Objective:To build an internet hospital cost-benefit evaluation index system based on a large public tertiary hospital, for references for improving the operation and management of internet hospitals.Methods:From May to October 2024, this study identified the elements of cost-benefit through on-site investigation, literature analysis and expert discussion, and built an initial evaluation index system of cost-benefit of internet hospitals; Delphi method and Pareto chart method were used to determine indicators and their weights; This evaluation index system was used to quantitatively evaluate an internet hospital since its operation for two years (from May 2022 to April 2024).Results:Five profit entities and 26 cost-benefit components had been identified; The expert authority coefficient of the two rounds of Delphi method was 0.73, and the Kendall coefficient was 0.80 ( P<0.001). The costs and benefits of an internet hospital since its operation for two years were 14.06 million yuan and 134.95 million yuan, respectively, with a benefit cost ratio of 9.60. Conclusions:The cost-benefit evaluation index system of internet hospitals built in this study was suitable for these relying on physical hospitals. This system was scientific and practical, and could provide references for cost-benefit evaluation of other Internet hospitals.

OBJECTIVE: To evaluate the clinical effect of "Tongdu Yisui" (unblocking the governor vessel and benefiting marrow) acupuncture and moxibustion on Meige syndrome. METHODS: Fifteen patients with Meige syndrome were treated with "Tongdu Yisui" acupuncture and moxibustion. Acupuncture was applied to Baihui (GV20), Dazhui (GV14), Shenzhu (GV12), Zhiyang (GV9), Jinsuo (GV8), bilateral Taixi (KI3), Zhaohai (KI6) and etc. Moxibustion was delivered at Jinsuo (GV8). After acupuncture and moxibustion at these body points, Jiao's scalp acupuncture was operated at bilateral chorea-tremor control area, and the patients were asked to walk for 20 min during needle retaining. Acupuncture and moxibustion were administered 20 min each time, once every two days, 3 times weekly and for 8 consecutive weeks. Assessments were conducted before treatment, after treatment, and follow-up at three months after treatment completion using the Burke-Fahn-Marsden dystonia rating scale (BFMDRS-M), abnormal involuntary movement scale (AIMS), and blepharospasm disability index (BSDI); and the clinical effect was evaluated after treatment. RESULTS: Compared before treatment, the scores of the sub-items of BFMDRS-M for eyes, mouth, speech and swallowing, and neck, as well as the total score of the scale, AIMS score and BSDI score decreased after treatment and during follow-up (P<0.05); the scores of the above indexes were not different statistically in comparison between the follow-up and after treatment (P>0.05). After treatment, 13 cases were effective, 2 cases were failed and the total effective rate was 86.7% (13/15). CONCLUSION "Tongdu Yisui" acupuncture and moxibustion can effectively alleviate motor symptoms and dysfunction of Meige syndrome and presents the sustained therapeutic effect.
Humans ; Moxibustion ; Male ; Female ; Acupuncture Therapy ; Adult ; Middle Aged ; Meige Syndrome/therapy* ; Acupuncture Points ; Young Adult ; Treatment Outcome ; Aged ; Adolescent

Objective:To build an internet hospital cost-benefit evaluation index system based on a large public tertiary hospital, for references for improving the operation and management of internet hospitals.Methods:From May to October 2024, this study identified the elements of cost-benefit through on-site investigation, literature analysis and expert discussion, and built an initial evaluation index system of cost-benefit of internet hospitals; Delphi method and Pareto chart method were used to determine indicators and their weights; This evaluation index system was used to quantitatively evaluate an internet hospital since its operation for two years (from May 2022 to April 2024).Results:Five profit entities and 26 cost-benefit components had been identified; The expert authority coefficient of the two rounds of Delphi method was 0.73, and the Kendall coefficient was 0.80 ( P<0.001). The costs and benefits of an internet hospital since its operation for two years were 14.06 million yuan and 134.95 million yuan, respectively, with a benefit cost ratio of 9.60. Conclusions:The cost-benefit evaluation index system of internet hospitals built in this study was suitable for these relying on physical hospitals. This system was scientific and practical, and could provide references for cost-benefit evaluation of other Internet hospitals.

