COVID-19 has caused more than 500 million infections and 6 million deaths. Due to a continuous shortage of medical resources, COVID-19 has raised alarm about medical and health resource allocation in China. A balanced spatial distribution of medical and health resources is a key livelihood issue in promoting the equalization of health services. This paper explores the spatial allocation equilibrium of two-tier medical and health resources and its influencing factors in Taiyuan. Using extracted POIs of medical and health resources of AMAP, we evaluated the spatial quantitative characteristics through the Health Resources Density Index, researched the spatial distribution pattern by kernel density analysis, hot spot analysis, and service area analysis, and identified the influencing factors of the spatial distribution equilibrium by the Geodetector model. The findings are as follows. The overall allocation level of medical and health resources in Taiyuan is low. There are tiered and regional differences; the response degree of primary care facilities to external factors is greater than that of hospitals; and the comprehensive influence of economic and topographic systems is crucial compared with other factors. Therefore, in order to promote the rational spatial distribution of medical and health resources in Taiyuan and to improve the construction of basic medical services within a 15 min radius, it is important to continuously improve the tiered healthcare system, uniformly deploy municipal medical and health resources, and increase the resource allocation to surrounding counties and remote mountainous areas. Future research should focus on collecting complete data, refining the research scale, analyzing qualitative differences, and proposing more accurate resource allocation strategies.

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Study design: This study was an experimental, controlled, animal study. Objective: This study was to determine the changes of molecular pathology in spinal cord decompression sickness (SC-DCS) based on a rabbit model of SC-DCS with the aid of an all-gene expression profile chip. Setting: Qingdao, Shandong Province, China. Methods: A gene expression profile chip containing 43 803 genes was used to compare the gene expressions in the spinal cords of four male New Zealand white rabbits in the SC-DCS and control groups, respectively. Selected differentially expressed genes were identified with quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry. Results: The chip hybridization results showed that the SC-DCS group had nine upregulated and seventeen downregulated genes, compared with the control group. These genes were mainly related to inflammation, ion channels, the cell cycle, material transfer and apoptosis. The qRT-PCR results showed that parathyroid hormone and tumor necrosis factor alpha (TNF-a) genes were upregulated compared with the control group (Po0.01). However, the acyl-CoA synthetase and voltage-gated channel genes were downregulated (Po0.05). The immunohistochemical staining results confirmed that there were significantly greater expression levels of TNF-a in the spinal cord tissues of the SC-DCS group compared with the control group. Conclusions: The spinal cord lesions of SC-DCS involve multiple gene changes in the rabbit; however, the significance of these findings needs further research. Meanwhile, the gene expression profile chip results provide us with a better understanding of the pathogenesis of DCS.

Aims. In recent years, SMARCA4-deficient nonsmall cell lung cancer (NSCLC) has been recognized as a distinct new subtype of lung cancer, which is characterized by loss of SMARCA4 (Brahma-related gene-1 [BRG1]) protein expression. Only a limited number of SMARCA4-deficient NSCLC case series have been reported, and their clinicopathological features have not yet been fully elucidated. Our main aim was to analyze the clinical history, histology, immunohistochemistry, and molecular pathology of 5 SMARCA4-deficient NSCLC patients with poorly differentiated or undifferentiated histology and neuroendocrine markers expression. Methods and results. Five patients with complete loss of nuclear BRG1 immunostaining were identified among 53 patients of poorly differentiated/undifferentiated NSCLC. We then performed immunohistochemical staining and gene mutation analysis using a real-time polymerase chain reaction. All patients were male aged between 58 and 82 years (average 67.6 years), with smoking exposure. Histologically, the tumors had a relatively monotonous morphology and showed solid nest-like, sheet-like growth, and geographic necrosis. Thyroid transcription factor 1, cytokeratin 7, and Napsin A were all negative (5 of 5). Moreover, all tumors showed a variable expression of neuroendocrine markers, including synaptophysin, chromogranin A and CD56. Hot spot epidermal growth factor receptor/anaplastic large-cell lymphoma kinase/c-ros oncogene 1 mutations were not detected in any of the 5 tumors. Conclusions. To the best of our knowledge, this is the first study that has reported the poorly differentiated morphology with a frequent expression of neuroendocrine markers. Our results have expanded the immunophenotype spectrum of SMARCA4-deficient NSCLC. However, the clinicopathological significance of this subset of SMARCA4-deficient NSCLC should be further clarified in larger series studies.