[Purpose]To investigate the choice of medical institutions for the first-treatment of can-cer patients after diagnosis and the factors influencing it,so as to provide a reference basis for the rational allocation of health resources and the promotion of hierarchical diagnosis and treatment of cancer.[Methods]A total of 1 140 common cancer patients from 1 provincial,3 municipal and 6 county-level medical institutions in Shandong Province were included in the study,and a ques-tionnaire survey was conducted on their basic personal information and the selection of medical institutions.Chi-square test and Fisher exact test were used to compare different groups,and mul-ti-classification unordered Logistic regression were used to explore the factors influencing the se-lection of cancer patients.[Results]1 077 valid questionnaires were collected.The selection rates of first-treatment institutions for cancer patients were county hospitals(29.90％),city hospitals(35.28％),and provincial hospitals(34.82％),and the high level of medical care was the main reason for the selection of first-treatment institutions for cancer patients.The results of multi-clas-sification unordered Logistic regression showed that when choosing municipal and county medical institutions as the first treatment institution compared to choosing a county medical institution for the first treatment as a reference,compared to patients with stage Ⅰ tumors,patients with tumor stages at stage Ⅲ(OR=1.789,95％CI:1.014～3.158)and stage Ⅳ(OR=2.005,95％CI:1.179～3.409)were more likely to choose municipal medical institutions;and patients with annual house-hold income of 10 000～＜50 000 CNY(OR=0.625,95％CI:0.414～0.943)were less likely to choose mu-nicipal medical institutions compared to those with an annual household income of＜10 000 CNY.When choosing provincial and county medical institutions as the first treatment institution com-pared to patients in stage Ⅲ(OR=2.885,95％C1:1.549～5.372)and stage Ⅳ(OR=3.104,95％CI:1.724～5.586)compared to patients with stage Ⅰ tumors when choosing a county medical institu-tion for the first treatment was used as a reference;married(OR=2.248,95％CI:1.127～4.484)patients were more likely to choose provincial healthcare organizations than unmarried/divorced/widowed patients;patients with a family history of cancer compared to patients without a family history of cancer(OR=1.650,95％CI:1.115～2.441)were more inclined to choose provincial healthcare institutions;compared with patients＜45 years old,patients over 60 years old(OR=0.483,95％CI:0.242～0.962)were less inclined to choose provincial hospitals;and compared with patients who were not aware of knowledge related to cancer,those who were aware of knowledge related to cancer(OR=0.613,95％CI:0.441～0.852)patients were less inclined to choose provin-cial hospitals.[Conclusion]Vigorously carrying out publicity on cancer prevention and treatment knowledge,improving the cancer prevention and treatment literacy of cancer patients.strengthen-ing vertical cooperation among medical institutions at all levels,improving the provincial-munici-pal-county cancer prevention and treatment network,and promoting the sinking of high-quality medical resources are important ways to improve the cancer prevention and treatment capacity of counties and promote the work of hierarchical medical system.

[Purpose]To investigate the choice of medical institutions for the first-treatment of can-cer patients after diagnosis and the factors influencing it,so as to provide a reference basis for the rational allocation of health resources and the promotion of hierarchical diagnosis and treatment of cancer.[Methods]A total of 1 140 common cancer patients from 1 provincial,3 municipal and 6 county-level medical institutions in Shandong Province were included in the study,and a ques-tionnaire survey was conducted on their basic personal information and the selection of medical institutions.Chi-square test and Fisher exact test were used to compare different groups,and mul-ti-classification unordered Logistic regression were used to explore the factors influencing the se-lection of cancer patients.[Results]1 077 valid questionnaires were collected.The selection rates of first-treatment institutions for cancer patients were county hospitals(29.90％),city hospitals(35.28％),and provincial hospitals(34.82％),and the high level of medical care was the main reason for the selection of first-treatment institutions for cancer patients.The results of multi-clas-sification unordered Logistic regression showed that when choosing municipal and county medical institutions as the first treatment institution compared to choosing a county medical institution for the first treatment as a reference,compared to patients with stage Ⅰ tumors,patients with tumor stages at stage Ⅲ(OR=1.789,95％CI:1.014～3.158)and stage Ⅳ(OR=2.005,95％CI:1.179～3.409)were more likely to choose municipal medical institutions;and patients with annual house-hold income of 10 000～＜50 000 CNY(OR=0.625,95％CI:0.414～0.943)were less likely to choose mu-nicipal medical institutions compared to those with an annual household income of＜10 000 CNY.When choosing provincial and county medical institutions as the first treatment institution com-pared to patients in stage Ⅲ(OR=2.885,95％C1:1.549～5.372)and stage Ⅳ(OR=3.104,95％CI:1.724～5.586)compared to patients with stage Ⅰ tumors when choosing a county medical institu-tion for the first treatment was used as a reference;married(OR=2.248,95％CI:1.127～4.484)patients were more likely to choose provincial healthcare organizations than unmarried/divorced/widowed patients;patients with a family history of cancer compared to patients without a family history of cancer(OR=1.650,95％CI:1.115～2.441)were more inclined to choose provincial healthcare institutions;compared with patients＜45 years old,patients over 60 years old(OR=0.483,95％CI:0.242～0.962)were less inclined to choose provincial hospitals;and compared with patients who were not aware of knowledge related to cancer,those who were aware of knowledge related to cancer(OR=0.613,95％CI:0.441～0.852)patients were less inclined to choose provin-cial hospitals.[Conclusion]Vigorously carrying out publicity on cancer prevention and treatment knowledge,improving the cancer prevention and treatment literacy of cancer patients.strengthen-ing vertical cooperation among medical institutions at all levels,improving the provincial-munici-pal-county cancer prevention and treatment network,and promoting the sinking of high-quality medical resources are important ways to improve the cancer prevention and treatment capacity of counties and promote the work of hierarchical medical system.

