Methods:To describe the connotation and construction mechanism of integrated medical service system.Methods:Based on the data of hierarchy diagnosis situation in China Statistical Yearbook from 2005 to 2015,the traditional medical service system and integrated medical service system were compared from the objective,method and core,while the construction mechanism of integrated medical service system was analyzed from the lead,control,supervision and adjustment.Results:Under the background of Health China,integrate medical system based on the purpose of health community,the method of division and cooperation and the core of cost management was different from the traditional medical service system which based on the aim of medical service,the method of competition and split and the core of ‘business of water'.Hierarchy diagnosis was the appearance/mehod of regional integrated diagnosis and the result from medial resource optimized allocation under the integrated medical service system.Constructing the integrated medical service system was the basic demand of medicine and health system reform.Conclusion:Constructing the integrated medical service system should be led by the performance appraisal of medical institutions,controlled by the cost accounting and adjusted by medical service prices,so that to make the benefits for the demander,the provider and the third party of medical service system to construct and share the health community.

Objective To design a quantitative criterion and grading system for injury from adverse drug reaction (ADR) in order to serve the compensation system of injury from ADR. Methods Based on the other grading system of injury cases, the independent scores and serial grades were given to the ADR injury of different organs or different levels through two turns of consultation to 27 experts from Shanghai. Results Injury from ADR was graded from stage 1 to stage 10 according to the damage degree, with 1 stand for death and 10 for slightest injury. Conclusion The grading method of ADR based on the characteristics of injury accords with the condition of China, and can provide reference for making up the compensation system of ADR injury.

Objective To estimate relationship between the brain atrophy rate and percent corpus callosum area change in patients with cerebral vascular disease.Methods Forty-six patients with cerebral vascular disease underwent MR scanning twice,at the baseline and at the end of the follow-up period.T1W images at both time points were processed automatically with structural image evaluation using normalization of atrophy(SIENA) software to determine the percent brain volume change(PBVC).In addition,the corpus callosum and the inner table of the skull on the mid-sagittal images of two scans were outlined manually to measure their areas.The percent of corpus callosum area change(PCCAC) was calculated.Then,the relationship between PBVC,PCCAC and age was statistically analyzed.Results Significant correlation was found among the three variables: spearman rank correlation coefficient was-0.295 for PBVC and age(P=0.047),while it was-0.4 for PCCAC and age(P=0.006),and 0.538 for PBVC and PCCAC(P=0.000).Conclusion SIENA software identifies brain atrophy quantitatively in patients with cerebral vascular disease,which correlated with area reduction of the corpus callosum.

Objective To discuss the MRI features and its clinical significance of bone contusion in knee joint.Methods MR images of injuries of knee in 40 cases were retrospectively analyzed,the complications were reviewed simultaneously.Results 69 lesions of bone contusion in 40 cases were discovered,of them,Ⅰ type was in 38 and Ⅱ type was in 31, in company with fractures were 24 in 22 cases and ligament injury was in 33 cases.Conclusion The present of bone contusion is prompt to the bone injuries,MRI is of significant value in showing bone contusion and its complications in knee.

Objective To evaluate the application of pooling HIV nucleic acid amplification testing (NAAT) among men who had sex with men (MSM) population, and to investigate suitable HIV screening strategy and the feasibility of calculation of HIV incidence using pooling NAAT among MSM population in China.Methods Four thousand eight hundred and fifty-six samples were collected from MSM population from April 2008 to September 2009 among with 4 156 were in Heilongjiang province and 700 were in Beijing in China. After standard testing with an HIV ELISA and WB confirmation testing, HIV antibody-negative samples were pooled and screened for HIV using NAAT.A three-stage pooling strategy was adopted.The HIV positive rate estimated by the four HIV screening strategies was calculated.In addition, 4 156 HIV positive specimens from Heilongjiang province were screened with the BED capture enzyme immunoassay (BED-CEIA).The HIV-1 incidences were estimated by BED-CEIA assay and pooling NAAT individually.ResultsOne hundred and forty-three of 4 856 subjects were HIV infected.130 were 3rd and 4th generation ELISA positive; 13 were antibody-negative but acutely HIV infected.According to the evaluation of four HIV screening strategies, routine HIV screening test together with pooling NAAT was more effective than other strategies for screening out window period generation ELISA+WB+pooling NAAT' were 2.68%(95% confidence interval CI=2.22%-3.14%), 2.82%(95%CI=2.35%-3.29%), 2.94%(95%CI=2.46%-3.42%) and 2.94%(95%CI=2.46%-3.42%), respectively.The differences were not significant (χ2=0.854 3, P=0.836 4).Of the 88 HIV positive samples from Heilongjiang province, 44 participants were tested as recent HIV infections by BED-CEIA assay. The estimated HIV-1 incidence was 2.36% (95%CI=1.63%-3.08%) and 2.92% (95%CI=1.01%-4.83%) based on BED-CEIA assay and pooling NAAT,respectively.Conclusions Pooling NAAT is a effective screening test in HIV negative population to detect window period infection among MSM population in China.

