Objective: To analyze the fairness of health resource distribution in various cities and provinces in China, to provide policy recommendations for the state to formulate relevant policies. Methods: Using Theil index method to measure the provincial disparity of health resources allocation and analyze the relevant data about regional health resources in 31 provinces from 2003 to 2011 in China. Results: Chinese medical and health technical personnel are seriously uneven distributed; the number of health technical personnel in big cities such as Beijing is denser than that in western areas like Guizhou. At the same time, the medical treatment level between urban and rural residents also exist serious inequality, urban residents have higher spending levels than rural residents. Conclusion:The state is recommended to adopt measures to encourage more medical technical talents to work in western underdeveloped region. At the same time, the state should improve the medical level of rural residents by improving the rural medical insurance reimbursement ratio and other measures.

This paper presents a design scheme of automated control system in sickroom. With the display unit controlled by 89C52 SCM, the main station checks up and measures the signals of the slave station, and the slave station regulates the height of the transfusion bottle through the step motor, then the transfusion velocity is adjusted. Relative experiments and data analyses are also performed.

AIM: To investigate the effects of Lobelia Chinensis Lour alkaloid (LCLA) on the proliferation of cultured vascular smooth muscle cells (VSMC) induced by ET-1. METHODS: Human umbilical artery VSMC was cultured and divided into five groups: ET group, ET+LCLA group, ET+BQ-123 group,ET+ staurosporine (ST) group and control group. The cell proliferation activity was subsequently quantified by cell counting kit-8 (CCK-8) and [3H]-TdR incorporation. Flow cytometry was used to examine cell cycle. Quantitative immunohistochemical technique was used to investigate the expression of proliferating cell nuclear antigen (PCNA) and confocal microscope was used to measure the fluorescent intensity of Ca 2+. Cytotoxicity was measured by Trypan blue exclusion and LDH colorimetry tests. RESULTS: BQ-123 (10 -6mol/L), ST (10 -7mol/L) and LCLA (100, 200 and 400 mg/L) inhibited the increase in cell number, [3H]-TdR incorporation, the percentage of the S phase and markedly decreased the expression of PCNA and fluorescent intensity of Ca 2+ in response to ET-1 of VSMC (P

ObjectiveTo study the methods of how to protect facial nerve function following complete resection of acoustic neurinomas and the value of the techniques of F wave assisted electrophysiological monitoring intraoperatively.Methods Retrospectivelysummarizing theresultsof combining three electrophysiological monitoring techniques such as nasal muscle F wave recording,online EMG and triggered EMG to monitor 46 cases of microoperations for acoustic neurinomas intraoperatively during the period of Feb.2004 to Dec. 2008. Correlating every intraoperative monitoring index with their follow-up results of facial nerve function 1 day and 6 months after their operations.The tendency of the two continuous monitoring techniques between nasal F wave recording and online EMG of facial muscles has also been studied in this paper. Results Among 46 cases of acoustic neurinomas, 45(97.83 %) tumors have been totally resected, and 1 (2.17 %) tumor subtotally resected,lcase (2.17 %)died after operation,and 2ases occurred the leakage of cerebrospinal fluid(CSF) which have been cured through conservative treatment. The whole anatomic protection rate of facial nerve is 97.83 %,and their functional protection rates 6 months after operation are:HB Ⅰ - Ⅱ,75.56 %;Ⅲ-Ⅳ,22.22 % and Ⅴ-Ⅵ,2.22 %.The completely accordant rate between the intraoperative findings of nasal F wave recording and online EMG is 52.17 %, partially accordant rate is 45.65 %, and totally opposite rate is 2.17 % (x2 趋势= 6.113, P ＜0.05). The intraoperative monitoring indexes in nasal muscle F wave recording are correlated well with the facial nerve function in the 6th month' s follow-up (κ=0.429, P ＜0.001).In triggered EMG monitoring after tumors being resected,the stimulus threshold ratio and maximum amplitude ratio of facial nerve between leaving brain stem part and inner acoustic porus part are also correlated well with the facial nerve function 6 months after operation(κ=0.576, P ＜0.001; κ=0.595, P ＜0.001). ConclusionNasal muscle F wa recording cooperated well with online EMG and triggered EMG intraoperatively and correlates well with the postoperative facial nerve function, so they should be routinely applied together intraoperatively.

