway cough Syndrome based on evidence-based medical evidence. This guideline will process registration, write a plan, and develop relevant processes and writing norms, develop and publish official documents. This plan mainly introduces the scope of the guidelines, the purpose and significance, the composition of the guidelines working group, the management of conflicts of interest, the collection, selection and determination of clinical problems, the retrieval, screening and rating of evidence, and the consensus of recommendations. Registration information: This study has been registered in the international practice guidelines registry platform with the registration code of PREPARE-2023CN087.

In order to identify two putative glutathione S-transferase (GSTs) genes in Fusarium oxysporum f. sp. cubense race 4 (Foc4), cDNA sequences of the entire coding regions of the two genes were cloned from Foc4 using RT-PCR method. Subsequently, the two genes were named Fogst1 and Fogst2 respectively. The length of open reading frame of Fogst1 was 609 bp and encoded a protein including 202 amino acid residues, Fogst2 possessed an open reading frame with 693 bp which encoded a 230-amino acid protein. Phylogenetic analysis showed that Fogst1 belonged to sigma (σ) subtype members of the GSTs superfamily, and Fogst2 was a new member of an unknown subfamily in the GSTs superfamily. To verify the expression of Fogst1 and Fogst2, the recombinant prokaryotic expression vector pET28a-Fogst1 and pET28a-Fogst2 were constructed and transformed into Escherichia coli expression strain BL21(DE3). The soluble recombinant proteins Fogst1 and Fogst2 were obtained after being induced by IPTG. GSTs activity assays showed that both of the two recombinant proteins had specific activity with CDNB. For real time RT- PCR analysis, the mycelium samples of Foc4 were collected after treatment by H₂O₂ for 1, 5, 12, 24 hours. The results showed that the expression of Fogst1 and Fogst2 were significantly up-regulated in the first 5 hours, and then decreased and returned to normal level. These results suggested that Fogst1 and Fogst2 may be involved in the process of Foc4 resistance to exogenous oxidative stress.

The standardization of pediatric Tuina is beneficial to pediatric Tuina practitioners in a norm practices. The paper collects the content from teaching textbooks, TCM ancient books and database literature, and tries to develop the technical specifications of pediatric Tuina by four rounds Delphi surveys and expert consensus. This specification covers the manipulation of pediatric Tuina, the position of acupoints, the effects of acupoints and the diagnosis and treatment of pediatric Tuina, including indications, contraindications, cautious use, operation steps and methods.

[Objective] To explore the efficacy of disposable flexible ureteroscopic lithotripsy (FURL) with flexible vacuum-assisted ureteral access sheath (FV-UAS) in the treatment of 2-3 cm upper urinary tract stones, so as to provide reference for the treatment selection. [Methods] Clinical data of 178 patients with upper urinary tract stones who received FURL or minimally invasive percutaneous nephrolithotomy (MPCNL) at our hospital during Apr. 2022 and Oct. 2023 were retrospectively analyzed. The patients were divided into FV-UAS group (n=90, received FV-UAS combined with diaposable FURL treatment) and MPCNL group (n=88, received MPCNL). The general information, perioperative data, and postoperative stone-free rate (SFR) of the two groups were compared. [Results] All operations were successfully completed. The operation time was significantly longer in the FV-UAS group than in the MPCNL group [(66.5±6.7) min vs. (63.9±7.4) min, P=0.015]. However, the intraoperative hemoglobin reduction [(7.3±3.1)g/L vs.(11.4±5.9)g/L], postoperative hospital stay (P<0.001) [(2.2±0.7)d vs.(5.4±1.3)d], and visual analogue score (VAS) [(2.7±0.9)vs.(5.6±1.1)] were significantly lower in the FV-UAS group than in the MPCNL group (P<0.001). The incidence of persistent gross hematuria was significantly higher in the MPCNL group than in the FV-UAS group (12.5% vs. 3.3%, P=0.023). The FV-UAS group had a similar postoperative immediate (83.3%) and final SFR (95.6%) to those of the MPCNL group (89.8%, 96.6%, P>0.05). [Conclusion] The combination of FURL with FV-UAS for 2-3 cm upper urinary tract stones has a higher SFR and a lower complication rate.Patients experience endurable pain and fast recovery, which is worth promoting and applying in clinical practice.

[Objective] To compare the clinical efficacy and safety of flexible ureteroscope lithotripsy (FURL) combined with flexible vacuum-assisted urethral access sheath (FV-UAS) and traditional UAS in the treatment of 1-2 cm lower renal calyceal stones, so as to provide reference for clinical practice. [Methods] Clinical data of 157 patients with 1-2 cm lower renal calyceal stones treated with FURL during Mar.2021 and Oct.2023 were retrospectively analyzed, including 80 treated with traditional UAS, and 77 with FV-UAS.General and clinical information of the two groups were compared. [Results] The immediate stone-free rate (SFR) (84.4% vs.67.5%, P=0.013) and final SFR (88.3% vs. 75.0%, P=0.032) of the FV-UAS group were significantly higher than those of the traditional UAS group, with significant difference.The incidence of postoperative complications such as fever, renal colic, and perirenal hematoma was significantly higher in the traditional UAS group than in the FV-UAS group (15.0% vs.5.2%, P=0.042). After treatment with anti-infective and analgesic drugs, both groups were improved, and no severe sepsis or septic shock occurred after surgery.The hospitalization expenses of the FV-UAS group were significantly lower than those of the traditional UAS group [ (18 341±1519)yuan vs.(19 152±1826)yuan, P=0.003]. [Conclusion] Compared to the traditional UAS, the combination of FURL and FV-UAS for the 1-2 cm lower renal calyceal stones has a high SFR and low incidence of complications.Patients experience less pain, recover faster and spend less.It's a new treatment option for inferior calyceal calculi.