Objective To understand the usage of national medical insurance negotiated drugs(hereinafter referred to as"negotiated drugs")at Tianjin Second People's Hospital and to provide references for optimizing and adjusting the hospital's drug catalog.Methods A retrospective study was conducted on the usage of negotiated drugs from January 1,2018 to December 31,2022 to compare changes in the unit price of drugs,the quantity and amount of sales,the usage frequency(DDDs)and the daily average cost(DDC),etc before and after the negotiation.Results Between 2018 and 2022,the varieties of negotiated drugs used in the hospital increased from the original 5 to 24.Among the 13 drugs analyzed for comparison,the unit prices of 11 drugs had been reduced after negotiation,and 7 drugs were included in the medical insurance and outpatient-specific disease payment directory.The average decrease in DDC was 36.43%,and the average increase in DDDs was 1 770.31%.The implementation of this policy had increased the accessibility of medication for patients and significantly increased sales quantity.Conclusion The quantity of sales of negotiated drugs significantly increased through reducing the unit price of drugs and including them in the scope of medical insurance payment,etc.These increase the pharmacoeconomic viability of negotiated drugs,effectively reduce the burden on patients,promote rational drug use in hospitals,and improve the access and efficiency of drugs.

Objective:To compare the clinical effects of endoscope-assisted and direct prosthetic augmentation mammaplasty through inframammary fold incisions.Methods:The clinical data of patients who underwent prosthetic augmentation mammaplasty through inframammary fold incisions in Chongqing Huamei Plastic Surgery Hospital from June 2021 to October 2022 were collected. At the same time, the clinical data of patients who underwent the operation under direct vision from June 2015 to May 2021 were collected as control group. The operation time, postoperative drainage tube indwelling time, length of hospital stay and postoperative drainage volume within 1-3 days were recorded in the two groups, and the incision healing, breast morphology and complications were collected. The data were processed by SPSS 26.0 software, which accorded with the measurement data of normal distribution with Mean ± SD, and t-test was used for comparison between the two groups. The data were presented as frequency and (or) percentage, and Fisher’s exact test was used for comparison between the two groups. When P < 0.05, the difference was considered statistically significant. Results:A total of 169 female patients aged 21-48 years old were enrolled, including 71 patients in the endoscope-assisted group and 98 patients in the direct group. There was no significant difference in age, body mass index, prosthesis volume and postoperative follow-up time between the two groups ( P > 0.05). The operation process of the two groups was smooth, and the incisions healed by first intention after the operation. The operation time in the endoscope-assisted group was (123.5±13.5) min, which was slightly longer than that in the direct group [(111.5±8.1) min] ( t=7.20, P<0.001), and the postoperative drainage tube indwelling time[(2.6 ±0.7) d)] was significantly shorter than that in the direct group [(4.2±1.0) d] ( t=-11.58, P < 0.001). The length of hospital stay in the endoscope-assisted group [(2.8±0.8) d] was significantly shorter than that in the direct group [(4.6±1.3) d] ( t=-10.33, P < 0.001). The total amount of bilateral drainage in the endoscope-assisted group was (151.0±30.1) ml on the 1st to 3rd day after the operation, which was significantly lower than that in the direct group[(265.0±48.1) ml ] ( t=-17.62, P < 0.001). During the follow-up for one year, the breast shape and hand feeling of the two groups were good, and there was no infection, prosthesis rupture, displacement or exposure. The patients were satisfied with the results of the operation. The rates of capsular contracture, nipple-areola hypoesthesia and scar hyperplasia in the endoscope-assisted group were 0.7% (1/138), 0.7% (1/138) and 0 (0/138), respectively, which were lower than those in the direct group [2.7%(5/188), 3.7%(7/188) and 2.7%(5/188)], respectively, but the differences were not statistically significant ( P > 0.05). Conclusion:Both endoscope-assisted and direct prosthetic augmentation mammaplasty through an inframammary fold incision can achieve satisfactory results. The operation time of endoscope-assisted augmentation mammaplasty is slightly longer than that under direct vision, but the surgical trauma of that is less, the postoperative drainage tube indwelling time and length of hospital stay are shortened, and the amount of bleeding in the operation area is reduced.

