ObjectiveThe research provided the constructive ideas for evaluation and training of deans of tertiary hospital by analyzing the leadership status quo through using the situational judgment test based on the leadership contingency theory.MethodsBased on the leadership contingency theory,we designed situational judgment test for the dean of tertiary hospital.There were 215 participants involved in the leadership evaluation. Results The coaching leadership style occupied the mainly leadership style of deans of tertiary hospital.In the management situation matched by the coaching leadership style,the leadership of the deans was significantly higher than other management situations.Conclusion The main conclusion included,firstly,the coaching leadership style was the mainly leadership style of deans of tertiary hospital.It was strongly correlated with the deans＇ background thatthey were mainly from clinical professionals.Secondly,the leadership of the deans was at middle level;therefore,it needed to increase the capacity building of deans through management training.

In the design of oral cone beam CT, cooperation between synergic control of X-ray source, real-time acquisition of flat detector and motion of mechanical structure affects the CT image quality. Based on the full analysis of the flat detector's timing signal characteristics, this research was carried out with microprocessor controller (MCU), complex programmable logic device (CPLD), and light couplings to design and realize synchronous exposure control system. To evaluate whether the design of the synchronous exposure control system in this project could reach the required imaging accuracy, we employed the projected images in the system to analyze its stability, linear consistency, signal to noise ratio and precede the FDK construction.
Cone-Beam Computed Tomography ; Phantoms, Imaging ; Radiography, Dental

Objective To explore the preliminary study of the four-dimensional CT-based respiratory gating applications in the IGRT treatment of lung cancer .Methods 38 patients′ were scanned with 4D-CT ,and could got 10 images:0-90% each one ,and then two kinds of radiation treatment plans :Plan-3D and Plan-4D were used ,respectively .Treatment of the patients in the IGRT mode with Plan-4D and following up were done in two months after treatment to evaluate the efficacy and complication probability . Meanwhile evaluation of the two plans by the volume histogram was done .Results The displacement of lung tumor respiratory mo-tion was different in three dimensions ,especially in the Vertical direction ,about(9 .1 ± 2 .2)mm .Accuracy of the distance was 2 .6 mm .The Plan-4D′s CTV was bigger than Plan-3D ,but its PTV was less than the Plan-3D significantly ,at the same time its lung V20 ,MLD were both less than the Plan-3D ,and the difference was statistically significant(P< 0 .05) .The total efficiency(CR+PR)was 77 .78% (28 case);the incidence of 1 ,2 ,3 acute radiation-induced lung injury were 86 .11% ,11 .11% ,2 .78% ,respectively ;the incidence of 1 ,2 acute radiation esophagitis injury were 80 .56% ,8 .33% .Conclusion The respiratory gating techniques based on 4D CT applied in image guided radiotherapy of lung cancer in clinical is feasible ,and it can reduce the volume of the planning tar-get volume ,and help to improve the accuracy of radiotherapy .The degree of respiratory motion is significantly different in individu-als ,and expanding outside the target ranges should be individualized .

The involvement of astrocytes and correlation between neuronal injury and astrocyte response were studied. Blockingmiddle cerebral artery and reperfusing o. 5～48 h, H-E staining, immunoccytochemistry single-and double-labeling, dotble label-ing combined with TUNEL and GFAP immunocytochemistry were used to investigate neuronal injury and astrocyte response.The is chemic area peaked at 24 h of reperfusion. The neurons presented irreversible degeneration at 6 h of reperfusion. At24 h,ischemic area in the preoptic area developed into infarcted area; astrocytes exhibited differential morphological features: reactive,malnourished and degenerative changes. At 48 h of reperfusion, the number of astrocytes began to go up. The astrocytes in is-chemic area didn't proliferate within 48 h. By contrast, a few astrocytes underwent apoptosis. In conclusion, these data indicatethat the reaction of astrocytes is closely connected with the extent of neuronal injuries. The reactive astrocytes imply that astro-cytes positively respond to the neuronal injuries, which might play a role in promoting neuronal survival.

Objective To study the iso-center point coincidence of two accelerators with treatment planning system (TPS) based on γ passing rates of intensity-modulated radiotherapy (IMRT) plan verification.Methods Twenty-one IMRT plans were verified by Varian accelerator and twenty by Elekta accelerator with a gamma criterion of 3 mm/3％.The passing rates were measured when the iso-center point of TPS had-2,-1,0,1,and 2 mm shift in the x or y direction.A binomial curve of γwas fit to figure out the values of the two accelerators on the x and y axes when γ value reached the maximum.The γ pass rate difference was analysed by x2 test.Results The mean values of γ-2,γ-1,γ0,γ1,and γ2 in the x direction were (92.56±3.27) ％,(96.53± 1.82) ％,(96.13± 1.41) ％,(90.14± 2.87) ％,and (82.28± 4.69) ％ for Varian accelerator,and (94.82± 2.04) ％,(97.05± 2.02) ％,(98.38± 1.33) ％,(97.96± 1.44) ％,and (94.49±2.34)％ for Elekta accelerator.There was no significant difference in the mean value of γ0between the two accelerators (P=0.332).When γvalue reached the maximum,the values on the x and y axes were0.65 and-0.30 mm for Varian accelerator and 0.01 and 0.30 mm for Elekta accelerator,respectively.Conclusions In the same TPS,different accelerators have different degrees of coincidence of the actual field center point with the iso-center point of TPS,to which more attention should be paid in clinical practice.

