Objective To summarize the exploration and current situation of pharmaceutical service fees in China,to analyze it in conjunction with practices in foreign countries,and to provide references for further improvement of pharmaceutical service fees in China.Methods The official websites of the National Health Commissi,National Healthcare Security Administration,and their provincial braches were retrieved to summarize the changes in policies in China and the latest pharmaceutical service fees policies in each province.At the same time,databases such as CNKI,VIP,and Pubmed were searched to summarize research on pharmaceutical service fees.Results There were some studies in China on the calculation of pharmaceutical service costs and fee standards,but they mostly focused on pharmacy dispensing services,with less discussion on the technical and labor value of specific pharmaceutical services,while international research in this area was relatively abundant.Currently,eight provinces and one municipality directly under the central government have issued medical service price items related to pharmaceutical service,with differences in fee items,fee standards,medical insurance payment ratios,and monitoring and evaluation indicators.Conclusions The inclusion of pharmaceutical services in the national medical pricing system recognizes the transformation of pharmaceutical services and the value of pharmacists.However,it is still in the early stages,and there is room for improvement and enhancement.

Objective To explore the efficacy of an 11-item modified frailty index(mFI-11)combined with surgical Apgar score(SAS)for predicting postoperative complications in elderly patients with colorectal cancer undergoing laparoscopic radical resection.Methods We enrolled a total of 481 elderly patients(aged≥65 years)undergoing laparoscopic radical resection of colorectal cancer.We performed a frailty assessment preoperatively using mFI-11 and calculated the SAS based on the lowest mean arterial pressure and heart rate as well as blood loss during surgery.Finally,we compared the clinical data,mFI-11,and SAS of patients with and without post-operative complications,and then analyzed their relationship with the postoperative complications and predictive values.Results The mFI-11,SAS,and operation time independently correlated with postoperative complication occurrence(P<0.05).The AUC of post-operative complications obtained using the mFI-11,SAS,and operation time were 0.805,0.800,and 0.610,respectively.The AUC of the postoperative complications derived from mFI-11 combined with SAS was 0.902.Conclusion In elderly patients undergoing laparo-scopic radical resection of colorectal cancer,the mFI-11,SAS,and operation time significantly correlated with postoperative complication occurrence.The combination of mFI-11 and SAS displayed a higher predictive power for postoperative complications compared to the use of a single indicator,which it could provide a reliable basis for early clinical identification of complications and reduce their occurrence.

Objective:To investigate the value of fetal heart quantification (fetal HQ) in assessing ventricular function of fetuses with small-for-gestational-age (SGA) and fetal growth restriction (FGR).Methods:A total of 152 singleton pregnancies with estimated fetal weight (EFW) or abdominal circumference less than the 10th percentile in the Third Affiliated Hospital of Zhengzhou University were prospectively selected from August 2022 to September 2023, where fetal EFW or abdominal circumference were in the 3rd to 9th percentile with normal Doppler findings were classified as the SGA group ( n=79), and the rest as the FGR group ( n=73). In the same period, 161 cases of normal single fetuses were matched as the control group.Based on the gestational week in which FGR occurred, the FGR group were categorized into the early-onset group (<32 weeks, n=46) and the late-onset group (≥32 weeks, n=27), and fetuses in the FGR group with absent end-diastolic velocity of the umbilical artery were defined as severe FGR ( n=11), and the rest as mild FGR ( n=62). Fetal ventricular fractional area change (FAC), global longitudinal strain (GLS), longitudinal fractional shortening (LFS) and 24-segment fractional shortening (FS) were obtained by fetal HQ. The cardiac systolic function between groups were compared, the correlations between each parameter and gestational week were analyzed, the inter-observer and intra-observer repeatability tests were performed. Results:Compared with the control group, ventricular FAC, LFS, and GLS were lower in the SGA and the FGR group, right ventricular FS of segments 9-24 were reduced in the SGA group, and left ventricular FS of segments 10-19, 21-24 and right ventricular FS of segments 18-24 were reduced in the FGR group, the differences were statistically significant (all P<0.05). Left ventricular GLS, LFS and right ventricular FAC, GLS, LFS, FS of segments 1-14 were lower in the severe FGR group than in the mild FGR group, the differences were statistically significant (all P<0.05). The values of left ventricular GLS and LFS were higher in the early-onset FGR group than in the late-onset FGR group, the differences were statistically significant (all P<0.05). The ROC showed that the ventricular systolic function parameters predicted adverse perinatal outcomes with an AUC>0.6 (all P<0.05). Left ventricular GLS and right ventricular partial-segments FS were no correlations with gestational week in the FGR group (-0.3< rs<0.3, all P<0.05). There was no correlation between the parameters and gestational week in the SGA group (all P>0.05). The inter-observer and intra-observer intraclass correlation coefficients (ICC) were >0.75, with good reproducibility. Conclusions:Fetal HQ can quantitatively assess the changes of ventricular function in SGA and FGR fetuses, and the ventricular overall, longitudinal and localized contractile function in SGA and FGR fetuses are reduced, and abnormal ventricular systolic function is associated with adverse perinatal outcomes.

