Medical service data center could play a pivotal role in the assessment and improvement of patient safety,assist of medical quality management,providing guidance for patients,promoting the development of biological bank,by collection,storage,maintenance and analysis of medical data.Even though the building of medical service data center in China is relatively late compared with developed countries,however,China has made some achievements in guiding medical service and medical service management.

Objective To analyze the present situation of medical service prices in Beijing,and provide scientific basis in order to carry out the reform of medical service prices of the city.Methods Literature review method to collate the administration policy of medical service price in Beijing,and the method of statistical analysis to compare the Beijing medical service prices with 1 9 other provinces across the country.Results The number of medical service projects (4 613 )in Beijing is higher than the national average (4 507),but the average medical service prices (423 yuan)in Beijing is lower than the national average (609 yuan),and medical service price and the regional economic level has no statistical significance Conclusion Medical service prices of Beijing need to be adjusted,and a reform of medical service prices in Beijing should be implemented by the Development and Reform Commission,Health and Family Planning Commission.

Objective To investigate the expression and clinical significance of tumor-associated carbohydrate anti-gen sTn in endometrium from patients with atypical hyperplasia of endometrium, endometrial carcinoma and benign the uter-ine lesion. And to analyze the association between sTn and the pathologic stage and grade of endometrial carcinoma. Meth-ods sTn was detected by immunohistochemistry in 193 patient samples, including 93 subjects with endometrial carcinoma, 50 subjects with atypical hyperplasia of endometrium and 50 subjects with benign uterine lesions. Results The positive sTn rate in endometrial carcinoma group was 73.1%,which was significantly different from that in atypical hyperplasia endo-metrium group (32%) and that in benign uterine lesion group (14%), (P＜0.017). sTn positive rate in patients with endometri-al carcinoma was 78.8%which is higher than that in patients with other diseases (P＜0.008 ). The positive rate of sTn in pa-tients with poorly differentiated endometrial carcinoma was significantly higher than that in patients with highly differentiat-ed endometrial carcinoma (P＜0.017). The positive rate of sTn in tissues of tumor infiltration with depth of more than half of myometrial was significantly higher than in tissues of tumor infiltration with depth of equal or less than half of myometrial (P＜0.05). But there was no significant difference in sTn positive rate between the endometrial carcinoma groups with and without lymph node metastasis (P>0.05). Conclusion sTn may play a role in the tumorigenesis and development of endo-metrial carcinoma.

Objective To study the methods of matching kilovolt CBCT image with planning CT scan. Methods A total of 121 CBCT scans were matched with planning CT scan using a manual and four automatic match methods by four observers in the offline. In the manual match, the live contour was used as a surrogate for image registration. Four automatic match methods, including routine soft?tissue match, routine bone match, automatic liver match and vertebral body match, were performed using image registration sofeware. First, the stability of the sofeware was tested. Then, the reproducibility of the same automatic match method was evaluated by comparing different observers’ match results. After the manual match by four observers, the mean of the match results was used as a standard to compare with others. The differerces was test by McNemar method. Results In the uniform match factors, automatic match result would not change. The reproducibility of routine soft?tissue and bone match are best, automatic vertebral body match is better than automatic liver match. Howerver, the automatic liver match result is the most similar to manual match, the percentages of match result have an absolute error no more than 3 mm in left?right, superior?inferior and anterior?posterior directions are 84?? 3%, 77?? 7% and 92?? 6%. Conclusions Automatic liver match can be used in image?guided radiotherapy for liver cancer, however, it should be performed by experienced oncologist and technologist together in each fraction, after that, the matching result should be adjusted carefully according to live contour.

There is an upward trend in the incidence of infertility, while its pathogenesis is very complex, including endocrine disorders and autoimmune diseases and so on. With the development of reproductive immunology, infertility caused by immune factors has attracted more attention. Various reproductive immune antibodies have been found in infertility patients. The role and prevalence of related autoantibodies in the pathogenesis of infertility vary from each other, thus their detection is of great significance for early diagnosing, treating and monitoring infertility patients.

OBJECTIVETo develop an HPLC method for the determination of oleuropein in Syringa oblata.

METHODAn Aigilent ZORBAX SB- C18 column (4.6 mm x 250 mm, 5 microm) was used. The mobile phase was acetonitrile-water (21 : 79). The flow rate was 1.0 mL x min(-1). The detection wavelenghth was set at 232 nm and the column temperature was 30 degrees C.

RESULTThe linear range of oleuropein were from 0.011 62 g x L(-1) to 1.162 g x L(-1). The average recovery was 98.7% with RSD 2.5% (n=9).

CONCLUSIONThe method is reliable, accurate and specific. It can be used for quality control of the stem of Syringa oblata.

Acetonitriles ; chemistry ; Benzoates ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; Iridoids ; Pyrans ; analysis ; Syringa ; chemistry ; Vasodilator Agents ; analysis

OBJECTIVE: To investigate the relationship between tumor-associated carbohydrate antigen sTn and endometrial carcinoma, and to evaluate the diagnostic value of 2 test methods. METHODS: A total of 200 patients were enrolled, including 100 subjects with endometrial carcinoma, 42 healthy nonpregnant women, 15 pregnant women without complications, and 43 patients with benign gynecologic diseases. The serum sTn-antigen concentrations were determined by 2 test methods (3P9 combined with 4A6, and B72.3 combined with CC49). RESULTS: There was a significant difference in the value and the positive rate of sTn in the serum between the subjects and the contrasts (P<0.05). The sTn level in the pregnant women was high. The sTn level in the serum and its positive rate in endometrial carcinoma became higher with the clinical stage. 3P9 combined with 4A6 was better than B72.3 combined with CC49 in the detection of sTn in the serum as to sensitivity, specificity, positive-prediction, negative-prediction, and accuracy. CONCLUSION The sTn antigen may become a new serological marker for the diagnosis of endometrial carcinoma, but pregnant women should be excluded. 3P9 combined with 4A6 is better than B72.3 combined with CC49 in the detection of sTn in the serum.
Antibodies, Neoplasm ; blood ; Antigens, Tumor-Associated, Carbohydrate ; immunology ; Biomarkers, Tumor ; blood ; Case-Control Studies ; Endometrial Neoplasms ; blood ; diagnosis ; Female ; Humans

