目的:构建一套科学、全面、可行的河南省基层卫生适宜技术推广实施评价指标体系.方法:利用文献分析法和德尔菲法构建指标体系,采用层次分析法确定各级指标权重,并进行敏感性分析,判断结果的稳健性.结果:构建了包含5个一级指标、18个二级指标的推广机构卫生适宜技术评价指标体系;构建了包含7个一级指标、26个二级指标的实施单位卫生适宜技术评价指标体系.敏感性分析结果显示本研究构建的评价指标体系权重具有稳健性.结论:建立的河南省卫生适宜技术推广和实施评价指标体系具有较好的客观性、实用性、系统性和科学性,可为卫生适宜技术评估提供参考依据.

目的:分析河南省县级医院儿科建设经费使用情况,为进一步提高儿科建设经费的管理水平和使用效率提供建议.方法:以河南省为例,通过数据收集表获取县级医院儿科经费支出信息和建设效果指标,对经费的使用情况和支出结构进行描述性统计分析,并对不同支出结构的儿科建设效果进行对比分析.结果:每个儿科建设项目平均支出金额为250.7万,经费的总体执行率为65.92％;儿科的设备支出占比较高,平均达到62.8％,而技术支出占比较低,平均仅有2.9％;支出均衡组在降低平均住院日、提高急危重症抢救成功率、引进本科及以上人数、增加亚专科诊疗病种数、开展县内市内领先新技术项数方面效果更好.结论:县级医院儿科建设应着力提高人才和技术支出,促进儿科建设经费支出的均衡性;严格控制设备支出,提高儿科建设经费支出的有效性;认真核查其他支出,增加儿科建设经费支出的规范性.

目的:分析河南省2010～2015年肿瘤登记地区胃癌发病与死亡流行状况.方法:胃癌发病与死亡数据来源于河南省31个肿瘤登记地区2010～2015年资料;计算胃癌发病(死亡)率、2000年中国标准人口构成调整率(中标率)、2000年Segi's世界标准人口构成调整率(世标率)和年龄别率.结果:河南省2010～2015年肿瘤登记地区胃癌年平均发病率为38.72/10万,中标率为31.04/10万,居恶性肿瘤发病顺位第2位.同期全省肿瘤登记地区胃癌年平均死亡率为28.15/10万,中标率为22.17/10万,居恶性肿瘤死因顺位第2位.胃癌发病率和死亡率均男性高于女性,农村高于城市.胃癌发病率和死亡率随年龄增长而增加.河南省2010～2015年胃癌发病率和死亡率比较稳定,无明显上升或下降趋势.结论:河南省2010～2015年胃癌发病率和死亡率处于较高水平,农村地区40岁以上人群是胃癌防控的重点对象.

目的:评估临床重点专科建设投入对县级医院持续发展能力的影响.方法:以河南省为典型样本,采用独立样本t检验、单因素方差分析与事后多重比较检验,以完成不同投入下持续发展能力的差异分析.结果:投入结构仍以设备购置为主;不同投入类型中,技术投入重视类硕士及以上、高级职称、送上进修、收下进修、科研论文与新技术开展增量显著高于忽视类;不同投入偏向中,指标硕士及以上、收下进修与科研论文差异存在统计学意义,LSD检验结果显示技术(硕士及以上、科研论文)与设备(收下进修)投入与其他组差异最大且显著.结论:河南省县级临床重点专科建设已初具成效,但仍存在分布不均衡与投入结构不合理的问题,需转变投入理念,以专科技术发展为导向,丰富投入内容与层次,健全人才流动的激励机制.

目的:分析县级临床重点专科建设单位综合运行效率,为提升基层医院专科建设能力提供政策建议.方法:采用数据包络分析(DEA)模型对2014-2018年河南省县级临床重点专科建设单位进行效率评价.结果:2014-2018年县级临床重点专科建设单位的综合技术效率为1的个数占比分别为44.44％、61.11％、42.31％、68.42％和42.85％;高级职称人员培养数、项目实施期间开展市县内领先新技术项数、县外转诊率降低值等产出不足.结论:县级临床重点专科建设应注重完善项目投入机制,创新全过程管理模式;同时应优化专科建设评价机制,强化建设项目综合评估.

