Objective:To investigate the clinical efficacy of long-pulsed 1064nm laser combined with amorolfine hydrochloride in the treatment of patients with onychomycosis. Methods:Totally 106 cases of patients with onychomycosis were randomly divided into the observation group (n=53) and the control group(n=53) according to the random number table. The control group was given 5%amorolfine hydrochloride liniment, while the observation group was treated with long-pulsed 1064nm laser additionally. The course of treatment was 6 months. The clinical efficacy, length of deck in ward areas, length of deck in health zone, clearance of mycology and adverse reactions were compared between the groups. Results:The total effective rate of the observation group(90. 57%) was signifi-cantly higher than that of the control group(75. 47%, P<0. 05). After the treatment, the length of deck in ward areas in both groups were significantly decreased, while the length of deck in health zone were significantly increased (P<0. 05). The length of deck in ward areas in the observation group was significantly lower than that in the control group, while the length of deck in health zone was significantly higher than that in the control group(P<0. 05). The clearance rate of mycology in the observation group (86. 79%) was significantly higher than that in the control group (67. 92%, P<0. 05). There were no serious adverse reactions during the treatment course. Conclusion:Long-pulsed 1064nm laser combined with 5% amorolfine hydrochloride liniment in the treatment of patients with onychomycosis has remarkable, safe and reliable clinical effects, which shows important study value.

Objective To analyze the variations and influencing factors of hospitalization expenditure of cervical cancer patients among urban employees in Beijing from 2006 to 2010,and to provide evidences for developing reasonable measures of medical expenses control.Methods Based on the hospitalization expenditure data of 1146 cervical cancer cases,the paper probed into the changes of hospitalization age and hospitalization expenditure,and the influencing factors of hospitalization expenditure by means of descriptive analysis and multiple stepwise regression.Results The last 5 years witnessed no significant change in the first hospitalization age of cervical cancer patients,rise of hospitalization age,gradual rise of the hospitalization expenditure per time along with their age groups,as well as a rising trend of the average hospitalization expenses,average drug cost and proportion of average drug cost year by year.Results of the multiple stepwise linear regression showed that days of stay,proportion of drug cost and surgery or not as important influencing factors for hospitalization expenditure.Conclusion Hospitalization expenditure of cervical cancer keeps growing.Against this background,reasonable shortening of the days of stay,reasonable setup of an appropriate proportion of out-of-pocket payment,and reduction of the proportion of drug costs become effective means to reduce hospitalization expenditure.

It's a new financial management system that our country implemented the management of separating the income and expenditure in the community health services.Beijing is one of the former pilot cities which carried on the management of separating the income and expenditure.To know the effectiveness of the implementations and its influence to the health services,this article analyses the status of community health services,the financial investment and the performance results in Beijing.Considering the above,this paper also provides policy recommendations on the development of health services in Beijing to improve the new urban medical service system which based on the community health services.

BACKGROUND: Prospective studies concerning bone metabolism and bone mineral density variation after fractures have been reported from the 1960s, but these studies are mainly focused on tibia and fibula and ankle fractures in patients with low sample size.
OBJECTIVE:To observe the changes in bone mineral density and bone metabolism indexes in elderly women within 6 to 12 months after hip fractures, and to analyze the correlation.
METHODS:We selected 48 elderly women with hip fractures admitted in the Department of Orthopedics, Beijing Aerospace General Hospital in China from May 2011 to July 2013. Standards for fol ow-up were developed to measure the bone mineral density and bone metabolism indexes in the L 1-4 spinal segments and both sides of the hip. The bone metabolism indexes included bone alkaline phosphatase, osteocalcin, cross-linked C-terminal peptide of col agen I, and serum tartrate-resistant acid phosphatase 5b levels. Multiple linear regression analysis was performed based on measurements of bone mineral density and bone metabolism indexes after fracture healing.
RESULTS AND CONCLUSION:After fracture healing, bone mineral density of the fractured hip and lumbar vertebra was significantly lower than the baseline value. There was no statistical difference in bone mineral density between the healthy hip and the baseline value. At 6 months after fractures, bone alkaline phosphatase, osteocalcin, cross-linked C-terminal peptide of col agen I, and serum tartrate-resistant acid phosphatase 5b levels were significantly higher than the baseline values. At 12 months after fractures, osteocalcin level was significantly higher than the baseline value, while other indexes of bone metabolism measurements showed no statistical difference from the baseline values. When healing of hip fractures met the clinical and radiographic standards, the partial regression coefficient of delta-Z score reached peak in the changes of serum osteocalcin and bone mineral density of the fractured hip. Under clinical healing of fractures, serum osteocalcin level exhibits a higher value for the assessment of recovery speed of bone mineral density. Monitoring corresponding bone metabolism indexes after fracture healing can improve the accuracy of judging bone mineral density changes to reduce the risk of secondary fractures.

