1.Adjustments and countermeasures of China's medical foreign investment policy
Chinese Journal of Health Policy 2017;10(9):75-80
Since the reform and opening up, the government of China has continuously adjusted its foreign medical policy and vigorously guided foreign investment to set up medical institutions in pilot provinces and cities. Based on healthy China 2030 plan, the paper summed up the foreign medical policy adjustment's process from its establishment, stagnation, and development to reform in China. The government of China liberalizes the market for foreign medical gradually, but the foreign medical institution is facing a series of bottlenecks, such as the lack of le-gal regulations, the cumbersome of approval procedures, and the limit of development and so on. The development of foreign medical care should be under the guidance of the country's legal and policy. Foreign medical institution can carry out some special medical care to improve the health of the residents.
2.Correlation between standardized uptake value and intravoxel incoherent motion parameters of cervical squamous cell carcinoma with 18F-FDG PET/MR
Siyao DU ; Hongzan SUN ; Le ZHANG ; Jun XIN ; Kaining SHI ; Qiyong GUO
Chinese Journal of Nuclear Medicine and Molecular Imaging 2018;38(4):229-233
Objective To assess the correlation between standardized uptake value (SUV) and intravoxel incoherent motion (IVIM) parameters of primary cervical squamous cell carcinoma (CSCC) and pelvic metastatic lymph nodes in the use of hybrid PET/MR.Methods Forty-six CSCC patients in Shengjing Hospital from January 2015 to December 2015 were prospectively enrolled and divided into well-differentiated (G1) group,moderate-differentiated (G2) group and poorly-differentiated (G3) group.PET/MR examination with the multi-b-value diffusion-weighted imaging (DWI) sequence was performed before treatment.Maximum SUV (SUVmax) and mean SUV (SUVmean) were calculated.IVIM parameters,including the slow diffusion coefficient (D),fast diffusion coefficient (D*),perfusion fraction (f) were also measured.Pearson correlation analysis was used to evaluate the correlation between IVIM parameters and SUV(SUVmax,SUVmean).Results The D of G1,G2,G3 lesions and metastatic lymph nodes were (0.827± 0.232) × 10-3,(0.640±0.153) × 10-3,(0.563±0.090) × 10-3 and (0.772±0.246) × 10-3 mm2/s respectively.The f was 0.310±0.068,0.348±0.073,0.287±0.057 and 0.413±0.103 respectively.The D* was (9.241± 2.001) × 10-3,(9.408± 1.927) × 10-3,(9.715± 1.827) × 10-3 and (8.830± 1.632) × 10-3 mm2/s respectively.The SUVmax was 9.988±3.806,12.941±5.990,14.543±7.050 and 9.890±3.906 respectively.The SUVmean was 5.717±2.830,7.094±3.518,8.263±4.124 and 4.952±1.343 respectively.The D of G1 and G2 lesions had negative correlations with SUVmax and SUVmean(G1,r values:-0.816,-0.842;G2,r values:-0.528,-0.559;all P<0.05);the f of G2 lesions had positive correlations with SUVmax and SUV (r values:0.554,0.550,both P<0.05).Conclusions The SUVmax and SUV of the well-moderate differentiated CSCC are consistent with D and f,which reflect the cell density and the microvascular perfusion.PET/MRIVIM could provide important complementary information for treatment-monitoring and prognostic assessment of patients with cervical cancer.
3.Effect of binaural beat therapy on sleep structure in patients with post-stroke sleep disorders
Siyao GUO ; Shuo GAO ; Jie CHENG ; Ying YU
Chinese Journal of Modern Nursing 2024;30(32):4426-4432
Objective:To investigate the impact of binaural beat therapy (BBT) on the sleep structure of patients with post-stroke sleep disorders (PSSD) .Methods:Using convenience sampling, a total of 135 patients with PSSD who were admitted to the Department of Neurosurgery at the Affiliated Hospital of North China University of Science and Technology from October 2022 to October 2023 were selected and randomly divided into three groups: BBT group, regular music group, and control group, with 45 patients in each group. The control group received routine care, while the BBT group received binaural beat music training in addition to routine care, and the regular music group received regular music training along with routine care. Polysomnography data were recorded one day before the intervention and on the 28th day to compare sleep structure differences before and after the intervention in the three groups.Results:Eventually, 42 cases were completed in the control group, 43 cases in the regular music group, and 42 cases in the BBT group. After the intervention, there was no statistically significant difference in the percentage of non-rapid eye movement (NREM) sleep among the three groups ( P>0.05). The percentage of N2 sleep in all three groups was lower than before the intervention, and the BBT group had a lower percentage of N2 sleep than the regular music group and the control group. The percentage of N3 sleep in all three groups was higher than before the intervention, and the BBT group had a higher percentage of N3 sleep than the regular music group and the control group, these differences were statistically significant ( P<0.05). The latencies of NREM and rapid eye movement sleep, as well as the number of awakenings, were lower in all three groups compared to before the intervention, and the BBT group had lower values than the regular music group and the control group, these differences were also statistically significant ( P<0.05). The sleep efficiency of all three groups was higher than before the intervention, and the BBT group had higher sleep efficiency than the regular music group and the control group, with a statistically significant difference ( P<0.05) . Conclusions:BBT can effectively improve sleep structure and enhance sleep quality in patients with PSSD.