Intracranial germ cell tumors (iGCT) is a common cause of delayed puberty (DP).　A retrospective analysis was conducted on the clinical data of two patients with DP caused by iGCT. The disease characteristics of the two patients included DP, primary amenorrhea, growth retardation, short stature, subclinical hypothyroidism, etc. They were diagnosed as DP through imaging and related biochemical tests, and some sex hormone drugs were given on the basis of active treatment of the primary disease. Two patients had varying degrees of development in height, weight and secondary sexual characteristics, and further treatment condition is being tracking by us. Early identification and appropriate clinical intervention are of great significance to the reproductive endocrine function, bone health and long-term health such as terminal height of DP patients.

Intracranial germ cell tumors (iGCT) is a common cause of delayed puberty (DP).　A retrospective analysis was conducted on the clinical data of two patients with DP caused by iGCT. The disease characteristics of the two patients included DP, primary amenorrhea, growth retardation, short stature, subclinical hypothyroidism, etc. They were diagnosed as DP through imaging and related biochemical tests, and some sex hormone drugs were given on the basis of active treatment of the primary disease. Two patients had varying degrees of development in height, weight and secondary sexual characteristics, and further treatment condition is being tracking by us. Early identification and appropriate clinical intervention are of great significance to the reproductive endocrine function, bone health and long-term health such as terminal height of DP patients.

Objective:To explore the effects of platelet parameters, coagulation indexes, platelet and lymphocyte ratio (PLR) values, neutrophil and lymphocyte ratio (NLR) values on coagulation disorders and perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP).Methods:A retrospective analysis of prothrombin time (PT) and activated partial thromboplastin time (activated partial) of 106 ICP patients (ICP group) and 138 normal pregnant women (control group) delivered from Gansu Provincial People's Hospital from January 2017 to December 2018 was performed. Activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet count, mean platelet volume (MPV), platelet distribution red blood cell distribution width (RDW), number of white blood cell (WBC), PLR, NLR, and postpartum hemorrhage and perinatal outcomes were compared between the two groups. Further based on whether serum bile acid (TBA) was ≥40 μmol/L, the patients in ICP group were divided into mild ICP subgroup and severe ICP subgroup, and the changes in the difference indicators were analyzed between the two subgroups.Results:Compared with control group, MPV ( t=4.929, P<0.001), FIB ( t=3.509, P<0.001), D-D ( t=7.834, P<0.001) and NLR ( t=4.098, P<0.001) were significantly increased in ICP group ( P<0.05). Platelet count ( t=4.367, P<0.001) and PLR ( t=2.448, P=0.015) were significantly decreased in ICP pregnant women. The incidence of postpartum hemorrhage ( t=10.003, P<0.001), fetal distress (χ 2=17.194, P<0.001), preterm birth rate (χ 2=13.938, P<0.001) and transfer into neonatal intensive care unit (NICU)(χ 2=29.736, P<0.001) in ICP group was higher than that in control group. Apgar score ( t=3.234, P=0.001) and neonatal birth weight ( t=6.509, P<0.001) in ICP group were lower than those in control group. Further analysis of ICP components for severe ICP and mild ICP revealed significant differences in MPV ( t=2.376, P=0.019), FIB ( t=2.174, P=0.032), D-D ( t=3.074, P=0.003), WBC ( t=2.021, P=0.046), neutrophil count ( t=2.131, P=0.035), NLR ( t=2.864, P=0.005), etc. Postpartum hemorrhage ( t=3.257, P=0.002), the preterm birth rate (χ 2=4.025, P=0.045), birth weight ( t=3.126, P=0.002), and transfer rate to the NICU (χ 2=5.518, P=0.019) were also significantly different between the two groups. Conclusion:ICP pregnant women have abnormal coagulation and fibrinolysis, which may lead to postpartum hemorrhage. The incidence of poor perinatal outcomes is high, which should be highly valued by the clinic. It is of great significance to evaluate the pregnancy outcome of pregnant women with ICP by analyzing the coagulation function and inflammatory markers of ICP pregnant women.

