Objective:Drawing upon behavioral economics theory,it aims to elucidate the irrational decision-making mechanisms and systematic governance strategies driving low-value care in oncology,optimize healthcare resource allocation and enhance service quality.Methods:Centered on the dual-system theory framework,the behavioral economics principles of loss aversion,anchoring effects,and intertemporal choice are integrated to develop a physician-patient shared decision-making model spanning the entire cancer care continuum(screening,diagnosis,treatment,rehabilitation).Results:Low-value oncology care are jointly driven by physicians' defensive psychology,patients'loss aversion preferences,and socio-cultural pressures.Conclusion:Multidimensional interventions,such as predefining high-value care pathways,establishing negative lists to constrain low-value supply,reforming payment mechanisms,and implementing targeted health education,can effectively disrupt the"cognitivebias-behavioral inertia"loop and improve the efficiency of resource allocation in cancer diagnosis and treatment.

Objective:Drawing upon behavioral economics theory,it aims to elucidate the irrational decision-making mechanisms and systematic governance strategies driving low-value care in oncology,optimize healthcare resource allocation and enhance service quality.Methods:Centered on the dual-system theory framework,the behavioral economics principles of loss aversion,anchoring effects,and intertemporal choice are integrated to develop a physician-patient shared decision-making model spanning the entire cancer care continuum(screening,diagnosis,treatment,rehabilitation).Results:Low-value oncology care are jointly driven by physicians' defensive psychology,patients'loss aversion preferences,and socio-cultural pressures.Conclusion:Multidimensional interventions,such as predefining high-value care pathways,establishing negative lists to constrain low-value supply,reforming payment mechanisms,and implementing targeted health education,can effectively disrupt the"cognitivebias-behavioral inertia"loop and improve the efficiency of resource allocation in cancer diagnosis and treatment.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Ramping-up is the magnet current injection procedure which is under the control of resistance, voltage, current lead temperature, magnet pressure, temperature and so on. In this procedure, the factors related to the stability of the magnet such as, magnet temperature, pressure and currents are constantly changing. This procedure is the main step which the magnet-quench occurs in. This study uses the data collected during 7 years and SIMENS MRI ramping-up theory, in order to help engineers understand the key factors to reduce the magnet quench during the ramping up procedure.
Magnets ; Temperature

The modifications of slices, flip angle, SAR mode and TR time are required when the SAR exceeds the limits. The scan time and image quality are affected by those. This study analyzes the SAR from the basic side. With the principle diagram of SIEMENS 1.5 T AVANTO and 3.0 T VERIO MRIS, the trouble shooting procedure of SAR problem is reached both in application and problem sides.
Algorithms ; Image Enhancement

Objective To investigate the effects of dexmedetomidine pre-treatment on pneumonocyte apoptosis and CCAAT/enhancer binding protein homologous protein (CHOP) in acute lung injury (ALI) induced by ischemia/reperfusion (I/R) during orthotopic liver transplantation in rats.Methods Forty adult male Sprague-Dawley (SD) rats were randomly divided into four groups by random number table method: sham operation group, I/R model group, dexmedetomidine low dose group and dexmedetomidine high dose group, 10 rats per group. Hepatic artery was ligated and cut off by two cuff method, and the portal vein was completely opened after donor liver transplanted into the recipient, thus, a hepatic I/R model was established. The perihepatic ligaments of rats were just separated after laparotomy in sham operation group and no other special treatment was performed. One hour prior to I/R, dexmedetomidine at a dose of 2.5μg·kg-1·h-1 and 5.0μg·kg-1·h-1, respectively, were pumped intravenously and finished within 1 hour in the rats of low dose group and high dose group. After experiment, the lung tissue was taken, and the lung wet/dry weight (W/D) ratio was determined. Pathological changes of lung tissue were observed and alveolar damage index of quantitative assessment (IQA) was tested by light microscope, and changes of ultrastructure of lung tissue were observed by transmission electron microscope. The mRNA and protein expressions of CHOP were detected respectively by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot. The apoptosis in lung tissue was determined by terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) method and apoptosis index (AI) was calculated.Results Compared to sham operation group, the lung W/D ratio (4.94±0.84 vs. 2.29±0.54), IQA [(40.52±5.15)% vs. (4.55±1.85)%] and AI [(36.57±5.85)% vs. (2.85±0.95)%] in I/R model group were significantly higher (allP < 0.01); remarkable injury of lung tissue was confirmed by light microscope and transmission electron microscope in the I/R model group. Compared to I/R model group, the W/D ratio (3.29±0.85, 2.68±0.78 vs. 4.94±0.84), IQA [(23.69±2.62)%, (15.86±3.61)% vs. (40.52±5.15)%] and AI [(25.73±3.71)%, (14.66±2.61)% vs. (36.57±5.85)%] in dexmedetomidine low and high dose groups were markedly lower (allP < 0.01); under light and transmission electron microscopes, the injury of lung tissue in these two dose groups was notably alleviated. There was a large amount of apoptotic cells of pulmonary vascular endothelium and alveolar epithelium in I/R model group, while the cell apoptosis was distinctly decreased in dexmedetomidine low and high dose groups compared to that in model group. Compared to sham operation group, the expressions of CHOP mRNA [absorbance (A) value: 0.96±0.18 vs. 0.43±0.08] and protein (gray scale: 2.79±0.74 vs. 1.02±0.27) were significantly higher in I/R model group (bothP < 0.01). Compared to I/R model group, the expressions of CHOP mRNA (A value: 0.69±0.13, 0.56±0.12 vs. 0.96±0.18) and protein (gray scale: 1.96±0.58, 1.34±0.49 vs. 2.79±0.74) were significantly lower in dexmedetomidine low and high dose groups, the decrease in dexmedetomidine high dose group being more marked (allP < 0.01).Conclusion The pretreatment of dexmedetomidine can protect lung tissue against I/R injury during liver transplantation in rats, and the mechanism may be related to the suppression of CHOP activation and alleviation of lung tissue cell apoptosis.

