Objective:Preformed anti-human leukocyte antigen(HLA)specific antibodies are a major risk for antibody-mediated rejection.The aim of this study is to detect and analyze anti-HLA specific antibodies in sera of renal transplant candidates for evaluating the status of presensitization.Methods:A total of 3 500 patients awaiting renal transplantation in our hospital from 1998 to 2007 were included in the study.Panel reactive antibody(PRA)in sera of 694 candidates was detected by complement-dependent cytotoxicity(CDC)before March 2000,then the sera of other 2 806 recipients were screened by enzyme-linked immune absorbent assay(ELISA)alternatively.The polymorphism,specificity and relevant factors of anti-HLA antibodies were analyzed.Results:Only IgG type of antibodies specific to HLA classⅠcould be detected by CDC,whereas both anti-HLA classⅠand classⅡ of IgG class could be found out by ELISA.Lower PRA positive rate by CDC(8%)was shown when compared to that by ELISA(17%).Furthermore,multiple types of specific antibodies against HLA-A(20),B(37),CW(8),DR(14)and DQ(7)were determined by ELISA.Some types of the antibodies presented higher frequencies,such as anti-HLA-A2,24,68,23 and 32;B27,56,57 and 7;DR7,4,9,13,17 and 12;CW1,2,6,4 and 8.These high frequenies of anti-HLA antibodies were somewhat different from the distribution of HLA antigens in South China population.There were significantly different positive rates of anti-HLA antibodies between the male and the female,as the male were sensitized mainly through blood infusion and the female were sensitized by either blood infusion or pregnancy.Conclusion:Specific antibodies against HLA can be detected out by ELISA accurately,whereby to find high freguencies of the antibodies and to avoid donor-recipient mismatching at HLA-loci.Detection of preformed anti-HLA and reducion of HLA-mismatched blood infusion to reduce production of anti-HLA antibodies may be the valuable pathway to improve graft survival.

Objective To investigate the characteristics of BK virus (BKV) infection in renal transplant recipients. Methods A total of 243 renal recipients from our clinic within 48 months after transplantation were enrolled as the trial group and 82 healthy people as the control group. Urine and peripheral blood samples of these two groups were harvested for urinary sediment BKV cytology by Decoy cell counting and BKV DNA by real-time PCR. Results The positive rates of urinary Decoy cell, BKV viruria and viremia were 35.4%, 36.6% and 16.9% in trial group, and 4.9%, 20.7% and 2.9% in control group, respectively. In trial group, the medians of urinary Decoy cell, urinary BKV and peripheral blood BKV were 6/10 HPF, 1.00×104 copy/ml and 6.87×103 copy/ml respectively, while in control group, they were 2/10 HPF, 1.10×104 copy/ml and 2.24×1(3 copy/ml. Compared with the healthy people, the positive rates and the levels of BKV DNA in urine and peripheral blood of recipients were significantly higher. The amount of urinary Decoy cells was positively correlated to urinary BKV load (r=0.636, P＜0.01). Conclusions BKV replication is easier to happen in renal recipients as compared to healthy people. Counting of urinary Decoy cells is convenient, useful and sensitive to evaluate BK viruria and viremia in renaltransplant recipients. BKV DNA detection in urine and peripheral blood can be used to screen the evidence of BK reaction in order to prevent irreversible graft damage by BKV.[ Key words ] Kidney transplantation; BK virus; Kidney diseases; Decoy cells

Objective:To analyze the effect of the implementation of diagnosis-intervention packet (DIP) on the doctors′ diagnosis and treatment behavior of chronic diseases, so as to provide reference for further improving medical insurance payment related policies.Methods:The first page information of chronic disease patients admitted to hospitals with diabetes, hypertension and coronary atherosclerotic heart disease as the main conditions in 103 hospitals at all levels and township health centers in a city from 2016 to 2020 was collected, and the patients were divided into non-DIP group and DIP group according to the implementation time of DIP. After 1∶1 propensity score matching to balance the general conditions of the 2 groups, the diagnosis and treatment behaviors were analyzed from two dimensions: diagnostic behavior and treatment behavior. The grade A rate of medical record writing, admission and discharge diagnosis coincidence rate, and the average length of stay were used to evaluate the diagnostic behavior; the proportion of drugs and the degree of change in the cost structure were used as the evaluation indicators of treatment behavior.Results:After matching, 41 050 patients were included in both the non-DIP group and the DIP group.From the perspective of diagnostic behavior, the grade A rate of medical record writing in the non-DIP group and the DIP group was 99.40% and 99.83%, the coincidence rate of admission and discharge diagnosis was 58.42% and 61.79%, the average hospital stay was 8.03 days and 7.04 days respectively, and the difference between the groups was significant ( P<0.05). From the view of treatment behavior, the proportion of drugs decreased from 33.00% in the non-DIP group to 27.59% in the DIP group, with a significant difference ( P<0.05); the drug cost represented by Western medicine changed negatively, while the diagnostic cost showed a positive change. Conclusions:DIP has played a certain role in regulating doctors′ diagnosis and treatment behavior for chronic diseases. Among them, doctors have significantly improved their diagnostic behavior for chronic diseases, and the proportion of drugs in treatment behavior has been well controlled.

