Objective:To establish a health economics evaluation-based adjustment mechanism for the medical insurance fund package in compact county-level medical community.Methods:A health risk assessment system was designed,with weights determined using the Delphi method.Population health risks were evaluated via rapid assessment methods to calculate health risk scores for each county(city,district),which were then used to determine the medical insurance fund package adjustment amount.Results:The county-level health risk evaluation index system encompassed four dimensions:health risk influencing factor,health protection resource,population health risk,and health level.Through information collection and field surveys,health risk scores for counties(cities,districts)in a case prefecture-level city were obtained,serving as a tool for allocating medical consortium package adjustment funds.Conclusion:The health economics evaluation-based medical insurance fund adjustment mechanism enhances the equity of total medical insurance fund allocation,activates the incentive role of medical insurance in healthcare delivery,and transmits intervention pressure to reduce residents'health risks to public management departments at the county level.This approach realizes mutual benefits among medical insurance,residents,and healthcare providers.

Objective To propose a novel method based on three-dimensional depthwise separable convolution network(3D DSN)for the separation of PET images with dual tracers of 18F-FDG and 18F-FAPI.Methods A total of 120 pairs of 18F-FDG and 18F-FAPI PET images of the same patient scanned separately at different time points were collected,and the dual-tracer PET image was generated through simulation.After the image registration of PET images of two tracers for ensuring spatial position matching,the registered PET images were forward-projected to generate sinogram data,and the sinogram data of two tracers were accumulated to obtain mixed sinogram data.Subsequently,the dual-tracer PET image was reconstructed using maximum likelihood expectation maximization and input into a 3D DSN based network for image separation,thereby obtaining PET images of two single tracers.Results Compared with 3D CNN method,the proposed method increased the structure similarity index measure(SSIM)of the separated 18F-FDG images to the real 18F-FDG images by 0.87%,increased the peak signal-to-noise ratio(PSNR)by 11.8%,and reduced the normalized root mean square error(NRMSE)by 52%.The SSIM of the separated 18F-FAPI images to the real 18F-FAPI images increased by 1.1%,PSNR increased by 17.0%,and NRMSE decreased by 51%.Conclusion The proposed method can be effectively applied to simultaneous PET imaging with dual PET tracers,reducing the number of scans and costs in time and money,and providing clinical doctors more accurate and abundant diagnostic information.

Objective:To establish a health economics evaluation-based adjustment mechanism for the medical insurance fund package in compact county-level medical community.Methods:A health risk assessment system was designed,with weights determined using the Delphi method.Population health risks were evaluated via rapid assessment methods to calculate health risk scores for each county(city,district),which were then used to determine the medical insurance fund package adjustment amount.Results:The county-level health risk evaluation index system encompassed four dimensions:health risk influencing factor,health protection resource,population health risk,and health level.Through information collection and field surveys,health risk scores for counties(cities,districts)in a case prefecture-level city were obtained,serving as a tool for allocating medical consortium package adjustment funds.Conclusion:The health economics evaluation-based medical insurance fund adjustment mechanism enhances the equity of total medical insurance fund allocation,activates the incentive role of medical insurance in healthcare delivery,and transmits intervention pressure to reduce residents'health risks to public management departments at the county level.This approach realizes mutual benefits among medical insurance,residents,and healthcare providers.

Objective To propose a novel method based on three-dimensional depthwise separable convolution network(3D DSN)for the separation of PET images with dual tracers of 18F-FDG and 18F-FAPI.Methods A total of 120 pairs of 18F-FDG and 18F-FAPI PET images of the same patient scanned separately at different time points were collected,and the dual-tracer PET image was generated through simulation.After the image registration of PET images of two tracers for ensuring spatial position matching,the registered PET images were forward-projected to generate sinogram data,and the sinogram data of two tracers were accumulated to obtain mixed sinogram data.Subsequently,the dual-tracer PET image was reconstructed using maximum likelihood expectation maximization and input into a 3D DSN based network for image separation,thereby obtaining PET images of two single tracers.Results Compared with 3D CNN method,the proposed method increased the structure similarity index measure(SSIM)of the separated 18F-FDG images to the real 18F-FDG images by 0.87%,increased the peak signal-to-noise ratio(PSNR)by 11.8%,and reduced the normalized root mean square error(NRMSE)by 52%.The SSIM of the separated 18F-FAPI images to the real 18F-FAPI images increased by 1.1%,PSNR increased by 17.0%,and NRMSE decreased by 51%.Conclusion The proposed method can be effectively applied to simultaneous PET imaging with dual PET tracers,reducing the number of scans and costs in time and money,and providing clinical doctors more accurate and abundant diagnostic information.