OBJECTIVETo investigate the effects of different concentrations of lipopolysaccharide (LPS) on proliferation and apoptosis of human umbilical cord mesenchymal stem cells (hUCMSCs) in vitro, and to explore their possible mechanism.

METHODShUCMSCs from umbilical cord tissue of full-term healthy fetus delivered by caesarean section were isolated and cultured in vitro using tissue attachment method. The 3rd passage hUCMSCs were used in the study. Cells were divided into groups A, B, C, D, and E, which were treated with DMEM/F12 medium containing 0, 0.1, 1.0, 10.0, and 100.0 µg/mL of LPS respectively. In groups B, C, D, and E, methyl-thiazole-tetrazolium assay was used to detect proliferative activity of hUCMSCs at post treatment hour (PTH) 12, 24, and 48 (denoted as absorption value), with 5 samples in each group at each time point; apoptosis of hUCMSCs at PBH 24 was identified with acridine orange-ethidium bromide (AO-EB) staining, with 4 samples in each group; apoptotic rate of hUCMSCs was determined by flow cytometer, with 5 samples in each group. Above-mentioned indexes were determined in group A at the same time points. Data were processed with analysis of variance and LSD- t test.

RESULTS(1) There was no statistically significant difference in proliferative activity of hUCMSCs at PTH 12 among groups A, B, C, D, and E (with t values from -1.67 to 1.33, P values above 0.05). Compared with that of group A, proliferative activity of hUCMSCs was increased in groups B, C, and D at PTH 24 and 48 (with t values from -13.42 to 17.34, P < 0.05 or P < 0.01), especially so in group C. Proliferative activity of hUCMSCs was lower in group E at PTH 24 and 48 than in group A (with t values respectively 8.64 and 17.34, P values below 0.01). (2) Obvious apoptosis of hUCMSCs was observed in group E but not in the other 4 groups with AO-EB staining. (3) Apoptosis rates of hUCMSCs in groups A, B, C, D, and E were respectively (3.1 ± 0.6)%, (2.6 ± 0.7)%, (2.9 ± 0.8)%, (3.1 ± 0.4)%, (25.1 ± 2.7)% (F = 272.19, P < 0.01). Apoptotic rate of hUCMSCs in group B, C, or D was respectively close to that in group A (with t values respectively 1.22, 0.57, -0.14, P values above 0.05), but it was higher in group E than in group A (t = -17.63, P < 0.01).

CONCLUSIONShUCMSCs proliferation may be promoted by low concentration of LPS. hUCMSCs proliferation is inhibited or induced to apoptosis along with the increase in concentration of LPS, and it may be related to activation of different major molecular signaling pathways by different concentrations of LPS.

Apoptosis ; drug effects ; Cell Proliferation ; Endotoxins ; adverse effects ; Humans ; Lipopolysaccharides ; pharmacology ; Membrane Proteins ; Mesenchymal Stromal Cells ; cytology ; drug effects ; Signal Transduction ; Umbilical Cord ; cytology

Objective To explore the application value of dipstick dye immuno-assay (DDIA) for screening the schistosomiasis chemotherapy targets in the low endemic areas of Xiaogan City.Methods The residents aged 6-65 years in a village in the low endemic areas of schistosomiasis of Xiaogan City were selected and tested by the methods of fecal examination,DDIA,indirect hemagghitination (IHA),enzyme linked immunosorbent assay (ELISA) and inquiry,and the results of fecal examination were determined as the gold standard.Results The Youden' s indices of IHA,DDIA,ELISA and inquiry were 0.74,0.72,0.62 and 0.30,respectively,and the consistency rates of them were 93.38%,91.99%,81.53% and 70.03%,respectively.It took 16.70,4.95,4.12,5.63 and 2.44 Yuan screening one patient with the fecal examination,IHA,DDIA,ELISA and inquiry,respectively.Conclusion The validity of DDIA with simple operation and low cost for screening the schistosomiasis chemotherapy targets is satisfying,and the method is suitable for large scale screening in low endemic areas.