Development of a hexagonal, mesh-based distribution method for community health centres

Community health centres (CHCs) are the health gatekeepers of the local population. Location and numbers of the CHCs affect fairness and effectiveness with regard to access to primary health care. In the past, the distribution of the CHCs was solely empiric-based. The goal of this study was to devise a method for CHC distribution based on the principle of improving equity as well as ensuring efficiency. We tested the effectiveness and operability of the method through a process of revision and simulation using Guangdong Province, China as sample district. A methodology based on literature review and expert consultation was repeatedly applied until an ideal result had been reached. A hexagonal, mesh-based method was developed and used to find a solution where the CHCs could be distributed where their location would be the most needed and total number suitable. Testing the effectiveness of the proposed plan, we found the proportion of area covered to be 52.8% and the proportion of the population covered 80.7%, which is 15.4% and 14.7%, respectively, better than before. It was concluded that the hexagonal mesh-based, distribution method can effectively define the location as well as the number or required CHCs, not only improving the accessibility for residents to primary health care services but also maximizing cost-effectiveness. Management of the city by grid is a new idea in urban management, which improves rationality of planning and also may be applied for many different purposes in addition to CHC localization

Duszność spowodowana gruźliczakami powstającymi w rdzeniu przedłużonym w czasie leczenia gruźliczego zapalenia opon mózgowo-rdzeniowych

Formation of tuberculoma is a rare response of neurotuberculosis in patients regularly and adequately treated with anti-tuberculous drugs. We report a 13-year-old girl with two tuberculomas which formed in the dorsal part of the medulla oblongata during chemotherapy for tuberculous meningitis. The tuberculomas were both removed via a suboccipital midline approach and were demonstrated by pathological findings but the girl died of cardiac arrest that was thought to be caused by postoperative medulla oblongata oedema. In combination with a literature review, we discuss the clinical features and treatment options of brainstem tuberculomas.Tworzenie się gruźliczaka jest rzadką reakcją w przebiegu właściwie leczonej gruźlicy układu nerwowego. W pracy autorzy opisują przypadek 13-letniej dziewczynki z dwoma gruźliczakami, które utworzyły się w grzbietowej części rdzenia przedłużonego w czasie farmakologicznego leczenia gruźliczego zapalenia opon mózgowo-rdzeniowych. Oba gruźliczaki usunięto z dostępu podpotylicznego w linii środkowej i potwierdzono ich rozpoznanie w badaniu histopatologicznym, ale pacjentka zmarła w wyniku zatrzymania krążenia, przypuszczalnie wskutek pooperacyjnego obrzęku rdzenia przedłużonego. Na podstawie przedstawionego przypadku i przeglądu piśmiennictwa omówiono objawy kliniczne i możliwości leczenia gruźliczaków pnia mózgu

Isoflavone Content of Soybean Cultivars from Maturity Group 0 to VI Grown in Northern and Southern China

Soybean isoflavone content has long been considered to be a desirable trait to target in selection programs for their contribution to human health and plant defense systems. The objective of this study was to determine isoflavone concentrations of various soybean cultivars from maturity groups 0 to VI grown in various environments and to analyze their relationship to other important seed characters. Forty soybean cultivars were grown in replicated trials at Wuhan and Beijing of China in 2009/2010 and their individual and total isoflavone concentrations were determined by HPLC. Their yield and quality traits were also concurrently analyzed. The isoflavone components had abundant genetic variation in soybean seed, with a range of coefficient variation from 45.01% to 69.61%. Moreover, individual and total isoflavone concentrations were significantly affected by cultivar, maturity group, site and year. Total isoflavone concentration ranged from 551.15 to 7584.07 μg g(−1), and averaged 2972.64 μg g(−1) across environments and cultivars. There was a similar trend regarding the isoflavone contents, in which a lower isoflavone concentration was generally presented in early rather than late maturing soybean cultivars. In spite of significant cultivar × year × site interactions, cultivars with consistently high or low isoflavone concentrations across environments were identified, indicating that a genetic factor plays the most important role for isoflavone accumulation. The total isoflavone concentration had significant positive correlations with plant height, effective branches, pods per plant, seeds per plant, linoleic acid and linolenic acid, while significant negative correlations with oleic acid and oil content, indicating that isoflavone concentration can be predicted as being associated with other desirable seed characteristics

Intraocular pressure effect of intravitreal conbercept injection for retinopathy of prematurity

Purpose: Intravitreal injection of conbercept (IVC) is a novel anti-vascular endothelial growth factor (anti-VEGF) treatment for retinopathy of prematurity (ROP). This study aimed to assess the intraocular pressure (IOP) effect of IVC.Methods: All IVC surgeries were performed in the Department of Ophthalmology, Guangdong Women and Children Hospital, from January 2021 to May 2021. In this study, 30 eyes of 15 infants who received intravitreal injections of conbercept at a dose of 0.25 mg/0.025 mL were included. The IOP of all participants was measured prior to administering the injection and subsequently at 2 min, 1 h, 1 day, and 1 week thereafter.Results: We included 30 eyes (10 boys and 5 girls) with ROP. For the male group, the mean birth weight, mean gestational age at birth, and the mean time of postmenstrual age (PMA) at IVC treatment were 1,174.0 ± 446.0 g, 28.4 ± 3.0 weeks, and 37.1 ± 1.6 weeks, respectively; for the female group, they were 1,108 ± 285.5 g, 28.2 ± 2.5 weeks, and 36.8 ± 2.1 weeks, respectively. For the male group, the IOP at baseline, 2 min, 1 h, 1 day, and 1 week after IVC were 12.4 ± 1.5 mmHg, 49.0 ± 3.1 mmHg, 26.3 ± 2.5 mmHg, 13.4 ± 2.2 mmHg, and 11.6 ± 1.7 mmHg, respectively; for the female group, they were 10.7 ± 2.0 mmHg, 47.3 ± 3.2 mmHg, 26.4 ± 3.2 mmHg, 10.7 ± 1.8 mmHg, and 10.2 ± 1.8 mmHg, respectively. In both groups, the IOP immediately (2 min) after the operation was significantly higher than that at any other time point (p < 0.01). IOP values returned to the preoperative baseline level on the first day after surgery, with no significant difference compared with that before injection (p > 0.05). IOP continued to be maintained at the preoperative baseline level on the first week after surgery, with no significant difference compared with that before surgery (p > 0.05).Conclusion: Infants with ROP who received IVC experienced a sharp increase in the IOP immediately after injection, which decreased to below 30 mmHg after 1 h and maintain that level for 1 week or longer

Subtype-Based Analysis of Cell-in-Cell Structures in Esophageal Squamous Cell Carcinoma

Cell-in-cell (CIC) structures are defined as the special structures with one or more cells enclosed inside another one. Increasing data indicated that CIC structures were functional surrogates of complicated cell behaviors and prognosis predictor in heterogeneous cancers. However, the CIC structure profiling and its prognostic value have not been reported in human esophageal squamous cell Carcinoma (ESCC). We conducted the analysis of subtyped CIC-based profiling in ESCC using “epithelium-macrophage-leukocyte” (EML) multiplex staining and examined the prognostic value of CIC structure profiling through Kaplan-Meier plotting and Cox regression model. Totally, five CIC structure subtypes were identified in ESCC tissue and the majority of them was homotypic CIC (hoCIC) with tumor cells inside tumor cells (TiT). By univariate and multivariate analyses, TiT was shown to be an independent prognostic factor for resectable ESCC, and patients with higher density of TiT tended to have longer post-operational survival time. Furthermore, in subpopulation analysis stratified by TNM stage, high TiT density was associated with longer overall survival (OS) in patients of TNM stages III and IV as compared with patients with low TiT density (mean OS: 51 vs 15 months, P = 0.04) and T3 stage (mean OS: 57 vs 17 months, P=0.024). Together, we reported the first CIC structure profiling in ESCC and explored the prognostic value of subtyped CIC structures, which supported the notion that functional pathology with CIC structure profiling is an emerging prognostic factor for human cancers, such as ESCC