Objective To investigate the influence of treatment table with C-arm and immobilization device in IMRT planning accuracy, and to explore methods to solve this problem.Methods The solid water slabs and the ionization chamber was scanned and images were transmitted to the treatment planning system (TPS).Beam parameters in the TPS were set with 6 MV beam and 100 MU exposures were used.Measurements were performed at two different sizes of 5 cm×5 cm and 10 cm×10 cm.The gantry was rotated through angles from 0° to 180° with measurements taken at 5° increments.The measure point was set at center of the ionization chamber' measure point, which was also the central point of planning.The center axis of Matrix was aligned with the center of couch and was irradiated in accordance with the same conditions.OmniPro-FmRT software was used to compare and analyze the dose distribution of the radiation field of measurement and the treatment planning system output.Using the function of add constant value to find the appropriate coefficient to improve the plan total dose.The dose distributions for each beam in IMRT plans which was increased or unincreased total dose were measured for 6 patients with pelvic tumor respectively.Results In radiation therapy, treatment couch and immobilization device may attenuate radiotherapy dose.The impact of the incident range from 65°-70° and 115°-125° were the largest.Increasing the total dose of the treatment plan by 2％ could compensate the attenuation of the treatment table and immobilization device.Conclusions In radiation therapy, the impact of the incident range from 65°-70°, 115°-125° and another side of 290°-295° and 230°-245° should be avoided.The attenuation should not be neglected in the TPS and dose should be compensated by adjusting beams' MU.

Pushing and pulling (P&P) is a common operating mode of operator's physical works, and plays an important role in evaluation of human behavior health and operation performance. At present, there are many research methods of P&P, and this article is a state-of-art review of the classification of P&P research methods, the various impact factors in P&P program, technical details of internal/external P&P force measurement and evaluation, the limitation of current research methods and the future developments in the ergonomics field.
Biomechanical Phenomena ; Ergonomics ; methods ; Hand Strength ; physiology ; Humans ; Low Back Pain ; prevention & control ; Physical Exertion ; Posture ; physiology ; Task Performance and Analysis ; Weight-Bearing ; physiology

Objective To establish a rapid,specific and sensitive TaqMan real-time fluorescence quantitative PCR assay for detection of murine polyomavirus ( MPyV) .Methods The specific primers and TaqMan probe were designed based on genome sequence of MPyV.The primers amplified a 69 bp fragment.After optimizing the reaction system and reaction condition, the standard curve was plotted by detecting recombinant plasmid standards.The specificity, sensitivity and reproducibility of this method were evaluated.In addition, samples of lungs, spleens and feces obtained from experimentally infected mice and 86 clinical samples were used to validate the efficacy of this real-time PCR assay.Results The specificity assay showed that this assay could specifically detect MPyV and the sensitivity for MPyV was about 100 copies/well.The coefficients of variation ( CV) of both intra-assay and inter-assay were less than 1.13%.All of the samples from experimentally infected mice were positive for MPyV and 3 out of 86 clinical samples were positive by this TaqMan-PCR detection with a positive rate of 3.5%.Conclusions The real-time fluorescence quantitative TaqMan-PCR assay established in this study has high specificity, sensitivity and stability.It can be used for clinical diagnosis, routine detection and epidemiological investigation of murine polyomavirus infections.

Objective:To explore the perceived differences of medical staff in the hierarchical diagnosis and treatment effectiveness of telemedicine from the perspective of supply and demand, as well as the moderating effects in their respective regions, in order to provide reference for the integrated development of telemedicine services and hierarchical diagnosis and treatment.Methods:From June to September 2023, a survey was conducted on the current status and effectiveness of telemedicine services among medical staff from 245 hospitals in 27 provinces. Using non participants as the reference group, an ordered probit model was used to explore the differences in perception of the hierarchical diagnosis and treatment effectiveness of telemedicine services among medical staff who only served as suppliers, only as demanders, and simultaneously as suppliers/demanders; Using the region as a moderating variable, explore the perceived differences among medical staff in different regions.Results:A total of 997 valid questionnaires were obtained. Medical staff who only served as the demanders ( β=0.197, P<0.05) and simultaneously served as suppliers/demanders ( β=0.189, P<0.01) thought that the implementation of telemedicine could significantly improve the effectiveness of hierarchical diagnosis and treatment, while those who only served as the suppliers thought that the implementation of telemedicine did not significantly improve the effectiveness of hierarchical diagnosis and treatment ( β=-0.028, P>0.05). With the eastern region, medical staff in the central and western regions believed that providing telemedicine services simultaneously as suppliers/demanders could better improve the effectiveness of hierarchical diagnosis and treatment ( β=-0.324, P<0.05). Conclusions:The role and location of medical staff involved in telemedicine services could lead to differences in their perception of hierarchical diagnosis and treatment effectiveness.

