Objective:Based on the theoretical framework of policy innovation diffusion,it systematically explores the diffusion mechanism and core influencing factors of national regional medical centers,and reveals their internal diffusion laws and key driving factors,so as to provide theoretical basis and practical guidance for the rational expansion,precise sinking and scientific layout of high-quality medical resources.Methods:Based on the panel data related to the construction of national medical centers in 31 provincial-level administrative regions of China from 2019 to 2023,the random effect and fixed effect models were used for benchmark regression analysis,and the spatial Durbin model was innovatively introduced to explore the influencing factors and internal mechanisms of the expansion of high-quality medical resources.Results:The degree of population aging,the level of regional education development and the intensity of medical financial expenditure showed a significant positive correlation with the layout of national regional medical centers,which has become the key strategic fulcrum driving the construction of national regional medical centers.Conclusion:In order to improve the efficiency of medical resource allocation and promote the expansion and balanced distribution of high-quality resources,it is necessary to accurately meet the demand for health services brought about by the evolution of population structure,systematically promote the upgrading of national education quality,and continue to increase the allocation of financial resources in the field of medical and health care,and establish a multi-institutional collaboration mechanism to promote the integration and sharing of resources to ensure the accessibility and equitable development of medical resources.

Objective:To observe any relationships among the nutritional status, the social abilities, and the eating and drinking ability of children with severe cerebral palsy.Methods:A total of 334 children with cerebral palsy, classified as level IV or V according to the gross motor function classification system, were enrolled. Their social ability, and their eating and drinking performance were assessed using the eating and drinking ability classification system (EDACS) or the mini-EDACS classification, and their nutritional status was also evaluated. Logistic regressions were evaluated seeking any useful inter-relationships.Results:The incidence of nutritional deficiency among the children was estimated at 71.5%, with 4.5% overweight or obese. 80.5% of the children exhibited mild to profound impairment in their social abilities, with another 15.0% on the borderline. The eating and drinking ability of 57.5% was rated as mildly to moderately dysfunction, with another 13.5% of severe dysfunction. The boys had a higher rate of nutritional deficiency and excess compared to the girls ( OR=2.41, P≤0.05). And eating and drinking ability was observed to improve with age ( OR=2.41, P≤0.05), while the average standard score for social ability improved ( OR=1.21, P≤0.05). Those nutritionally deficient or in excess had a significantly higher rate of impaired social ability compared to healthy children ( OR=1.38, P≤0.05). A higher standard score for social living ability was associated with a lower risk of severe eating and drinking dysfunction ( OR=0.45, P≤0.05). Conclusions:Malnutrition, impaired social ability, and impaired eating and drinking ability are common in children with severe cerebral palsy, and these three factors are inter-related. Boys have a significantly higher rate of nutritional deficiency or excess compared to girls. However, eating and drinking ability improves with age.

Objective:Based on the theoretical framework of policy innovation diffusion,it systematically explores the diffusion mechanism and core influencing factors of national regional medical centers,and reveals their internal diffusion laws and key driving factors,so as to provide theoretical basis and practical guidance for the rational expansion,precise sinking and scientific layout of high-quality medical resources.Methods:Based on the panel data related to the construction of national medical centers in 31 provincial-level administrative regions of China from 2019 to 2023,the random effect and fixed effect models were used for benchmark regression analysis,and the spatial Durbin model was innovatively introduced to explore the influencing factors and internal mechanisms of the expansion of high-quality medical resources.Results:The degree of population aging,the level of regional education development and the intensity of medical financial expenditure showed a significant positive correlation with the layout of national regional medical centers,which has become the key strategic fulcrum driving the construction of national regional medical centers.Conclusion:In order to improve the efficiency of medical resource allocation and promote the expansion and balanced distribution of high-quality resources,it is necessary to accurately meet the demand for health services brought about by the evolution of population structure,systematically promote the upgrading of national education quality,and continue to increase the allocation of financial resources in the field of medical and health care,and establish a multi-institutional collaboration mechanism to promote the integration and sharing of resources to ensure the accessibility and equitable development of medical resources.