Objective:To compare the clinical effects of endoscope-assisted and direct prosthetic augmentation mammaplasty through inframammary fold incisions.Methods:The clinical data of patients who underwent prosthetic augmentation mammaplasty through inframammary fold incisions in Chongqing Huamei Plastic Surgery Hospital from June 2021 to October 2022 were collected. At the same time, the clinical data of patients who underwent the operation under direct vision from June 2015 to May 2021 were collected as control group. The operation time, postoperative drainage tube indwelling time, length of hospital stay and postoperative drainage volume within 1-3 days were recorded in the two groups, and the incision healing, breast morphology and complications were collected. The data were processed by SPSS 26.0 software, which accorded with the measurement data of normal distribution with Mean ± SD, and t-test was used for comparison between the two groups. The data were presented as frequency and (or) percentage, and Fisher’s exact test was used for comparison between the two groups. When P < 0.05, the difference was considered statistically significant. Results:A total of 169 female patients aged 21-48 years old were enrolled, including 71 patients in the endoscope-assisted group and 98 patients in the direct group. There was no significant difference in age, body mass index, prosthesis volume and postoperative follow-up time between the two groups ( P > 0.05). The operation process of the two groups was smooth, and the incisions healed by first intention after the operation. The operation time in the endoscope-assisted group was (123.5±13.5) min, which was slightly longer than that in the direct group [(111.5±8.1) min] ( t=7.20, P<0.001), and the postoperative drainage tube indwelling time[(2.6 ±0.7) d)] was significantly shorter than that in the direct group [(4.2±1.0) d] ( t=-11.58, P < 0.001). The length of hospital stay in the endoscope-assisted group [(2.8±0.8) d] was significantly shorter than that in the direct group [(4.6±1.3) d] ( t=-10.33, P < 0.001). The total amount of bilateral drainage in the endoscope-assisted group was (151.0±30.1) ml on the 1st to 3rd day after the operation, which was significantly lower than that in the direct group[(265.0±48.1) ml ] ( t=-17.62, P < 0.001). During the follow-up for one year, the breast shape and hand feeling of the two groups were good, and there was no infection, prosthesis rupture, displacement or exposure. The patients were satisfied with the results of the operation. The rates of capsular contracture, nipple-areola hypoesthesia and scar hyperplasia in the endoscope-assisted group were 0.7% (1/138), 0.7% (1/138) and 0 (0/138), respectively, which were lower than those in the direct group [2.7%(5/188), 3.7%(7/188) and 2.7%(5/188)], respectively, but the differences were not statistically significant ( P > 0.05). Conclusion:Both endoscope-assisted and direct prosthetic augmentation mammaplasty through an inframammary fold incision can achieve satisfactory results. The operation time of endoscope-assisted augmentation mammaplasty is slightly longer than that under direct vision, but the surgical trauma of that is less, the postoperative drainage tube indwelling time and length of hospital stay are shortened, and the amount of bleeding in the operation area is reduced.

Objective:To investigate the therapeutic effect of comprehensive geriatric assessment(CGA) in elderly patients with chronic heart failure(CHF) complicated with sarcopenia, and to provide a theoretical reference for clinical application.Methods:This study was a prospective randomized controlled study. 110 elderly CHF patients with myopenia admitted to the Third People's Hospital of Hefei from January 2019 to February 2022 were selected. Using the random number table method, 56 cases were divided into an observation group and 54 cases into a control group. Before treatment, the control group of patients underwent a selective single assessment based on the hospital's requirements and the patient's actual situation, including a fall risk assessment, nutritional risk screening checklist assessment, and routine medication to improve cardiac function and prognosis; Before treatment, the patients in the observation group were assessed with CGA, including the assessment of physical function, mental and psychological status, multiple drug management, pain, Sleep disorder, and social environment. According to the assessment results, individual diagnosis and treatment plans were formulated, implemented, and dynamically adjusted. The two groups were treated for 12 weeks. The general information, treatment compliance, B-type brain natriuretic peptide (BNP) level, left ventricular Ejection fraction (LVEF), 6 min walking distance (6MWD), arm strength of upper limbs and 6 m walking speed, clinical efficacy and prognosis of the two groups were compared before and after treatment. The measurement data is represented by xˉ± s, group t-tests are used for inter group comparison, and paired t-tests are used for intra group comparison before and after treatment; Counting data is represented as an example (%), and inter group comparisons are made using χ 2 test, non parametric rank sum test was used for inter group comparison of hierarchical data. Results:There was no statistically significant difference in gender, age, course of CHF, smoking, alcohol consumption, number of comorbidities, cardiac function grading, and treatment compliance between the two groups of patients (all P>0.05), indicating comparability. Before treatment, there was no statistically significant difference in plasma BNP, LVEF, 6MWD, upper limb grip strength, and 6-meter walking speed between the two groups of patients (all P>0.05); After treatment, the BNP of both groups of patients was lower than before treatment and the observation group was lower than the control group. LVEF, 6MWD, upper limb grip strength, and 6-meter walking speed were all higher than before treatment and the observation group was higher than the control group [(343.45±34.95) ng/L vs (387.09±46.96) ng/L, (49.61±7.11)% vs (42.94±5.72)%, (348.92±37.73) m vs (297.74±43.48) m, (22.64±3.82) kg vs (19.48±3.88) kg, (0.97±0.10) m/s vs (0.83±0.12) m/s], The differences were statistically significant ( t-values were 5.51, -5.40, -6.60, -4.31, -6.60, all P<0.001). After 12 weeks of treatment, there was no statistically significant difference in clinical efficacy between the two groups of patients ( P=0.216), but the overall poor prognosis rate in the follow-up observation group was lower than that in the control group [7.14%(4/56) vs 22.22% (12/54)], and the difference was statistically significant (χ 2=5.03, P=0.025). Conclusions:Developing, implementing, and dynamically adjusting the individualized treatment plan involving CGA can improve the prognosis of elderly CHF patients with sarcopenia, help improve cardiac function, increase grip strength and somatic function, and reduce the risk of major adverse cardiovascular events ,all-cause mortality in elderly patients with CHF combined with sarcopeni and has certain clinical application value.

