Objective To explore the clinical features,diagnosis and treatment of solid-pseudopapillary tumor(SPT)of pancreas.Methods The clinical data of 19 patients with SPT treated in 8 years were studied retrospectively,included 3 males and 16 females.Results The type of operation was decided by the size and location of tumor.Pancreatic leakage was a familiar complication,there were 9 cases.Patients were followed up from 3 to 70 months,and no recurrence or metastsis was found.Conclusion Pancreas SPT is a rare type neoplasm of pancreas.Pancreas SPT is affecting primarily young women,complete resection results in excellent prognosis.

Objective To summarize the damaging effect of infectious burden on cognition and the potential mechanisms, and reveal a newly insight into the prevention and treatment of cognitive impairment.Methods Based on the PUBMED, CBM and CNKI database, the articles involving the definition of infectious burden and the relationship between infectious burden and cognition were searched with the main key words infectious burden , cognition and inflammation.Results This study finally included 42 articles from the primarily retrieved 342 articles.Overall, the definition of infectious burden remains controversial.Infectious burden was related to cognitive impairment whereas the potential mechanisms had not been fully elucidated.Conclusion Infectious burden is the risk factor of cognitive impairment via the possible mechanisms of inflammation,vascular lesion and neuronal toxicity.

Objective To observe histologic changes of human cytomegalovirus(hCMV)-infected explants of first trimester human placenta and expression of hCMV gene in the hCMV-infected explants, and investigate the mechanism of intrauterine transmission of hCMV from mother to fetus.Methods The first trimester placenta explants cultures were carried out, and they were infected with hCMV for 10 days. The expression of hCMV immediate early protein(IEP) 72-IEP86 were determined using indirect-immuno fluorescent assay, and in situ hybridization method was used to examine the hCMV late gene (LG)mRNA. For histologic evaluation of morphological changes in villi, transmission electron microscope was used.Results (1) Typical hCMV-induced lesions bearing hCMV IEP72-IEP86 were consistently localized in the trophoblast of covering placenta villi, interstitial cell and vascular endothelia cell 12 hours after infection, and were predominant in cytotrophoblast. (2) Replication of hCMV in placenta explants culture occurred from 12 hours to 24 hours and disappeared since 48 hours after infection with different concentrations of hCMV when examined by in situ hybridization. (3) Tissue integrity and viability of first trimester placenta explants were obtained in culture for 10 days and then explants were infected with different concentrations of hCMV 100 tissue culture infectious doses(TCID_ 50 ),200 TCID_ 50 and 300 TCID_ 50 , the progression of the infection was observed in the tissue that maintained its normal cellular organization under light microscope. But typical inflammation of cellular organization was observed under transmission electron microscope. Conclusions (1) A flash replication of hCMV in placental explants culture occurs; IEP72-IEP86 may be in intrauterine infection of hCMV for a long time. (2) There are pathological ultrastructure changes in hCMV-infected explants.

Objective:To explore and test a blending prospective payment that suitable for integrated care delivery system in China.Methods:Referring to Accountable Care Organization and domestic reforms,it designed a performance-based and prospective global budget payment mechanism which mainly contained strategies as medical alliance contract,prepay by DRGs and performance-based management.Through a quasi-experiment,it tested its effects on controlling the inpatient spending and continuity of care.Results:There were 38 980 cases included from inpatient claims data out of 4 towns.194 medical records came from township and county hospitals.Compared to control group,the average hospitalization rate per capita every 5 months in treated group significantly declined by 0.08％,the likelihood of using upper level hospitalization significantly declined by 0.16％,and the continuity of care significantly increased by 33.80％.Global budget system would benefit decreasing hospitalization structure and improving medical collaboration.However,the effects of new model might be underestimated by the imperfect implementation of compulsory referral system.Conclusion:The medical alliances should center on combined objectives as stimulating medical cooperation and improving on quality of care.It should make the blending prospective payment decisions on basis of information-shared grading and referral medical system and empirical evidence.

