In order to understand the representative situation of medical services supply for China's public hospital in the mobile side,the research takes China hospital technology (comprehensive) influence ranked top 100 hospitals as the research object.From service supply channels,service content,providing mode,supply cooperation,comparative analysis of public hospitals from the traditional medical treatment to the mobile health reform is done.The 100 hospitals attaches great importance to the channel construction of mobile terminals,and App and WeChat have been mostly layout;On the basis of the medical process,a variety of service content is derived and innovated;Service providers change gradually to the context of navigation and mobile O2O medicine;The cooperation between hospitals and the technology companies is becoming more and more frequent.At the same time,these changes will also in turn promote the hospital process optimization,interconnection and multi game deepening governance.

Objective To observe the effects of family intervenes on the social function of chronic schizophrenic outpatients in countryside.Methods 150 chronic schizophrenic patient were divided into the intervention group(75 cases)and the control group(75 cases).The intervention group accepted comprehensive family intervention education by the professional,while the control group only accepted the medical intervention.They were assessed with Social Disability Screening Schedule(SDSS),Scale for Assessment of Positive Symptoms(SAPS),Scale for Assessment of Negative Symptoms(SANS),Morningside Rehabilitation Stats Scale(MRSS)before,1 year,2 years and 3 years after intervention.Results The scores of SANS and MRSS improved in the intervention group compared with that of the control group(P<0.001),as well as the ability of self-care,family,responsibility,vocation of SDSS(P<0.05).Conclusion The family intervenes may improve the negative symptom and some social ability of chronic schizophrenic outpatients in countryside.

In this paper, the specific male sequeuce in paraffin section of various tissues with autolys is ofdifferent degrees was detected by polymerase chain reaction(PCR).The results shewed that PCR could be used for identifying sex in the tissues with low degrees ofautolysis; its positive rate was lower in high degrees with disappearance of nuclaic member and cell ou-tline,and often gave false negative results when the autolysis degree was high.

Objective To investigate the changes of IL-6, IL-10 and TNF-αafter cholecystectomy.Methods 46 cases with cholecystolithiasis were selected and divided into 2 groups.23 in control group were treated with open cholecystectomy, experimental group were treated with laparoscopic cholecystectomy.The levels of IL-6, TNF-α, IL-10 and CD4 +/CD8 +T were compared in the two groups pre-and post-treatment.ResuIts Compared with pre-treatment, two groups of patients with IL-10, TNF-α, IL-6 and CD4 +T and CD4 +/CD8 +T increased (P<0.05), compared with control group, experimental group IL-10, TNF-α, IL-6, CD4 +/CD8 +T levels were higher (P<0.05).ConcIusion Laparoscopic cholecystectomy can significantly reduce the IL-6, TNF-αand IL-10 levels, reduce the body′s stress response to surgery, and reduce blood flow, shorten the operation time.

Objective To assess the clinical value of 131I-metaiodobenzylguanidine (MIBG) scintigraphy in pheochromocytoma. Methods A total of 430 patients with clinically suspected pheochromocytoma underwent 131I-MIBG whole body scintigraphy, 326 among them underwent B-ultrasound, 400 for CT and 77 for MR examination respectively. While 178 among them were diagnosed with pathology and the others were diagnosed clinically. Results Of all the patients, 108 were diagnosed pheochromocytoma, including 89 131I-MIBG scan positive and 19 negative. The sensitivity, specificity and accuracy of 131I-MIBG were 82.41%, 100% and 95.70%, respectively. 131I-MIBG scan detected 90.00% of unilateral adrenal, 45.45% of bilateral adrenal, 85.71% of ectopic and 66.67% of malignant lesions, respectively. The proportion of patients with positive 131I-MIBG scan increased from 20.69% in all patients to 35.15% in patients with clinical symptoms and positive conventional imaging (at least one of B-ultrasonography, CT or MR was positive) and 64.58% in those with clinical symptoms, positive conventional imaging, and elevated 24 h urinary catacholamines. In 59 patients with adrenal incidentaloma, 8 were scan-positive and all had confirmed pheochromocytoma, while 2 of scan-negative patients also had confirmed pheochromocytoma. Conclusion 131I-MIBG scintigraphy is the first choice for the diagnosis of both adrenal and extra-adrenal pheochromocytoma. However, it is inappropriate to take this method as the initial screening approach.

Objective:To explore the value of preablative stimulated thyroglobulin (ps-Tg) in predicting distant metastasis (DM) at the time of 131I therapy in children and adolescents with differentiated thyroid cancer (DTC). Methods:From January 2016 to March 2020, 54 children and adolescents who underwent total thyroidectomy due to DTC in Peking Union Medical College Hospital were retrospectively reviewed and divided into 2 groups according to the presence of DM or not: M0 group( n=29, 10 males, 19 females, age (16.3±3.8) years) and M1 group( n=25, 13 males, 12 females, age (12.4±4.3) years). Independent-sample t test, χ2 test (or Fisher′s exact test) and Mann-Whitney U test were used to analyze the general characteristics between the two groups. According to status of regional lymph node (RLN) at the time of 131I therapy, the two groups were further divided into M1RLN+ ( n=8) and M1RLN-( n=17), M0RLN+ ( n=5) and M0RLN-( n=24) subgroups. Mann-Whitney U test was used to analyze the different ps-Tg levels between M0 and M1, M1RLN+ and M1RLN-, as well as M0RLN+ and M0RLN-groups. The receiver operating characteristic (ROC) curve analysis was employed to obtain a cut-off value of ps-Tg as a predictor of DM. Results:Patients with DM tended to have higher ps-Tg level (medians: 406.80 μg/L vs 7.90 μg/L, U=690.000, P<0.001), younger age ( t=-3.559, P=0.001), larger tumor size ( t=3.523, P=0.001), more advanced T stage ( U=506.500, P=0.010) and more multifocality( P=0.013) in comparison with those without DM. Though ps-Tg did not significantly differ between M1RLN+ group and M1RLN-group ( U=98.500, P>0.05) or between M0RLN+ group and M0RLN-group ( U=63.000, P>0.05), the two RLN+ groups tended to hold higher medians than the two RLN-groups (18.05 vs 5.71 μg/L; 1 698.50 vs 216.40 μg/L). In order to avoid the possible influence on the ps-Tg cut-off value, 13 RLN+ samples were removed, and the area under the ROC curve was 0.946 (95% CI: 0.883-1.000). The ps-Tg level of 55.87 μg/L was established as the optimal cut-off value to distinguish M0RLN- from M1RLN-, with the sensitivity and specificity of 14/17 and 95.8%(23/24), respectively. Conclusion:Ps-Tg holds a high predictive value in identifying DM, which may be of great help in avoiding inadequate 131I treatment in children and adolescents with metastatic DTC ignored by radiological examinations.

