Objective:To study the allocation status of traditional Chinese medicine health resources in Shanxi Province from 2009 to 2021,conduct a vertical evaluation of the operation efficiency of traditional Chinese medicine health resources in Shanxi Province,discuss the related causes,and propose improvement method.Methods:The Gini coefficient method was used to make statistical data of traditional Chinese medicine health resources in Shanxi Province according to population allocation,Lorentz curve was drawn to analyze the equity of resource allocation,and BCC model was used to evaluate the input-output efficiency of resources.Results:The allocation of TCM health resources per population in Shanxi Province was the shortest in 2014,showing a trend of first decreasing and then increasing.The data output of operation efficiency showed that the allocation of TCM health resources in Shanxi Province was DEA effective in 2013,2015,2017-2019 and 2021,weak in 2009-2012 and 2014,and non-DEA effective in 2016 and 2020.Conclusion:The health resources of traditional Chinese medicine invested in Shanxi are not reasonably matched,the utilization of resources is not sufficient,the technical efficiency and scale efficiency of operation need to be improved.The redundancy of health resources and the"increasing return to scale"phenomenon coexist.

Objective:To explore the effect of nurse-led multidisciplinary collaborative nutrition management on cancer patients.Methods:Using the convenient sampling method, 106 cancer patients in Henan Provincial People's Hospital from January 2019 to December 2020 were selected as the research objects. According to the admission time, the patients were divided into two groups. A total of 51 patients admitted from January to December 2019 were selected as the control group, while 55 patients admitted from January to December 2020 were selected as the research group. The control group was given routine nutrition intervention, while the research group was given nurse-led multidisciplinary nutrition management on the basis of the control group. Nutritional grading and Quality of Life Instruments for Cancer Patients-Core Module (EORTC QLQ-C30) scores before and after intervention were compared between the two groups. The target achievement of nutritional management and the occurrence of gastrointestinal adverse reactions were counted.Results:After intervention, nutrition of the research group was better than that of the control group and EORTC QLQ-C30 score was higher than that of the control group, and the differences were statistically significant ( P<0.05) . The achievement rate of nutrition management goals in the research group was 67.27% (37/55) , higher than 39.22% (20/51) in the control group, and the difference between the two groups was statistically significant ( P<0.05) . The incidence of gastrointestinal adverse reactions in the research group was 3.64% (2/55) , lower than 17.65% (9/51) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The implementation of nurse-led multidisciplinary collaborative nutrition management in cancer patients can improve their nutritional status and quality of life, increase the rate of achieving nutritional management goals and reduce the incidence of gastrointestinal adverse reactions.

Objective:To investigate the prognostic significance of different IDH mutations and accompanying gene mutations in patients with non-M 3 acute myeloid leukemia (AML) . Methods:Second-generation sequencing was performed to detect the mutations of 22 genes in 389 patients with AML in the First Affiliated Hospital of Zhengzhou University from June 2016 to December 2018, and Kaplan-Meier and Cox regression models were used to analyze the prognostic factors.Results:The mutation frequency of IDH1 and IDH2 was 6.2% and 8.7% , respectively, in all patients without co-mutation. The IDH2 mutant group had an older age, higher proportion of bone marrow primitive cells, more common normal karyotype, and more common RUNX1 and SRSF2 mutations compared with IDH2 wild-type group. Univariate analysis of variance showed that the median OS and PFS of IDH1 mutation group were significantly shorter than those of the wild-type group ( P<0.05) . IDH2 mutation as a single variable and IDH2R140 mutation had no significant effect on the prognosis, while different mutation sites had different effects. Compared with the IDH2 wild-type group, the IDH2R172 mutation group had lower complete remission (CR) rate and shorter median OS and PFS ( P<0.05) . In patients with normal karyotypes or aged ≥50 years, IDH2 mutation as a single variable had no significant effect on the prognosis, IDH1 mutation and IDH2R172 mutation were associated with poor OS and PFS ( P<0.05) , and IDH2R140 mutation had no significant effect on OS and PFS. Approximately 74.1% (43/58) of patients with IDH mutation simultaneously carried other gene mutations; however, the number of accompanying gene mutations had no significant effect on the prognosis. Among 58 patients with IDH mutation, the CR rate of patients with NPM1 mutation was significantly higher than that of patients in the NPM1 wild-type group (81.8% vs 36.4% , P=0.014) , the median OS in patients with DNMT3A mutation was lower than that of patients with DNMT3A wild type [4.0 months (95% CI 3.8-4.2) vs 6.3 months (95% CI 2.4-10.2) , P=0.041) ]. Multivariate analysis showed that age ≥60 years and white blood cell count ≥100×10 9/L were independent risk factors for OS and PFS, while CR after two courses of treatment and hematopoietic stem cell transplantation were independent prognostic favorable factors for OS and PFS. Conclusion:In patients with AML (non-M 3) , IDH gene mutations often coexisted with other gene mutations, and different subtypes and accompanying gene mutations of IDH have different prognostic significance.