Objective To discuss the risk factors and therapeutic options of delayed would healing after craniotomy. Methods Sixteen patients with poor would healing after craniotomy, admitted to our hospital from January 2012 to September 2016, were chosen in our study. The secretion culture results, imaging findings, devastating infections, paranasal sinuses, would debridement and prognoses were analyzed. Results All 16 patients were treated with artificial materials in the initial operations. The paranasal sinuses were confirmed open during operation in 7 patients by comparison of preoperative imaging. Six patients who had positive results by secretion culture were cured through removal of the artificial materials and bone flap during the first debridement surgery; 4 of the 10 patients who had negative results were cured only by removing artificial materials during the first debridement surgery, and the remaining 6 were cured with reoperation through removal of the bone flap. Conclusions Chronic infection caused by bacteria, which mainly comes from surgical field and paranasal sinuses, is important to elucidate the mechanism of delayed would healing after craniotomy. The implants and autologous tissues have important roles in this process. Early complete debridement is very critical on such infected would, meanwhile we must repack the ostia of the sinuses based on preoperative images, and relax the indications for throwing the bone flap.

Objective To compare the effects of remifentanil and fentanyl in urologic surgery under endoscopic anesthesia and the incidence of adverse reactions in patients.Methods A total of 170 patients undergoing urological surgery admitted to the Second People 's Hospital of Jinzhong from February 2015 to April 2016 were randomly divided into the study group and control group according to the digital table ,with 85cases in each group. Remifentanil and fentanyl was used in the study group and control group respectively .The preoperative anesthesia was performed in the patients who received anesthesia before and after tracheal intubation and before and after tracheal intubation,and the time of induction of anesthesia ,the operation time and the time of postoperative wakefulness were compared between the two groups.Pressure and heart rate changes ,the incidence of adverse reactions were recorded and compared between the two groups.The amount of anesthesia ,anesthesia surgery costs and the amount of bleeding during surgery were compared.Results The induction time of anesthesia in the study group was significantly shorter than that in the control group (9.8min vs.6.9min,t＝12.029,P＜0.05).The mean arterial pressure and heart rate in the study group were significantly larger than those in the control group ( all P＜0.05).The incidence rate of adverse reactions in the study group was significantly lower than that in the control group (5.9% vs.12.9%,χ2＝7.935,P＜0.05).The cost and blood loss of the study group were significantly lower than those of the control group (2 871.4 CNY vs.3 014.9 CNY;23.4mL vs.32.7mL,t＝20.391,17.907,all P＜0.05).Conclusion The application of remifentanil in preoperative anesthesia of urologic surgery can save time ,reduce the economic burden of patients and the incidence of adverse reactions in patients.It is worthy of widely recommended in clinic.

Objective To construct the digital pituitary adenoma image and explore the value of simulation of single nostril-transsphenoidal surgery.Methods Thirty patients with pituitary adenoma,admitted to our hospital from October 2009 to March 2011,were performed single nostril-transsphenoidal surgery; thin slice images of preoperative examinations included computed tomography and magnetic resonance imaging were imported into Dextroscope workstation to construct digital pituitary adenoma image; the related anatomic structures of surgical approach were observed and the procedures were formulated and performed.Results Models based on three-dimensional shapes could show the related anatomical structures dynamically and stereoscopically and simulate the operation processrepeatedly.The preoperative planning indicators in the anatomic segment of nasal,anterior sphenoidal wall,basilar pituitary fossa and structures around the tumor were completed.The anatomic characteristics of simulated surgery were consistent with the real operation.Conclusions The digital models can provide some individual anatomic information to develop the preoperative planning programs for single nostril-transsphenoidal surgery,which can facilitate the work of operation and avoid injuring the important anatomical structures.