Based on international framework of rehabilitation, this paper summarized the theories and practice of rehabilitation in Shenzhen. An inclusive rehabilitation model had been established in Shenzhen in light of international concepts of rehabilitation, in which the functions of medical rehabilitation, education, employment, assistive technology, care, right protection, accessible environment and culture had been integrated. The comprehensive services had been provided through this model and the target of inclusive development had been realized.

Objective To evaluate the toxicity and efficacy of post-operative chemoradiotherapy for gastric cancer. Methods Forty-five gastric cancer patients treated with post-operative radiation ± concurrent chemotherapy were retrospectively analyzed. Among them, 14 were female and 31 were male. The median age was 54 (30-72) years. Pathology stages were IB-IV. Radiotherapy of doses from 45 Gy/25fx to 55 Gy/30fx was delivered to the tumor bed and regional lymph nodes with 3D conformal or IMRT technology.Concurrent chemotherapy agent was fluorouracil or capacitabine. Results All patients except 2 (4%)completed radiotherapy as planned. The most common acute toxicities were hematologic and gastrointestinal effects. The incidence of the patients was 56% with mild nausea/vomiting,71% and 7% with grade Ⅰ / Ⅱ and Ⅲ leucopenia, and 38% with grade Ⅰ/Ⅱ hypodynamia and anepithymia. The 1-year overall survival,relapse-free survival and local control rates were 87% ,82% and 95%, respectively. Conclusions Postoperative chemoradiation for patients with locally advanced gastric cancer is tolerable. Our study shows the advantage of post-operative chemoradiation for local control. However,further prospective randomized trial is needed to validate the efficacy.

Background and purpose: Currently endoscopic ultrasonography is clinically accepted for preoperative staging of gastric cancers. Endoscopic raucosai resection (EMR) and endoscopic subraucosal dissection (ESD) have been widely applied in the treatment of early gastric cancer. We need to improve the accuracy of pre-operative staging of gastric cancers, especially of early gastric cancers. This paper was to investigate the clinical significance of high frequency endoscopic ultrasound mini probe (UMP) in the preoperative T-staging of gastric cancer. Methods: Both UMP and MSCT were performed in 63 patients with pathologically proven gastric cancer frora Oct. 2008 to Apr.2009, and the results of UMP and MSCT were compared with surgical pathologic findings. Results: The accuracy of UMP and MSCT in T staging was 82.26% (51/62) and 88.71% (55/62) respectively, and there was no statistical difference (P>0.05). The accuracy of UMP and MSCT for early gastric cancer was 100.00% and 88.89% respectively.The accuracy of UMP and MSCT for advanced gastric cancer was 79.25% and 88.68% respectively. Conclusion: UMP appears to have a substantial diagnostic value for early stage gastric cancer. It is the approach of choice for superficial lesions.

Objective To verify the feasibility and accuracy in the measurement of tricuspid valve annulus diameter(TVD) in the right ventricular outflow tract view.Methods Seventy five patients under the valve replacement surgery for the left heart valve lesions were divided into mild,moderate and severe group according to the severity of the regurgitation.The TVD was get on the apical four-chamber heart viewpreoperatively by transthoracic echocardiography(TTE),noted as TTE-TVD,meanwhile it was also get by the transesophageal echocardiography on the four-chamber view (TEE-TVD),right ventricular inflow (RVIT-TVD) and outflow tract view(RVOT-TVD).The changes of tricuspid regurgitation severtity was observed preoperatively.And the morphology of tricuspid annulus were observed using both real-time three dimensional transesophageal echocardiography (RT-3D TEE) and the quantitative software.Results Comparison in the groups:no statistically significant difference (P ＞0.05) was found between TTE-TVD,TEE-TVD and RVIT-TVD;while the RVOT-TVD was significant greater than that in the same group from other views (P ＜ 0.05).Comparison between the groups:no significant difference was found between mild and moderate regurgitation group on the same view.There was a significant difference of the TVD between the severe regurgitation group and the former two groups on each view(P ＜0.05).The severity of tricuspid regurgitation in intraoperative anesthesia was reduced.The saddle tricuspid ring evolved into the narrow planar structure on the RT-3D TEE.For the expansion of the annulus,it departure from the tricuspid septal leaflet.Conclusions TVD measured on the right ventricular outflow tract view reflect the maximum expansion of the tricuspid valve annulus diameter,and can effectively guide the decision-making choices of the surgeon.