Objective To get an understanding of the patient experience in public hospitals nationwide, and to evaluate the implementation of the Action Plan to Improve Health Care. Methods Supported by the mobile technology, from September 6, 2017 to December 15, 2018, the authors conducted an online survey that measured the satisfaction of both inpatients and outpatients at secondary and tertiary hospitals across the country. 15 questions from six dimensions including registration experience, patient-doctor communication, nurse-patient communication, the healthcare signage system, responsiveness of care providers and privacy protection were prepared for outpatients, while 20 questions from nine aspects such as nurse-patient communication, patient-doctor communication, pain management, medication communication, admission and discharge information, responsiveness of care-givers, food service, friendliness to patient family, and the healthcare signage system were directed at inpatients. Descriptive statistical analysis was used to describe the basic features of the data. Results 9.18 million valid responses from outpatients and another 5.38 million from inpatients were obtained. The overall satisfaction rate with outpatient services had reached a score of 90.45 points where nurse-patient communication stands out as the top-rated dimension and privacy protection gets the lowest rating. On the other hand, the inpatient satisfaction stands at a score of 93.01 with friendliness to patient family receiving the top score and patient-doctor communication the lowest. Conclusions Despite the positive feedback Chinese patients give on the outpatient care they receive, we should make efforts to improve the outpatient care environment, the wayfinding system, privacy protection, and responsiveness of care-givers.

Objective: To investigate the effects of donor-specific HLA antibodies(DSA) for graft failure in un-manipulated haploidentical hematopoietic stem cell transplantation(haplo-HSCT) and the feasible treatment for DSA. Methods: HLA antibodies were examined using the Luminex-based single Ag assay for 92 patients who were going on haplo-SCT and the correlations of graft failure and DSA among the patients who had finished SCT were analyzed. Results: Of the total 92 patients who were going on haplo-HSCT, sixteen (17.4%) patients were HLA Ab-positive, including six (6.5%) patients with antibodies corresponding to donor HLA Ags (DSA-positive). Among the patients who had finished the haplo-HSCT with conventional myeloablative conditioning regimen, the engraftment rate was significantly higher in DSA (-) patients than that in DSA (+) patients [92.3% (24/26) vs 25.0%(1/4), χ²=8.433, P=0.004] and DSA was the only factor relevant with graft failure in multiple-factor analysis [OR=12.0(95% CI 1.39-103.5), P=0.024]. Strategies to decrease antibody levels were taken for 4 patients, two were their first transplantations, and the other two patients were their second haplo-HSCT. Three of the four patients were HLA-I-DSA positive and had gained donor engraftment by means of donor platelet transfusions to decreased the level of DSA, the fourth patient with both HLA-I and HLA-II DSA also gained engraftment with the treatments of TBI, rituximab and donor platelet transfusion. Conclusion DSA is one of the key factors of graft failure in haplo-HSCT. Donors should be selected on the basis of an evaluation of HLA antibodies before transplantation. If haplo-HSCT from donors with DSA must be performed, then recipients should be treated for DSA to improve the chances of successful engraftment.

Objective To summary the pathological and clinical characteristics,treatments and prognosis of malignant renal perivascular epithelioid cell tumor (PEComa).Methods Between August 2013 and June 2017,8 cases of malignant renal PEComa were analysed respectively.Of all the patients,there were 4 males and 4 females,aged 27-65 years with the average of 46.3 years old.Three cases were detected in routine examination occasionally,three cases complained of intermittent back pain with fever,one presented with swollen and painful right hand and right foot,and one case presented with hematuria.CT or MRI examinations indicated the malignant lesions before the surgery.Clinical staging was performed with 2 cases of T1N0M0,1 case of T1 N0M1,2 cases of T2N0M0,1 case of T3M0M0,and 2 cases of T4N0M1.Three cases underwent radical nephrectomy,1 case underwent radical nephrectomy plus renal artery embolization,2 cases underwent partial nephrectomy,and 2 cases underwent nephrectomy plus inferior vena cava tumor thrombectomy.One case was treated with ifosfamide plus epirubicin after operation due to multiple distant metastases and 1 case was treated with oxaliplatin before the sugery because of excessive tumor diameter.None of the rest received any adjuvant therapy.Results Postoperative histopathological examination showed multiple nodules in reddish gray and yellow color,with soft texture and partial incomplete capsule.Microscopically,there were large atypical cell components,some of which were spindle shaped,with disordered cell arrangement,some of which were associated with a large amount of necrotic tissue,and abundant light eosinophil cytoplasm.Tissue components can be found thick-wall blood vessels,smooth muscle-like cells,and adipose tissue.Immunohistochemistry showed 4 cases were positive of HMB-45,4 of Melan-A,7 of SAM.Seven cases were negative of CK,6 of S-100 75％ (6/8) and Ki67 (10％-70％).Two cases died of multiple metastases (lung,bone,liver),1 case survived with tumor recurrence,with a follow-up from 14 to 60 months (mean 29 months).Conclusions Primary malignant renal PEComa is rare in practice with relative large diameter.The diagnosis depends on pathological findings,and radical nephrectomy is the first choice of treatment.It is easy to recur and metastasize after the operation.