Objective:To investigate the application and feasibility of the night-vision puncture technique in performing peripherally inserted central catheter(PICC).Methods:Seventy patients were randomly divided into ultrasound guided puncture group or modified blind puncture group,35 cases in each group.The puncture success rate,the achievement ratio of catheterization,the puncture site,arm circumference,catheterization time and complications were recorded in two groups.Results:Two groups had no significant difference in the puncture success rate,the achievement ratio of catheterization,the puncture site,arm circumference,phlebitis incidence,subcutaneous congestion (bleeding) (P ＞ 0.05).The catheterization time in modified blind puncture group was shorter than the ultrasound guided puncture group (P ＜ 0.001).In modified blind puncture group,a negative correlation (correlation coefficient:-0.475,P =0.004)between arm circumference and the puncture success rate was found.Conclusion:The puncture success rate of the modified blind puncture technique in performing peripherally inserted central catheter (PICC) is high and close to the puncture success rate of the PICC under ultrasound.Additionally,the modified blind puncture technique does not increase the incidence of complications and delay the catheter time.

Objective To explore the clinical application effect of squamous cell carcinoma antigen (SCC) ,cancer embryo antigen (CEA) and carbohydrate antigen 125(CA125) chemiluminescence combined detection in early diagnosis of lung cancer .Methods The SCC ,CEA and CA125 levels in the patients with early stage lung cancer ,benign lung diseases and healthy subjects undergoing physical examination were detected by using the automatic chemiluminescence immune analyzer .Results The concentrations of three tumor markers in the lung cancer group were significantly higher than those in the benign disease group and control group (P<0 .05);t he concentrations of CEA and CA125 in the adenocarcinoma patients with were significantly higher than those in the patients with squamous cell carcinoma and small cell carcinoma (P<0 .05) .The concentration of SCC in the patients with squamous cell carcinoma was significantly higher than that in the patients with adenocarcinoma and small cell lung cancer (P<0 .05) .The sen-sitivity ,specificity ,positive predictive value and negative predictive value of combined detection of three tumor markers were signifi-cantly better than that of single tumor marker ,and the difference was statistically significant (P<0 .05) .Conclusion The combined detection of SCC ,CEA and CA125 can be used in the early diagnosis of lung cancer and has the promotion value .

Objective:Based on the perspective of supply and demand balance, to analyze the implementation effects of primary-feature medical services measures in medical alliances.Methods:From July to September 2019, two regions with different levels of economic development were chosen, and from each region one leading hospital and two community health service centers/township hospitals were selected from its medical alliance. A total of 213 medical staff and 703 residents were surveyed, to learn their awareness and performance appraisal of these feature services.Frequency and proportion were calculated in a descriptive statistical analysis. The scores of the performance appraisal of both supply and demand sides were tested by independent sample t. Results:In the performance appraisal of such measures, the average scoring by medical staff was 4.39±0.07, and that by residents was 3.85±0.06; the residents were more concerned with service capabilities and contents, while medical staff were more concerned with service content and delivery mode; supply and demand sides were found with consensus in terms of improving the medical service quality of chronic diseases in primary level and service accessibility.Conclusions:The county-level medical alliances should focus on enhancing their capacity of primary medical services, and improving their primary service mode with the help of medical insurance institutions. Meanwhile, it is imperative to optimize the primary medical service policy in view of supply and demand balance.

Building an integrated health care service system is key to the Healthy China strategy. Based on the integrated health care service conceptual framework, the authors took two pilots regions of health-centered medical alliances in Zhejiang province as an example, and analyzed their conception framework, organizational structure, operation elements and effects. The study found initial success of the two alliances in terms of the contents, capabilities, effects and satisfaction of primary health care service. Such alliances feature a health-centered multi-entity participation mechanism, carry out health care and prevention integration leveraging the information platform, hence conducive to the effective governance of the alliances. However, the contents of their health related services are expected to be broadened and deepened; functionalities of health-related institutions need to be clarified and refined, while their performance appraisal needs to be further improved.

Objective: To evaluate the impact of KIT D816 mutation on the salvage therapy in relapsed acute myeloid leukemia (AML) with t(8;21) translocation. Method: The characteristics of the first relapsed AML with t(8;21) translocation from 10 hospitals were retrospectively collected, complete remission (CR₂) rate after one course salvage chemotherapy and the relationship between KIT mutation and CR₂ rate was analyzed. Results: 68 cases were enrolled in this study, and 30 cases (44.1%) achieved CR₂. All patients received KIT mutation detection, and KIT D816 mutation was identified in 26 cases. The KIT D816 positive group had significantly lower CR₂ compared with non-KIT D816 group (23.1% vs 57.1%, χ²=7.559, P=0.006), and patients with longer CR₁ duration achieved significantly higher CR₂ than those with CR₁ duration less than 12 months (74.1% vs 31.9%, χ²=9.192, P=0.002). KIT D816 mutation was tightly related to shorter CR₁ duration. No significant difference of 2 years post relapse survival was observed between KIT D816 mutation and non-KIT D816 mutation group. Conclusion KIT D816 mutation at diagnosis was an adverse factor on the salvage therapy in relapsed AML with t(8;21) translocation, significantly related to shorter CR1 duration, and can be used for prediction of salvage therapy response. KIT D816 mutation could guide the decision-making of salvage therapy in relapsed AML with t(8;21) translocation.

Ulcerative colitis（UC）is a disease characterized by chronic persistent inflammation of the colorectal mucosa. Its complex pathological mechanism is related to immune inflammation and enhanced apoptotic activity. The Janus kinase（JAK）/signal transducer and activator of transcription（STAT）is an important regulatory pathway in the body's physiological function, which can regulate the release of intestinal pro-inflammatory factors and induce apoptosis, resulting in colon tissue damage. In the condition of UC, the biological activities and expression levels of JAK and STAT increased, and the tissue inflammatory response and apoptosis rate increased, which led to the destruction of intestinal mucosal tissues. At present, in the treatment of UC, glucocorticoids and immunosuppressants are mainly employed to reduce intestinal inflammation. Although they can block the progress of UC to some extent, the adverse reactions are severe. A large number of studies have shown that traditional Chinese medicine（TCM） has significant advantages in the prevention and treatment of UC and can significantly reduce the recurrence rate of this disease. In recent years, plenty of studies have been carried out to explore the role of TCM in the treatment of UC by regulating the JAK/STAT pathway. The results have shown that the JAK/STAT pathway is the key target pathway of TCM in the treatment of UC. Based on the etiology and pathogenesis of deficiency and excess, TCM regulates the JAK/STAT pathway by clearing heat, drying dampness, cooling and activating blood, invigorating the spleen, warming the kidney, and performing both tonification and elimination to maintain the balance between pro-inflammatory factors and anti-inflammatory factors, weaken colonic inflammatory response, inhibit apoptosis, and play a role in the treatment of UC. The present study analyzed the mechanism and effect of TCM in intervening in UC by targeting the JAK/STAT signaling pathway and summarized the molecular mechanisms of different cytokines such as interleukin-6（IL-6）, IL-10, IL-23, microRNA（miRNA）-146a, and suppressors of cytokine signaling 2/3（SOCS2/3） on many family subtypes of the JAK/STAT signaling pathway to facilitate the comprehensive understanding of researchers on the mechanism of TCM on the JAK/STAT pathway in UC, which is expected to provide a theoretical basis for the treatment of UC and further drug development.