Since mid-December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has outbroken in Wuhan, Hubei Province, China, and spread rapidly to other provinces in China and dozens of countries and regions around the world, becoming the Public Health Emergency of International Concern (Public Health Emergency of International Concern). SARS-CoV-2 can mainly transmit by droplets or close contact, and is generally susceptible in the crowd. Tumor patients are at high risk of this pathogen because of their impaired immune function. Identifying tumor patients with 2019 novel coronavirus disease (COVID-19) early, and understanding its distribution characteristics can help to improve the cure rate of patients, and better control the epidemic and development of SARS-CoV-2 much better. With comprehensive analysis of relevant literature, this paper reviews the clinical characteristics of neoplastic patients with COVID-19, and puts forward some suggestions on how to deal with this epidemic.
Betacoronavirus ; Coronavirus Infections ; complications ; epidemiology ; prevention & control ; transmission ; Epidemics ; Humans ; Neoplasms ; complications ; Pandemics ; prevention & control ; Pneumonia, Viral ; complications ; epidemiology ; prevention & control ; transmission

Under the structural pressure of aging acceleration and increased chronic disease burden,in order to implement the reform tasks of"promoting healthcare,insurance and pharmaceutical sectors coordinated develop-ment and governance"proposed by the 20th National Congress of the Communist Party of China,it is urgent to build a medical insurance governance system that is adapted to the"Synergistic goverance on healthcare,insurance and pharmaceutical sectors".In order to break the single,fragmented,and passive medical insurance management methods in the past,according to the theoretical framework of system theory,it proposes the"chain-net"gover-nance system of hospital medical insurance built by the policy responsibility chain,information process chain,col-laborative consensus chain,inspection evaluation chain,and performance value chain,and analyzes,the implemen-tation path,necessity and completeness and support elements of this system.

Under the structural pressure of aging acceleration and increased chronic disease burden,in order to implement the reform tasks of"promoting healthcare,insurance and pharmaceutical sectors coordinated develop-ment and governance"proposed by the 20th National Congress of the Communist Party of China,it is urgent to build a medical insurance governance system that is adapted to the"Synergistic goverance on healthcare,insurance and pharmaceutical sectors".In order to break the single,fragmented,and passive medical insurance management methods in the past,according to the theoretical framework of system theory,it proposes the"chain-net"gover-nance system of hospital medical insurance built by the policy responsibility chain,information process chain,col-laborative consensus chain,inspection evaluation chain,and performance value chain,and analyzes,the implemen-tation path,necessity and completeness and support elements of this system.

Under the structural pressure of aging acceleration and increased chronic disease burden,in order to implement the reform tasks of"promoting healthcare,insurance and pharmaceutical sectors coordinated develop-ment and governance"proposed by the 20th National Congress of the Communist Party of China,it is urgent to build a medical insurance governance system that is adapted to the"Synergistic goverance on healthcare,insurance and pharmaceutical sectors".In order to break the single,fragmented,and passive medical insurance management methods in the past,according to the theoretical framework of system theory,it proposes the"chain-net"gover-nance system of hospital medical insurance built by the policy responsibility chain,information process chain,col-laborative consensus chain,inspection evaluation chain,and performance value chain,and analyzes,the implemen-tation path,necessity and completeness and support elements of this system.

Under the structural pressure of aging acceleration and increased chronic disease burden,in order to implement the reform tasks of"promoting healthcare,insurance and pharmaceutical sectors coordinated develop-ment and governance"proposed by the 20th National Congress of the Communist Party of China,it is urgent to build a medical insurance governance system that is adapted to the"Synergistic goverance on healthcare,insurance and pharmaceutical sectors".In order to break the single,fragmented,and passive medical insurance management methods in the past,according to the theoretical framework of system theory,it proposes the"chain-net"gover-nance system of hospital medical insurance built by the policy responsibility chain,information process chain,col-laborative consensus chain,inspection evaluation chain,and performance value chain,and analyzes,the implemen-tation path,necessity and completeness and support elements of this system.

Under the structural pressure of aging acceleration and increased chronic disease burden,in order to implement the reform tasks of"promoting healthcare,insurance and pharmaceutical sectors coordinated develop-ment and governance"proposed by the 20th National Congress of the Communist Party of China,it is urgent to build a medical insurance governance system that is adapted to the"Synergistic goverance on healthcare,insurance and pharmaceutical sectors".In order to break the single,fragmented,and passive medical insurance management methods in the past,according to the theoretical framework of system theory,it proposes the"chain-net"gover-nance system of hospital medical insurance built by the policy responsibility chain,information process chain,col-laborative consensus chain,inspection evaluation chain,and performance value chain,and analyzes,the implemen-tation path,necessity and completeness and support elements of this system.

Under the structural pressure of aging acceleration and increased chronic disease burden,in order to implement the reform tasks of"promoting healthcare,insurance and pharmaceutical sectors coordinated develop-ment and governance"proposed by the 20th National Congress of the Communist Party of China,it is urgent to build a medical insurance governance system that is adapted to the"Synergistic goverance on healthcare,insurance and pharmaceutical sectors".In order to break the single,fragmented,and passive medical insurance management methods in the past,according to the theoretical framework of system theory,it proposes the"chain-net"gover-nance system of hospital medical insurance built by the policy responsibility chain,information process chain,col-laborative consensus chain,inspection evaluation chain,and performance value chain,and analyzes,the implemen-tation path,necessity and completeness and support elements of this system.