Objective: To explore the relationship between longitudinal trajectory of systolic blood pressure (SPB) and atrial fibrillation (AF) in Kailuan group population. Methods: Our study cohort consisted of 40727 participants with the specific criteria in Kailuan group, Tangshan. SAS Proc Traj procedure was used to identify longitudinal trajectories of SPB throughout 2006-2007, 2008-2009 and 2010-2011. There were 5 longitudinal trajectories generated: Low-stable group,n=10950, Moderate-stable group, n=19158, Moderate-high stable group,n=3713, High-moderate stable group,n=4702 and High stable group,n=2181. Log-rank test was performed to compare AF incidence throughout 2012-2013 and 2014-2015 by physical examination among different groups; Multi Cox regression analysis was conducted to study the relationship among different SBP longitudinal trajectories and AF occurrence. Results:①The mean age of participants was (51.81±11.54) years including 30693 (75.4%) male.②AF occurrence rates in Low-stable, Moderate-stable, Moderate-high stable, High-moderate stable and High stable groups were 0.1%, 0.2%, 0.5%, 0.5% and 0.6% respectively, allP<0.05.③Multi Cox regression analysis presented that with adjusted confounding factors, compared with the patients in Low-stable group, Moderate-high stable, High-moderate stable and High stable SBP longitudinal trajectories were the risk factors for new AF occurrence (HR=7.58, 95% CI 2.08-27.73), (HR=5.30, 95% CI 1.88-14.95) and (HR=8.52, 95% CI 1.96-37.09) respectively, allP<0.05. With excluded history of myocardial infarction/stroke, the sensitivity study showed the similar result with the major research trend. Conclusion: Elevated long trajectory of SPB was the risk factor for new AF occurrence in Kailuan group population.

Objective To investigate the relationship of carotid artery intima-media thickness(IMT) and blood pressure variation in patients with prehypertension. Methods Three hundred and ninety-two patients were selected as our subjects. Artery IMT was measured by Doppler ultrasonography. All patients were divided into carotid artery IMT group( n = 204 ),not carotid artery IMT group( n = 188 ) based on carotid IMT. Meanwhile,all patients were monitored by ambulatory blood pressure. Results (1)The indices of 24 h mean systolic blood pressure,systolic blood pressure variability and diastolic blood pressure variability in patients of carotid artery IMT group were(136. 85 ± 9. 67)mmHg,(4. 13 ± 0. 67)% ,(2. 97 ± 0. 45)% respectively, higher than those of Not carotid artery IMT group((121. 92 ± 6. 54)mmHg,(2. 64 ± 0. 86)% ,(2. 06 ± 0. 36)% ;t = 21. 08,5. 97,3. 32;P < 0. 05).(2)The rate of the carotid artery thickness increased with systolic blood pressure variability increasing( P = 0. 001). There were no significant correlations between rate of the carotid artery thickness and diastolic blood pressure variability,24 h mean diastolic blood pressure(P = 0. 435, 0. 126). The IMT thickening rate was higher when the average systolic blood pressure was greater(P = 0. 013). (3)Regression analysis indicated that carotid artery IMT was positively related with systolic blood pressure variability,high-sensitivity C-reactive protein,24 h mean systolic blood pressure,2-hour postprandial blood glouse. Conclusion Carotid artery IMT is independently associated with variation of blood pressure,especially with systolic blood pressure variability in prehypertension patients.