Objective:To compare the social support levels as understood by family doctor team members in township hospitals/community health centers, and village clinics/community clinics, and their influencing factors, in order to provide reference for improving the work status of family doctor team members and enhancing the quality of family doctors′ contracted services.Methods:A multi-stage random cluster sampling method was used to sample medical workers from contracted family doctor teams in township hospitals/community health centers and their subordinate village clinics/community clinics in 6 counties (cities, districts) of Tai′an city, Shandong province. In August 2020, a questionnaire survey was conducted on the perceived level of social support among family doctor team members using the perceived social support scale. Descriptive analysis was conducted on the data, and independent sample t-tests and one-way ANOVA were used to conduct univariate analysis on the influencing factors of perceived social support scores of family doctor team members at different levels, while multiple linear regression analysis was used to conduct multivariate analysis. Results:A total of 765 valid questionnaires were collected, with 203 and 562 from township hospitals/community health centers and village clinics/community clinics, respectively. The total perceived social support scores of family doctor team members in township hospitals/community health centers and village clinics/community clinics were (65.56±10.29) and (67.31±10.14), respectively, featuring statistically significant differences ( t=-2.11, P<0.05). In-mirage marital status ( β=0.18, P=0.008), good/very good self-rated health status ( β= 0.25, P=0.048), participation of work-related training within one year ( β=0.17, P=0.010), relatively satisfied/very satisfied for job promotion ( β= 0.17, P=0.046), as well as above/far above average self-rated economic status as ( β=-0.15, P=0.027), were the influencing factor on the perceived social support scores of family doctor team members in township hospitals/community health centers. In-marriage marital status ( β= 0.12, P=0.002), good/very good self-rated health status ( β=0.14, P=0.026), junior or intermediate level or above professional title ( β=-0.11, P=0.003; β=-0.10, P=0.006), participation of work-related training within one year ( β= 0.14, P<0.001), and relatively satisfied/very satisfied for job promotion ( β= 0.16, P<0.001) were the influencing factors on the perceived social support scores of family doctor team members in village clinics/community clinics. Conclusions:Members of the family doctor teams in primary medical institutions in Tai′an city had a higher level of understanding of social support. There were differences in the social support levels of family doctor team members between the two levels of primary medical and health care institutions, and the influencing factors were not completely consistent. Targeted measures should be taken based on specific circumstances to enable them to better receive and perceive support from family and friends, and to improve the quality of family doctors′ contracted services.

In order to strengthen the supervision of the use of drugs in hospitals，the Sichuan Academy of Medical Sciences· Sichuan Provincial People’s Hospital took the lead in compiling the Principles for the Rational Use of National Key Monitoring Drugs （the Second Batch） with a number of experts from multiple medical units in accordance with the Second Batch of National Key Monitoring Rational Drug Use List （hereinafter referred to as “the List”） issued by the National Health Commission. According to the method of the WHO Guidelines Development Manual， the writing team used the Delphi method to unify expert opinions by reading and summarizing the domestic and foreign literature evidence of related drugs， and applied the evaluation， formulation and evaluation method of recommendation grading （GRADE） to evaluate the quality of evidence formed， focusing on more than 30 drugs in the List about the evaluation of off-label indications of drugs， key points of rational drug use and key points of pharmaceutical monitoring. It aims to promote the scientific standardization and effective management of clinical medication， further improve the quality of medical services， reduce the risk of adverse drug reactions and drug abuse， promote rational drug use， and improve public health.