Humans ; HIV Infections ; HIV-1 ; Integrases ; China ; Drug Resistance, Viral ; Mutation

Humans ; Neutrophils ; Receptors, Cell Surface ; GPI-Linked Proteins ; HIV Infections ; Isoantigens

Autophagy is essential for the maintenance of cellular homeostasis and its dysfunction has been linked to various diseases. Autophagy is a membrane driven process and tightly regulated by membrane-associated proteins. Here, we summarized membrane lipid composition, and membrane-associated proteins relevant to autophagy from a spatiotemporal perspective. In particular, we focused on three important membrane remodeling processes in autophagy, lipid transfer for phagophore elongation, membrane scission for phagophore closure, and autophagosome-lysosome membrane fusion. We discussed the significance of the discoveries in this field and possible avenues to follow for future studies. Finally, we summarized the membrane-associated biochemical techniques and assays used to study membrane properties, with a discussion of their applications in autophagy.

Objective:To search for the clinical indicators in differentiating Graves′ disease from subacute thyroiditis (SAT).Methods:Retrospective analysis was performed on thyroid function measurement of 265 cases of newly diagnosed Graves′ disease, 76 cases of SAT with thyrotoxicosis, 100 cases of non-toxic thyroid nodules, 105 cases of autoimmune thyroid diseases with normal thyroid function, and 151 cases of outpatients with normal thyroid function and without thyroid diseases.Results:Free triiodothyronine(FT 3)/free thyroxine(FT 4) ratio of Graves′ disease patients was significantly higher than that of SAT patients with thyrotoxicosis (0.65±0.29 vs 0.32±0.75, P<0.05). Receiver operating characteristic curve(ROC curve) analysis of FT 3/FT 4 ratio between Graves′ disease group and SAT group showed that FT 3/FT 4 ratio greater than 0.4 with a sensitivity of 98.11% and a specificity of 83.81% for diagnosis of Graves′ disease. Conclusion:FT 3/FT 4 ratio greater than 0.4 is helpful for differentiating Graves′ disease from subacute thyroiditis with thyrotoxicosis.

Objective:Hepatic steatosis has a high incidence in human immunodeficiency virus (HIV) infected people, and there is no effective non-invasive method to evaluate it. This study aims to evaluate the diagnostic value of non-invasive models for hepatic steatosis in this population.Methods:A single-center retrospective study was applied to evaluate: (1) the diagnostic value of controlled attenuation parameters (CAP) and hepatic steatosis index (HSI) in HIV-infected patients with hepatic steatosis; (2) the ability of the non-invasive model to distinguish hepatic steatosis caused by abnormal glucose and lipid metabolism and hepatic steatosis caused by hepatitis C virus infection; (3) the diagnostic value of the above models for hepatic steatosis in patients co-infected with HIV/hepatitis C virus. The diagnostic value of the model was analyzed and evaluated by diagnostic test and receiver operating characteristic curve.Results:(1) the diagnostic value of hepatic steatosis for HIV-infected patients: when CAP = 232 dB/m, the sensitivity and specificity were 89.2% and 78.1%, respectively; when HSI = 34, the sensitivity and specificity were 79.1% and 83.2%, respectively. (2) The ability to identify the causes of hepatic steatosis in HIV-infected patients: when CAP = 258dB/m, the sensitivity and specificity were 81.5% and 88.2%, respectively; when HSI = 37, the sensitivity and specificity were 70.7% and 92.4%, respectively. (3) The diagnostic value of hepatic steatosis in patients co-infected with HIV/hepatitis C virus: when CAP = 241 dB/m, the sensitivity and specificity were 80% and 71.4%, respectively; when HSI = 32, the sensitivity and specificity were 73% and 68.9%, respectively.Conclusion:CAP and HSI have superior diagnostic value for hepatic steatosis in patients infected with HIV.

Objective: To understand the intention of pediatricians turnover in Shenzhen and its influencing factors. Methods: From September to December 2016, a multi-stage stratified cluster sampling method was used to select 948 pediatricians from Shenzhen to conduct a questionnaire survey. The questionnaire cover the following: 1. Basic information: general demographic characteristics(gender, age, marriage, education, etc.); 2. Work status survey: turnover intention, experiences with violence against medical workers, professional job satisfaction, and work stress, etc. Univariate analysis and multivariate analysis were used to identify factors for pediatrician′s turnover intention. Results: Among the 948 pediatricians in Shenzhen, 62.5% had turnover intention; age, title, education, seniority, monthly income, medical institution nature, medical institution level, length of sleep, job satisfaction, work stress, experience with violence and family support all affect the pediatrician′s turnover intention(P<0.05); multivariate logistic regression analysis showed that age, education, monthly income, job satisfaction, work stress and experience with violence were the influencing factors of pediatrician′s turnover intention(P<0.05). Conclusions The pediatrician′s turnover intention in Shenzhen is not low. Relevant measures should be taken by the government, hospital administrators, children patients and their family to ensure the supply of children′s medical services.