BACKGROUND: The pathological change of femoral head was observed after treating necrosis with core decompression and autogenous iliac bone implantation, expected to obtain a better understanding of the prognosis of autogenous iliac bone implantation method.OBJECTIVE: To explore the curative effect of the ischemic necrosis of femoral head filling the hole of the core decompression with autogenous iliac bone implantation in animal models. DESIGN, TIME AND SETTING: Animal trial observation. The experiment was performed at the Central Laboratory of the Guilin Medical University from April 2006 to September 2007.MATERIALS: Nine hybrid adult dogs were prepared for necrosis of femoral head models.METHODS: The ischemic necrosis of femur head was made with the liquid nitrogen in dogs. The rod-shape autogenous cancellous bone that comes from the posterior superior iliac spine was driven into the full depth of the core r decompression tunnel to the subchondral bone. The dogs were divided into 3 groups, 3 dogs in each groups were sacrificed respectively at 3, 6, 12 weeks after operation. Radiograph and histological examination were used to evaluate the results.MAIN OUTCOME MEASURES: Histological changes of the femoral head necrosis and bone graft at the weeks 3, 6 and 12.RESULTS: No collapse of femoral head was observed at the 3 weeks after operation. The graft as well as perivascular tissues showed necrosis with empty lacune. Fiber granulation tissues could be seen ingrowth of capillaries and perivascular tissues into the bone graft. At 6 weeks after operation, basophilia blue area and new born osteoblast, cartilage, as well as chondroblasts zone could be found at the surface of bone trabecula. After 12 weeks of operation, new bone formation, representing typical process of "creeping substitution". And the cancellous bone of necrotic femoral head was rebuilt gradually. CONCLUSION: Core decompression combined with implantation of autogenous iliac bone implantation can accelerate femoral head repairing, delay or prevent femoral head from necrosis.

Objective To investigate the association between postprandial triglyceride and the severity of coronary artery disease in patients with metabolic syndrome (MS). Methods AlI of 91 patients with MS were recruited for this study. Thirty-one patients with normal fasting and postprandial triglyceride was in MS1 group, 29 patients with normal fasting triglyceride and postprandial hypertrigtyceridemia was in MS2 group, and 31 patients with fasting hypertriglyeeridemia was in MS3 group. Blood triglyceride at the time of postprandial 4 hours was measured and the quantity of coronary artery branch disease was determined by coronary angiography. The relationship between them was analyzed. Result There was significant positive correlation between the quantity of coronary artery branch disease and the level of blood triglyceride at the time of postprandial 4 hours (r = 0.42, P < 0.01 ). Conclusions It is important to detect the level of blood triglyceride at the time of postprandial 4 hours. Prompt intervention maybe decrease the incidence and mortality rate of cardiovascular disease in patients with MS.

Objective We reported the rehabilitative nursing points of patients with pectoralis minor muscle transplantation for recovery of thumb oppositional function. Methods We selected 10 patients who underwent pectoralis minor muscle transplantation for recovery of thumb oppositional function and gave them perfect preoperative examination and psychological nursing. We also implemented rigorous monitoring postoperation and auxiliary electric stimulation and functional exercises. The emphasis was put on the exercise of thumb oppositional function. Results The thumb oppositional function of all the ten patients recovered. The myodynamia reached level 4 and the shape of thenar was satisfying after 6 to 12 months of follow-up visit. Conclusions Sufficient preoperative psychological nursing and effective postoperative rehabilitative treatment had pivotal significance for the success of operation and the recovery of thumb oppositional function.

To study the effect of titanium alloy cage on the treatment of the ischemic necrosis of femoral head in dog, the model of the ischemic necrosis of femoral head was made with the liquid nitrogon in 15 hybrid adult dogs. The titanium alloy cage made of a hollow cylinder was driven into the subchondral bone of necrotic femoral head via central channel. The dogs were divided into 3 groups, each group was sacrificed 3, 6, 12 weeks after the operation respectively. No collapse of femoral head was observed after the operation. The position of the cages was good on radiograph. Microscopically, the cancellous bone of necrotic femoral head rebuilt gradually and grew into cage. After 12 weeks of creeping substitution, the cancellous bone filled up the hollow cavity and holes of the cages. It is concluded that the titanium alloy cage can provide structural support for the subchondral bone and prevent collapse and can be used for the treatment of the ischemic necrosis of femoral head.