Objective To define the variety and action mechanism of endogenous health resources as well as their economic features, utilization results and influence and to put forward suggestions for giving priority to their development in policy making. Methods Materials from on the spot investigations and materials already available were used to conduct a positive economic study by means of combining document summaries with descriptive studies and analyses. Results Static, exogenous and endogenous health resources were defined, the contribution rate of progress in science and technology in 23 hospitals was determined to be 35.5%, senior human resources were found to be scarce, and the competitiveness of hospitals at the central hospital level was discovered to be weak. Conclusion Effective utilization and optimum distribution of endogenous health resources constitute the key to the realization of the structural readjustment of the health industry and the attainment of sustainable economic growth and development.

Objective To investigate the application of MRI in evaluation of the traumatic temporomandibular joint (TMJ) injury induced by type Ⅵ condylar fracture. MethodsMRI was performed in TMJs in 18 patients with type Ⅵ condylar fractures at days 3-14 post-injury and the MRI findings were analyzed. ResultsMRI findings of 18 patients with traumatic TMJ injury with 19 sides of type Ⅵ condylar fractures showed 15 sides of TMJ disk displacement,nine sides of capsule tear,16 sides of retrodiscal tissue tear (double-plate area) and 19 sides of joint effusion change. Conclusions MRI is very important in the diagnosis and evaluation of traumatic TMJ injury,since it can clearly display the TMJ injuries in type Ⅵ condylar fractures.Therefore,the clinical application of MRI is beneficial for selection of the therapeutic schedules.

Objective To explore a new approach to isolate the umbilical cord-mesenchymal stem cells (UC-MSCs) from a whole umbilical cord. Methods Single enzyme was used to digest the whole umbilical cord,and passaged and cultured,draw the growth curve,cell cycle and cell wall antigen on the surface by flow cytometry. In particular inducing system, the adherent cells were induced into adipocytes and osteoblast. Results The mesenchymal stem cells (MSCs) were derived from the whole umbilical cord. The growth curve showed that the cell doubling time was (24.15 ± 0.49) h and the percentage of G1phase cells was 82.66%.The adherent cells expressed the CD93,CD105,CD44,CD29and CD73, and did not express the CD34, CD45, CD31and human leukocyte antigen DR (HLA-DR). UC-MSCs could differentiate into adipocytes and osteoblast. Conclusions Single enzyme approach is a good method to obtain UC-MSCs from whole human umbilical cord,and it provides a theoretical basis for the establishment of MSCs bank and clinical application.

The fabrication and experimental test results were presented for a micro-electro-mechanical systems (MEMS)-based gas chromatography column. Compared with conventional column, this micro-gas chromatography column is suitable for on-line analysis and monitoring because of the small size, rapid analysis and other characteristics. These 0.5, 1 and 3 m GC columns were fabricated using a deep reactive-ion etching (DRIE) and were coated the stationary phase via a dynamic coating procedure. These GC columns perfectly separated the mixture of benzene, toluene and o-xylene in less than 200 s, where, the 3.0 m of the GC column achieved) a high resolution of 14.3 between toluene and o-xylene and yielded approximately 6160 plates. Moreover, the effect of separation performance for different column length were examined and compared. These GC columns are suitable for the application of a variety of disciplines, including environmental analysis, methane gas probes and homeland security.

To establish an HPLC method to determine osimertinib mesylate,Agilent ZORBAX Eclipse Plus C18 column (4.6 mm × 250 mm,5 μm) was used with a mobile phase consisting of methanol-buffer solution (20 mmoL/L NaH2PO4,pH 3.0 adjusted with 85％ H3PO4) (50 ∶ 50) at the flow rate of 1.0 mL/min.The detection wavelength was 210 nm,and the column temperature was kept at 35 ℃.The calibration curve was liner over the range from 50％ to 150％ of determination concentration (0.201 1-0.603 2 mg/mL,r =0.999 9).The limit of quantitation (LOQ) and limit of detection (LOD) were 0.32 μg/mL and 0.08 μg/mL,respectively.The contents of osimertinib mesylate in samples were 100.1％,99.5％ and 99.7％.Good chromatographic separation of osimertinib mesylate and its related substances,including synthetic impurities and degradation products,were obtained.The established HPLC method is specific,accurate,simple and durable,and could be used for the determination of osimertinib mesylate.

Objective To investigate the influence of the pain management path on the postherpetic neuralgia patients. Methods Ninety patients with postherpetic neuralgia were divided into two groups by random digits table method:the control group and the experimental group, 45 cases in each group. The patients in the control group accepted conventional nursing care, the patients in the experimental group accepted the pain management path nursing care. The scores of pain and the overall satisfaction were assessed, the incidence of common adverse reactions at 5 and 10 days after the treatment, hospitalization expenses and hospitalization days were recorded. Results The gender, age, course of disease and degree of pain had no significant difference between the experimental group and the control group at admission (P>0.05). After 5 and 10 days treatment, the scores of pain in the experimental group were (3.07±1.34) , (1.09±0.90) points, and these were (4.29±1.74), (2.27±1.32) points in the control group, the differences were statistically significant (t=3.74, 4.94, all P<0.01). After 5 and 10 days treatment, the scores of the overall satisfaction in the experimental group were (5.50 ± 1.71), (7.96 ± 1.30) points, and these were (4.50 ± 1.60), (7.00 ± 1.50) points in the control group, the differences were statistically significant (t=-2.89,-3.37, all P<0.01). After 10 days treatment, the incidence of constipation was 26.67% (12/45) and 53.33% (24/45) in the experimental group and the control group respectively, the difference was statistically significant between the two groups (χ2=6.667, P<0.05). The hospitalization days were (13.71 ± 3.05) d and (15.76 ± 3.54) d in the experimental group and the control group respectively, the difference was statistically significant between the two groups (t=2.934, P<0.01). The hospitalization expenses were (11798.38 ± 3312.33) yuan and (13972.24 ± 3726.66) yuan respectively, there was significant difference between the two groups (t=2.925, P < 0.01). Conclusions The application of the pain management path for the pain management in patients with postherpetic neuralgia, can relieve the pain, reduce the incidence of adverse effects, hospitalization expenses and days, improve the overall satisfaction of the patients.

