The paper gives an account of the four systems that are currently used for evaluating hospital quality in America, viz. America's Best Hospitals, Solucient 100 Top Hospitals, International Quality Indicator Project, and the Joint Commission on Accreditation of Healthcare Organizations. The "America's Best Hospitals" methodology takes into account three factors, infrastructure, process and outcome. Hospitals are first ranked in specialties, then the index of hospital quality is calculated by means of weighted indexes, and after that the best hospitals are selected according to the specialty rankings and the number of the hospitals. The "Solucient 100 Top Hospitals" methodology selects 100 top hospitals among hospitals of the same size on the basis of hospital quality and safety indexes. The evaluation indexes include eight items, such as index of risk-adjusted mortality rates, index of complications, and disease severity-adjusted average length of hospital stay. The methodologies of "International Quality Indicator Project" and "the Joint Commission on Accreditation of Healthcare Organizations" are used in many countries to evaluate clinical efficiency and enjoy high reputation in monitoring and promoting medical quality.

AIM: To investigate the role of ubiquitin-proteasome system ( UPS) in adipocyte differentiation. METHODS:Differentiation of 3T3-L1 preadipocytes into adipocytes was induced by treatment with insulin, 3-isobutyl-1-methylxanthine and dexamethasone.Western blot and immunoprecipitation were performed to detect the protein abundances and association, respectively.Oil red O staining was used to determine the intracellular lipid of 3T3-L1 adipocytes.The levels of mRNA were measured by reverse transcription polymerase chain reaction ( RT-PCR) .RESULTS:UPS inhibitor bortezomib (BZM) suppressed the differentiation of 3T3-L1 pre-adipocytes, evidenced by reduced intracellular content of triglyceride, and decreased mRNA expression of adipogenic marker proteins such as adiponectin and adipocyte protein 2.In contrast, administration of sildenafil (SDN), an activator of protein kinase G which was also found to activate UPS, promo-ted adipocyte differentiation.In addition, BZM treatment decreased the expression of heat shock protein 90 (HSP90) and peroxisome proliferator-activated receptor gamma ( PPARγ) in the soluble fraction and reduced association of HSP90 and PPARγ.Furthermore, HSP90-specific N-terminal inhibitor geldanamic mitigated SDN-induced increase in PPARγlevel and 3T3-L1 cell differentiation.CONCLUSION:UPS modulates HSP90-dependent PPARγstability, thus leading to pro-motion of adipocyte differentiation.

The real-time monitoring of cerebral hemorrhage can reduce its disability and fatality rates greatly. On the basis of magnetic induction phase shift, we in this study used filter and amplifier hardware module, NI-PXI data-acquisition system and LabVIEW software to set up an experiment system. We used Band-pass sample method and correlation phase demodulation algorithm in the system. In order to test and evaluate the performance of the system, we carried out saline simulation experiments of brain hemorrhage. We also carried out rabbit cerebral hemorrhage experiments. The results of both saline simulation and animal experiments suggested that our monitoring system had a high phase detection precision, and it needed only about 0.030 4s to finish a single phase shift measurement, and the change of phase shift was directly proportional to the volume of saline or blood. The experimental results were consistent with theory. As a result, this system has the ability of real-time monitoring the progression of cerebral hemorrhage precisely, with many distinguished features, such as low cost, high phase detection precision, high sensitivity of response so that it has showed a good application prospect.
Algorithms ; Animals ; Cerebral Hemorrhage ; diagnosis ; Computer Systems ; Magnetics ; Rabbits ; Software

