Objective To analyze the factors influencing the long-term allograft survival in cadaver- ic renal transplantation.Methods Parameter data were obtained from 249 patients who received immuno- suppressive agents after renal transplantation.Health resources were evaluated for 1-5 years;and 14 relevant factors,including age,sex,therapeutic regimen choice and complications,etc were analyzed.Life table method and COX regression model were used to analyze the risk factors influencing the outcomes and to calculate the survival rates.Results Following renal transplantation,the survival rates of recipients who lived for 1,2 and 3 years were 72.6%,56.0% and 40.8%,respectively;and the rates of those who lived for 4 and 5 years both were 22.5%.The median survival time was 34.9 month.With the therapy prolonged,the survival benefit in MMF group was superior to that in AZA group,with the median survival time being 38.9 months 30.6 months,respectively.COX regression model showed that the main predictive factors were treatment regi- men(P=0.000),follow-up period(P=0.000),patient's compliance(P=0.000),acute rejection episode (P=0.020),sex(P=0.001)and hospitalization period(P=0.040).Conclusions Life table and COX regression model are useful methods for evaluating long-term outcome and influencing factors in renal trans- plant patients.

At present, we are facing challenges in the development of rare disease drugs. The paper introduces the ethical theories of rare disease treatment, the characteristics of pharmacoeconomic evaluation on orphan drugs, the risk of reimbursement in medical insurance funds, the international experiences on the balance between the accessibility and cost containment of high-cost orphan drugs, the orphan drug list promulgated by Hong Kong SAR of China in 2019 and the status quo of orphan drugs in China. The author also analyzes the international practice from different perspec-tives, such as, the Orphan Drug Act(ODA)in the United States, the new concept of high specific technology introduced by National Institute Health and Clinical Excellence(NICE)in the UK, the retrospective review of pharmacoeconomics of orphan drugs by National Centre for Pharmacoeconomics(NCPE)in Ireland, the principles of orphan drug evaluation by TLV in Sweden, a special research program on the cost of orphan drugs in Turkey, and the four measures to control the cost of high-priced drugs in the Republic of Korea. The aim of this paper is to introduce international experiences for reference on the formulation of drug policies in rare diseases and development of related pharmacoeconomics in China.

Chemotherapy, Adjuvant ; Gastrectomy ; Humans ; Microsatellite Repeats ; Neoadjuvant Therapy ; Stomach Neoplasms/pathology*

Taking Children's Hospital in Hunan Province as an example,the paper introduces the design and application of the security mode for the mobile business platform of hospital from the aspects of the overall structure,implementation plans of security access equipment,security authentication modes and strategies,etc.,and provides ideas for safely implementing remote deployment and mobile application.

The paper points out that informatization development of hospital has three stages,namely,the stage of hospital management informatization,the stage of clinical management informatization and the stage of regional health informatization.It expatiates on the impact of each stage on medical staffs' behavior,points out that informatization is able to increase medical staffs' work efficiency,regulate their diagnosis and treatment behavior and enhance diagnosis and treatment quality.

In order to improve the access and control of core data in medical information security,the paper builds a virtual isolation private cloud storage architecture in hospital,including virtualized reconstruction,metadata model application based on hierarchical model,access to remote clients design and application based on virtual isolation and so on,providing a reliable method for the isolation and intercommunication between the intranet and extranet.

To construct the Bac-to-Bac expression system of Bombyx mori nucleopolyhedrovirus (BmNPV), a transfer vector was constructed which contained an Escherichia coli (E. coli) mini-F replicon and a lacZ: attTN7: lacZ cassette within the upstream and downstream regions of the BmNPV polyhedrin gene. B. mori larvae were cotransfected with wild-type BmNPV genomic DNA and the transfer vector through subcutaneous injection to generate recombinant viruses by homologous recombination in vivo. The genomic DNA of budded viruses extracted from the hemolymph of the transfected larvae was used to transform E. coli DH10B. Recombinant bacmids were screened by kanamycin resistance, PCR and restriction enzyme (REN) digestion. One of the bacmid colonies, BmBacJS13, which had similar REN profiles to that of wild-type BmNPV, was selected for further research. To investigate the infectivity of BmBacJS13, the polyhedrin gene was introduced into the bacmid and the resultant recombinant (BmBacJS13-ph) was transfected to BmN cells. The budded viruses were collected from the supernatant of the transfected cells and used for infecting BmN cells. Growth curve analysis indicated that BmBacJS13-ph had a similar growth curve to that of wild-type BmNPV. Bio-assays indicated that BmBacJS13-ph was also infectious to B. mori larvae.

Objective To explore the ameliorative effects of standardized tertiary rehabilitation(STR)on the quality of life(QOL)of stroke patients with hemiplegia.Methods Eighty-two stroke patients were randomly divided into two groups:a rehabilitation group(R group)and a control group.All patients were given routine inter- nal medicine treatment,but STR was also administered to the R group.The QOL of all of the patients was assessed with the brief scale of quality of life(QOL-BREF)at the beginning,and at the end of the Ist month,3rd month and 6th month after stroke.Results There were two deaths in the control group,but no deaths in the R group.At ever- y stage,the R group returned better scores for physiological health,psychological state,social and environment rela- tionships,the subjective QOL and health items,and in comprehensive self-evaluation.QOL scores,except for social relationships,were consistently,significantly higher in the R group.The R group's QOL scores improved obviously in the first 3 months after stroke,and then more slowly in the next 3 months.Conclusions STR markedly improved the QOL of stroke patients.Their QOL scores improved obviously soon after stroke,but slowly later on.

Objective To examine the reliability,validity and sensitivity of FCA for stroke patients. Methods A total of 82 patients with stroke were divided into a treatment group and a control group randomly.The patients in the control group were given routine internal medicine treatment,while those in the treatment group were given standardized rehabilitation therapy in addition to the routine internal medicine treatment.All patients were as- sessed with FCA and Modified Barthel Index(MBI),at admission and the end of the 1st month,3rd and 6th month,respectively after the onset of stroke.The internal consistency,split-half reliability,content validity,crite- ria validity and sensitivity of FCA were tested.Repeat measure ANOVA and correlation analysis were used in the statistical analysis.Results There existed a good internal consistency(Cronbach?=0.901～0.973)as well as a good split-half reliability(R=0.949～0.981)of FCA.There was a medium to strong correlation among the 18 items scores of the FCA and FCA scores(P

Objective To evaluate the effects of 'patch-skill'in the management of refractory bleeding during the process of open heart surgery.Methods Between May 2007 to Oetober 2008,7 patients undergoing open-heart surgery experienced active bleeding.Autologous perieardial patches were used in 6 patients, and polyester patch in the other one.The patches were sutured continuously by 5-0 Prolene suture.Results The 24 hour chest tube output was less than 500 ml in all 7 cases after operation.There were no death, secondly active bleeding,or mediastinal in-faction.Conclusion The'patch-skill' can effectively control the refractory bleeding during open heart surgery.Au-tologous perieardial patehe is the first choice because it has multiple advantages.The polyester patch ean be used al-ternatively when autologous pereardiurn cannot be used (for various reasons such as edema and infection).