IntroductionPatients with cancer are more vulnerable to COVID-19 than the general population. Accordingly, it is necessary to identify the risk factors for death in patients with cancer and COVID-19.MethodsPubMed, Cochrane Library, and Embase Ovid databases were searched for relevant articles published before July 31(st), 2020. Studies that explored the risk factors for mortality were included. The effect size was relative risk (RR) and 95% confidence interval (CI).ResultsWe included 17 observational studies involving 3268 patients. The pooled mortality was 24.8%. Male gender, age above 65 years, and comorbidities (especially hypertension and COPD) were risk factors for death (RR 1.16, 1.27, 1.12; 95% CI 0.7-1.95, 1.08-1.49, 1.04-1.2; P = 0.006, 0.004, and 0.002, respectively). Recent anti-cancer treatments did not increase mortality (P 0.05). Dyspnea, cough, and sputum canused an elevated risk of death (P 0.05). Antibiotics, glucocorticoids, interferons, invasive ventilation, and complications were associated with a high probability of death (P 0.05).ConclusionsVarious demographic and clinical characteristics, such as male gender, advanced age, comorbidities, and symptoms, were risk factors for mortality in patients with cancer and COVID-19. Our findings suggest recent anti-cancer treatments do not increase mortality.

目的:总结县级临床重点专科人才队伍建设成效,提出优化县级公立医院人才队伍建设的策略建议.方法:以河南省为典型案例,通过调查问卷收集各临床重点专科人才队伍建设相关指标,采用描述性统计分析方法对不同专科在人才引进、进修和培训,以及职称变化方面进行比较分析.结果:平均每专科引进本科4.84人,硕士及以上0.93人,外科类专科平均每专科引进本科人数仅为2.96人;平均每专科前往省级医院进修的人数为3.18人,接收乡村两级卫生人员进修的科室以内科类专科为主;平均每专科副高级职称人数增加1.14人,高级职称人数增加0.44人.结论:建立人才引进长效工作机制,加强外科人才引进力度;提升进修学习质量,完善以内科为核心的培训模式;加强高级职称人才培养,优化县级医院人才职称结构;持续改善儿科人才队伍建设,加强其他薄弱专科人才培养.

Introduction Patients with cancer are more vulnerable to COVID-19 than the general population. Accordingly, it is necessary to identify the risk factors for death in patients with cancer and COVID-19.

The outbreak of the coronavirus disease (COVID-19) occurred in Wuhan, China, in December 2019. As of 21 March 2020, this epidemic has spread to 179 countries with more than 200 000 confirmed cases and 8578 deaths. The outbreak has put enormous pressure on the medical establishment and even led to exhaustion of medical resources in the most affected areas. Other medical work has been significantly affected in the context of COVID-19 epidemic. In order to reduce or avoid cross-infection with COVID-19, many hospitals have taken measures to limit the number of outpatient visits and inpatients. For example, emergency surgery can only be guaranteed, and most other surgeries can be postponed. Patients with cancer are one of the groups most affected by the epidemic because of their systematic immunosuppressive state and requirement of frequent admission to hospital. Consequently, specific adjustments for their treatment need to be made to cope with this situation. Therefore, it is of significance to summarize the relevant experience of China in the prevention and control of COVID-19 infection and treatment of patients with cancer during the epidemic.

Abstract: In this work, the MWCNTs -OH/ polyether sulfone (PES) flat membranes were prepared by nonsolvent-induced phase separation (NIPS),.The effect of the contents of MWCNTs -OH was studied. Additionally, the novel membranes were characterized by XRD, FTIR and other methods. The antifouling ability of the membranes were tested in our work, exhibited high flux and rejection when the contents of the MWCNTs -OH were 0.04wt%, the water flux was enhanced to 88.42%, the rejection of BSA was increased to 95.77%, the water contact angle was decreased to 62.21°, The good properties of the MWCNTs -OH /PVDF composite membranes make it possible to be a good potential candidate for water treatment.

