Reform on medial service compensation mechanism,as a key point in the heahhcare system reform,runs through the entire reform process.It plays a key role for the establishment and improvement of urban medical care system,medical service system,medical management system and operating system,for its guidance and regulation effects.Such a refonn to build a scientific and perfect compensation model and mechanism will be highly significant for the smooth progress of the new round of healthcare reform and its success in the end.

The specific features of diabetic microangiopathy include thickening of basement membrane with deposition of a transparent material.Diabetic retinopathy,neuropathy,cardiomyopathy,as well as diabetic foot are the main complications.It remains controversial whether intensive treatment may reduce the clinical renal end point events significantly,while evidence-based medicine confirmed that intensive treatment can reduce the trace and heavy proteinuria,neuropathy,and retinopathy.It will benefit the patients if comprehensive,and standard and,persistent treatments,are started as early as possible,and it consider the features of elderly patients.Managing Older People with Type 2 Diabetes Global Guidelines (IDF) and Chinese Elderly Diabetes Expert Consensus on Diagnosis and Treatment Measures point out that microvascular complications in elderly patients with diabetes closely related to the quality of life,to which we should pay great attention.Early prevention,early diagnosis,early treatment,reach the standard in early stage will be of important clinical significance for the prevention and treatment of senile diabetic microvascular lesion.

Glycosylated hemoglobin A1c(HbA1c)is the products of slow,continuous non-enzymatic saccharification reaction,which can reflect the average blood glucose of 2~3 months of the patients,and it is the most important index for long-term monitoring of glucose.There are so many methods for detecting HbA1c that America,Japan and Swede proposed their own standardized detection methods to reduce the difference laboratories.However,these methods were non-specific.A new method for was developed by International Federation of Clinical Chemistry and laboratory medicine (IFCC) in 2007,which was of high specificity,but which resulted in relatively low glycosylated hemoglobin.To avoid the confusion in reference value of glycosylated hemoglobin,average blood glucose was recommended by American Diabetes Association (ADA),European Association for the Study of Diabetes (EASD),and International Diabetes Federation (IDF).This paper review the origin of average blood glucose substituting HbA1c,relationship of HbA1c with average blood glucose,and the international multiple-center research of ADAG and its enlightenment,and we also discuss the relevant development in future.

AIM:To study the prepartion of Ruanganxiaoshui Cataplasma and it's percutaneous absorption in vitro as well as dissolvability in vitro. METHODS: In the experiment,orthogonal test was used to optimize the preparation.Meanwhile,with the help of azole and propylene alcohol the percutaneous absorption of ginsenoside Rg_1 from the cataplasma carriers in vitro was determined by Franz's diffusion cell and HPLC,as well as dissolution rate in vitro. RESULTS: The percutaneous absorption rate of ginsenoside Rg_1 through rat skin in vitro was 0.394 ?g/cm~2/h.And the dissolution process fitted to first order model. CONCLUSION: The Cataplasma carriers possess a good drug dissolution property.To add compound penetration enhancers is one of the effective methods for raising percutaneous absorption.

Abstract: Objective　To retrospectively analyze the individual dose monitoring of radiation workers in Chongqing City from 2016 to 2020, so as to provide scientific reference for occupational health monitoring and radiation protection. Methods　Radiation workers who performed individual dose monitoring in Chongqing Center for Disease Control and Prevention from 2016 to 2020 were selected as the research objects, and the monitoring data were collected and analyzed. Results　A total of 40 926 individuals were included in this study, with a total of 135 622 person-years. The average annual individual effective dose of radiation workers over the five-year period was 0.56 mSv. NR1 and NR5, the ratio of the number of works receiving annual individual does exceeding 1 and 5 mSv to the to the total monitor workers were 13.019% and 0.335%. The annual effective dose per capita in Chongqing City showed a trend of first decreasing, then increasing and then decreasing again over the study period, with significant differences between different years (F=971.754, P<0.001). Although there were some differences in the variation trend of annual effective dose among different occupational categories, the overall trend was decreasing year by year. The average annual effective dose of nuclear medicine and interventional radiology was relatively high, and the difference was not statistically significant (P>0.05). The average annual effective dose of industrial flaw detection and accelerator operator in industrial application was relatively higher, and the difference was not statistically significant (P>0.05). There were statistically significant differences in the per capita effective doses of different occupational categories of medical application in different years (F=8.892-682.852, P<0.001). Among them, the per capita annual effective doses of five occupational categories of medical application were the highest in 2016, and the per capita annual effective doses of interventional radiology were the highest in 2018 and 2019. Conclusions　The per capita annual effective dose of radiation staff in Chongqing has decreased year by year from 2016 to 2020, and remained at a relatively low level that meets national standards. The monitoring results suggest that the radiation staff of nuclear medicine, interventional radiology, industrial non-destructive testing and accelerator operator should give special attention to protect their occupational health and safety.