Objective:To compare the effect of intracorporeal anastamosis and extracorporeal anastamosis on abdominal infection associated with laparoscopic right hemicolectomy.Methods:The clinical data of 210 patients with colon cancer who underwent laparoscopic right hemicolectomy in Dalian Third Peoples′s Hospital, Liaoning Province from January 2015 to December 2019 were analyzed retrospectively.Among them, 79 patients underwent intracorporeal anastamosis (intracorporeal anastamosis group) and 131 patients underwent extracorporeal anastamosis (extracorporeal anastamosis group). The perioperative indexes and postoperative abdominal infection were compared between the two groups.Results:In intracorporeal anastamosis group, the intraoperative bleeding was (45.2±4.2) mL, the operative time was (161.3±22.4) min, the number of lymph node dissection was (30.8±9.6), the postoperative exhaust time was (3.3±1.2) d, and the postoperative hospital stay was (7.6±0.5) d. In extracorporeal anastamosis group was (42.1±5.0) mL, (167.3±26.7) min, (32.9±8.6), (3.4±1.0) d and (7.5±0.6) d, respectively, there were no significant difference between the two groups (t value were 0.417, 0.207, 0.829, 0.338 and 0.293, respectively; P value were 0.699, 0.845, 0.231, 0.734 and 0.802, respectively). In intracorporeal anastamosis group, the incidence of abdominal infection (with anastomotic fistula)was 13.9%(11/79), the incidence of abdominal infection (without anastomotic fistula)was 10.1%(8/79), and in extracorporeal anastamosis group was 1.5%(2/131)and 0.8%(1/131), the differences were statistically significant (χ 2=12.805, 10.238; P=0.003, 0.008). In intracorporeal anastamosis group, the incidence of respiratory system infection was 1.3%(1/79), the incidence of urinary system infection was 2.5%(2/79), the incidence of surgical incision infection was 1.3%(1/79). In extracorporeal anastamosis group was 3.1%(4/131), 0.8%(1/131) and 3.1%(4/131), respectively.There were no significant difference between the two groups (χ 2 value were 0.662, 0.420 and 0.662, respectively; P value were 0.364, 0.587 and 0.364, respectively). Conclusion:Laparoscopic right hemicolectomy with intracorporeal anastamosis and extracorporeal anastamosis have the same surgical effect, but intracorporeal anastamosis may increase the risk of postoperative abdominal infection.

Objective To evaluate the effect of Orem self‐care mode on sense of well‐being in patients with schizophrenia by Me‐ta analysis .Methods The databases of CBM ,VIP ,CNKI and Wan Fang Data were searched .All randomized controlled trials(RCT ) about Orem self‐care mode for patients about sense of well‐being were included .Data collection and literature review were per‐formed by two reviewers independently .The RevMan 5 .2 software was taken for analysis .Results Three literatures were includ‐ed .All these articles were regarded as low quality ,and only one article′s score of methodological quality are more than three .The Meta analysis showed there were significant differences between the Orem self‐care mode group and the normal nursing mode group in sense of well‐being .Besides the scores of the Orem self‐care mode group are higher(MD = 16 .29 ,95% CI(14 .54 - 18 .05) ,P<0 .05) .Conclusion The Orem self‐care mode is better than normal nursing for sense of well‐being in patients .However ,trials are only three ,and most trials included in the review are of low quality .So large scale randomized controlled trials of higher quality are needed to confirm the result .

Objective To evaluate the policy of human organ transplantation in China, aiming to provide theoretical basis for further optimizing the policy of human organ transplantation. Methods Based on text mining and statistical analysis, seven normative policies of human organ transplantation formulated by national government from 2000 to 2022 were quantitatively evaluated by constructing policy modeling consistency (PMC) with 10 first-level variables and 35 second-level variables. Results Among the seven policies, six were graded as excellent policies and one as perfect policy, with an average PMC index of 8.476. Except X₈ policy audience, the scores of other second-level variables of P5 were higher than or equal to the mean. The scores of all second-level variables of P1 were lower than or equal to the mean. P1 and P5 significantly differed in X₃ policy timeliness, X₄ policy norms and X₆ policy tools. P5 was more specific and relatively comprehensive in these aspects, and its score was significantly higher than that of P1. Conclusions Human organ transplantation policies in China are generally excellent, scientific and rational. Health administrative departments at all levels should pay attention to the grasp of policy timeliness, the combination of policy tools, and fully mobilize the initiative and enthusiasm of all policy audience to participate in organ transplantation management when formulating organ transplantation policies.

