Objective:To analyze the efficiency of 77 public hospitals' medical services and influencing factors in Tianjin.Methods:Using DEA method to measure the hospitals' medical service efficiency,establishing Tobit regression model to analyze the influencing factors of public hospitals medical service efficiency.Results:The overall efficiency of Tianjin public hospitals was low,most hospitals were not reasonable in the size,the significant influencing factors of Tianjin public hospitals' medical service efficiency including the per capita physician outpatient,the proportion of senior technical staffs,hospital gearing ratio,drug-income ratio and average fee per patient.Conclusion:Increasing the per capita physician outpatient and the proportion of senior technical staff could significantly enhance the overall technical efficiency,while decreasing the gearing ratio and the average fee of per patient were also beneficial to improve hospital efficiency.

Objective To explore the correlation of ultrasonographic,pathologic,and clinical findings of breast fibroadenomas.Methods 157 cases of breast fibroadenomas demonstrated by pathologic findings were examined with color Doppler ultrasound prior to biopsy.Images were classified according to ultrasound characteristics and analysed with latter pathologic findings.Results Ultrasound images of 157 cases could be divided into 6 types:uniformity( n =82),linage( n =37),bicolor( n =15),nodule-in-nodule (n =3),cyst-massity mixed ( n =9),calcify( n =11).5 cases were mistakenly judged to breast cancer on ultrasound images(1 ease in the linage,1 case in the cyst-mass mixed,3 cases in the calcify).Accurate ratio of ultrasound diagnosis was 96.82％.Pathologic finding:①Uniformity type,hyperplasia of both the gland and fibrous tissue of tumor in order.② Linage type,hyperplasia fibrous tissue in belt.③ Bicolor type,significant difference in the proportion and arrangement of the hyperplasia gland and fibrous tissue.④Nodule-in-nodule type,extensive hemorrhagic infarction in tumor.⑤Cyst-massity mixed type,hydatoncus,metaplasia in great sweat gland,hyperplasia conduit epithelial,conduit cystic-expansion.⑥ Calcify type,fibroadenomas on growth of static or regression transformation,and calcify of interstitial tissue.Conclusions Ultrasonic diagnosis and its simple typing is an accurate,simple and effective way for the diagnosis of breast fibroadenoma,which may improve the accuracy of diagnosis rate for breast fibroadenoma.It is helpful for choosing the surgical remedies.

Antitumor drugs that target the signaling of vascular endothelial growth factor and its receptors have attracted increasing attention with the development of antiangiogenic targeted therapy. Apatinib is a second-generation vascular endothelial growth factor receptor-2 inhibitor and a potent antiangiogenic agent. Apatinib is one of the recent oral molecular targeted anti tumor drugs. Clinical studies have indicated that apatinib exhibits high bioavailability and a tolerable safety profile. A series of large-scale randomized and controlled clinical trials before and after the release of the drug in the market have demonstrated encouraging objective response rate and survival benefit across a broad range of malignancies, including non-small cell lung cancer, breast cancer, and gastric cancer. Apa-tinib was approved and launched in China in 2014 as a subsequent-line treatment for patients with advanced gastric cancer. Apatinib is currently undergoing phase II/III clinical trials for the treatment of numerous cancer types, such as gastric carcinoma, lung cancer, he-patocellular carcinoma, esophageal cancer, and colorectal cancer. These clinical trials are conducted to determine the antitumor activi-ty of apatinib when administrated alone or in combination with other therapies. This review summarizes the latest research progress of apatinib, including antitumor mechanisms, clinical effects on different tumor types, safety profile and adverse effects, drug interac-tions, as well as drug resistance and biomarkers. This article presents a deeper understanding of the clinical application of apatinib in anti tumor treatment, and provides reference for future clinical practice in therapeutic options for cancer patients.

Objective To investigate the clinical effect of flupentixol and melitracen tablets combined with macrogol 4000 powders on treatment of irritable bowel syndrome with constipation (IBS-C) in elderly patients. Methods Fifty paients aged from 65 to 95 years with IBS-C were randomly divided into 2 groups: control group (23 patients) and treatment group (27 patients). The patients in treatment group received flupentixol and melitracen tablets (1 tablets, once a day) combined with macrogol 4000 powders (1 bag/time, 2 times a day) , while the patients in control group received macrogol 4000 powders alone. The treatment period was 4 weeks. The curative effect, the scores of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) and adverse reaction were compared between two groups. Results At the improvement of depressive symptoms, the effective rate in treatment group and control group was 88.9%(24/27) and 39.1%(9/23), and there was significant difference (P<0.01). At the improvement of anxiety symptoms, the effective rate in treatment group and control group was 74.1%(20/27) and 26.1%(6/23), and there was significant difference (P<0.01). The total effective rate in treatment group and control group was 88.9%(24/27) and 65.2%(15/24), and there was significant difference (P<0.05). Conclusions Flupentixol and melitracen tablets combined with macrogol 4000 powders on treatment of aged IBS-C patients have more distinguished therapeutic effect in improving constipation symptoms, stools times, anxiety and depression.

