Objective To investigate the expression and effect of FOXC2 (forkhead box C2) and Vimentin in gastric carcinoma tissues .Methods To detect the protein expression of FOXC2 and Vimentin in 20 normal gastric tissues and 65 gastric carcinoma tissues with immunochemistry .Results FOXC2 and Vimentin were highly expressed in all gastric carcinoma tissues .In all gastric carcinoma cases ,the FOXC2 expression rate was 41 .53% ,the rate of Vimentin was 35 .38% .The average expression rates of FOXC2 and Vimentin in TNM ( Ⅲ + Ⅳ ) group were significantly higher than those in TNM (Ⅰ + Ⅱ ) group ,respectively (58 .60% vs .27 .78% ,P=0 .012 ;55 .88% vs .29 .03% ,P=0 .018) .The expression rates of FOXC2 and Vimentin in lymph node transfer group were statistically higher than those in no lymph node transfer group (51 .72% vs .22 .22% ,P=0 .013;41 .20% vs . 14 .80% ,P=0 .010) .The correlation between FOXC2 and Vimentin was positive (P= 0 .037) .Conclusion It is possible that FOXC2 and Vimentin are involved in the transformation of epithelial cells into the mesenchymal cells .And they may play an impor-tant role in the metastasis of gastric carcinoma .

OBJECTIVETo explore the effects of ultrafiltration technique in preventing and relieving pulmonary injury in children undergoing open heart surgery and cardiopulmonary bypass (CPB).

METHODSThirty cases with congenital heart defects were divided into a control group and an experimental group. In the control group, conventional cardiopulmonary bypass was used without ultrafiltration; while in the experimental group, cardiopulmonary bypass with balanced ultrafiltration and modified ultrafiltration were used. Pulmonary static compliance (Cstat), airway resistance (Raw), alveolar-arterial oxygen difference (A-a DO2), hematocrit (HCT), serum albumin (Alb), interleukin-6 (IL-6), endothelia-1 (ET-1) and thromboxane (TXB2) were measured.

RESULTSThe pulmonary function was improved, HCT and serum albumin concentrations were increased, and some harmful medium-size solutes were decreased in the experimental groups compared with the control group.

CONCLUSIONSCombination of balanced ultrafiltration with modified ultrafiltration can effectively concentrate blood, exclude harmful inflammatory mediators, and attenuate lung edema and inflammatory responsive pulmonary injury.

Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; methods ; Child, Preschool ; Heart Defects, Congenital ; surgery ; Humans ; Lung Diseases ; prevention & control ; Pulmonary Edema ; prevention & control ; Ultrafiltration ; methods

Objective:To study the current setup of diagnosis and treatment subjects in China and make reform suggestions in light of existing problems.Methods:Relevant documents on medical institutions′ diagnosis and treatment subjects setup were retrieved from such databases as CNKI, Wanfang and Weipu database, while relevant national policies, laws and regulations were reviewed. On-site visits were conducted to health committees and medical institutions in 7 provinces from June 2020 through December 2020. Seminars and special interviews were held with relevant management personnel and doctors of different positions, for the purpose of learning the current medical institutions′ diagnosis and treatment subjects and their suggestions for reform. Data gained from the above methods were summarized to arrive at reform suggestions for optimizing China′s medical institutions′ diagnosis and treatment subjects, with further improvement made based on expert consultation method.Results:Problems found focus on such areas as inconsistent setup standards for medical treatment subjects, multiple overlapping services, and unclear numbering rules. Based on the disease list and skill list of the DRG system, a novel diagnosis and treatment subject setup method guided by service items could be established. Otherwise, the numbering and categories could changed on the current basis to correct existing problems. The subjects could be divided into such five categories as clinical, oral, traditional Chinese medicine, medical technology, and comprehensive, with level-1 and level-2 subjects set up respectively.Conclusions:In terms of subject functions, the setup of diagnosis and treatment subjects should be regularly adjusted or filed, instead of complete equivalence with administratively licensed subjects. As the current setup of diagnosis and treatment subjects had been in place for years, and had become key references for the department setup and performance appraisal of medical institutions, it was proposed to make adjustment on the current basis for the purpose of correcting existing problems.

Objective:To analyze the setup basis and registration rules of the practice scope of physicians in China, and take into account the current situation of individual provinces, for suggestions on further revision of the practice scope of these physicians.Methods:Relevant documents on practice scope setup were retrieved from such databases as CNKI, Wanfang and Weipu databases, while relevant national policies, laws and regulations were reviewed. On-site visits were conducted to health committees and medical institutions in 7 provinces from June 2020 through December 2020. Seminars and special interviews were held with relevant management personnel and doctors of different positions, for the purpose of learning the current physician practice scope setup and their suggestions for reform. Data gained from the above methods were summarized to arrive at reform suggestions for optimizing China′s practice scope setup, with further improvement made based on expert consultation method.Results:Several setbacks were found in the setup of their practice scope in China, namely as unclear setup principles, generalized setup of the national standards, inconsistent setup standards among the provinces, prohibition of cross-category registration, and roadblocks against in changing scope of practice. As the setup of the practice scope should set free manpower, unleash vitality, and delegate power, the practice scope should be changed to three categories of " discipline" , " discipline+ technology" and " comprehensive" . Physicians should be entitled to register separately as " discipline" and " discipline+ technology" as their practice scope, with " comprehensive" practice scope approved by a simple procedure of a notice.Conclusions:The setup and modification of the practice scope should be in a general rather than detailed manner, and conducive to the development of related disciplines. Such measures should also fully unleash the vitality of Chinese physicians, and take into account of both peacetime and emergencies, and both medical service and prevention.

Objective:To measure the demand of physicians in 2020-2035 period by constructing an unequal weight combination forecasting model, and to provide scientific reference for health manpower planning.Methods:This study called into play the trend extrapolation method, human/population ratio method and health service demand method to preliminarily predict the demand of physicians in 2020-2035, followed by Delphi method to carry out unequal weight combination of the results of these three methods. Hence the physicians demand in 2020-2035 in China was calculated.Results:Based on the unequal weight combination forecasting model, the physicians demand of the period in China was estimated to increase from 2.64 people / 1 000 population to 3.67 people / 1 000 population, and the physicians demand to gradually increase at a growth rate in gradual slowdown.Conclusions:This research used the unequal weight combination forecast model, based on the service demand and the historical situation. It is suggested that relevant policies of medical education and specialists division be made based on both the demand and the factors affecting the supply and demand balance of physicians.

Objective:To analyze the changes in the number and workload of pediatricians, for evidences in further optimizing the allocation of pediatrician resources and formulating relevant policies in China.Methods:According to data from the National Bureau of Statistics and the " China Health and Health Statistics Yearbook", descriptive analysis was made to investigate the changes in the number and workload of pediatricians in China from 2010 to 2019.Results:During 2010 and 2019, the number of pediatric practitioners(assistants) increased from 115 800 to 158 500, and the growth rate was faster than that of the children aged 0-14 years, but slower than that of overall medical practitioners(assistants). The number of pediatric practitioners(assistants) per thousand children in China had grown steadily from 0.52 to 0.67, compared with the burden and the workload of medical practitioners nationwide, the workload of pediatricians was still relatively heavy.Conclusions:The number of pediatricians had increased gradually between 2010 and 2019, and the effects of various policies began to work, while the workload was still heavy. It is recommended to further develop a salary system and supporting policies in line with the characteristics of pediatrics sector, and focus on such problems as unbalanced and inadequate distribution of pediatricians.