No abstract available.

Abstract Diagnosis-related groups (DRGs), designed to reflect the complexity of grouped cases and the consumption of medical resources, has been utilized for evaluating hospital specialty capabilities and assessing performance. A provincial tertiary hospital in Zhejiang Province has developed a management model based on DRGs performance evaluation with strengthening the medical record quality control, optimizing disease admission structures, and refining data analysis. This article introduced the application of DRGs performance evaluation in this hospital, and proposed suggestions for improvement, including leveraging artificial intelligence and big data and integrating clinical pathway management to further enhance medical care quality. These insights provided the reference for high quality development of hospitals.

Aim To study the inhibitory effect of gast-rodin (GSTD) on oleic acid (OA)-induced fat accu-mulation in HL-7702 cells and explore possible cellular signaling pathways. Methods The MTT method was used to study the impact of GSTD on cell viability in HL-7702 cells. Cellular steatosis was induced by 1 mmol·L-1 of OA administration for 24 h, and differ-ent concentrations of GSTD were added at the same time. Oil red O ( ORO) staining was used to determine fat accumulation in cells, and intracellular triglyceride ( TG) contents were assayed. Western blot was used to determine the phosphorylation levels of AMPKα and ACC in cells after GSTD administration. Compound C was used to treat the cells in order to study its influ-ence on the efficacies of GSTD. Results GSTD had no obvious toxicity in HL-7702 cells when its concen-tration was≤3 386. 5 μmol · L-1 . After 24 h of OA administration, there were large amounts of lipid drop-lets accumulated in HL-7702 cells, and intracellular TG contents greatly increased as well. However, when 169. 3 or 338. 7 μmol · L-1 of GSTD was added to-gether with OA, fat accumulation in cells was greatly inhibited, and intracellular TG contents were reduced averagely by 35% and 43 . 6%, respectively ( P<0. 01 vs OA alone ) . After administration, GSTD could in-crease the levels of p-AMPKα and p-ACC in HL-7702 cells time and dose dependently. Compound C could completely abolish the stimulating activity of GSTD on AMPK pathway and block its reducing effect on hepatic TG accumulation. Conclusions GSTD greatly inhibits OA-induced fat accumulation and reduces intracellular TG contents in HL-7702 cells;the efficacy of GSTD is dependent on the activation of cellular AMPK pathway.

Objective To investigate the correlation of social capital and professional burnout in nursing staff. Methods Totally 1329nursing staff were recruited from 6 hospitals in China. They were investigated with the social capital scale and nursing personnel professional burnout scale. Results The mean score of social capital was 13.37±1.30;the mean score of 3 Scales of professional burnout was 24.39± 9.98, 6.24 ± 4.78, 23.37 ± 10.12. The 4 Scales scores of social capital were negative correlated with emotional exhaustion scale, the lack of human individual scale(r=-0.564 to-0.211,P<0.05). Besides with trust and security dimension, low sense of achievement were positively correlated with the total score of social capital (r=0.281-0.281, P<0.05). Conclusion Social capital of nursing staff have important effects on nurse's professional burnout. Nursing managers should take effective measures to reduce nurse's professional burnout.

Objective To research the role of matrix metalloproteinase-9(MMP-9), transforming growth factor ?1(TGF-?1) in viral myocarditis(VM) and their relationships with myocardial fibrosis, and to explore the forensic significance on sudden death due to viral myocarditis. MethodsSelected 30 cases of VM as experimental group,there cases were divided into definite VM group(n=18) and borderline VM group (n=12);Non-VM(n=10) were selected as control group. Collagen hyperplasia was observed by Masson staining. The expression and localization of MMP-9 and TGF-?1 in viral myocarditis were quantified by immunohistochemical method. Image analysis systems and statistical methods were used for quantitative analysis. ResultsThe amount of collagen fibre in the viral myocarditis group was more than that in the control group. The expression of MMP-9 and TGF-?1 were increased obviously. MMP-9、TGF-?1 expression were positively correlated with the collagen hyperplasis. ConclusionsThe MMP-9 and TGF-?1 may contributes to myocardial fibrosis, and may act as the assistant diagnostic indexes of sudden death due to viral myocarditis.

Objective To explore the molecular mechanism of hypophrenia induced by Down syndrome (DS).Methods Ts65Dn mice were used as DS animal model.Three female mice and three male mice of three to twelve weeks old were mated.Among the 17 first-generation mice alive,five mice remained Ts65Dn trisomy and 12 mice were normal.Five Ts65Dn mice and five normal mice were selected randomly as Ts65Dn group and control group,and bred till 16 to 18 weeks old for experiments.Differential proteins in hippocampus of mice were tested by isobaric tags for relative and absolute quantitation (iTRAQ).Expressions of the differential proteins in Ts65Dn group were detected compared with those in control group.Results A total of 2805 proteins were identified in hippocampus of Ts65Dn group and control group,and significant differences were observed in the expressions of 374 proteins.Compared with those in control group,expressions of 195 proteins increased and 179 reduced in Ts65Dn group.Sorted by P value from low to high,the seven proteins with the lowest P value were uncharacterized protein C2orf47 homolog,isoform 2 of filamin A-interacting protein 1-like,zinc finger protein,isoform 1 of pericentriolar material 1 protein,SEC23 interacting protein,BAG family molecular chaperone regulator 3 and serpin H1.Conclusions Differential proteins are observed in hippocampus of Ts65Dn mice,perhaps closely correlating to neurological defects.The new technology of iTRAQ helps to screen and identify differential proteins in hippocampus.

Hand-Arm Vibration Syndrome ; Humans

Adult ; Aged ; Cross Infection ; microbiology ; Drug Resistance, Bacterial ; Drug Resistance, Fungal ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications

Objective To prospectively study the main risk factors of variceal bleeding in cirrhotic patients. Methods Fifty-seven patients with liver cirrhosis and esophageal varices who had never experienced variceal bleeding were followed up for 12 months. The patients underwent measurements of esophageal variceal pressure by non-invasive endoscopic balloon technique. The endpoint of the study was the presence of a variceal hemorrhage. The relationship between variceal hemorrhage and endoscopic findings including varices, variceal pressure, Child-Pugh status, ascites, and etiology of cirrhosis was studied. Results Thirty-four patients (59.6% ) developed a variceal hemorrhage. In univariate analysis, the level of variceal pressure (P= 0. 001), the size of varices (P=0. 006), and the endoscopic red color sign on the variceal wall (P=0. 012) predicted higher risks of variceal hemorrhage. The multiple logistic regression revealed that variceal pressure was a major predictor of the risk for a first variceal bleeding (OR=2. 817, P=0. 003). The area under the receiver operating characteristic (ROC) of variceal pressure for predicting variceal bleeding was 0. 98, and the variceal pressure cutoff value was 25.3 mm Hg (1 mm Hg=0. 133 kPa) with both specificity and sensitivity of 91 %. Conclusion The level of variceal pressure is a major predictor for variceal bleeding in cirrhotic patients.

Background Abnormality of intraocular pressure (IOP) leads to ocular shape change and functional damage.Previous study on the influence factors of IOP mostly focus on eye tissue,but the research of systemic affecting factor is lack.Objective This study was to survey the distribution of IOP and its association with the systemic factors in Chinese population.Methods A cross-section study was designed in this study.The subjects were enrolled from the government employees physical check-up cohort in Guangzhou.IOP was measured using non-contact tonometry.The height,weight and blood pressure were measured based on a presupposed standard protocol.Fundus and slit lamp examinations were performed by trained ophthalmologists.Frequency-doubled perimetry was carried out in the subjects with the suspicious optical disc abnormality,and abnormal perimetry result and operated eye were rejected in the survey.The operative history was learned by questionnaire.Stata 11.0 was used for the data analysis.Results Total 7763 subjects finished all the examination,including 4213 male and 3550 female.Four hundred and fifteen subjects were excluded due to previous intraocular surgery and glaucoma,and the clinical data of the right eyes of 7348 subjects who were eligible for the protocol were brought into statistical analysis.The mean IOP was (15.6±2.8) mmHg in the subjects,and that in the male and female subjects was (15.6±2.8) mmHg and (15.7±2.8) mmHg,respectively,showing a statistically significant difference (t =2.415,P =0.016).A good consistence was found in the IOP between the right eyes and the left eyes (r=0.830,P＜0.001).The IOP value in the subjects presented with a near normal distribution.IOP value was gradually decreased with the increase of age.Multivariate regression suggested a negative correlation between IOP and age or gender (P＜0.001) as well as a positive correlation between IOP and body weight index (BMI),systolic blood pressure or diastolic blood pressure (P ＜0.001).Conclusions Similar to other studies in East Asia population,IOP is associated with age,gender,BMI,systolic and diastolic blood pressure in this survey.