Risk Analysis of Pneumothorax Caused by Acupuncture and its Prevention and Control

Objective To evaluate pulmonary tuberculosis (TB) distribution and reporting in different types of medical and health institutions in Beijing, and provide evidence for standardizing TB diagnosis and reporting in medical institutions. Methods The information of pulmonary TB cases in Beijing in 2019 was collected via national Tuberculosis Information Management System (TBIMS) and analyzed by descriptive epidemiology method. Results In 2019, a total of 25 566 pulmonary TB cases were reported by 336 medical and health institutions in Beijing, of which 11 301 were confirmed pulmonary TB cases, accounting for 44.20%. A total of 12 151 pulmonary TB cases were reported by 21 designated medical institutions, accounting for 47.53%, and 13 415 pulmonary TB cases were reported by 315 non-designated medical institutions, accounting for 52.47%. Among the designated medical institutions, Beijing Chest Hospital reported the most pulmonary TB report cases (9 228 cases, 36.09%). Among the non-designated medical institutions, the Eighth Medical Center of PLA General Hospital reported the most pulmonary TB cases (1 402 cases, 5.48%). A total of 15 721 pulmonary TB cases were local residents in Beijing (61.49%) and 9 845 cases were not local residents in Beijing (38.51%). The pulmonary TB cases in local residents were mainly reported by general hospitals (7 737 cases, 49.21%), and the pulmonary TB cases in non-local residents were mainly reported by special hospitals (5 163 cases, 52.44%). The pulmonary TB cases in non-local residents were mainly from the surrounding provinces of Beijing, such as Hebei (3 703 cases, 37.61%). The proportions of confirmed pulmonary TB cases in designated and non-designated medical institutions were 58.76% and 31.02% respectively. The difference was significant (χ2=1 989.69, P Conclusion More pulmonary TB patients visited non-designated medical institutions, but the proportion of confirmed pulmonary TB cases reported by them was lower than that reported by designated medical institutions. The reported pulmonary TB cases were mainly local residents in Beijing, and the pulmonary TB cases in non-local residents were mainly from Hebei. The registration management rate was higher in pulmonary TB cases in local residents than in pulmonary TB cases in non-local residents, and there were also differences in the registration management rate in pulmonary TB cases in local residents among different districts (counties) in Beijing.

The important manifestation of social civilization proves to meet the demands of patients for medical treatment to the greatest extent through promoting grass-roots medical reform, improving construction of grass-roots medical and health institutions and improving their service capabilities. Chongqing, the youngest municipality in China, has a population of 34.04 million, is also a typical city with a prominent urban-rural dual structure. Construction and development of service system in primary-level medical and health institutions is of great significance for improving health of people in Chongqing. This essay uses observation variables such as “community health service center”, “township health institution” and “village clinic” as it’s basis and puts its research objects on Chongqing Statistical Yearbook 2015-2018, the latest data from the National Bureau of Statistics and from Chongqing Municipal Health Commission Statistics Bulletin 2015-2018. Through statistical methods, collected and sorted data are imported into EXCEL table, and corresponding database is established. While statistical indicators include composition ratio, utilization rate, average and etc. and a descriptive statistical analysis is performed. Research and study are given on changes of observation variables of primary medical institutions in Chongqing from 2015 to 2018. It is found that: the number of primary medical institutions showed a downward trend as a whole; the proportion of patients seeking medical treatment through primary diagnosis and treatment was still relatively high; composition of observation variable in township and village level is unreasonable; and slow growth happens in the number of township first-level medical and health institutions and the number of beds. In view of problems found in the research, the essay puts forward some solutions to improve construction of service system of primary health institutions in Chongqing, namely, to invest more in basic construction of primary medical and health institutions, to guide medical graduates to work in primary medical institutions and to increase training and guidance of primary medical technicians. In this way, we can better promote the development of primary-level medical and health institutions in Chongqing and provide citizens with more and better medical services.

BackgroundThe game of interest is the root cause of the non-cooperative competition between urban and rural medical and health institutions. The study investigates competition and cooperation among urban and rural medical institutions using the evolutionary game analysis.MethodsWith the evolutionary game model, analysis of the stable evolutionary strategies between the urban and rural medical and health facilities is carried out. A numerical simulation is performed to demonstrate the influence of various values.ResultsThe result shows that the cooperation mechanism between urban and rural medical Institutions is relevant to the efficiency of rural medical institutions, government supervision, reward, and punishment mechanism.ConclusionsSuggestions for utilizing the government's macro regulation and control capabilities, resolving conflicts of interest between urban and rural medical and health institutions is recommended. In addition, the study again advocates mobilizing the internal power of medical institutions' cooperation to promote collaboration between urban and rural medical and health institutions.