Objective To investigate the construction and value of radiation pneumonitis(RP)predic-tive model based on machine learning algorithm.Methods A retrospective analysis was conducted on the clin-ical data in 77 patients with breast cancer receiving radiotherapy and regular follow-up in this hospital from August 2019 to September 2022.The affected side lung was delineated on the localization CT as the area of in-terest and the radiomics features were extracted,meanwhile the affected side lung dosimetric parameters were extracted.After feature screening,the patients were divided into the training set and testing set by a 7∶3 rati-o.The features of positioning CT radiomics were extracted and combined with the dosimetry parameters of the affected side lung,and the model was established by using stochastic gradient descent(SGD)algorithm.The performance of the model was validated by using the area under the receiver operating characteristic(ROC)curve(AUC)and decision curve analysis(DCA).Results Among 77 patients,24 cases developed RP after ra-diotherapy end with an incidence rate of 31.17％.Compared with the patients without RP occurrence,V5,V10,V15,V20,V25,V30 and mean lung dose(MLD)in the patients with RP occurrence were higher,and the differ-ence was statistically significant(P＜0.05).In the training set,36 cases did not develop RP.17 cases devel-oped RP,in the testing set,17 cases did not develop RP and 7 cases developed RP.The affected side lung dosi-metric parameters had no statistical difference between the training set and testing set with and without RP occurrence(P＞0.05).After characteristics screening,the 8 optimal characteristics combinations were finally obtained.The average AUC of SGD model in 50％off cross-validation of the training set was 0.900 and AUC in the test set was 0.882.Conclusion The positioning CT radiomics features combined with dosimetry param-eters of the affected side lung has the good predictive value for RP after breast cancer radiotherapy.

Objective To investigate the risk factors,mechanism and treatment strategies of expanding regional brain injury (traumatic intracerebral contusion or hematoma) in patients with acute traumatic epidural hematoma (ATEDH) after surgical evacuation.Methods Fifty-nine patients with ATEDH,admired to and accepted surgical evacuation in our hospital from February 2013 to September 2018,were chosen in this study;their clinical data and CT imaging data were retrospectively analyzed.The volume ofintracranial hematoma was measured by 3D Slicer software.According to the progress of local brain injury revealed by first CT examination after surgical evacuation,patients with ATEDH were divided into progressive group and non-progressive group.Risk factors of patients with expanding regional brain injury after surgery were analyzed by univariate and multivariate Logistic regression analyses.Results After surgery,22 showed expanding regional brain injury,accounting for 37.29％:9 occurred expanding intracerebral hematoma,and 2 of them died after conservative treatment;two had both expanding intracerebral contusion and hematoma;11 expanding intracerebral contusion patients developed into hematoma,and three of them occurred delayed intracerebral hematoma adjacent to the area of ATEDH,and two underwent secondary craniotomy with good recovery.As compared with patients from the non-progressive group,progressive group had significantly higher percentages of patients with preoperative hyperglycemia (＞9.1 mmol/L),patients with preoperative abnormal coagulation and patients accepted decompressive craniectomy (P＜0.05).Multivariate Logistic regression analysis revealed that preoperative abnormal coagulation was an independent risk factor for expanding intracerebral contusion or hematoma after surgery (OR=6.498,95％CI:1.076-39.253,P=0.041).Conclusion Expanding regional brain injury has high morbidity in patients with ATEDH after surgery evacuation;preoperative abnormal coagulation is an independent risk factor for its occurrence.

Objective To explore the efficacy and experience of surgical approaches of puncture drainage and urokinase thrombolysis for spontaneous hypertensive pontine hemorrhage.Methods The clinical data of 42 patients with spontaneous pontine hemorrhage, admitted to our hospital from January 2014 to December 2018, were retrospectively analyzed. Craniotomy evacuation of hematoma was performed in 18 patients (control group), and puncture drainage and urokinase thrombolysis assisted by neuronavigation was performed in 24 patients (observation group). The clinical efficacies of the two groups were observed and analyzed.Results There were 24 patients having hematoma clearance rate≥50％, including 7 from control group and 17 from observation group. The hematoma clearance rate≥50％ in the observation group (70.83％) was significantly higher than that in the control group (38.89％,P<0.05). Postoperative Glasgow-Pittsburgh scale scores of the observation group (24.21±4.85) were slightly higher than those of the control group (23.61±5.45), and the mortality of the observation group (66.67％) was lower than that of the control group (72.22％) without statistical significance (P> 0.05).Conclusion The surgical approach of puncture drainage and urokinase thrombolysis can effectively improve hematoma clearance rate for spontaneous hypertensive pontine hemorrhage, but clinical prognoses are not improved due to influence of multiple factors.