Objective To investigate the clinical efficacy and side reaction of brucea javanica oil ( BJO) combined with 125I and chemotherapy on stageⅢ?Ⅳpatients with non?small cell lung cancer ( NSCLC) . Methods One hundred and twenty cases on stageⅢ?Ⅳpatients with NSCLC were randomly divided into two groups,60 cases received BJO combined with 125I and chemotherapy treatment(observation group),the other 60 cases received 125I combined with chemotherapy treatment(control group). Results The objective response rate(ORR) and disease control rate (DCR) were 71. 7%,86. 7% of observation group and 66. 7%,85. 0% of control group,there were no significant difference(χ2=0. 352,0. 069;P>0. 05) . The improvement rate of KPS score in observation group was significantly superior to that in control group, the difference was significant (76. 7% vs. 55. 0%;χ2=6. 261,P<0. 05) . The incidence of myelosuppression and gastrointestinal adverse e?vents in observation group was significantly lower that in control group ( 68. 3% vs. 83. 3%,41. 7% vs. 61. 7%;χ2=3. 883,4. 805;P<0. 05) . Conclusion BJO combined with 125I and chemotherapy for treating on stageⅢ?Ⅳ patients with NSCLC can reduce the toxicity and side effects caused by chemotherapy,and significantly im?prove the clinical symptoms and quality of life of patients.

Based on the Australian AR-DRGs, this research gathered the diagnosis related information on the first page of medical records and accomplished the computerization of data collection and analysis through the data-base of Shanghai Shenkang Hospital Development Center.According to the clinical practices, the DRGs model has been adjusted to complete the localization and a severity-based-DRGs model and grouping tool have been established for the municipal hospitals in Shanghai.

Objective To analyze pharmacologic action features of single Chinese herbal medicine for the treatment of fatty liver based on literature; To provide references for clinical treatment of fatty liver.Methods Animal research literature about single Chinese herbal medicine for the treatment of fatty liver in CNKI, Wanfang database, and VIP from January 2003 to December 2014 was retrieved by computers. The number of single Chinese herbal medicine and the pharmacologic action features of active ingredients (or extracts) were statistically concluded. Results A total of 279 articles were retrieved, including 67 kinds of single Chinese herbal medicine, among which 8 were used to treat AFLD, 45 were used to treat NAFLD, and 14 were used to treat AFLD and NAFLD simultaneously. Pharmacologic action features of the medicine for AFLD mainly included reducing lipid, protecting liver, antioxidation, and anti-inflammation. Pharmacologic action features of the medicine for NAFLD had the effects of improving insulin resistance additionally.Conclusion Chinese herbal medicine for the treatment of AFLD and NAFLD shows significant efficacy, having the features of multiple pathways and liver damage resistance, which provide references for clinical treatment of fatty liver.

The severity of disease can be used to evaluate the current situation of patients as well as to predict the diseases outcome.In the meantime, the severity among different diseases has been more and more applied in the evaluation of the patients at hospital level.This study collected and summarized different types of international disea-ses grouping tools'characteristics and applications based on the severity of disease, and their suitability and practical values in hospital performance evaluation were compared and analyzed.

ObjectiveTo investigate the clinical features and treatment of ascending paralysis after thoracolumbar fracture.MethodsThree male patients with 2 fracture levels at T12 and one at L1 were retrospectively studied.Their mean age was 41.3 years(range,39-42 years).All 3 cases were undertaken open decompression,reduction and internal fixation.Paralysis level began to ascend at 2-5 days after injury,with 2 cases up to C2,3 and 1 case up to T7.Two patients suffered irritating pain over the paralysis level before onset of ascending.Postoperative MRI images demonstrated well reduction and no compression of spinal cord.In the early phase after ascending,MRI obviously showed swelling in spinal cord and long T1 and long T2 signals shaped patchy and stripy distribution in the central area.One patient's MRI displayed that the spinal cord shrinked 16 days after trauma with abnormal high signal in the central area.ResultsTwo cases died of respiratory muscle paralysis and 1 case suffered paraplegia with no recovery 5 years after surgery.ConclusionAscending paralysis after thoracolumbar fracture is a rare complication with very poor prognosis.MRI is available for evaluating operational effects and affected level.The exact mechanism and effective treatment are still unclear and need further investigated.

The paper described the professional approach of Shanghai Hospital Development Center(SHDC)in developing a professional team of public hospital directors by such means as operation and management-autonomy,fixed tenures system,performance appraisal,part-time job control and income distribution. Recommendations raised include an organic unity of management functions of investors and power of management of the directors to motivate them in their management;building a comprehensive investor management system and strict cadre management mechanism to enhance supervision of the directors.

Objective:To develop a prediction model based on imaging features by contrast-enhanced MRI radiomics combined with clinical features for early recurrence of hepatocellular carcinoma (HCC) after radical resection.Methods:A retrospective study was carried out on 109 HCC patients who underwent radical resection at the Fifth Affiliated Hospital of Wenzhou Medical University from January 2015 to December 2020. Of 109 patients enrolled in this study, there were 96 males and 13 females, aged (58.3±10.7) years. Based on whether there was recurrence within 12 months after operation, the patients were divided into the early recurrence group ( n=31) and the control group ( n=78). These 109 patients were then randomly divided into the validation set ( n=23) and the training set ( n=86) at a ratio of 1∶4. Based on preoperative multi-phase contrast-enhanced MRI scanning, the tumor lesions were delineated on the Radcloud platform, and 1 409 quantitative radiomic features were extracted. Dimension reduction and screening of these features were carried out using variance threshold, SelectKBest and LASSO. Combined with clinical features (alpha fetoprotein, tumor size), several prediction model were established through machine learning. The predictive efficiencies of these models were evaluated using the area under the receiver operating characteristic (ROC) curve, accuracy rate, recall rate and balanced F score. Results:The proportions of irregular tumor shape and unclear tumor boundary, as well as maximum tumor diameter in the early recurrence group were significantly higher than that in the control group, but the proportion of pseudocapsule was significantly lower than that in the control group (all P<0.05). A total of 465 features were screened from the 1 409 features using the variance threshold method, followed by 38 features were screened using the method of SelectKBest. Finally 7 optimal radiomic features were screened based on the LASSO method. When combined with clinical features, 5 prediction models were established through machine learning. These models were support vector machine, Gaussian naive bayes, logistic regression, Multinomial naive bayes and K-nearest neighbor (KNN), respectively. Among these 5 models, the prediction efficiency of the KNN model was relatively highest, with the area under the ROC curve, accuracy rate, recall rate and balanced F score being 0.90, 0.98, 0.74 and 0.84 in the training set, and 0.76, 0.92, 0.75 and 0.83 in the verification set, respectively. Thus, the KNN model was selected as the best prediction model in this study. Conclusion:The prediction model of KNN was developed for early recurrence of HCC after radical resection based on preoperative contrast-enhanced MRI radiomics combined with clinical features.

Preventing and mitigating major risk exposure is an important task for modern countries to maintain sustained and healthy economic development and overall social stability. In this manuscript, the authors introduced Israel′s current medical and health care risk prevention system, including the regional health emergency response coordination mechanism, hospital′s external emergency rescue capacity building and hospital′s internal security system. Israel′s risk prevention system has been tested by wars and terrorist attacks, as well as many infectious diseases outbreaks. Thus the authors expected that its successful experiences can be introduced as a reference for improving China′s medical and health care risk prevention system.