Anastomosis, Surgical ; Anastomotic Leak ; Humans ; Neoadjuvant Therapy ; Rectal Neoplasms/surgery* ; Rectum/surgery* ; Retrospective Studies ; Suction ; Therapeutic Irrigation

Objective To investigate the association of angiotensinogen(AGT)gene A-6G、T174M and G-217A polymorphisms with the risk of essential hypertension(EH)in the elderly of Han nationality.Methods Genotypes of AGT gene A-6G,T174M and G-217A polymorphisms in 177 aged EH patients and 86 sex and age-matched controls were analyzed with gene chip technology.Results The A-6G and T174M polymorphisms of AGT gene were significantly associated with EH.The numbers of the three genotypes of A-6G were 113,58 and 6 in the patient group and 70,15 and 1 in the control group(P= 0.014)and those of T174M were 94,77 and 6,60,25 and 1(P=0.031),respectively.G-217A polymorphism was not related to EH.Individuals carrying A-6G AA and T174M CC genotypes showed 57% and 56% lower risk of EH(OR=0.43;95%CI=0.23-0.82 and OR=0.44;95%CI=0.25-0.79, respectively).Conclusions The A-6G AA and the T174M CC genotype may be related with decreased risk of EH and G-217A polymorphism may have little role in the etiology of EH in Han nationality.

Objective: To analyze the semen quality parameters of sperm donor volunteers, so as to provide insights into male infertility control and related research. Methods: A total of 155 sperm donors were recruited from the Human Sperm Bank of Zhejiang Province using the convenience sampling method from January to March 2021. Demographic information were collected through questionnaire surveys. Semen were collected, and parameters including semen volume, sperm concentration, total number of sperm, forward motility rate and total sperm viability were measured. Semen quality was evaluated according to the WHO Laboratory Manual for the Examination and Processing of Human Semen. : Results Conclusion There were 20.65% of the 155 sperm donors with unqualified semen, and the unqualified rates of forward motility rate and total sperm viability were relatively high.

Antigens ; immunology ; Antigens, Neoplasm ; drug effects ; immunology ; metabolism ; Gallbladder Neoplasms ; immunology ; metabolism ; pathology ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Neoplastic Stem Cells ; immunology ; Octamer Transcription Factor-3 ; genetics ; metabolism ; Prostatic Neoplasms ; genetics ; metabolism ; pathology ; Tumor Cells, Cultured

Objective To explore the differences in morphology and structure of collagen fiber of the hilar bile duct between human and rat. Methods The morphology and structure of vertical and horizontal cross-section of human and rat collagen fiber of the normal and dilated hilar bile duct, and their changes under stress were observed after Masson trichrome staining. Results The morphology and structure of collagen fiber of hilar bile duet in human was similar to that in rat. The collagen fiber mainly distributed in the middle and outer layer of the hilar bile duct. The wave-like collagen fiber bundles were arranged in parallel, consistent with the longitudinal axis direction of the bile duct, and connected by the small branches. Conclusions The morphology and structure of collagen fiber of the hilar bile duct in human is similar to that in rat. The anatomical structure of the collagen fiber is adapted to its function.