Objective To explore the effects of yttrium nitrate on hemogram in rats Methods 48 rats were randomly divided into 4 groups,such as one control group treated with distilled water and 3 exposure groups treated with 70 mg/kg,14 mg/kg and 2 8 mg/kg yttrium nitrate via peritoneal injection twice a week for 6 weeks.After the continous 6 week exposure,the differences of hemogram between control group and exposure groups were observed Results No significant differences were observed in the counts of red blood cells,white blood cells and platelets,the contents of hemoglobulin and coagulation times between control group and each exposure group( P

Objective To know the air benzo[a]pyrene (B[a]P) pollution level in a coke plant of Chongqing Iron & Steel Group. Methods The concentrations of B[a]P in coke oven operating environment were determined by high performance liquid chromatography (HPLC) in different places of work in Sep. 2008.B[a]P concentration at different distances on the surrounding regions of coke plant and real-time monitoring in every quarter around the different functional areas was conducted. Results The air B[a]P concentration in the coke plant was descending following the order: the top of coke oven, the side of coke oven, the bottom of coke oven. B [a]P concentrations of oven bottom, oven side, oven top showed a gradual increase tendency with the extension of the sampling time (P

Objective To evaluate the effect of -477C/T single nucleotide polymorphism (SNP) in promoter region of ABCA1 gene on plasma levels of high density lipoprotein cholesterol (HDL-C) and coronary artery disease (CAD). Methods -477C/T genotypes in promoter region of ABCA1 gene were assessed in 96 CAD patients and 100 healthy individuals with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and distribution of the -477C/T genotypes was compared between CAD group and healthy group, and also between patients with different CAD clinical manifestations. The clinical indexes associated with CAD were also compared among the three genotypes. Results The distributive frequency of CC, CT, or TT genotype of CAD group and healthy group was different from one another, and the proportion of the TT genotype or the T allele was obviously higher in CAD group than in healthy group (P

0.05). Conclusion The genotypes of ABCA1 R1587K polymorphism were associated closely with the plasma levels of HDL-C. The HDL-C levels of K allele carriers were remarkably lower. However, there was no significant association of the ABCA1 R1587K polymorphism and the susceptibility to CAD.

Objective To investigate the effect of high altitude aviation on the pressure and diameter of the trachea cannula cuff after injecting air or water. Methods In the circumstance 5 km height and 795 hPa cabin pressure, the air injected cuffs were divided into two groups, one was under the ground circumstance, the other was in the high altitude aviation environment. The volumes of injected air were 5 ml, 7 ml, 9 ml, 11 ml, 13 ml, 15 ml, 17 ml, and the cuff pressure and its diameter were measured. The water injected cuffs were also divided into two groups of ground and high altitude aviation environment. The volumes of injected water were 10 ml, 12 ml, 14 ml, 15 ml, 16 ml, and the cuff pressure and its diameter were measured. The results were compared between the ground circumstance and high altitude aviation environment. Results The diameter of injection air group versus under the ground circumstance group had the statistical significance (t=5.000-9.449, P<0.05), when the injection air was larger than 15 ml, the pressure effect had statistical significance (t=5.000, 8.000, P<0.05). Water injection group had not statistically significant. Different water volume injection had no effect on pressure and diameter (P>0.05), while different air volume injection had significant effect on pressure and diameter (F=5.132, 5.980, P<0.01). When the water volume was 10 ml, the cuff pressure was (24.00±4.62) cmH2O (1 cmH2O=0.098 kPa) , which was appropriate to the range of cuff pressure (20-30 cmH2O). Conclusions In high altitude aviation environment the trachea cannula cuff should adopt water injection, and the best water volume is about 10 ml.

ObjectiveTo investigate the effect and mechanism of ischemic preconditioning (IP)on preservation/reperfusion injury of rat liver graft.MethodsOne hundred and twenty eight male Sprague Dawley rats undergoing orthotopic liver transplantation were randomly divided into 4 groups: group A (control group), group B (IP group), group C (adenosine,Ado group), and group D (inhibitor of NO synthesis,NAME group).ResultsPosttransplantation one week survival rate, 2 hrs reperfusion serum NO, and hepatic tissue adenosine in IP group and Ado group were 88%(7/8) and 88%(7/8), (33 0?6 1)??mol/l and (29 1?6 5)??mol/l, ( 7 2? 1 8)??mol/g and (5 7?1 3)??mol/g, respectively, while in control group they were 38%(3/8),( 15 4? 3 0)?mol/l, and (3 69?0 54)??mol/g, respectively(all P 0 05). However, hepatic tissue adenosine level was (5 56?1 19)??mol/g, higher than that in control group( P