Objective: To investigate the role of PRDM1 gene inactivaion in the regulation of C-MYC in diffuse large B-cell lymphoma (DLBCL), and to explore the correlation of its immunophenotype and prognosis. Methods: 100 cases paraffin-embedded DLBCL tissues were collected from January 2009 to December 2015 at the First Affiliated Hospital of Xinjiang Medical University along with 20 cases of reactive proliferative lymph nodes as control. Immunohistochemical methods were used to detect the expression of CD20, CD10, MUM1, Ki-67, bcl-6, PRDM1/Blimp1, C-MYC and PAX5 protein. The tumors were classified into two subtypes according to Hans classification.The expression of PRDM1 and C-MYC gene in tumor group and control group was detected by reverse transcription PCR (RT-PCR) and the relationship between PRDM1 and C-MYC gene was analyzed.OCI-LY1 (GCB subtype) and OCI-LY3 (non-GCB subtype) cell lines were transfected with small interfering RNA by cationic liposome reagent transfection, and the expression of C-MYC in the transfected cell lines was detected by RT-PCR and Western blot. The Kaplan-Meier method was used to analyze the prognostic significance of PRDM1/Blimp1 and C-MYC at protein and mRNA levels. Results: There were 27 cases of GCB subtype and 73 cases of non-GCB subtype according to Hans classification. The positive expression of Blimp1 in DLBCL group and proliferative lymph nodes in control group was seen in 26(26.0%) and 20 cases(100%), respectively. There were 58 cases with high expression of PRDM1 at mRNA level, including 22 cases of GCB subtype and 36 cases non-GCB subtype, and the difference was statistically significant (P=0.004). There were differences in PRDM1 gene expression between the two immunological subtypes, serum lactate dehydrogenase (serum LDH) level, presence of B symptoms, tumor primary sites and other clinical pathological parameters, while C-MYC expression was different in gender, IPI score, and serum LDH levels. Upon PRDM1/Blimp1 gene silencing in the two cell lines, C-MYC protein and gene expression were up-regulated in the transfection group, compared with the blank control group and negative control group by reverse transcription PCR and Western blot analyses. Moreover, PRDM1 expression was significantly associated with C-MYC(χ²=7.648, P=0.006) at mRNA level. Conclusion The up-regulation of C-MYC gene expression induced by PRDM1 inactivation in DLBCL may play an important role for the development of DLBCL.PRDM1 protein and mRNA are associated with immunophenotyping and PRDM1 mRNA is a marker of poor prognosis.

Objective To observe the effect of patient controlled intravenous analgesia(PCIA)of remifentanil combined with butorphanol in high-intensity focused ultrasound(HIFU)treatment of uterine fibroids or adenomyosis. Methods A total of 56 patients with uterine fibroids or adenomyosis treated with HIFU were selected.At 15 min before the treatment,1 mg of butorphanol was intravenously injected,and then a PCIA pump was connected.The PCIA solution was butorphanol 2 mg and remifentanil 2 mg diluted to 100 ml.The initial dose was 1 μg/kg,the basal rate was 6 μg· kg-1· h-1,the bolus was 1 μg/kg,and the lock out time was 1 min.The respiratory rate,heart rate,mean arterial pressure(MAP),oxygen saturation(SpO2), VAS scores,and Ramsay sedation scores were recorded at each time points,which were T1(at the beginning of surgery),T2(the vital signs were recorded every 30 min during the surgery,the mean values of the data were taken as T 2 values),T3(the end of surgery),and T4(30 min after the end of surgery).Additional medications and complications,such as dizziness,nausea,vomiting,respiratory depression were recorded,too. Results The operations were accomplished in all the 56 cases.The operation time was(97.8 ±44.7)min.As compared to the T1 time point,the MAP and SpO2during and after treatment at each time points had no significant differences(F=1.398, P=0.245;F=1.819, P =0.155).The respiratory frequency and heart rate during treatment significantly decreased as compared to before treatment(F=109.020,P=0.000;F=115.023,P=0.000).At 30 min after treatment,the respiratory frequency rose but had no significant difference as compared to the baseline(P=1.000).The heart rate also speeded up but still below the level at the beginning of the treatment,with the difference having statistical significance(P=0.002).Analgesia effective rate was 94.6%(53/56).The Ramsey scores were(2.4 ±0.5)points during the treatment,(2.2 ±0.5)points at the end of the treatment,and(2.0 ±0.2)points at 30 min after treatment.The sedation effect was satisfactory. Conclusion PCIA of butorphanol combined with remifentanil is effective and safe for HIFU in the treatment of uterine myoma or adenomyosis.