Healthy Sanming is a new stage, a new goal and a new station of Sanming′s reform of medical and health system. Based on the rainbow model, the author summarized and analyzed the theoretical logic, content framework and practical effectiveness of the health protection system in new era, summarized the advanced experience and practices in the construction of Healthy Sanming, and systematically interpreted the Sanming practice in Healthy China. Vertically, the macro-level of institutional integration constructed a regional healthcare mechanism to improve the protection system, the meso-level of organizational integration promoted the four-tier referral mode to build a protection network, the micro-level of the professional integration carried out in-depth medical and preventive synergy and fusion to protect the key populations, and the service integration provided life-cycle health services to consolidate the health coverage. Horizontally, the instrumental level drived health performance through the innovation of the health insurance fund and payment method, and the value level standardized and balanced the layout of resources by enhancing the primary medical service capacity. Constructing the health protection system in new era is an important initiative for the construction of healthy Sanming, public hospitals have shifted their focus from treating diseases to treating diseases and health management, the service system has shifted from the program system of health care and health to the synergy and integration of medical and preventive care, and medical insurance payment has shifted from regulating the behavior of doctors′ practice to encouraging the development of health promotion. These health transformations have resulted in a series of experiences that can inform the articulation of the reform of medical and health system with the construction of Healthy China.

Objective:To evaluate the effectiveness of the new operation mechanism of public hospitals in Sanming, so as to provide a theoretical basis for the sustainable development of the new operation mechanism for public hospitals.Methods:The data on medical income and patient costs of public hospitals in Sanming and the whole country from 2011 to 2021 were selected, structural variation analysis was used to analyze and compare the changes in the structure of medical income of public hospitals in Sanming City and the whole country, and descriptive analysis was carried out on the patient burden costs, in order to validate the effect of the new operation mechanism for public hospitals in Sanming.Results:From 2012 to 2021, the cumulative values of structure variation in medical service revenue and drug/consumable revenue of public hospitals in Sanming City were 29.58% and -32.29% respectively, better than the national figures of -0.95% and -0.68%; the annual contribution rate of structural variation in the medical service revenue and drug/consumable revenue of public hospitals in Sanming were 78.10% on average, higher than the national figure of 49.43%. From 2011 to 2021, the average increase in the average outpatient and emergency care costs per patient in public hospitals in Sanming was 4.35%, lower than the national average of 5.97%; the average increase in the average inpatient costs per patient was 3.91%, lower than the national average of 5.40%.Conclusions:The new mechanism for the operation of public hospitals in Sanming is effective and sustainable under certain policy conditions.

The reform of medical insurance payment methods is one of the important measures for Sanming City to achieve universal health. This study explored the design and implementation of DRG payment method under global budget based on the case of Sanming, in order to promote the transformation from disease treatment to health promotion. The transformation practice of Sanming City involved three aspects: concept reshaping, structural reconstruction, and functional reconstruction, which were promoted from the dimensions of goals, paths, and methods, and have achieved significant results. The author proposed three recommendations, including adhering to and improving DRG payments under global budget, attaching importance to medical quality assessment and monitoring, and designing a global budget plus composite payment method that is suitable for various health scenarios.