Objective To explore the psychological experience of ICU nurses who had worked follow different work patterns, and find the most appropriate staffing model. Methods A phenomenological approach of qualitative research was conducted in 5 ICU nurses by intensive interview,then the data collected were read, analyzed, reflected,finally the theme was got. Results In the work pattern of shifted every 12 hours, with low work frequency and strong feeling of fatigue. In the work pattern of shifted every 8 hours, with high work frequency and the disadvantage of nurse- patient relationship. In the short-time continuous APN work pattern, with continuous management of patients' condition, promotion of nurse-patient relationship, improvement of doctor-nurse relationship, comparatively stable biological clock. Conclusions The short-time continuous APN work pattern can concentrate nurses' work and rest time, relieve the press that caused by the shifted work, at the same time, promote the patients',patients' family and doctors' satisfaction degree with nursing work, increase nurses' effect in the ICU team, guarantee the quality of care, eventually ensure the patients' safety.

Three dimensional (3D)printing technology has been adapted to medical applications at an impressive rate since 2011.It has been widely used in the field of craniofacial,oromaxillofacial,orthopedic and cardiothoracic specialties.3D biometric printing represents one of the highest levels of 3D printing technology and it can be used to print individual anatomical models,implants,prosthetics,external fixators,splints,surgical instrumentation,and for surgical guidance.The application of 3D printing technology in pediatric cardiothoracic surgery start late and has difficulties.This technology is mainly used for cardiothoracic surgery guidance and preoperative schemes selection,organ and tissue transplantation at present.It is of high value in the diagnosis and treatment of complex congenital heart disease,complex trachea and esophagus malformation and thoracic tumor.This article reviews the application progress and prospect of 3D printing technology in the field of pediatric cardiothoracic surgery.

At present, hepatitis B virus (HBV) infection is recognized as an important risk factor for hepatocellular carcinoma (HCC) in the world; however, during the development and progression of hepatitis B, liver cirrhosis, and liver cancer, other factors may promote the development of HCC independently or synergistically with HBV, such as sex, age, family history, alanine aminotransferase/aspartate aminotransferase, smoking and drinking history, metabolic syndrome, and HCV or HIV infection. This article reviews the research advances in the risk factors associated with HCC.

Objective To investigate the noninvasive indicators of indications for antiviral therapy in HBeAg-negative chronic hepatitis B virus (HBV) infection patients with alanine aminotransferase (ALT) ≤40 U/L under the guidance of liver pathology. MethodsA retrospective analysis was performed for the clinical data of 377 HBeAg-negative chronic HBV infection patients with ALT ≤40 U/L who were hospitalized in Affiliated Hospital of Yan’an University, from October 2013 to August 2018 and underwent liver biopsy, among whom the patients with inflammatory activity ＜A2 and fibrosis stage ＜F2 were enrolled as non-antiviral therapy group(n=266), and the patients with inflammatory activity ≥A2 or fibrosis stage ≥F2 were enrolled as antiviral therapy group(n=111). The chi-square test was used for comparison of categorical data between two groups; the t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; univariate and multivariate binary logistic regression analyses were used to screen out the influencing factors for the initiation of antiviral therapy; the receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency of each indicator in determining the need for antiviral therapy in HBeAg-negative chronic HBV infection patients with ALT ≤40 U/L. ResultsOf all 377 patients, 266 (70.6%) did not need antiviral therapy for the time being, and 111 (29.4%) had marked liver damage and thus needed active antiviral therapy. The multivariate analysis showed that liver stiffness measurement (LSM) (odds ratio ［HR］=2.003, 95% confidence interval ［CI］: 1.647-2.437, P＜005), HBsAg (HR=1.563, 95% CI: 1.110-2.200, P＜0.05), HBV DNA (HR=1.519, 95% CI: 1173-1.966, P＜0.05), and albumin (HR=0.939, 95% CI: 0.884-0.998, P＜0.05) were independent influencing factors for the initiation of antiviral therapy. The ROC curve analysis showed that the area under the ROC curve (AUC) was 0.749 (95% CI: 0.699-0799) for LSM, 0642 (95% CI: 0.586-0.699) for HBV DNA, and 0.565 (95% CI: 0.507-0.623) for HBsAg, and the combination of LSM, HBV DNA, and HBsAg had a larger AUC of 0.779 (95% CI: 0.732-0.827). ConclusionThe levels of LSM, HBV DNA, and HBsAg have a reference value in determining the initiation of antiviral therapy in HBeAg-negative chronic HBV infection patients with ALT≤40 U/L.