Objective:To analyze the medical service utilization preference of middle-aged and elderly residents (aged 45 and above) in Chongqing,and provide references for the local government to further promote the hierarchical diagnosis and improve the equity and efficiency of medical service utilization. Methods:Using a discrete choice experiment method,the preferences of 576 Chongqing residents,middle-aged and elderly,under conditions of mild and severe illness were measured for 6 attributes:medical service level,doctor's level,medical service mode,registration difficulty,drug supply and medical expenses. Results:Among patients with mild conditions,the attribute level most valued is"ability to register on the same day or the next day"(β=0.298,P<0.001) . They also prefer services from lower-level medical institutions and general practitioners (β=-0.200),as well as medical services with less cost (β=-0.003) . For patients with severe conditions,the attribute level they value the most is the medical service level (authoritative hospitals)(β=0.401,P<0.001),and they prefer services with ample drug supply (β=0.223),specialists (β=0.210),specialized departments (β=0.153),and higher costs (β=0.002) . The willingness to pay for patient shows an overall lower tendency for mild conditions and a higher one for severe conditions. Conclusion:Primary healthcare institutions have played a positive role in diverting patients,yet the tiered diagnosis and treatment system still requires ongoing improvement. Patients with mild conditions prefer convenient medical services,whereas those with severe conditions favor high-quality medical services. Under the burden of serious illness,medical expenses is a secondary factor influencing patients' choice of medical care. It is recommended to enhance the capacity and accessibility of high-quality medical resources,improving infrastructure and equipment at the primary level,expanding the availability of medications at these facilities,increasing the efficiency of specialist utilization,and strengthening the coordination among healthcare delivery,medical insurance,and pharmaceutical services—the"three-medicine linkage",address the difficulties and high costs of medical treatment experienced by the public,and achieve the goal of enabling residents to access affordable,high-quality health services locally.

Objective:To analyze the medical service utilization preference of middle-aged and elderly residents (aged 45 and above) in Chongqing,and provide references for the local government to further promote the hierarchical diagnosis and improve the equity and efficiency of medical service utilization. Methods:Using a discrete choice experiment method,the preferences of 576 Chongqing residents,middle-aged and elderly,under conditions of mild and severe illness were measured for 6 attributes:medical service level,doctor's level,medical service mode,registration difficulty,drug supply and medical expenses. Results:Among patients with mild conditions,the attribute level most valued is"ability to register on the same day or the next day"(β=0.298,P<0.001) . They also prefer services from lower-level medical institutions and general practitioners (β=-0.200),as well as medical services with less cost (β=-0.003) . For patients with severe conditions,the attribute level they value the most is the medical service level (authoritative hospitals)(β=0.401,P<0.001),and they prefer services with ample drug supply (β=0.223),specialists (β=0.210),specialized departments (β=0.153),and higher costs (β=0.002) . The willingness to pay for patient shows an overall lower tendency for mild conditions and a higher one for severe conditions. Conclusion:Primary healthcare institutions have played a positive role in diverting patients,yet the tiered diagnosis and treatment system still requires ongoing improvement. Patients with mild conditions prefer convenient medical services,whereas those with severe conditions favor high-quality medical services. Under the burden of serious illness,medical expenses is a secondary factor influencing patients' choice of medical care. It is recommended to enhance the capacity and accessibility of high-quality medical resources,improving infrastructure and equipment at the primary level,expanding the availability of medications at these facilities,increasing the efficiency of specialist utilization,and strengthening the coordination among healthcare delivery,medical insurance,and pharmaceutical services—the"three-medicine linkage",address the difficulties and high costs of medical treatment experienced by the public,and achieve the goal of enabling residents to access affordable,high-quality health services locally.

Objective To investigate the expression of phosphorylated RB (pRB) in the invasion front of papillary thyroid carcinoma and the clinical pathological implications. Methods Immunohistochemistry was ap-plied in analyzing pRB expression feature and the clinical pathological implications in a total of 82 patients who underwent total or subtotal thyroidectomy and neck lymph node dissection for papillary thyroid carcinoma. Results The displacement of pRB proteins from the nucleus to the cytoplasm was observed in the invasive front of papil-lary thyroid carcinoma , which was an independent predictor of lymph node metastasis in papillary thyroid carci-noma. Conclusion Nuclear-cytoplasmic transport of pRB in the invasive front was an independent predictor of lymph node metastasis in papillary thyroid carcinoma.

Objective: To establish the quality standards for Xiegananshen Capsules. Methods: Poria in this prescription was identified by microscopic examination; Radix Gentianae, Fructus Gardeniae, Radix Angelicae Sinensis and Radix Scutellariae were identified by TLC. Gentiopicrin was determined by HPLC. Results: Poria could be detected by microscopic examination; Radix Gentianae, Fructus Gardeniae, Radix Angelicae Sinensis and Radix Scutellariae could be detected by TLC. Gentiopicrin showed a good linear relationship at a range of 2.6 ～13?g, r=0.9995. The average recovery was 97.8%, and RSD was 1.0%. Conclusion: The established methods are simple, feasible and reproducible. This study provided a method for the quality control of Xiegananshen Capsules.