Objective:To observe any relationships among the nutritional status, the social abilities, and the eating and drinking ability of children with severe cerebral palsy.Methods:A total of 334 children with cerebral palsy, classified as level IV or V according to the gross motor function classification system, were enrolled. Their social ability, and their eating and drinking performance were assessed using the eating and drinking ability classification system (EDACS) or the mini-EDACS classification, and their nutritional status was also evaluated. Logistic regressions were evaluated seeking any useful inter-relationships.Results:The incidence of nutritional deficiency among the children was estimated at 71.5%, with 4.5% overweight or obese. 80.5% of the children exhibited mild to profound impairment in their social abilities, with another 15.0% on the borderline. The eating and drinking ability of 57.5% was rated as mildly to moderately dysfunction, with another 13.5% of severe dysfunction. The boys had a higher rate of nutritional deficiency and excess compared to the girls ( OR=2.41, P≤0.05). And eating and drinking ability was observed to improve with age ( OR=2.41, P≤0.05), while the average standard score for social ability improved ( OR=1.21, P≤0.05). Those nutritionally deficient or in excess had a significantly higher rate of impaired social ability compared to healthy children ( OR=1.38, P≤0.05). A higher standard score for social living ability was associated with a lower risk of severe eating and drinking dysfunction ( OR=0.45, P≤0.05). Conclusions:Malnutrition, impaired social ability, and impaired eating and drinking ability are common in children with severe cerebral palsy, and these three factors are inter-related. Boys have a significantly higher rate of nutritional deficiency or excess compared to girls. However, eating and drinking ability improves with age.

Objective To investigate the impact of anti-reflux modified duodenal exclusion surgery on glucose metabolism in rats with type 2 diabetes mellitus (T2DM), and to elucidate the role of the duodenum in maintaining glucose homeostasis. MethodsForty male Sprague-Dawley rats aged 5 weeks were fed a high-fat diet and induced with T2DM using low-dose streptozotocin. Thirty-six rats that met the T2DM model criteria were randomly divided into three groups: the simple duodenal exclusion surgery group (DE group), the anti-reflux modified duodenal exclusion group (MDE group), and the sham operation group (SO group), with 12 rats in each group. Gastroenterography was performed 4 weeks after surgery, and the body weight, fasting blood glucose levels, and serum glucagon-like peptide-1 (GLP-1) concentrations were measured before surgery and at 1, 2, 4, and 8 weeks post-surgery. Eight weeks post-surgery, the rats were euthanized, and a 1 cm segment of the biliopancreatic loop was collected from each group for pathological sectioning and HE staining to observe the intestinal mucosal villus length under an optical microscope. Results Gastroenterography showed that there was significant reflux of the contrast agent into the duodenal lumen in the DE group, while no reflux was observed in the MDE group. At one week post-surgery, the body weights of rats in all three groups significantly decreased compared to before surgery (P<0.05), and then the body weights of all groups increased over time, with no significant differences between the groups (P>0.05). Compared with the SO group, the fasting blood glucose levels in the MDE and DE groups significantly decreased at all time points post-surgery (P<0.05), while GLP-1 concentrations significantly increased (P<0.05). The fasting blood glucose levels in the MDE group were lower than those in the DE group at all time points post-surgery (P<0.05), but there were no significant differences in serum GLP-1 concentrations between the MDE and DE groups (P>0.05). Regarding intestinal mucosal morphology, the villus lengths of the biliopancreatic loops in the MDE group were significantly shorter than those in the DE and SO groups (P<0.05). Conclusion Anti-reflux modified duodenal exclusion surgery effectively improves glucose metabolism in T2DM rats by preventing the reflux of chyme into the diverted duodenum, thereby enhancing its hypoglycemic effect.

OBJECTIVE: To assess the value of BACs-on-Beads (BoBs) technique for the detection of chromosomal abnormalities in abortus tissues from recurrent pregnancy loss. METHODS: A total of 109 abortus samples were collected and analyzed with the BoBs technique. The incidence and types of chromosomal abnormalities for different age groups and gestational weeks were compared. RESULTS: The BoBs assay has succeeded in all cases, with an incidence for chromosomal abnormalities reaching 62.39% (68/109). The major findings included trisomy 16 (12/68), trisomy 22 (9/68), trisomy 13 (9/68) and trisomy 21 (8/68). The abnormal rate was significantly higher in those above 35-year-old compared with that of the <35-year-old group (P<0.05). More aberrations were found among abortus tissues derived from 42-70 days of pregnancy albeit with no statistical significance (P>0.05). The aberration rates were similar for samples derived from second, third and fourth time abortions (P>0.05). CONCLUSION BoBs technique can detect chromosomal aberrations in miscarriages and may be routinely used for the analysis of early spontaneous abortions.
Abortion, Habitual ; Abortion, Spontaneous ; Adult ; Chromosome Disorders ; Down Syndrome ; Female ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis