Comparative Analysis of Profit Model of Typical Pharmaceutical O2O Enterprises in China

Objective To study the profit model of Chinese pharmaceutical O2O enterprises.Methods A case study of three typical pharmaceutical O2O enterprises was conducted,and their profit models were compared.Results and Conclusion The pharmaceutical O2O enterprises in China are divided into three categories according to the profit models.It is found that the current pharmaceutical O2O enterprises have problems such as simple profit model and low corporate profits.Based on these problems,it is recommended that relevant enterprises develop various business models to increase profit channels.Besides,they should establish and improve internal cost control systems.

Epidemiological Analysis on Reported Hepatitis C Cases in China from 2012 to 2016

Viral hepatitis is an important challenge to public health worldwide.As hepatitis B is well controlled due to vaccination,the disease burden caused by the spread of hepatitis C has become increasingly prominent.Hepatitis C is an infectious disease that is mainly blood-borne.The rate of chronicity ranges from 55% to 85% after people are infected with the hepatitis C virus （HCV）.

Effect of CBL Combined with Case Analysis in the Teaching of Clinical Anesthesia

Objective:To evaluate the effect of CBL(case-based learning)combined with case analysis in the teaching of clinical anesthesia.Methods:From June 2018 to June 2020,a total of 100 clinical anesthesia interns in Shaanxi Provincial People’s Hospital were selected as the research subjects.They were divided into two groups,the reference group(50 interns)and the study group(50 interns),by random sampling method.The reference group was under the traditional teaching method,whereas for the study group,CBL combined with case analysis was implemented.The teaching satisfaction and achievement of the interns in both the groups were evaluated.Results:The teaching satisfaction of the study group was 98%,which was significantly higher than that of the reference group(86%)(P<0.05);before teaching,there was no significant difference in the theoretical and clinical practice scores between the two groups(P>0.05);however,after teaching,the theoretical and clinical practice scores of the two groups increased significantly,in which the change of the research group was significantly greater than that of the reference group(P<0.05).Conclusion:The application of CBL combined with case analysis in the teaching of clinical anesthesia has an ideal effect,improving the teaching satisfaction and achievement.It is a high-quality teaching method and is worthy of application.

Clinical characteristics and prognosis of traumatic basal ganglia hematomas: A retrospective analysis of 40 cases

AIM： To retrospectively analyze the pathogenesis, clinical characteristics, treatment and prognostic characteristics in patients with traumatic basal ganglia hematomas （TBGH）. METHODS： A retrospective analysis of the clinical data was performed in 40 patients with TBGH who were selected from 1 250 patients with closed brain injury, who admitted to the Department of Neurosurgery of Shangqiu First People＇s Hospital from January 1990 to January 2004. The pathogenesis, clinical characteristics and signs, results of radiological examination, treatment and prognostic characteristics were analyzed. The patients all had definite history of brain injury, manifested by neurological functional disturbance to different extent after brain injury, and basal ganglia hemorrhage was identified by CT after brain injury, and hemorrhagic volume were more than or equal to 2 mL. Totally 34 males and 6 females were enrolled, aged 16-72 years and 28 cases of them were younger than 40 years old. The prognosis of the patients was evaluated with Glasgow outcome scale （GOS） at 6 months after injury, and GOS scoring standard was 1-5 points （1 for dead; 2 for vegetative survival, long-term coma, manifestations of decorticate rigidity or decerebrate rigidity; 3 for severely disabled, should be look after by others; 4 for moderately disabled, be able in self-care; 5 for good recovery, adults can work and study）. RESULTS： The enrolled cases accounted for 3.20% of the 1250 patients with closed brain injury admitted at the same period. ① The causes of injury included traffic accident in 36 cases, fall in 2 cases, and assault in 2 cases. ②At admission, the Glasgow coma scale （GCS） scores were as follow： 13-15 scores （mild） in 10 cases, 9-12 scores （moderate） in 20 cases, and 3-8 scores （severe） in 10 cases. Hemiplegia presented in 37 cases, aphasia in 20 cases, conscious disturbance in 10 cases, unilateral mydriasis in 6 cases, and decerebrate rigidity in 2 cases. ③ TBGH was detected by CT within 30 minutes to 24 hours after injury in 37 cases, and delayed TBGH was diagnosed by serial CT reexamination at 24 to 48 hours after injury in 3 cases. Apart from the TBGH, signs of diffuse axonal injury （DAI） were observed in 22 cases and the criterion of CT diagnosis was that apart from TBGH, small hemorrhagic loci were found in the deep white matter of the hemisphere, corpus callosum, dorsolateral quadrants of the midbrain and the upper pons, internal capsule, basal ganglia area, intraventricle, and cerebellum, etc., but there was no obvious mass effect （clinically manifested by conscious disturbance immediately after brain injury, and primary coma lasted for longer than 6 hours）. Secondary intraventricular hemorrhage occurred in 19 cases, acute subdural hematoma in 3 cases, acute epidural hematoma in 1 case, cerebral contusion in 7 cases, and diffuse cerebral swelling in 3 cases. TBGH located at contralateral to the side of impact in 29 cases. The volume of TBGH was 3-9 mL in 8 cases, 10-19 mL in 10 cases, 20-29 mL in 12 cases, and more than 30 mL in 9 cases. ④Ten patients underwent surgical treatment, including TBGH were evacuated by craniotomy in 7 cases, drained by drilling hole in 2 cases, and hematoma drainage combined with extraventricular drainage in 1 case. 30 patients received conservative treatment, including hyperbaric oxygen treatment in 22 cases. ⑤At 6 months after injury, good recovery obtained in 10 cases （25%）, moderately disabled in 17 cases （42.5%）, severely disabled in 2 cases （5%） and dead in 11 cases （27.5%） respectively. CONCLUSION： In our study, the proportion of TBGH in closed brain injury was 3.2%, and it had a higher incidence of disability. Most of the patients were young people and injured in traffic accident, and TBGH mostly oc- curred at contralateral to the side of impact. The patients suffered from hemiplegia and long-term coma, incidence rate of diffuse axonal injury was higher, but conscious disturbance was milder. Conservative treatment was mainly applied in our study. CT scan can not only establish the position, volume of TBGH, but also establish if it combines with other intracranial injury, and it is helpful to detect delayed TBGH.

PRIMARY PLASMA CELL LEUKEMIA(A COMPREHENSIVE ANALYSIS OF 44 CASES)

Four cases of primary plasma cell leukemia (PPCL) admitted to Zhongshan Hospital from 1959 to 1987 are reported with a review on additional 40 cases reported in China. Comparing with the 57 cases of multiple myeloma (MM) treated in our hospital, the following features were observed in PPCL: (1) The age was younger, with a mean of 45.2 years, 34.1% of the patients were under 40 years. (2) Onset was abrupt. Duration from onset to diagnosis was 2 months or less in 77% patients but never beyond 6 months. (3) 81.8% patients had liver enlargement, 59.1% splenomegaly and 61.4% sternum tenderness. (4) All patients showed marked anemia with an average hemoglobin of 65 g/L. BPC count was less than 100 × 109/L in 76% patients and WBC was more than 10×109/L in 77%. (5) Plasma cell number in the marrow was markedly increased with an average of 69%, of which the blast cells and immature forms were predominant. (6) No destruction of bones was shown on X-ray film in 68.3% patients. (7) The response to chemotherapy was poor with a total response rate of 18% and a mean survival of 2 months. All the above-mentioned clinical features were significantly different from those of MM. In addition, these two diseases were also different in cytology, cytogenetics and ultrastructure. Therefore, PPCL should be considered as a special type of acute leukemia distinct from MM. High dose of alkylating agents in combination with autologous bone marrow transplantation might improve the prognoses.

Severe liver injury by heat stroke: analysis of 10 cases

Objective: To analyse the clinical features and prognosisof liver injury caused by heat stroke.Methods: The clinical data of 10 patients with severe liverinjury caused by heat stroke were analysed retrospective-ly.Results: In 4 patients the level of ALT was over 1000 U/L, in 3 patients ranged from 300 to 1000 U/L, and in 3patients 50-300 U/L. The level of TBIL in 2 patientswas over 400 μmol/L and in 5 varied from 20 to 75μmol/L. Two patients showed jaundice and petechia on

FEMALE LARYNGOCARCINOMA (CLINICAL ANALYSIS OF 267 CASES)

Two hundred and sixty-seven cases of female laryngocarcinoma, treated in our hospital in the past 33 years, were analysed. It is suggested that a relating preponderance of male sex hormonal influence after menopause should be a contributing factor responsible for the high prevalemce of laryngeal cancer in women. The other etiological factor was cigarette smoking. The pathological types and patterns of metastasis to cervical lymphnodes in the female laryngocarcinoma were similar to those observed in male patients but the superglottic cancer was more common than the flottic type. However, no significant difference in prognosis was observed between superglottic and glottic cancers. Provided indications are strictly adhered to, partial laryngectomy that can give therapeutic resulrs similar or even superior to total laryngocarcinoma.

Case Analysis of a Pump-Driven Heat Pipe Heat Recovery Ventilator in an Existing Experiment Building

The building energy consumption is an important part among the total society energy consumption,in which the energy consumption for air conditioning occupies almost 70%.The energy consumption of the air conditioning system for fresh air handling can be saved effectively when the exhaust air energy could be recovered to preheat or precool the fresh air.Considering the install locations requirements on field,the pump-driven heat pipes(PHP)were developed as heat recovery ventilators(HRVs)and used in an existing experiment building in Beijing Urban.The thermal performance of the PHP HRVs was tested in real operation time periods under winter running mode.Both the power and heat consumption of the modular air handling units with and without HRVs were monitored and obtained,as well as the hourly power and heat consumption.The energy savings of HRVs were analyzed.The results indicate that the PHP HRVs can work steadily and meet the energy recovery need well.The temperature effectiveness of the HRVs can be kept from 60%to 70%.The test total energy saving rate was 24.48%,and the average hourly heat consumption reduced by 28.54%.The daily energy consumption can be saved by 118 kWh,and the energy savings can reach to 9440 kWh for a whole winter.

THE DIAGNOSIS OF MESENTERY TUMOR (CLINIC-PATHOLAGIC ANALYSIS OF 171 CASES)

One hundred and seventy one patients with mesentery tumors confirmed by surgery and/or pathology in five hospitals of Hubei Province from 1966 to 1986 are analyzed retrospectively. The main manifestations were abdominal pain, abdominal mass and emaciation. Cyst and leiomyomas were common in benign tumors. Malignant lymphoma, leiomyosarcoma and liposarcoma were predominant in malignant tumors. The morbidity, clinicopatholo-gic characteristics, diagnosis and differential diagnosis of this group of tumor are discussed.

Neuroelectrophysiological indexes and clinical characteristics of patients with peroneal muscular atrophy: Retrospective analysis of 24 cases

BACKGROUND: Peroneal muscular atrophy (PMA) is characterized by insidious onset, gradually progressive course of disease, very mild disability degree and easily subjecting to missed diagnosis and misdiagnosis. Nerve conductive velocity is helpful in the diagnosis of atypical cases. OBJECTIVE: To retrospectively analyze the characteristics of clinical manifestation, electromyogram (EMG), motor and sensory nerve conduction velocity of patients with PMA. DESIGN: Retrospective case analysis. SETTING: Department of Neurology, Guangzhou First People's Hospital. PARTICIPANTS: Twenty-four patients with PMA, including 16 males and 8 females, aged 5-68 years old, admitted to Guangzhou First People's Hospital between March 1996 and January 2006 were recruited. Informed consents were obtained from all the patients. METHODS: All the patients subjected to EMG and detection of nerve conduction velocity at distal end of four extremities with a Keypoint evoked potential/ EMG instrument (Denmark). Sensory and motor conduction velocity, EMG changes of upper and lower extremities were observed, and relationship of neuroelectrophysiological characteristics and clinical symptoms was analyzed. MAIN OUTCOME MEASURES: Changes in sensory and motor conduction velocity, EMG and clinical manifestations of 24 patients. RESULTS: ① All the patients suffered from insidious onset and gradually progressive course of PMA. Muscular atrophy of lower extremity was found in 14 patients, and that of upper extremity in 5 patients. ②Routine nerve conduction study showed that sensory and motor conduction velocity were stepped down, especially in 16 patients with typeⅠPMA (demyelinating pattern, nerve conduction velocity below normal level 50%). Motor nerve conduction velocity of median nerve, ulnar nerve, common peroneal nerve and tibial nerve averaged 34.8 m/s, 37.2 m/s, 16.5 m/s and 17.4 m/s, respectively; Sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve averaged 27.9%, 24.6 m/s and 3.1 m/s, respectively. Slowing conduction velocity and muscular strength involvement were disproportionate, i.e. myasthenia was relatively lessened, sensory and motor conduction velocities were greatly decreased. Nerve conduction velocity in distal end of two lower extremities was not detected in 8 patients, but who could still walk. CONCLUSION: ①PMA of patients is characterized by insidious onset and gradually progressive course of disease. Clinical symptom is the base to diagnose PMA. ②Neuroelectrophysiological study is a simple and easy-to-operate means with good reproducibility in diagnosing PMA. Patients with abnormal myasthenia in lower extremity can be detected in the early stage.