Acupuncture Therapy for the Treatment of Myelosuppression after Chemotherapy: A Literature Review over the Past 10 Years

To understand the capability of parasitic disease control and prevention among professional and technical personnel in medical and health institutions in Wuxi City, so as to provide the evidence for promoting relative capability building. Forty-one professional and technical persons from 22 medical and health institutions received the evaluation through the theoretical knowledge exam and laboratory operation skill assessment. The average score of theoretical knowledge exam was (76.5±15.6) with the pass rate of 80.5% and excellent rate of 48.9%. The average score, pass rate and excellent rate for Plasmodium blood slide making were (7.3±1.5), 87.8% and 41.5% respectively, the average score, pass rate and excellent rate for Plasmodium blood slide reading were (14.0±7.2), 31.7% and 12.2% respectively; the average score, pass rate and excellent rate for helminthes microscope examination were (19.4±10.4), 24.4% and 0 respectively; the average score, pass rate and excellent rate for Oncomelania hupensis snail identification were (8.6±1.1), 95.1% and 73.2% respectively. The average scores of helminthes microscope examination and Oncomelania hupensis snail identification were higher in the participants with middle-level professional title or above than in the participants with primary level professional title (both P < 0.05). The average scores of theoretical knowledge exam, Plasmodium blood slide reading and helminthes microscope examination were higher in the participants from disease control and prevention institutions than in the staff who came from medical institutions (all P <0.05). The professional and technical personnel in medical and health institutions in Wuxi do better in theoretical knowledge, Plasmodium blood slide making and Oncomelania hupensis snail identification. However, the capability of parasite microscope examination is urgently needed to be improved in the future.

Based on the implementation status of the hierarchical diagnosis and treatment policy in China since the new medical reform, this paper systematically combs the text of the hierarchical diagnosis and treatment policy in China after the new medical reform, analyzes the effectiveness and problems of the implementation of the hierarchical diagnosis and treatment policy in China, and further puts forward the policy development direction. The study found that five hierarchical diagnosis and treatment models have been formed in the implementation of the hierarchical diagnosis and treatment policy in China, the service capacity of grassroots medical institutions has been enhanced, and the regional sharing of medical resources has made positive progress, reducing the burden of patients' medical care. But at the same time, it is also faced with problems such as the ability of grassroots medical service institutions to be further improved, two-way referral has not really been realized, the concept of medical care of the masses has not been successfully changed, the siphon effect of high-level hospitals is obvious, the number of general practitioners is small, and the training system is not perfect. In the future, our country's tiered diagnosis and treatment policy should increase the emphasis on the resource allocation of primary medical institutions, guide the masses to change the concept of medical care, establish and improve the two-way flow of personnel, two-way referral docking and standardized training system, and strengthen the training of primary medical personnel and general practitioners. This study has certain inspiration and reference significance for further promoting the construction of hierarchical diagnosis and treatment system and deepening the reform of medical system in China.

Objective To analyze the acupoint selection and medication rule of acupoint application for cough among pneumonia children with the method of cluster analysis. Methods Literatures on acupoint application for cough among pneumonia children were retrieved by computer in main databases at home and abroad. Data of literatures met the inclusion criteria were extracted by two researchers respectively with the Excel including literature titles, selection of acupoint and medication. The frequency was counted by taking acupoint and medication as the unique variable. Cluster analysis was used to acupoint and medication with the frequency equal to 10 times or higher with SPSS 19.0. Results A total of 120 literatures were included and all in Chinese which referred to 28 acupoints appearing 350 times. There were 8 acupoints with the usage frequency equal to 10 times or higher. A total of 113 literatures all involved the drug composition of acupoint application including 97 kinds of traditional Chinese medicines appearing 634 times; there were 13 kinds of traditional Chinese medicines with the usage frequency equal to 10 times or higher. Conclusions In adjuvant treatment of acupoint application for cough among pneumonia children, the most frequently used acupoints includes Feishu, Tiantu, Danzhong, Ashi point, and the most frequently used medicines involves Baijiezi, Dahuang, Mahuang and Xixin. Key words: Pneumonia; Child; Cough; Cluster analysis; Acupoint application

IntroductionTo explore the mechanism and clinical effect of acupoint selection and acupuncture therapy on premature ovarian failure.Material and methodsA total of 100 cases of POF were collected and divided into POF group and POF+acupoint selection and acupuncture therapy (POF+ACU) group. Cerebrospinal fluid samples from patients in each group were extracted by lumbar puncture, and exosomes were isolated and purified. The expression level of exosome protein NELL2 was analyzed by western blot, and the morphology of exosomes was observed by transmission electron microscopy (TEM). The changes of sex hormone levels were detected by TOSOH AIA 1800 automatic chemiluminescence analyzer. Follicular development and ovulation were monitored by B-ultrasound.ResultsThe expression of protein CD9, CD81 and NELL2 in POF+ACU group all increased compared with POF group. TEM images showed that the exosomes were oval or round membranous vesicles. After 3 months of continuous acupoint selection and acupuncture therapy, it was found that the level of testosterone (T) and estradiol (E2) in the POF+ACU group were significantly increased, while the follicular stimulating hormone (FSH) and luteinizing hormone (LH) were significantly decreased, showing a significant difference compared with the POF group. B-ultrasound observation of the endometrial thickness and the maximum follicle diameter showed that the values of POF+ACU group increased, showing no statistical difference compared with the NC group. Ovulation occurred in 20% of the 50 patients in the POF group and 70% in the POF+ACU treatment group.ConclusionsAcupoint selection and acupuncture therapy can treat POF by promoting the secretion of exosome protein NELL2