Objective:To explore the effects of platelet parameters, coagulation indexes, platelet and lymphocyte ratio (PLR) values, neutrophil and lymphocyte ratio (NLR) values on coagulation disorders and perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP).Methods:A retrospective analysis of prothrombin time (PT) and activated partial thromboplastin time (activated partial) of 106 ICP patients (ICP group) and 138 normal pregnant women (control group) delivered from Gansu Provincial People's Hospital from January 2017 to December 2018 was performed. Activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet count, mean platelet volume (MPV), platelet distribution red blood cell distribution width (RDW), number of white blood cell (WBC), PLR, NLR, and postpartum hemorrhage and perinatal outcomes were compared between the two groups. Further based on whether serum bile acid (TBA) was ≥40 μmol/L, the patients in ICP group were divided into mild ICP subgroup and severe ICP subgroup, and the changes in the difference indicators were analyzed between the two subgroups.Results:Compared with control group, MPV ( t=4.929, P<0.001), FIB ( t=3.509, P<0.001), D-D ( t=7.834, P<0.001) and NLR ( t=4.098, P<0.001) were significantly increased in ICP group ( P<0.05). Platelet count ( t=4.367, P<0.001) and PLR ( t=2.448, P=0.015) were significantly decreased in ICP pregnant women. The incidence of postpartum hemorrhage ( t=10.003, P<0.001), fetal distress (χ 2=17.194, P<0.001), preterm birth rate (χ 2=13.938, P<0.001) and transfer into neonatal intensive care unit (NICU)(χ 2=29.736, P<0.001) in ICP group was higher than that in control group. Apgar score ( t=3.234, P=0.001) and neonatal birth weight ( t=6.509, P<0.001) in ICP group were lower than those in control group. Further analysis of ICP components for severe ICP and mild ICP revealed significant differences in MPV ( t=2.376, P=0.019), FIB ( t=2.174, P=0.032), D-D ( t=3.074, P=0.003), WBC ( t=2.021, P=0.046), neutrophil count ( t=2.131, P=0.035), NLR ( t=2.864, P=0.005), etc. Postpartum hemorrhage ( t=3.257, P=0.002), the preterm birth rate (χ 2=4.025, P=0.045), birth weight ( t=3.126, P=0.002), and transfer rate to the NICU (χ 2=5.518, P=0.019) were also significantly different between the two groups. Conclusion:ICP pregnant women have abnormal coagulation and fibrinolysis, which may lead to postpartum hemorrhage. The incidence of poor perinatal outcomes is high, which should be highly valued by the clinic. It is of great significance to evaluate the pregnancy outcome of pregnant women with ICP by analyzing the coagulation function and inflammatory markers of ICP pregnant women.

Objective To investigate the effects of calcium levofolinate and 5-fluorouracil combined with epirubicin on stress response and vascular endothelial growth factor (VEGF) level in patients with gastric cancer.Methods A total of 160 patients with gastric cancer treated in Huxi Hospital Affiliated to Jining Medical College from April 2016 to March 2018 were selected as research objects.All the patients were divided into two groups according to the random number table method and each group consisted of 80 cases.The control group was treated with epirubicin,while the study group was treated with calcium levofolinate and 5-fluorouracil combined with epirubicin.The clinical efficacy and adverse reactions of the two groups were observed and compared.The levels of VEGF and quality of life were compared before and after the treatment.The stress response indexes such as cortisol (Cor),norepinephrine (NE) and total antioxidant capacity (TAC) were detected,and the stress levels of the two groups were compared.Results The total effective rate of the study group was 67.5％ (54/80),which was significantly better than that of the control group [45.0％ (36/80)],and the difference was statistically significant (x2 =8.229,P =0.004).The quality of life of the two groups after the treatment was significantly higher than that before the treatment,and the quality of life scores of the study group were significantly higher than those of the control group (all P ＜ 0.001).After the treatment,the levels of Cor,NE and TAC of the study group were (239.27 ± 19.63) μg/L,(258.46 ± 18.31) ng/L,(11.01 ± 0.77) KIU/L,which were significantly lower than those of the control group [(286.35 ± 20.63) μg/L,(294.18± 21.95) ng/L,(12.73 ± 1.58) KIU/L],and the differences were statistically significant (t =10.003,P ＜ 0.001;t =9.476,P ＜ 0.001;t =6.984,P ＜ 0.001).After the treatment,the VEGF levels of the two groups were lower than those before the treatment,and the VEGF level of the study group was significantly lower than that of the control group [(39.4 ±0.9) pg/ml vs.(42.3 ± 1.1) pg/ml,t =18.251,P ＜ 0.001].The total incidences of adverse reactions in the control group and the study group were 82.5％ (66/80) and 48.8％ (39/80),respectively.The incidence of adverse reactions in the control group was significantly higher than that in the study group,and the difference was statistically significant (x2 =20.197,P ＜ 0.001).Conclusion Calcium levofolinate and 5-fluorouracil combined with epirubicin has a good clinical effect in treating patients with gastric cancer.It can not only improve the level of VEGF in the serum of patients,but also can improve the quality of life of patients,reduce the incidence of adverse reactions and body stress response.It has broad application prospects and is worthy of further promotion and application in clinic.