Objective To study the relationship between expression of G-protein-coupled bile acid receptor 1 (GPBAR1) in gallbladder mucosa and formation of lithogenic bile in patients with gallstones.Methods Gallbladder mucosa,gallbladder wall,bile and plasma were collected from 34 patients with gallstone (GS) and 15 individuals who were gallstone free (GSF).The gallbladder wall was stained with hematoxylin-eosin (HE) and immunohistochemistry to detect pathologic changes and expressions of GPBAR1,mucin 1 (MUC1) and mucin 5AC (MUC5AC).Reverse-transcription polymerase chain reaction (RT-PCR) was used to test mRNA expressions of GPBAR1,MUC1 and MUC5AC in the gallbladder mucosa.The contents of total cholesterol (TC),total bile acid (TBA),triglyceride (TG),low density lipoprotein (LDL) and high density lipoprotein (HDL) in plasma and cholesterol,TBA,phospholipid (PL) and mucin in the bile of gallbladder were measured.Results The gallbladder mucosa in all GS patients showed chronic inflammation on hematoxylin-eosin staining.The expressions of GPBAR1 and MUC5AC were more markedly increased in the GS group than in the GSFgroup (61.34±8.06 vs.43.05±7.83,P＜0.01; 52.11±9.62 vs.45.05±9.27,P＜0.05).The mRNA expressions of GPBAR1 and MUC5AC in the GS group were also more markedly increased than in the GSR group (0.87±0.07 vs.0.80±0.09,P＜0.05; 1.04±0.22 vs.0.8±0.17,P＜0.01).Serum cholesterol,as well as biliary cholesterol,cholesterol mol percentage,cholesterol saturation index and mucin in the GS group were more significantly higher than in the GSF group (5.07±1.64 vs.3.62±1.42,P＜0.01; 17.23±3.67 vs.12.47±2.31,P＜0.01; 7.47±0.65 vs.5.05±0.24,P＜0.01; 1.03±0.58 vs.0.69±0.38,P＜0.01; 92.02±20.89 vs.76.36±19.71,P＜0.05).Biliary total bile acids and bile acids mol percentage were lower in the GS group than in the GSF group (162.68±20.19 vs.180.21±26.05,P＜0.05; 71.28±1.84 vs. 73.29±0.96,P＜0.01). In the GS group,there were negative correlations between the mRNA expression of GPBAR1 and biliary TBA (γ=-0.341,P＜0.05).There were negative correlations in the GS group between the GPBAR1 expression and the level of biliary TBA (γ=- 0.403,P＜0.05),and between the GPBAR1 expression and the level of biliary total lipid (γ=-0.365,P＜0.05).Conclusions This study shows an increase in expression of GPBAR1 in gallbladder mucosa in patients with GS.It is suggested that GPBAR1 may accelerate formation of lithogenic bile by inducing re-absorption of bile acid.

Objective To study the influence of tripterygium glycosides (LGTDG)in the bone morphogenetic protein(BMP)signal transduction pathway and BMP-2 expression,and to clarify the mechanism of anti-ankylosing spondylitis (AS)ossification of LGTDG.Methods The in vitro cultured AS fibroblasts were divided into control group and 0.5,1.0,1.5,2.0 mg·L-1 LGTDG groups.The alkaline phosphatase (ALP)activities of the cells and optimal drug concentrations in various groups were detected;CCK-8 assay was used to detect the proliferation rate of the cells in 1.0 mg· L-1 LGTDG group;the biochemical tests were performed to quantitatively detect the BMP-2 expression levels in control group and 1.0 mg· L-1 LGTDG group;Western blotting method was used to determine the BMP-2 and Cbfal protein expressions. Results The ALP activities in LGTDG groups were lower than that in control group,especially in 1.0 mg·L-1 LGTDG group (P<0.01).The CCK-8 assay results showed that the proliferation rate of AS fibroblasts in 1.0 mg·L-1 LGTDG group was significantly low than that in control group(P<0.01),the proliferation rate reached the peak at the 4th day after LGTDG treatment and entered into the plateau phase,then the proliferation rate of the cells was decreased.The biochemical assay and Western blotting results indicated that the protein expression levels of BMP-2 in 1.0 mg·L-1 LGTDG group was significantly lower than that in control group (P<0.01).Conclusion LGTDG can effectively inhibit the BMP-2 expression in AS fibroblasts and delay the cells to differentiate into the osteoblasts and lead to AS ossification by BMP signal transduction pathway.

AIM:To investigate the potential effect of all-trans retinoic acid (ATRA) on the proliferation of human breast cancer MCF-7 cells and its underlying mechanism.METHODS:Human breast cancer MCF-7 cells were in-cubated in DMEM supplemented with 10%fetal bovine serum and 1%penicillin/streptomycin.Western blot was performed to detect the protein expression and its phosphorylation.MTT assay and bromodeoxyuridine ( BrdU) incorporation, and TUNEL staining were carried out to determine the cell proliferation and apoptosis, respectively.Lentivirus carrying shRNA sequences targeting the gene of docking protein 1 ( DOK1 ) was used to silence DOK1 expression.The activity of peroxi-some proliferator-activated receptor gamma ( PPARγ) was measured using a PPARγtranscription factor assay kit.RE-SULTS:ATRA treatment suppressed the proliferation and promoted the apoptosis of MCF-7 cells.ATRA was also found to induce DOK1 expression in a time-dependent manner.Silence of DOK1 mitigated anti-cancer effect of ATRA evidenced by recovered the cell proliferation and reduced the cell apoptosis.In addition, DOK1 knockdown inhibited PPARγexpression and activity.Furthermore, inhibition of PPARγwith its specific inhibitor GW9662 attenuated impacts of ATRA on the cell proliferation and apoptosis.CONCLUSION: ATRA suppresses MCF-7 cell survival through inhibiting cell proliferation and promoting cell apoptosis, which is mediated by DOK1-activated PPARγ.

