Objective To observe the influence of subarachnoid space associated with epidural anesthesia at different posture on the hemodynamics during cesarean section.Methods One hundred and twenty uterine-incision delivery patients were chosen,the patients were separated into the left lateral decubitus group(LL group) and right lateral decubitus group(RL group) with 60 cases each by random digits table method,all the patients were blocked by subarachnoid space associated with epidural anesthesia after puncturation 2 ml 0.5％ ropivacaine was given.Then the head end epidural catheter insertion in 3-4 cm,asked maternal supine after fixed catheter enjoin.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate were recorded before anesthesia and at 3,5,10,15 min after anesthesia.Apgar scores of 1 and 5 min were observed as well.Results SBP and DBP at 3,5 min after anesthesia were significantly lower than those before anesthesia in RL group,SBP was (120.1 ± 11.2),(106.7 ± 17.2),(127.3 ± 13.6)mmHg (1 mmHg =0.133 kPa) respectively,DBP was (77.5 ± 6.3),(55.2 ± 21.2),(80.3 ± 10.5) mmHg,respectively,and there were significant differences (P ＜0.05).And SBP,DBP in RL group were also significantly lower than those in LL group,SBP was (123.2 ± 12.4),(110.3 ± 16.3) mmHg,DBP was (80.1 ± 9.9),(63.1 ± 13.2) mmHg,and there was significant difference (P ＜ 0.05).There was no significant difference in Apgar scores of 1 and 5 min between two groups.Conclusion The left lateral decubitus position could effectively reduce the incidence of hypotension during caesarean section under subarachnoid space associated with epidural anesthesia.

Objective To study the expressions of survivin and PTEN in ampullary carcinoma and their clinical significance.Methods The expressions of Survivin and PTEN proteins were tested by EnVision immunohistochemistry in 40 cases of ampullary carcinomas and 8 cases of normal ampulla of vater as control.Results The positive rate of Survivin in ampullary carcinomas was significantly higher than normal human controls (82.5％ vs 0％,P ＜ 0.01 ).The differences of the expression of Survivin in ampullaty carcinoma of duodenal invasion,pancreatic invasion,and lymph node metastasis were significant ( P ＜0.05 ).Significant differences were also observed in the expression rate of PTEN hetween the patients with ampullary carcinoma and the normal controls (50％ vs 100％,P ＜ 0.01 ).The differences of the expression of PTEN in ampullary carcinoma of duodenal invasion,pancreatic invasion,and lymph node metastasis were significant ( P ＜ 0.05 ).Significantly negative correlation was found between the expression of Survivin and PTEN by using spearman correlation analysis ( r =-0.57,P ＜ 0.01 ).Conclusions The abnormal expression of Survivin and PTEN gene may promote tumor genesis and progression of ampullary carcinomas and it may be used as the marker for prognosis.

ObjectiveTo study the expressions of Survivin and Bcl-2 in carcinoma of the ampulla of Vater and their clinical significance.Methods The expressions of Survivin and Bcl-2 proteins were tested by EnVision immunohistochemistry in 40 cases of ampullary carcinomas,and 8 cases of normal ampulla of rater as control.ResultsThe positive expression of Survivin and Bcl-2 in the tissues from the ampullary carcinoma was significantly higher than that in the normal controls(82.5％,72.5％ vs 0％,12.5％,P ＜0.05).The expression of Survivin and Bcl-2 had no relations with the sex,age,tumor size,histological types,and clinical stages( P ＞ 0.05 ).The differences of the expression of Survivin and Bcl-2 in ampullary carcinoma of duodenal invasion,pancreatic invasion,and lymph node metastasis were significant(P ＜ 0.05) ; Significantly positive correlation was found between the expression of Survivin and Bcl-2 by using spearman correlation analysis( r =0.647,P ＜ 0.05 ).Conclusions Survivin and Bcl-2 may play an important role in tumorigenesis of ampullary carcinoma.Combined detection of Survivin and Bcl-2 may be useful to determine the degree of malignancy and the progress of the ampullary carcinoma.

Objective To study a fingerprint of raw material of Rhizoma Polygoni Cuspidati from(various) habitats by RP-HPLC. Methods Kromasil C_(18) column(150 mm?4.6 mm,5 ?m) was used,with mixtures of acetonitrile and water as mobile phase in a gradient mode.The flow rate was 1 mL/min and wavelength was 303 nm.Results According to the optimum chromatographic conditions,a good fingerprint of Rhizoma Polygoni Cuspidati has been described.Conclusion The method is simple and accurate with good reproducibility.It may be practical value for the quality control of sample for Rhizoma Polygoni Cuspidati from various habitats.

Objective:This study analyzes COVID-19 prevention and treatment technology patents from 103 countries and regions worldwide, in order to have a good grasp of the most-current trends in COVID-19 prevention and treatment technology research worldwide, discuss the research directions of such technologies, provide theoretical foundations for interdisciplinary and multi-team cooperation.Methods:The retrieval strategies were constructed utilizing the retrieval and analysis system by the Regional Patent Information Service (Nanjing) Center of The State Intellectual Property Office and IncoPat's scientific and technological innovation platform, using third-level branches as the unit and separating the retrieval and proof processes, the queries built using IPC classification numbers and key words; the search was limited to invention patents, with utility models and designs excluded.Results:On February 14, 2020, there had been a total number of 136 087 invention patent applications for COVID-19 prevention and treatment technologies globally. In terms of the country of origin, the U. S. ranked first with 56 095 patents, followed by China (18 096). In terms of technical field, the top three were chemical therapeutic agents (47 634), vaccines (47 248) and diagnostic tests (12 991), with the U. S. possessing absolutely advantageous patent portfolios in all three fields. The applicants were mainly comprised of large enterprises abroad and universities and research institutes in China.Conclusions:China′s COVID-19 related patent applications are relatively scattered. In the field of chemotherapy, there is room for improvement compared with the advanced countries, and cooperation between scientific institutions and enterprises is insufficient. Therefore, China should further increase investment in chemical drug research and development and seize the opportunity to actively promote the research and development of vaccine technology. On the other hand, we need to consolidate the technical advantages and product advantages of epidemic prevention and control which are already accumulated, and strengthen the protection and layout of intellectual property rights. Furthermore, the technological innovation system combining production, education and research is the breakthrough point to encourage enterprises to become the subject of technological innovation.Last but not least, we should build a service platform for the transfer and transformation of scientific and technological achievements to enhance intellectual property rights and promote the transformation of scientific and technological achievements.

Purpose/Significance Achieving automatic generation of medical imaging reports is important for reducing the workload of radiologists and promoting the standardization of clinical workflow.Method/Process Focusing on finding the chest report generation mod-els with open source code in recent years,the paper develops an automatic medical image report generation method based on the CDGPT2 model.Result/Conclusion The advantages of the model in report generation are still to be explored,the quality of reports generated after modifications to the decoder inputs of the model is not high.Future research could improve the performance of the model by using large datasets and incorporating more clinical information.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.