4.The value of synthetic MRI in identifying different molecular types of breast cancer and triple negative and non triple negative breast cancer
Ruimeng ZHAO ; Siyao DU ; Liangcun GUO ; Guoliang HUANG ; Xixun QI ; Shu LI ; Lina ZHANG
Chinese Journal of Radiology 2022;56(6):636-642
Objective:To investigate the value of synthetic MRI quantitative parameters in identifying different molecular types of breast cancer and triple negative breast cancer (TNBC) and non-TNBC.Methods:A retrospective analysis was performed on 208 patients diagnosed with invasive ductal breast cancer in the First Affiliated Hospital of China Medical University from March 2019 to September 2020. All patients underwent synthetic MR examinations and the following quantitative parameters were measured, including tumor diameter, volume, apparent diffusion coefficient (ADC), and corresponding values of T 1, T 2, and proton density (PD). According to the immunohistochemical results, there were 122 cases of progesterone receptor (PR) positive and 86 cases of PR negative, 123 cases of estrogen receptor (ER) positive and 85 cases of ER negative, 79 cases of human epidermal growth factor receptor-2 (HER2) positive and 129 cases of HER2 negative, 149 cases of Ki-67 high expression and 59 cases of Ki-67 low expression; there were 36 cases of TNBC and 172 cases of non-TNBC. Independent samples t test or Mann-Whitney U test were used to compare the quantitative parameters of different molecular types, TNBC and non-TNBC patients. Multivariate logistic regression was used to analyze independent predictors of TNBC, and receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the efficacy of sole and combined parameters in identifying TNBC. Results:T 1 and T 2 values in PR negative breast cancer patients were higher than those in PR positive patients ( t=2.30, Z=2.04, P<0.05); the values of T 1 and T 2 in ER negative patients were higher than those in ER positive patients ( t=2.52, Z=2.48, P<0.05); ADC value and tumor diameter of HER2 positive patients were larger than those in HER2 negative patients ( t=-3.21, Z=-3.22, P<0.05). T 2 value, tumor volume and diameter in patients with Ki-67 high expression were significantly higher than those in patients with Ki-67 low expression ( Z=-3.47, -2.51, -2.84, P<0.05); ADC value in Ki-67 high expression group was less than that in Ki-67 low expression group ( t=3.94, P<0.001). T 1, T 2 values and tumor volume in TNBC patients were higher than those in non-TNBC patients ( t=-3.26, Z=-5.58, Z=-2.02, P<0.05], and ADC value in TNBC patients was lower than that in non-TNBC patients ( t=3.07, P=0.002). Multivariate logistic regression analysis showed that T 2 (OR=1.060, 95%CI 1.028-1.093, P<0.001) and ADC value (OR=0.947, 95%CI 0.911-0.984, P=0.005) were independent predictors of TNBC. The efficacy of each parameter alone and in combination to identify TNBC showed that the T 2 value in the single parameter had the largest AUC (0.759), and there was no significant difference between T 2 value and its combined parameters in the diagnosis of TNBC. Conclusions:The quantitative parameters based on synthetic MRI, especially T 2 value, have value in differentiating different molecular types of breast cancer, TNBC and non-TNBC may be another non-contrast parameter for evaluating tumor aggressiveness beyond ADC value.
5.Peripheral retinal defocus in adolescents based on multispectral refraction to-pography
Siyao WANG ; Shuangfeng LIANG ; Yujuan GUO ; Yu LI ; Yuehua ZHOU
Recent Advances in Ophthalmology 2024;44(5):396-400
Objective To explore the association between peripheral retinal defocus and myopia in adolescents.Methods This study encompassed 192 adolescents(192 right eyes),aged between eight and fifteen years,who sought treatment at Ineye Hospital of Chengdu University of TCM from October 2022 to April 2023.Based on the spherical equiva-lent(SE),the patients were divided into three groups:Emmetropia(E),low myopia(LM),and moderate myopia(MM),with each group comprising 64 patients(64 right eyes).After mydriatic refraction,the SE values were documen-ted.Ocular biological parameters,including axial length(AL),central corneal thickness(CCT),lens thickness(LT),and keratometry values(K1,K2),were obtained using IOL Master 900.Multispectral refraction topography was employed to measure the retinal defocus:positive values indicated hyperopic defocus,while negative ones represented myopic defocus.With the macular fovea as the center,the total retinal defocus value was recorded as TRDV.The ring partition(eccentrici-ty)was divided into 0°-10°、>10°-20°、>20°-30°、>30°-40°、>40°-53°,which was recorded as RDV-0°-10°,RDV-10°-20°,RDV-20°-30°,RDV-30°-40°,and RDV-40°-53°,respectively;the quadrants were recorded as RDV-Superior(RDV-S),RDV-Inferior(RDV-I),RDV-Temporal(RDV-T)and RDV-Nasal(RDV-N),respectively.The variance of RDV across different ranges was analyzed using One-Way ANOVA and non-parametric tests.The associations between SE,AL and RDV were examined using Spearman and Pearson correlation analyses.Results The RDV-20°-30°,RDV-30°-40° and RDV-40°-53° of Groups E,LM and MM all exhibited hyperopic defocus.Statistically significant differences were identi-fied in TRDV,RDV-10°-20°,RDV-20°-30°,RDV-30°-40°,RDV-40°-53°,RDV-S,RDV-T and RDV-N among the three groups(all P<0.05).TRDV,RDV-20°-30°,RDV-30°-40°,RDV-40°-53°,RDV-S,RDV-T,and RDV-N were found to be negatively correlated with SE while positively correlated with AL(all P<0.05).RDV-0°-10° and RDV-I were uncorrelated with both SE and AL(all P>0.05);RDV-10°-20° was positively correlated with AL(P=0.012)while uncorrelated with SE(P=0.233).Conclusion Peripheral retinal hyperopic defocus tends to advance with escalating eccentricity and my-opia.Peripheral retinal defocus is asymmetrical.Peripheral(10°-53°),superior,nasal and temporal retinal defocus may be closely related to the development of myopia.