Based on the organization and implementation of the comprehensive reform of countylevel public hospitals in 15 provinces (municipalities)in southern China,the research discussed the progress and problems of such reforr.The progress made and areas of the reform vary among provinces and municipalities.For example,the reform has completely covered all the counties in four provinces such as Zhejiang and Jiangsu province.Medicine markups have been canceled in all the pilot counties by adjusting the service prices to pave the way for hospital compensation.Contemporary hospital management,remuneration system and personnel system reform are also main targets of the reform,while the collaboration between superiors and subordinates,and hospital regulatory system have recently been included.Problems are also found with the current reform:for example,lack of attention for the system reform,no fundamental changes in place in the business orientation of hospitals,as well as problems in collaboration among departments,and hospital debts.

An analysis of the readmission service in rural townships and counties.Based on the concept of health integration,the authors proposed the service integration among hierarchical institutions in alignment with hierarchical medical system,and the autonomous service integration among differentiated hierarchical institutions.The purpose is elevation of quality of care in rural areas and better capital usage efficiency in NRCMS.

Objective To analyze family clustering of inpatient service utilization in rural areas of Hubei Province.Method Inpatient service information of all families in rural areas of sample counties was obtained on the basis of New Cooperative Medical System (NCMS) inpatient database;Lorentz curve was drawn by area graph and scatter diagram of Excel 2010,so was Gini coefficient;descriptive statistic,variance analysis and so on were carried by IBM SPSS Statistic 20.0.Result 3％ family takes up 19％ inpatient service,and rural family's Gini coefficient of inpatient service utilization is 0.366;high inpatient service utilization family(HIUF) uses less outpatient service(29.2±26.9) than middle inpatient service utilization family (31.7±23.5).Inpatient member of HIUF used more inpatient service than other families,except the low inpatient service utilization member(NHH9.2＞NMH4,NHM2.4＞NMM2.2＞NLM1.7);HIUF use least time to reach county hospital(tH44.3＜tM44.9＜tL45.2),have more inpatient members than others (NM＞4.5＞NH4.4＞NL3.9).Conclusion Great family clustering of inpatient service utilization exists in rural area,and irrationality exists in some way;more outpatient service utilization may reduce inpatient service utilization.

Objective To analyze family clustering of outpatient service utilization in rural areas of China.Method Outpatient service information of all families in rural area of sample county was obtained on the basis of new cooperative medical system (NCMS) outpatient database,and family outpatient service utilization database was cleared out with the help of functions like IF,LOOKUP and so on in Excel 2010.Lorentz curve was drawn by area graph and scatter diagram with Excel 2010,so was Gini coefficient.Descriptive statistic,variance analysis and so on were carried by IBM SPSS Statistic 20.0.Result 20％ family takes up 53％ of outpatient service,and rural family's Gini coefficient of outpatient service utilization is 0.516.Members of high outpatient service utilization family (HOUF) used (17.7) more outpatient service than other families (10.4,4.2).HOUF were mainly distributed in towns with high capability of township hospital and low capability of township hospital.Conclusion Great family clustering of outpatient service utilization exists in rural areas.Family homogenization is distinct,in which irrationality exists.The capability of primary medical institutions influences the outpatient service utilization of residents in rural area.

Medical service utilization monitoring of county areas residents is one of the important contents of health policy management and research.Traditional service utilization monitoring, such as National Health Services Survey (NHSS), residents healthcare treatment (clinical) data from medical insurance, had problems of high cost, large deviation, slowly updating monitoring indicators, out of time in health management decisions.The data convergence and re-architecture of multi-source data provide a new idea for the monitoring of residents'' service utilization.Different linking data-sources would come true with the tools of Microsoft Access database administration and Excel programming techniques.At the same time, a new database would be accessed with the indices of residents'' annual medical service utilization, preference in medical services, unconscionable service utilization, and lead to the promotion of medical service utilization monitoring research development.

Humans ; Male ; Middle Aged ; Polycythemia ; etiology ; Sleep Apnea, Obstructive ; complications