Objective Different methods were used for the analysis of different medical and health institutions in Henan Province in 2012 of hospital bed utilization, to find bed utilization problems, and provide reference for the rational allocation of resources. Methods Static beds utilization model method(SBMA)and the method of rank sum ratio(RSR)were used for planning of data in2012 health statistics yearbook of Henan province, for comprehensive analysis of bed utilization efficiency. Results Among the medical and health institutions in Henan province in 2012, general hospitals, maternal and children hospitals(centers)are found with higher utilization of hospital beds, while other institutions(nursing homes), community health service centers(stations)are found lower. Conclusion Henan Province in 2012 was found on the whole with efficient utilization of hospital beds, yet with rooms of improvement for different medical institutions, especially those at the primary level. Key words: Static beds utilization model; Rank sum ratio; Hospital bed utilization efficiency

At the beginning of 2020, COVID-19 began to explode on a large scale around the world, with medical and health institutions around the world are facing great pressure. During this period, medical institutions that treat patients with COVID-19 will also generate a large amount of medical waste. If not handled properly, infectious viruses will enter the environment and cause secondary pollution and new epidemic. Wuhan was the first city to have a large-scale outbreak during the outbreak. In the early stage of the outbreak, the relevant competent departments of medical and health institutions and medical waste disposal agencies in China quickly and timely issued a series of technical guidelines and Management measures to control secondary pollution of medical waste during COVID-19. This article analysed the medical waste disposal capacity in Wuhan city, Hubei Province and China at 2020, which also introduce the medical waste treatment measures taken in China during the outbreak, hoping to provide technical reference for other countries.

Background Acupuncture has long been used for treating many diseases including pain. In recent years, much attention has been paid to the application of acupuncture during the perioperative period, and correct selection of Acupoints is the key. Objective To summarize and analyze the recent progress in theoretical basis for Acupoints selection and clinical application during the perioperative period and provide reference for future research. Content The latest clinical progress of acupuncture application and relevant theoretical basis for Acupoints selection during the perioperative period was reviewed. Trend There are limitations in the selection of acupoints. With the improvement of application methods during the perioperative period, the effects of acupuncture will also be greatly improved. Key words: Acupuncture; Perioperative period; Acupoints selection; Clinical application

Tributes to Allen McDaniels, MD 1942-2019

Job training and organizational performance: Analyses from medical institutions in China

Purpose: The purpose of this study is to examine acupuncture treatment suggested on the papers of hyperemesis gravidarum(HG) in medicine journals and to establish the future direction. Methods: The papers which were associated with acupuncture and HG published between 2000 and 2012 in Medline were searched. Results: 14 studies met the condition. They were 13 randomized controlled trial (RCT)s and 1 clinical study. 13 studies revealed that acupuncture has efficacies in HG. 1 study was shown to have no statistically significant efficacy. 2 studies revealed that acupuncture was safe treatment, and 1 study revealed that acupuncture was reliable treatment. Conclusions: From the paper research, acupuncture treatment seems to be effective on HG. However, due to the lack sufficient research of HG, it would be necessary to fulfill further study about the period of acupuncture treatment on HG and the selection of acupoint through well-designed study and establish standard of evidence of them.

Background Traditional Chinese medicine has special efficacy in the treatment of some intractable diseases. For instance, acupuncture has been demonstrated to protect organs from damage in patients with sepsis. The mechanisms underlying the effectiveness are not clear. Objective To review the effects of acupuncture on organs of patients with sepsis, and discuss possible mechanism underlying the effects. Content Patients with sepsis exhibit injury in multiple organs. Acupuncture at Tsusanli or Neiguan has been reported to significantly improve the pathology of lung, liver, kidney, gastrointestinal tract, and heart in sepsis, and to restore normal functions of these organs. These protective effects of acupuncture could be associated with its modulation of several cellular and molecular events. For instance, acupuncture helps maintain the balance between pro-inflammatory and anti-inflammatory processes, limits oxidation stress and apoptosis, and controls destruction of epithelia and disruption of coagulation. Trend Further studies are warranted to optimize the selection of acupoints and stimulating paradigm for acupuncture to maximally reverse the deleterious effects of sepsis not only on the aforementioned organs, but also on the brain and other organs. Key words: Sepsis; Acupoint stimulation; Organ protection