A 8-channel neural signal′s simultaneous transducer detection micro system was developed to research the neural loop located at the brain hippocampus zone. The components of the system contained the neural probe manufactured with the Micro-electro-mechanical-systems (MEMS) technique based on silicon-on-insulator (SOI) substrate, biological low noise chopper-stabilization amplifier, low noise and intermediate speed SAR-ADC converter, reduced and low power ASK/FSK modulation radio transmitter. The micro system was applicable with the characters of small volume, interferences free, neural electrophysiology and neurotransmitter simultaneous detection, high sensitivity, high linearity, etc. The electrode resistance was optimized to 35.0 kΩ after depositing nanometer platinum black on the 4 electrophysiological sites on the Pt electrode. With the modification enzyme technique, nanomaterial enzyme membrane (Pt-mPD-GluOx) was directly fixed on the glutamate detection locus for selectively detecting special neural neurotransmitter matter. In addition, the electrochemistry measurement results indicated that the linear range of glutamate was 6-35 μmol/L with correlation coefficient of 0.97, the sensitivity was 0.0069 pA/(μmol/L). The current response error was less than 3.0 pA, which showed that the neural needle satisfied differential selection. Also, the logic/analog mixed signal 180-nm Application specific integrated circuit (ASIC ) technique (SmicRF180 nm 1Poly6M) was used to manufacture the transducer back-end disposing IC chip, and the test results provided some key parameters such as chopper-stabilization amplifier (equivalent in putting noise voltage ≤0.7 μV rms@1 kHz, gain of 71-82 dB, CMRR/PSRR>100 dB), SAR-ADC (ENOB is 12 bits, power consumption is 1.2 mW when maxmium conversion speed is 1 Msps, signal-noise-ratio is 60.9 dB, etc), and ASK/FSK modulation radio transmitter (the PA′s outputting power of 4-5 dBm, the radiation range of 10 meters). The micro neural transducer integrated system was convenient and wireless wearable for the research of brain hippocampus region.

Objective To explore nursing scheduling mode in ICU. Methods Grouping was carried out on the basis of nursing decentralized management and the two-way selection between group heads and group members. The research target was the 60 nurses in ICU. Degrees of the nurses' job satisfaction and changes of nursing quality before and after grouping were compared and analyzed. Results The general degree of the nurses' satisfaction towards scheduling was (3.75±0.70) points before grouping while (4.30±0.50) points six months after grouping. The difference had the statistical significance (t=6.5645, P < 0.01);the scores of nursing quality check on classification management, ward management, nursing security, emergency management and hospital infection management were (91.97±1.47), (93.07± 1.66), (93.43 ± 1.50), (94.03 ± 1.10), (94.07 ± 1.39) points respectively before grouping and (95.08 ± 1.63), (95.77±1.55), (96.07±1.41), (97.37±1.56) and (97.07±1.48) points respectively six months after grouping. The differences had the statistical significance (t=6.5192-10.9934, P<0.01). Conclusions The two-way selection among nurses and decentralized management grouping can improve the degree of nurses′job satisfaction and nursing quality.

In order to favor the growth and development of the fetus,the maternal-placental-fetal unit is characterized by profound physiologic changes.These adaptations may affect maternal and fetal absorption,distribution,placental transfer,metabolism and excretion of drugs.When evaluating drug use in pregnancy,understanding both pregnancy physiology and the gestation-specific pharmacokinetics of different drugs is necessary to achieve effective treatment and limit maternal and fetal risk.This topic will focus on the pharmacokinetics and safety of drugs during pregnancy in light of changes in maternal physiology and function of placental.