Objective To investigate the relationship between the level of serum triglyceride and early pain after posterior lumbar interbody fusion.Methods A total of 79 patients who were admitted into our hospital from March 2016 to December 2016 were selected into the study,and these patients were divided into two groups according to the degree of pain which means 32 cases in the minor pain group and 47 cases in the intermediate pain group.The difference of serum triglyceride level 3 days after operation were compared between the two groups.Pearson correlation analysis was performed to test the correlation between the level of serum triglyceride and early post-surgical pain.Logistic regression analysis was performed to test the risk factors for early post-surgical pain.Results The data indicated the level of pain was significant higher in the intermediate pain group than that of the minor pain group.Level of serum triglyceride had a significantly positive correlation with the level of post-surgical pain and it was the risk factor of pain after posterior lumbar interbody fusion.Conclusion The level of serum triglyceride is the risk factor of early post-surgical pain of lumbar single level interbody infusion,and it should be adjusted in the perioperative treatment.

Objective The study aimed to identify risk factors of lumbar disc herniation in patients after decompression,and provide theoretical basis for postoperaive rehabilitation.Methods A told of 169 patients with lumbar spinal stenosis underwent bilateral partial laminectomy were included in the study,24 patients in herniation group,and 145 patients without develop postoperative acute sciatica as a control group.The radiographic variables were measured.The threshold of risk factors was evaluated by multiple logistics analysis and receiver operating characteristic curve(ROC) analysis.Results The results revealed that preoperative retrolisthesis during extension was the independent risk factor for lumbar disc herniation(1.24,95％CI[1.07～1.43];P<0.01).The area under the curve(AUC) was 0.801,and the cutoff value was 6.89％.Conclusion The preoperative retrolisthesis was the risk factor of lumbar disc herniation.

Objective To investigate the effect of intravenous anesthesia with sufentanil combined with propofol on hemodynamics and oxygen metabolism in patients with esophageal cancer under high altitude.Methods 60 patients with esophageal cancer radical surgery was selected from March 2015 to March 2017 in our hospital and were divided into two groups according to the random number table,30 patients in each group.Patients in the control group were given with fentanyl and propofol intravenous anesthesia,and patients in the observation group were given sufentanil combined with propofol anesthesia.The occurrence of restlessness during the recovery of anesthesia in the two groups were observed,the spontaneous breathing recovery time,extubation time and postoperative Mini-mental State Examination (MMSE) score were recorded,and the indexes of hemodynamics and oxygen metabolism were measured at the time of before induction of anesthesia (T0),tracheal intubation (T1),skin incision (T2),thoracotomy (T3),free esophagus (T4),esophageal catheter removal time (T5).Results The spontaneous respiration recovery time and extubation time of the observation group were significantly shorter than those of the control group (P ＜ 0.05).The degree of restlessness in the observation group was weaker than that in the control group (P ＜ 0.05).Mean arterial pressure (MAP) in the control group at T2-T4 were significantly higher than those in T0 (P ＜ 0.05),but MAP and heart rate (HR) in the observation group at T1-T5 were significantly lower than those of T0 (P ＜ 0.05).Compared with T0 group,oxygen saturation (SpO2),oxygen saturation of mixed venose blood (SvO2) and oxygen delivery (DO2) at T1-T5 were significantly decreased (P ＜ 0.05),oxygen consumption (VO2) at T2-T4 was significantly increased (P ＜ 0.05),especially in the control group (P ＜ 0.05).The MMSE scores of the two groups were significantly lower than those before the operation (P ＜ 0.05),and the scores in observation group was significantly higher than the control group (P ＜ 0.05).Conclusions The intravenous anesthesia with sufentanil combined with propofol is more helpful in maintaining hemodynamic stability and oxygen metabolism balance than intravenous anesthesia with fentanyl combined with propofol and has little effect on postoperative anesthesia recovery and cognitive function.