Objective To analyze the epidemiological features and trends of glenoid fractures from 2003 through 2012 in the Third Affiliated Hospital to Hebei Medical University.Methods The clinical data were collected of the patients with glenoid fracture who had been treated between January 2003 and December 2012 in our hospital.The patients' gender,age and fracture type of Ideberg classification were documented.The data from January 2003 to December 2007 were assigned into group A and those from January 2008 to December 2012 into group B.The 2 groups were compared to find out the general epidemiological characteristics and trends in the recent 10 years.Results A total of 225 patients with glenoid fracture were collected,including 176 males and 49 females.The total male/female ratio was 3.59∶ 1.The glenoid fractures predominated in an age range of 31 to 40 years (23.56％).According to Ideberg classification,there were 35 cases (15.56％) of type Ⅰ,58 ones (25.78％) of type Ⅱ,64 ones (28.44％) of type Ⅲ,21 ones (9.33％) of type Ⅳ,30 ones(13.33％) of type Ⅴ and 17 ones(7.56％) of type Ⅵ.The male/female ratio was 5.29∶1 in group A of 107 patients and 2.69∶1 in group B of 118 patients.The mean age of group A was 40.2 ± 16.0 years and that of group B 47.5 ± 14.8 years.The differences in male/female ratio,mean age and distribution of age were statistically significant between the 2 groups (P ＜ O.05).The fractures predominated in an age range of 31 to 40 years (28.97％) in group A and in the age group of 51 to 60 years (27.12％) in group B.The most frequent fracture type was type Ⅲ in both groups,accounting for 29.91％ and 27.12％ respectively.There was no significant difference between the 2 groups in distribution of Ideberg classification (P ＞ 0.05).Conclusions The peak age of glenoid fractures was from 31 to 40 years.There was an increasing trend in the mean age.There were more male patients than female ones.The high-frequency type was Ideberg type Ⅲ.

This article was aimed to study the different clinical characteristics using drug pair of Cassia twig and white peony root with the contents ratio of 1:1 and 1:2. Based on the different clinical treatment of drug pair of Cas-sia twig and white peony root, different compositional ingredients in ratio of 1:1 and 1:2 were illuminated by HPLC/MS method. The drug pair of Cassia twig and white peony roots in ratio of 1:1 and 1:2 and single herbs were ex-tracted for HPLC/MS analysis. A protocol was followed, including acetonitrile - 0.1% acetic acid with gradient elution, positive mode, 350℃ capillary temperature and 300℃ vaporization temperature. The results showed that Procyanidol B2 and 2-Hydroxy cinnamal dehyde can be extracted from single Cassia twig, but 2-Hydroxy cinna-mal dehyde cannot be detected in drug pair. It showed the contents of Procyanidol B2 in 1:1 ratio was more than 1:2 ratio. Simultaneously, Palbinone, paeoniflorin sulfonate, 1,2,3,6-Tetra-O-galloyl-β-D-glucose, Paeoniflorin, Pae-oniflorin isomers, Benzoylpaeo-niflorin, and Benzoyl Paeoniflorin isomers can also be dissolved in white peony root. In addition, the contents of 1,2,3,6-Tetra-O-galloyl-β-D-glucose, Paeoniflorin, Benzoylpaeo-niflorin, and Benzoyl Paeoniflorin isomers in 1:1 were more than 1:2. The contents of Palbinone, paeoniflorin sulfonate and Paeoniflorin isomers in 1:2 were more than 1:1. It was concluded that Procyanidol B2, 1,2,3,6-Tetra-O-galloyl-β-D-glucose, Paeoniflorin, Benzoylpaeo-niflorin and Benzoyl Paeoniflorin isomers in 1:1 were more than 1:2. The contents of Pal-binone, Paeoniflorin sulfonate and Paeoniflorin isomers in 1:2 were more than 1:1. It provided a scientific basis for traditional Chinese medicine treatment using rational drug pair.

Objective To investigate the changing characteristics of the fractional anisotropy (FA) in cerebral peduncles and its relation with motor evoked potential (MEP) after acute cerebral infarction and to clear the clinical sigiificance of the low limit value of the FA in cerebral peduncles. Methods The low limit value of the FA in normal cerebral peduncles was determined based on mean - 1. 64 standard deviation. The patients with acute cerebral infarction (n = 58) were divided into MEP positive group and MEP negative group according to the absence and presence of MEP, in which the patients in the MEP positive group were redivided into the FA in cerebral peduncles ＜ the low limit value and≥ the low limit value groups according to the FA in cerebral peduncles on the affected sides. Results The low limit value of the FA in normal cerebral peduncles was 0. 36. There was significant difference in the FA in cerebral peduncles on the affected sides between the MEP negtive and MEP positive groups. The MEP negative group was the lowest (P=0. 000). The FA in cerebral peduncles on the affected sides in the positive group was significantly lower than that on the unaffected sides (P=0. 000), and the latency on the affected sides was longer than that on the normal sides (P=0. 000). The FA in cerebral peduncles on the affected sides was negatively correlated with the MEP latency (r=-0.332,P=0. 042). The MEP latency in the FA＜the low limit value group was significantly longer than that in the FA ≥ low limit value group (P=0. 002). There were no significant differences in the FA in cerebral peduncles on the normal sides and the MEP latency among an groups. The detection rate of the FA in cerebral peduncle＜0. 36 on the affected sides was the highest (50%). Conclusions In the evaluation of the prognosis of the patients, the changes of the FA in cerebral peduncles on the affected sides in patients with acute cerebral infarction had correlation,consistency, and complementarity with MEP.The detection rate of the low limit value of the FA in normal cerebral peduncles was the highest in the MEP negative patients. When the FA in cerebral peduncles was＜0.36 on the affected sides, particularly when MET was negative, it might predict that the prognosis was poor.