Objective To discuss the clinical application value of ultrasound contrast on evaluating fallopian tube patency.Methods Ultrasound contrast examination was conducted on 84 patients suffering from infertility and the flowing status of contrast agent in the uterine cavity and the fallopian tube and the distribution condition in the pelvic cavity were observed under the real -time ultrasound to judge the patency condition of the fallopian tube.Results After 84 patients receiving ultrasound contrast,38 cases'bilateral fallopian tubes were unobstructed,26 cases'lateral fallopian tube were unobstructed and 20 cases'bilateral fallopian were obstructed.Comparing the result of ultrasound contrast with laparoscopy,the diagnosis accuracy was 89.5%,the specificity 86% and the sensitivity 94%.Conclusion Fallopian tube ultrasound contrast technique can make an accurate and objective evaluation on the fallopian tube patency,it is an effective method to check fallopian tube patency and it is of high clinical application value.

AIM To observe the clinical efficacy of Maixuekang Capsules (hirudin) combined with female progestational hormone treating blood-stagnated cryptogenic hypomenorrhea and their mechanism of action.METHODS Ninty eligible patients were randomly and equally divided into treatment group (Maixuekang Capsules combine with female progestational hormone) and control group (female progestational hormone),treated for three menstrual cycles,the menstrual blood volume,blood D-dimer,maximum platelet aggregation rate,the thickness of endometrium,spiral artery blood flow peak systolic velocity (PSV),resistance index (RI) and pulsatility index (PI) were recorded during the three months period.RESULTS The menstrual blood volume of the two groups were all increased post-treatments (P ＜ 0.05),the treatment group was superior to the control group (P ＜ 0.05);blood D-dimer and maximum platelet aggregation rate of the treatment group had reduced post-treatments (P ＜ 0.05),there was no difference in the two values of the control group between post-treatment and pre-treatment (P ＞ 0.05);the thickness of endometrium of the two groups were both increased after the treatment (P ＜ 0.05),while there was no remarkable statistical difference between the two groups (P ＞ 0.05);RI in the treatment group had remarkable reduction post-treatments (P ＜ 0.05),but there was no remarkable difference of RI in the control group (P ＞ 0.05);there was no statistical difference of PSV and PI in both groups before and after the treatment (P ＞ 0.05).CONCLUSION The combination treatment of Maixuekang Capsules and female progestational hormone can obviously increase menstrual blood volume,improve uterine blood perfusion and endometrial microcirculation.It has more advantages than use hormones alone.

Objective To find the similarities and differences between SD rat and C 57 mouse models of chronic renal failure established by 5/6 nephrectomy ,and select an appropriate experimental animal for the study of the treatment and prevention of chronic renal failure .Methods 60 SD rats and C57 mice were randomly and equally divided into 5/6 nephrectomy group and sham operatied group .The mice and rats were killed at 4 weeks , 8 weeks and 12 weeks after the operation, respectively.Serum and renal tissue samples were collected for the detection and analysis of renal function andα-SMA.Results There was no significant difference in the survival rates between the rat and mouse models (P>0.05). The serum creatinine and urea nitrogen in the 5/6NX rat group showed a stable state at 8-12 weeks, which was different from that of the 5/6NX mouse group.Conclusions A 5/6 nephrectomy mouse model of chronic renal failure is successfully established .Although both 5/6 NX mouse and rat groups appear progressive renal failure after the operation , their disease processes are not quite the same .In clinic, appropriate experimental animals should be selected according to the length of the observation period in order to accurately show the disease states .