Rabdosia serra(R.serra),an important component of Chinese herbal tea,has traditionally been used to treat hepatitis,jaundice,cholecystitis,and colitis.However,the chemical composition of R.serra and its effect against colitis remain unclear.In this study,the chemical composition of the water extract of R.serra was analyzed using ultra performance liquid chromatography coupled with a hybrid linear ion trap quadrupole-orbitrap mass spectrometer(UPLC-LTQ-Orbitrap-MS).A total of 46 compounds,comprising ent-kaurane diterpenoids,flavonoids,phenolic acids,and steroids,were identified in the water extract of R.serra,and the extract could significantly alleviate dextran sulfate sodium salt-induced colitis by improving colon length,upregulating anti-inflammatory factors,downregulating proinflammatory fac-tors,and restoring the balance of T helper 17/T regulatory cells.R.serra also preserved intestinal barrier function by increasing the level of tight junction proteins(zonula occludens 1 and occludin)in mouse colonic tissue.In addition,R.serra modulated the gut microbiota composition by increasing bacterial richness and diversity,increasing the abundance of beneficial bacteria(Muribaculaceae,Bacteroides,Lactobacillus,and Prevotellaceae_UCG-O01),and decreasing the abundance of pathogenic bacteria(Turi-cibacter,Eubacterium_fissicatena_group,and Eubacterium_xylanophilum_group).Gut microbiota depletion by antibiotics further confirmed that R.serra alleviated colitis in a microbiota-dependent manner.Overall,our findings provide chemical and biological evidence for the potential application of R.serra in the management of colitis.

Objective To explore the differences in the perceived benefits of carrying out telemedicine services between medical staff as invitees and inviters,and to provide theoretical basis and suggestions for optimizing telemedicine collaboration and benefit patterns.Methods The questionnaire survey was conducted with 997 medical staff around the roles and perceived benefits of telemedicine services,and correlation analysis,multivariate linear regression,univariate analysis of variance,and logistic regression were used to explore differences in medical staff's perceived benefits of conducting telemedicine services.Results Regarding the perceived benefit of reputation,the invited party believed that carrying out telemedicine services could publicize and enhance personal influence(OR=1.771),and could enhance the influence of hospital(OR=1.455),while the opposite was true for the invited party(OR=0.737).Regarding the perceived benefits of capacity enhancement,the invited parties believed that carrying out telemedicine services was not conducive to enhancing their personal capacity to diagnose and treat difficult cases(OR=0.651);and as an inviting party,they believed that it was conducive to the development of their hospital's discipline(OR=1.317).Conclusion The invited party mainly focuses on the perceived benefits of reputation,while the inviting party mainly focuses on the perceived benefits of capacity enhancement.Both have complementary perceived benefits,but there may be a game of interests,so it is necessary to optimize the participation incentive mechanism,operation mechanism and performance evaluation mechanism of telemedicine services around the motivation of the invited party and the difficulties of the inviting party.

Objective To explore the differences in the perceived benefits of carrying out telemedicine services between medical staff as invitees and inviters,and to provide theoretical basis and suggestions for optimizing telemedicine collaboration and benefit patterns.Methods The questionnaire survey was conducted with 997 medical staff around the roles and perceived benefits of telemedicine services,and correlation analysis,multivariate linear regression,univariate analysis of variance,and logistic regression were used to explore differences in medical staff's perceived benefits of conducting telemedicine services.Results Regarding the perceived benefit of reputation,the invited party believed that carrying out telemedicine services could publicize and enhance personal influence(OR=1.771),and could enhance the influence of hospital(OR=1.455),while the opposite was true for the invited party(OR=0.737).Regarding the perceived benefits of capacity enhancement,the invited parties believed that carrying out telemedicine services was not conducive to enhancing their personal capacity to diagnose and treat difficult cases(OR=0.651);and as an inviting party,they believed that it was conducive to the development of their hospital's discipline(OR=1.317).Conclusion The invited party mainly focuses on the perceived benefits of reputation,while the inviting party mainly focuses on the perceived benefits of capacity enhancement.Both have complementary perceived benefits,but there may be a game of interests,so it is necessary to optimize the participation incentive mechanism,operation mechanism and performance evaluation mechanism of telemedicine services around the motivation of the invited party and the difficulties of the inviting party.