Objective:To report a case of McCune-Albright syndrome (MAS). Methods:Investigated one case's clinical data of McCune-Albright syndrome and reviewed related literatures. Analyzed the cause of disease,clinical manifestation, diagnosis, treatment and prognosis. Results: The diagnostic criteria of MAS are the fibrous dysplasia of bone (FD), in addition to at least a kind of typical hypercrinemia, and (or) special café-au-lait skin spots. A definite diagnosis can be made by discovering the mutation of Gs α-gene in cyst fluid from the ovarian follicle and exceptional bone tissue by gene diagnosis. Conclusion:MAS is a rare disease in clinic and the most of domestic doctors don't know it yet, so it is easy to be misdiagnosed or missed diagnosis. There is no specific treatment for MAS. We must consider it when encounter these patients with sexual precocity as well as with café-au-lait skin spots, and it will be helpful to treat by earlier discovery.

Objective:To study the effect of microRNA (miR)-330-3p on hepatic ischemia-reperfusion injury (IRI) in mice, meanwhile, and to determine potential molecular mechanism.Methods:Eighty male C57BL/6 mice, aged 7-8 weeks, 23-25 g, specific pathogen free, were randomly divided into 8 groups (10 mice in each group) using random number table: reperfusion 2 h group, 6 h group, 12 h group, 24 h group, sham group, miR-330-3p agomir group (preoperative injection of agonist), miR-330-3p antagomir group (preoperative injection of inhibitor) and miRNA-NC group. Except for the sham group, the hepatic IRI model were established in mice. Polymerase chain reaction (PCR), Western blot and immunohistochemistry were used to detect the expression of miR-330-3p and phosphoglycerate mutase family member 5 (PGAM5), cleave caspase-1 and GSDMD. Luciferase reporter assay was performed to investigate whether miR-330-3p directly targets PGAM5. At the same time, AML12 cells were also treated with miR-330-3p mimics/inhibitor or PGAM5 siRNA, then the expression of PGAM5, NLRP3, cleave caspase-1 and GSDMD were detected by Western blot analysis.Results:Level of miR-330-3p gradually decreased after reperfusion, however, mRNA level of PGAM5 was increased thereafter ( P<0.05) as compared with the sham group. Serum level of AST and ALT were decreased in miR-330-3p agomir group while that of were increased in miR-330-3p antagomir group as a function of time following reperfusion, and the differences were statistically significant (all P<0.05). Cleave caspase-1 expression was decreased in miR-330-3p agomir group but was increased in miR-330-5p antagomir group ( P<0.05). Luciferase reporter assay was performed to determine PGAM5 was a target gene of miR-330-3p. SiRNA-mediated knockdown of PGAM5 decreased level of GAM5 (0.24±0.09), NLRP3(0.12±0.07), cleave caspase-1 (0.15±0.07) and GSDMD (1.08±0.08) as compared with the siRNA-NC group (1.17±0.14), (0.36±0.09), (0.68±0.09), (1.36±0.08), and the differences were statistically significant (all P<0.05). Conclusion:MiR-330-3p can alleviate hepatic IRI in mice, which may be related to inhibition of PGAM5-induced pyroptosis.

Objective:To analyze the department distribution and workload of China′s physician team, and promote the establishment of a well-structured physician team.Methods:Based on the relevant data of Health Statistics Yearbook, the distribution of departments and workload of diagnosis and treatment of physicians during the 13th Five-Year Plan period were analyzed. Results:During the " 13th Five-Year Plan" period, the number of physicians increased by an average of 6.11% per year, of which the average annual growth rate in medical cosmetology and rehabilitation medicine exceeded 10%, and the number of infectious disease physicians declined. The daily visits per physician decreased by an average of 4.67% per year, and the daily inpatients per physician decreased by 4.14%. Among them, the daily visits per physician in infectious diseases, preventive health care, oncology had increased overall, and the daily inpatients per physician in medical cosmetology, dental had decreased the most.Conclusions:It is suggested to optimize the professional structure and department distribution in accordance with the principle of " matching medical service needs with a certain workload" , and promote the establishment of a physician team with reasonable distribution to better meet medical service needs.

Objective:To investigate and analyze the loss of personnel in health institutions, and put forward the suggestions.Methods:The staff turnover in various health institutions was analyzed based on a continuous monitoring data from 2012 to 2019.Results:In 2012-2019, the turnover rate of health institutions had generally remained at about 1.5%-2.0%. In 2015-2019, the natural attrition rate was 0.44%-0.70% and the job-changing rate was 0.06%-0.12%. Among all kinds of institutions, the loss of staff in township health centers and Centers for Disease Control and Prevention were the most serious.Conclusions:Some new characteristics have emerged in the flow of health personnel, which have gradually adapted to the demand for health services, and the role of market mechanisms in the allocation of health human resources has gradually emerged.For the institutions with serious attrition, it is suggested to strengthen policy integration, guide the rational flow of health personnel.

This is the design of a mechanical systems for use in the balanceable system of ambulance, which can keep the medical service bed at the ambulance level, whatever the terrain is. A level detector will detect the level state of the bed and turn it to a signal. The central processing unit will use this signal to analyse and control the movement of the motor. By this design (which uses the rolling rail as a drive transmission and makes three supports of the bed go up and down), the bed will keep level. With the use of this design, the balanceable system of ambulance can counteract 35 degrees. The error is controlled within +/- 1 degree. And the response time is within 0.3 s. The method of registration can be effective for keeping the bed at the ambulance level, and for reducing the chance of making the patient get hurt on the way to hospital.
Ambulances ; Equipment Design ; Humans ; Robotics ; methods ; Transportation of Patients