Public Participation in Land Use Planning:Values and Case Analysis

Objective:we want to explore values and methods of public participation in land use planning through analysis on values of public participation and case of Ji'an County in Jiangxi Province.Methods:document and data method,case analysis method,qualitative and quantitative combined methods.Results:public participation in land use plays a positive role in improving science and practice of planning.Conclusions:preparation and implementation of land use planning should manifest human-oriented,public participation,wisdom of the masses,scientific demonstration,and democratic decision-making.

Focal nodular hyperplasia with concomitant hepatocellular carcinoma: a case report and clonal analysis

This report describes a hepatocellular carcinoma (HCC) with concomitant focal nodular hyperplasia (FNH) in a 56 years old Chinese man. There were two well circumscribed tumours measuring 3×2.5×2 cm and 2×1.5×1.5 cm. The larger mass was grey and soft with a small area of bleeding and necrosis and an intact capsule. The smaller mass was yellow and had no capsule. Clonal analysis was carried out to clarify the relation between the HCC and the adjacent FNH. The clonal analysis was based on the methylation pattern of the polymorphic X chromosome linked androgen receptor gene (HUMARA). In FNH, after Hpa Ⅱ digestion, the allelic bands showed two well defined peaks. The intensity of the two peaks in the DNA from cirrhotic tissue did not differ significantly, consistent with a random pattern of X chromosome inactivation. However, in HCC, after Hpa Ⅱ digestion, the allelic bands differed significantly in intensity. Therefore, there was a typical polyclonal pattern of inactivation in FNH but the HCC was interpreted as being monoclonal.

Clinical Analysis of 60 Cases of Children's Anorexia Treated with Massage

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Cases analysis of rational use of medicine (31) Nongonococcal urethritis(NGU)

1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after intercourse.

Analysis on the Evolution Path of Transformation of Manufacturing Enterprises through Servitization——A Case Study Based on ShaanGu Group

Service-oriented manufacturing is an emerging innovative development model,and its core is the deep integration of products and services.It has become a hot issue in current research.In order to deeply explore the evolution path of servitization transformation of manufacturing enterprises,ShaanGu Group is taken as a case,and discusses practical application of service-oriented manufacturing model in different development processes of ShaanGu Group.Thus,four stages of transformation of ShaanGu Group through servitization are summarized:specialized after-sales service stage,rental service stage,engineering complete service stage and financial service stage.Through comparative research,it is found that general evolution path of manufacturing enterprises to service transformation is:the primary stage(providing product-oriented product service system)→the intermediate stage(providing application-oriented product service system)→the advanced stage(providing utility-oriented product service system)→the completed stage(providing pure service).On this basis,some suggestions are provided for manufacturing enterprises to integrate productive services in the process of transformation.

Research on the Teaching Reform of Polymer Materials Foundation Course-Based on the Case Analysis Method

In today's education and teaching reform,the traditional teaching method in the teaching of polymer materials has been gradually replaced with various new teaching methods.Among them,the case analysis method is a very efective teaching method,which has been applied to the teaching of polymer materials.Through example-based teaching,students 125 participation can be effectively improved,and their theoretical knowledge can be fully utilized.This would have a positive role in promoting the improvement of students'knowledge system and their learning ability.In regard to this,this article analyzes the application of case analysis in the teaching of polymer materials so as to improve its efficiency and quality.

Clinical analysis of 251 cases of soft tissue sarcomas

Objective To explore the therapeutic principles and prognostic factors of soft tissue sarcoma. Methods Two hundred and fifty-one patients with soft tissue sarcoma (STS) treated at Shanghai Cancer Hospital during 1986 -1990 were reviewed retrospectively. Results The 1-, 3 - , 5 - , 10 - year tumor-free survival rates were 67. 74% , 57. 16% , 52, 41% , 38. 60% , respectively.The overall survival rates for 1,3,5 and 10 years were 81. 01 % ,67.75% ,60.79% ,and 49.23% respectively. Log-rank test showed that the patients with different pathological findings, histological grades,mass location and size, anatomical depth, and surgical margin showed different outcomes. Whether the sarcomas invaded the vessels or metastasized would influence the survival rates. The patients who underwent different interventions or operations also had different outcomes. The prognosis of STS was associated with age,histological type,histological grade, tumor size, surgical margin and metastasis according to the Cox regression