Anaplastic lymphoma kinase (ALK) rearrangement, one of the common oncogene rearrangements in the mutational history of lung adenocarcinoma, occurs in approximately 5% of non-small cell lung cancer (NSCLC) patients who could be effectively treated with ALK tyrosine kinase inhibitors (TKIs). The earlier phase III PROFILE 1014 study has shown that crizotinib, a first-generation ALK-TKI, significantly improved progression-free survival (PFS) compared with platinum-based chemotherapy in patients with previously untreated advanced ALK-positive NSCLC. Thus, clinicians must screen potential candidates for this driver alteration to guide ALK inhibitor therapy with a molecular testing platform capable of capturing all ALK fusions. Echinoderm microtubule-associated proteins, including the EML4 gene, are the most common ALK rearrangement partner. With the widespread use of the next-generation sequencing (NGS) techniques, which could approach enable the simultaneous screening of multiple genetic alterations, increasingly ALK rearrangement partners have been documented. However, the concurrent two ALK rearrangements within the same patient have rarely previously been reported. Here, we describe a novel CCNY-ALK (C1:A20) and ATIC-ALK (A7:A20), coexisting in the same case with poorly differentiated NSCLC and providing evidence of its sensitivity to ALK inhibitors. The newly identified rearrangement partners can be added to the list of ALK rearrangements that occurred in ALK-positive NSCLC, as it could lead to prolonged disease control. Also, while different ALK rearrangement variants might bring differing clinical outcomes, we discuss the impact of the co-mutations of these two ALK rearrangements on the sensitivity to ALK inhibitors. However, the impact of co-mutations on the pathogenesis of NSCLC should be further studied to supply more theoretical insight that co-mutations present for personalized anti-cancer therapy.

Wei Wang Jinshu Wang Xinzhong Zhang Gang Liu 1Department of Obstetrics and Gynecology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan 450003, People’s Republic of China; 2Department of Center for Clinical Single Cell Biomedicine, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan 450003, People’s Republic of China; 3Department of Oncology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan 450003, People’s Republic of China Purpose: Circular RNAs (circRNAs) are emerging as promising biomarkers for various human malignancies. However, the application of circRNAs as non-invasive biomarkers in high-grade serous ovarian cancer (SOC) remains to be elucidated. Here, we aim to investigate the feasibility of using serum circSETDB1, a tumor-promoting circRNA generated from the SET domain bifurcated histone lysine methyltransferase 1 (SETDB1), known to be upregulated in SOC, as a biomarker for detecting SOC progression, predicting relapse, and evaluating the effectiveness of SOC treatment. Methods: Serum circSETDB1 levels were measured using quantitative real-time RCR in 60 SOC patients (18 primary chemoresistance, 42 primary chemosensitive) and 60 healthy volunteers. Progression-free survival curve was calculated by Kaplan-Meier analysis. Diagnostic value was analyzed using receiver operating characteristic curve (ROC) method. Results: Serum circSETDB1 expression is upregulated in SOC patients. Higher levels of circSETDB1 are positively associated with advanced clinical stage, lymph node metastasis of SOC patients. Notably, serum circSETDB1 levels are significantly increased in primary chemoresistance patients. Patients with higher levels of circSETDB1 have a shorter progression-free survival time. In addition, diagnostic value analyses revealed that serum circSETDB1 can distinguish patients with SOC from healthy volunteers as well as patients with primary chemoresistance from those with primary chemosensitivity. Conclusion: Our data suggest that serum circSETDB1 may serve as a novel non-invasive biomarker for detecting SOC progression and predicting response to chemotherapy and relapse in high-grade serous ovarian cancer.