Child ; Humans ; Karyotyping ; Male ; Osteochondrodysplasias ; classification ; diagnosis ; genetics

Objective To test the key indexes of full-field digital mammography to keep it in good condition.Methods The testing was carried out based on clinical experiences and GBZ 186—2007 Mammography Quality Control Testing Specification.Results The testing items and indexes were proposed to facilitate the staff to check and operate the machine.Conclusion Clinical safety of full-field digital mammography and image quality are both enhanced greatly.

Objective To evaluate the interactive relationship between inflammation detected by single photon emission computed tomography combined with computed tomography (SPECT/CT) and magnetic resonance imaging (MRI) detection of synovitis,bone marrow edema (BME) in the early rheumatoid arthritis (RA) patients.Methods Twenty patients with early RA were included into this study.All patients were diagnosed based on the 2010 ACR/EULAR classification criterion.Patients' unilateral hands (MCP 2-5 and PIP 2-5 joints) were inspected by SPECT/CT (label:99Tcm-MDP) and MRI (3.0 T).SPECT/CT and MRI images were analyzed by two reviewers blinded to other clinical information.Increased bone metabolism of the regional area of interest (ROI) was analyzed and the uptake ratio was calculated.MRI quantitative evaluation was completed by RAMRIS score system.Statistical analysis was performed using SPSS 17.0 software.Student's t-test,analysis of variance (ANOVA),x2 test and post-hoc analysis (Scheffe) were used for comparison of datas,correlation analysis was carried out with Spearman rank correlation test.Results Twent ypatients with a total of 160 joints were examined.MRI examination revealed synovitis (39,24.4％),or BME (24,15.0％) in 63(39.4％) joints.99Tcm-MDP uptake increased in 79(49.4％) joints,and the uptake ratio was higher than normal joints (1.59±0.26 vs 1.15±0.09,t=6.408,P＜0.01).The uptake ratio between the graded synovitis level and RAMRIS synovitis score had a moderate correlation (r=0.535,P=0.001).The uptake ratio of BME level and BME score was well correlated (r=0.765,P=0.001).Conclusion In early RA patients,MRI is sensitive for synovitis and BME.SPECT/CT can detect early abnormal bone metabolism associated with inflammation,which is more sensitive than MRI.SPECT/CT can be used to detect changes of RA at the molecular level.Compared with synovitis,BME is more closely related to bone metabolism changes,which may suggest that BME may play a major role in the bone destruction in RA.However,further studies are needed to verify this hypothesis.

Objective To improve the biocompatibility of the metallic stent used for interventional treatment. Methods Inner coatings, outer coatings and micro-porous coatings were made using the solution-injection method, and salt crystallite with demanded size was added in order to develop micro-porous coatings. Results The optical concentrations of polyurethane solution and of salt crystallite (for micro-porous coatings) were obtained, and the corresponding processes were developed. Conclusion The poly-coated stent retains its elasticity, and it become very convenient to develop stents carrying drugs. Its effects on animals ard under test.

Acupuncture Therapy ; Facial Paralysis ; therapy ; Humans ; Male