6.Changes in periretinal defocus and visual quality after femtosecond laser-as-sisted in situ keratomileusis
Yu LI ; Yujuan GUO ; Siyao WANG ; Meimei ZHANG ; Yuehua ZHOU
Recent Advances in Ophthalmology 2024;44(7):558-563
Objective To explore the changes in periretinal defocus and visual quality after femtosecond laser-assis-ted in situ keratomileusis(FS-LASIK).Methods Fifty-one myopic patients(102 eyes)who underwent FS-LASIK at the Ineye Hospital of Chengdu University of Traditional Chinese Medicine from March to May 2023 were selected for the study,including 27 females(54 eyes)and 24 males(48 eyes).The defocus around the retina was measured using a multispectral refraction topography,and the total refraction difference value(TRDV)was recorded.The refraction difference value(RDV)in four quadrants:superior RDV(RDV-S),inferior RDV(RDV-I),nasal RDV(RDV-N),and temporal RDV(RDV-T),as well as the RDV in the concentric ring areas corresponding to 10°,20°,30°,40°,and 53° from the fovea of the mac-ula(represented as RDV 0°-10°,RDV 10°-20°,RDV 20°-30°,RDV 30°-40°,and RDV 40°-53°,respectively)were also re-corded.The objective scattering index(OSI),Strehls ratio(SR),modulation transfer function(MTF)values(represen-ted as 10 c·d-1 MTF,20 c·d-1 MTF,and 30 c·d-1MTF,respectively)and cutoff frequencies(MTF cutoff)at the spa-tial frequencies of 10 c·d-1,20 c·d-1 and 30 c·d-1 were measured and recorded using a visual quality analysis system.The data of corneal vertical trefoil(Z3-3),vertical coma(Z3-1),horizontal coma(Z31),horizontal trefoil(Z33),vertical tetrafoil(Z4-4),vertical secondary astigmatism(Z4-2),spherical aberration(Z40),horizontal secondary astigmatism(Z42),horizontal tetrafoil(Z44),and total higher-order aberration(HOA)were measured and recorded using the iTrace aberration meter.The measurement data of patients before surgery,one month after surgery,and three months after sur-gery were compared,and their correlations were analyzed.Results TRDV,RDV-S,RDV-N,RDV 20°-30°,RDV 30°-40°,and RDV 40°-53° around the retina of patients decreased one month and three months after surgery compared with those be-fore surgery,and the differences were statistically significant(all P<0.001).There were statistically significant differences in OSI,MTF cutoff,and 10 c·d-1 MTF among patients before surgery,one month after surgery,and three months after surgery(all P<0.05).There were statistically significant differences in corneal Z3-3,Z3-1,Z31,Z33,Z4-4,Z4-2,Z40,Z42,Z44,and HOA among patients before surgery,one month after surgery,and three months after surgery(all P<0.001).The Pearson correlation analysis results showed that,ΔRDV 0°-10° was positively correlated with ΔZ3-3,ΔZ31,ΔZ4-2,ΔZ40,and ΔZ42(all P<0.05);ΔRDV 10°-20° was positively correlated with ΔZ4-4 and ΔZ4-2(both P<0.05);ΔRDV 20°-30° was positively correlated with ΔZ4-4 and ΔZ44(both P<0.05);ΔTRDV and ΔRDV 40°-53° were negatively correla-ted with ΔHOA(both P<0.05).ΔRDV-S and ΔZ3-1 were negatively correlated with ΔHOA(both P<0.05)and positively correlated with ΔZ44(P<0.05);ΔRDV-N was positively correlated with ΔZ4-4(P<0.05).Conclusion FS-LASIK can reduce periretinal hyperopic defocus in myopic patients,but it introduces corneal HOA,and there is a certain correlation between the two.