Objective To investigate the neural mechanisms of speech motor control in individuals with Parkinson's disease (PD) under different strategies of motor execution control.MethodsThe techniques of the psychoacoustic and event-related potentials (ERPs) based on the altered auditory feedback paradigm were used in the present study. Two groups, including 17 PD patients and 17 healthy controls, were instructed to produce sustained vowels under the internal and external cueing tasks while hearing their voice randomly pitch-shifted downwards. The vocal responses and associated ERPs were recorded and compared across the groups and tasks.ResultsBehavioral results showed that the amplitude of acoustic compensation response was larger in PD patients than in the healthy controls (F=5.415, P=0.027), however, the main effect was not significant in the tasks (F=0.039, P=0.840). At the cortical level, PD patients produced significantly larger N1 responses to pitch perturbations in the internal cueing task related to the external cueing task (F=8.634, P=0.006), while such task effect was not observed in the healthy controls (F=1.550, P=0.231). Also, PD patients produced significantly larger N1 responses than the healthy controls in the internal cueing condition (F=5.476, P=0.026), but not in the external cueing condition (F=0.249, P=0.621). Conclusion Speech motor control in PD can be influenced by the strategies of motor execution control. Compared to the internal cueing task, the external cueing task can increase neural efficiency in the encoding of speech auditory feedback PD patients that improve auditory-motor integration for speech production.

Objective: To analyze the difference of bleeding frequency, plain radiographic (X-ray) , risk factors in hemophilic arthropathy progression and the Arnold-Hilgartner classification. Methods: A retrospective study was conducted in 211 hemophilia patients hospitalized in our medical center between January 2007 and December 2010, some patients with hemarthrosis were followed up for 5 years. Results: All patients were male, including 150 hemophilia A (HA) and 61 hemophilia B (HB) . The HA patients bled more frequently than HB patients with annualized total bleeding rate 20.5 (0-48) vs 13 (1-40) ; annualized joint bleeding rate 13.5 (0-38) vs 8 (0-33) , especially in moderate hemophilia [26 (1-48) vs 12 (1-36) , P<0.001; 18 (0-36) vs 7.5 (0-26) , P=0.001], but severe hemophilia had no difference in bleeding frequency [33 (1-41) vs 26 (1-40) , P=0.702; 22 (0-36) vs 18 (0-33) , P=0.429]. The condition of the affected joints of 108 HA and 54 HB was evaluated on roentgenography. In HA patients, the Arnold-Hilgartner classification increased with the severity ratings (r=0.063, P=0.004) . However, similar associations were not found in HB patients (r=0.045, P=0.082) . Five years later, 36 HA and 19 HB patients received the same joint X-ray, there were no significant differences in joints radiographic progression between the total HA and HB groups (z=1.941, P=0.052) . However, significant difference between moderate HA and HB was observed (z=0.076, P=0.002) . Multivariate unconditioned Logistic analysis showed that annualized joint bleeding rate [P<0.001, OR=1.166 (95%CI 1.097-1.239) ] and articular structural injuries [P=0.018, OR=2.842 (95% CI 1.196-6.755) ] were independent risk factors for the joints radiographic progression. Conclusion The study suggests that there was a difference in bleeding phenotype between HA and HB, especially in moderate hemophilia. HB patients showed mild but progressive development over time, compared with HA patients. Annualized joint bleeding rate and articular structural injuries were independent risk factors for the joints radiographic progression.