Objective To investigate the potential causal relationship between gut microbiota and pituitary adenoma(PA).Methods Two-sample Mendelian randomization(MR)analysis was adopted by using genome wide association study(GWAS)summary statistics from the MiBioGen consortiums(obtaining 211 gut microbiota taxa)and FinnGen consortiums R9 release data(from 1402 cases PA patients and 375 875 control cases)to evaluate the causal association between gut microbiota and PA.Inverse variance weighted method was used as main analysis method,and pleiotropy and heterogeneity tests were used to verify the reliability of the results.In addition,a reverse MR analysis was performed to rule out the possibility of a reverse causal association.Results Genus Ruminococcaceae UCG004(OR=1.391,95％CI:1.004-1.932,P=0.049),Fusicatenibacter(OR=1.654,95％CI:1.101-2.494,P=0.017),and family Acidaminococcaceae(OR=1.994,95％CI:1.252-3.173,P=0.004)were found to increase the risk of PA.Conversely,the genus Ruminiclostridium 5(OR=0.634,95％CI:0.415-0.991,P=0.043),genus Eisenbergiella(OR=0.701,95％CI:0.551-0.915,P=0.007),class Negativicutes(OR=0.574,95％CI:0.362-0.895,P=0.014),and phylum Euryarchaeota(OR=0.784,95％CI:0.644-0.975,P=0.022)exhibited a negative correlation with PA.Sensitivity analyses indicated the absence of pleiotropy and heterogeneity.Conclusion The causal relationship between gut microbiota and PA may provide a new theoretical basis for the pathogenesis of PA.

Objective To investigate the potential causal relationship between gut microbiota and pituitary adenoma(PA).Methods Two-sample Mendelian randomization(MR)analysis was adopted by using genome wide association study(GWAS)summary statistics from the MiBioGen consortiums(obtaining 211 gut microbiota taxa)and FinnGen consortiums R9 release data(from 1402 cases PA patients and 375 875 control cases)to evaluate the causal association between gut microbiota and PA.Inverse variance weighted method was used as main analysis method,and pleiotropy and heterogeneity tests were used to verify the reliability of the results.In addition,a reverse MR analysis was performed to rule out the possibility of a reverse causal association.Results Genus Ruminococcaceae UCG004(OR=1.391,95％CI:1.004-1.932,P=0.049),Fusicatenibacter(OR=1.654,95％CI:1.101-2.494,P=0.017),and family Acidaminococcaceae(OR=1.994,95％CI:1.252-3.173,P=0.004)were found to increase the risk of PA.Conversely,the genus Ruminiclostridium 5(OR=0.634,95％CI:0.415-0.991,P=0.043),genus Eisenbergiella(OR=0.701,95％CI:0.551-0.915,P=0.007),class Negativicutes(OR=0.574,95％CI:0.362-0.895,P=0.014),and phylum Euryarchaeota(OR=0.784,95％CI:0.644-0.975,P=0.022)exhibited a negative correlation with PA.Sensitivity analyses indicated the absence of pleiotropy and heterogeneity.Conclusion The causal relationship between gut microbiota and PA may provide a new theoretical basis for the pathogenesis of PA.

In order to compare the setting of difference coefficients in DRG point payment in different cities in Zhejiang province, the implementation rules of DRG point payment issued by 11 cities in Zhejiang province were comprehensively analyzed. It was found that the difference coefficients in different cities could be divided into three categories, including hospital coefficients alone, hospital coefficients and grade coefficients weighted, and weighted by hospital coefficients, grade coefficients, personal burden levels, case mix indexes, and head-to-time ratio. Its setting differences included four aspects: connotation composition, weight distribution, threshold value, and classification of medical institutions. The authors suggested that the adjustment cycle should be set scientifically to dynamically adjust the difference coefficient, and the scientific setting of the difference coefficient should be promoted through provincial coordination.

China has entered the task stage of comprehensive medical insurance payment reform, but there are problems restricting the development of innovative medical technology in the reform of diagnosis-related groups(DRG) payment system. The author introduced the international definition and scope of innovative medical technology, and summarized the preconditions and payment policy of short-term payment of innovative medical technology under the DRG payment system; And put forward suggestions in line with China′s actual situation, including clarifying the definition of innovative medical technology, setting access conditions for additional payment or actual payment, setting up special transition funds for high-value innovative drugs, clarifying the payment amount of innovative medical technology, and formulating payment strategies for innovative medical technology.

Objective Based on the experience of the first round cooperation between Jinhua Municipal Central Hospital and School of Medicine,Zhejiang University,to evaluate the effects of this collaboration and provide reference for the next round cooperation.Methods A database of research performance from 2008-2017 was established to compare the scientific research situation of collaborating disciplines and non-collaborating disciplines before and after the cooperation between.Results The quality and quantity of scientific research projects,funds,papers were promoted after cooperation,and the improvement of collaborating disciplines was greater than non-collaborating disciplines.Conclusions The hospital college cooperation was helpful to promote the scientific research situation in a district hospital.It should be paid attention to the balance of disciplines development and improve the quality of scientific research in the next round cooperation.

Objective To investigate the anti-apoptotic effect of gene A20 in treatment of trau-matic brain injury (TBI). Methods Thirty-five Sprague-Dawley rats were made severe TBI models and assigned randomly to experimental group and control group (35 rats in each group). After severe TBI, the rats in experimental group were injected with liposome-pcDNA3.1-A20 and those in control group injected with liposome pcDNA3.1-A20 at 30 minutes after severe TBI. The animals in both groups were sacrificed to remove the brain of five rats from each group at 12, 24, 48, 72 and 168 hours for sec-tioning. The expression of A20 and neurocyte apoptosis were defined by immunohistological method and TUNEL accordingly. The other ten rats were testified for neurological function at 1,2, 3 and 4 weeks af-ter TBI. Results The expression of A20 in experimental group was higher than that in control group, with statistical differences (P < 0. 01). The peak neurocyte apoptosis was found at 72 hours after TBI. The number of apoptosis cells in experimental group was lower than that in control group at 12, 24, 48 and 72 hours afte TBI (P < 0.01 or 0.05). At the 4th week after TBI, the neurological function in exper-imental group was better than that in control group (P < 0.05). Conclusion Gene therapy with A20 may have anti-apoptosis effect and exert neuroprotective effect on severe TBI.