Objective:To investigate the differences of resting-state spontaneous neural activity between smoking addicted teenagers and healthy non-smokers.Methods:In the current study, the percent amplitude of fluctuation (perAF) approach was applied to explore the differences of resting-state spontaneous neural activity between smoking addicted teenagers and healthy non-smokers.Pearson correlation analysis was used to investigate the relationships between the altered perAF values and smoking years, fagerstrom test for nicotine dependence (FTND) and pack-years of smokers.Results:Compared with healthy non-smokers, smoking addicted teenagers showed increased perAF values in the parahippocampal gyrus (smoking addicted teenagers: 2.026 5±0.516 7, nonsmokers: 0.781 6±0.148 9), middle temporal gyrus (smoking addicted teenagers: 0.796 7±0.203 2, nonsmokers: 0.545 5±0.134 1), and superior frontal gyrus (smoking addicted teenagers: 2.734 5±0.372 8, nonsmokers: 1.962 4±0.416 8) (all P<0.001). It was noteworthy that the perAF values of the parahippocampal gyrus were negatively correlated with smoking years of smoking addicted teenagers( r=-0.6007, P=0.0084). Conclusion:Compared with healthy non-smokers, the resting-state regional neural activity in smoking addicted teenagers was altered, mainly manifested as increased perAF value in the parahippocampal gyrus, which is correlated with smoking years of smoking addicted teenagers.These findings may help us understanding neural mechanisms underlying nicotine addiction of smoking addicted teenagers.

Objective To summarize the clinical features of patients with diffuse coronary artey diseases,and evaluate the clinical efficacy of off-pump coronary artery bypass grafting(OPCABG) combined with selective coronary venous bypass grafting (SCVBG).Methods Retrospectively analyzed the clinical data of 61 patients with diffuse right coronary stenosis undergoing operation of OPCABG + SCVBG from January 2007 to December 2013,and couducted the comparative study of the patients who underwent OPCABG during the same period based on propensity score.Patients were divided into SCVBG group(61 cases,underwent OPCABG + SCVBG) and control group(60 cases,matched by propensity score and underwent OPCABG without SCVBG).Results Compared with control group,the rate of myocardial infarction in SCVBG group was higher (67.2％ vs.46.7c％,P ＜0.05),the heart rate was faster[(69.92 ± 15.82) bpm vs.(64.48 ± 13.72) bpm,P ＜ 0.05],the low density lipoprotcin and triglyceride were higher[(2.67 ± 0.78) mmol/L vs.(2.37 ± 0.78) mmol/L (1.84 ± 0.79) mmol/L vs.(1.36 ± 0.60) mmol/L,both P ＜ 0.05] and the troponin I was higher in the first postoperative day [0.85 (0.29,3.15)μg/L vs.5.09 (2.02,13.03)μg/L,P ＜ 0.05].The perioperative(postoperative) mortality(1.6％ vs.0) and the long-term survival curve difference had no statistically significance(P ＞0.05).Conclusion Patients with coronary artery disease should pay more attention to the control of heart rate and blood lipids,poorly controlled heart rate and high blood lipids are the important factors for the development of coronary heart disease.The exact efficacv of selective coronary vein arterialization for diffuse coronary artery disease is confirmed through the small sample comparative study.

To develop a clinical diagnosis technique for bluetongue virus infection, we established serotype-specific methods to detect serotype 4 of bluetongue virus (BTV-4). Two monoclonal antibodies (mAbs) against VP2 protein of BTV-4, named 4A-1G7 and 4B-1B6, were used as competitive antibodies in the competitive enzyme-linked immunosorbent assays (C-ELISA). We detected 50 negative serum samples from sheep, goats and cattle by C-ELISA. The cut-off values of 4A-1G7 and 4B-1B6 mAbs were 49% and 40%, respectively. The results of the sensitivity, specificity and repeatability by detecting standard positive serum, were consistent with the general standard of Office International Des Epizooties. Furthermore, serum samples of BTV-4, BTV-18 and BTV-20 infection could be screened out through the combined C-ELISAs by 4A-1G7 and 4B-1B6 mAbs. Thus, this technique may diagnose BTV-4, BTV-18 and BTV-20 infections.

To confirm the B cell epitope recognized by monoclonal antibody (MAb) 3G11 of bluetongue virus type 8 (BTV-8) VP2 protein prepared in our laboratory, antigen epitopes recognized by 3G11 were screened and identified by phage display technology. KLLAT sequence was found by sequencing of blue spot after four rounds panning and 283LL284 of common short peptide sequence was obtained after comparison to amino acid sequence of BTV-8 VP2 protein. The peptide sequences KLLAA, KALAT, KLAAT and KLLAT were synthesized and identified by indirect ELISA. KLLAA and KLLAT bound strongly with supernatant and as cites of 3G11 cells and reacted specifically with BTV-8 positive standard sera. Further sequence analysis showed that amino acid sequence 283LL284 was conserved among different serotypes of BTV-8 strains, and283LL284 was the key amino acids of antigen epitopes recognized by 3G11. This study laid the foundation to establish type 8 BTV specific immunological detection methods.