Objective To estimate the operational efficiency of 37 county level public general hospitals in Hubei province using the world popular method of Bootstrap-data envelopment analysis.The aim is to make up for the theory and methodology gaps on DEA research for hospitals in China,and to provide policy and management recommendations for their further improvement.Methods The input and output indicators of hospital efficiency evaluation were selected based on our previous research.R Software was used to describe the current input and output indicators,while FEAR package used to measure Bootstrap-DEA efficiency value of the sample hospitals with bias corrected,along with such applied analysis as efficiency benchmarking for the technical efficiency outcomes.Results There are great differences among the healthcare input and output of these hospitals.In particular,the difference in the number of actual beds was 4.67 times between the highest hospital and the lowest one.All of the bias corrected efficiency scores were lower than those before correction,and the average bias corrected score of the sample hospitals is 0.717 9.Moreover,only 20 hospitals(54.05%)have their efficiency scores above the median level.Conclusions The healthcare resources allocation of these hospitals needs to be further optimized.Hospitals still have big potential to improve their efficiency.Besides providing policy support,the government is advised to guide hospitals to innovate their management mechanisms,such as introducing and applying benchmarking,ranking,inter-hospital learning among others,so as to continuously improve their operational efficiency.

Deafness is a seriously disabling disease affecting the quality of human life and genetic fac-tors account for a large proportion in the pathogenesis of newborn deafness.With the development of genomics technology,molecular genetics of hearing loss has become a cutting-edge field under investigation in otology. Molecular diagnostic technique plays an important role in exploring the pathogenesis,assisting clinical diagnosis and the prenatal diagnosis.In this review,we introduce the common pathogenic gene mutations and the diagnosis of non-syndromic inherited hearing impairment.

Glucose-6-phosphatedehydrogenase( G6PD) is the main regulatory enzyme of pentose-phos-phate pathway,which plays an important role in maintaining the balance of cell energy and redox reactions in the cell. G6PD deficiency is the most common hereditary erythrocyte enzyme deficiency disease. There are no effective treatments for the disease. Currently,the key of control and treatment is to make a definitive diagnosis in time and keep away from related risk factors of the disease. At present,the main clinical diagnostic method is the detection of G6PD enzyme activity,but it is limited in accuracy of detecting the heterozygote females. It has already been confirmed at home and abroad that G6PD heterozygote is a risk factor of neonatal hyperbilirubi-nemia. Thus,the detection method of different genotypes of G6PD deficiency at the same time is urgently needed in clinical diagnosis. This paper reviews on recent research progress of the G6PD deficiency disease.

Integrity of gut barrier is the foundation of the multiple function of intestinal tract to keep normal.Dietary conditionally essential amino acids are major fuels for the small intestinal mucosa as well as important substrates for syntheses of intestinal proteins,nitric oxide and metabolic products,and are required for maintaining intestinal integrity.The article reviewed recent advances in dietary uses of functional amino acids(including glutamine,glutamate,and arginine) to enhance the gut health and immune status of animals.

BACKGROUND:Current researches on whether the intramuscular injection of heterogeneous umbilical cord mesenchymal stem cells (UC-MSCs) is safe or not lack theoretical basis. OBJECTIVE:To explore the effects of intramuscular injection of heterogeneous UC-MSCs on expression of myocardial vascular endothelial growth factor (VEGF), cardiac troponin I (cTnI) and serum VEGF, hepatocyte growth factor (HGF), insulin-like growth factor 1 (IGF-1) and granulocyte macrophage colony stimulating factor (GM-CSF) in normal Wistar rats. METHODS:A total of 60 Wistar rats were divided into six groups randomly. Rats in the six groups were respectively administrated with intramuscular injection of PBS, Dulbecco’s modified Eagle’s medium, hUC-MSC supernatant, 0.25×105, 1.0×105, 4.0×105 hUC-MSCs. Rats received a second intramuscular injection 4 weeks after first injection. Eight weeks later, the blood sample and myocardial tissue were taken. The serum concentration of VEGF, HGF, IGF-1 and GM-CSF were measured with enzyme-linked immunosorbent assay kit. The myocardial VEGF and cTnI expression were detected by immunohistochemical technique. RESULTS AND CONCLUSION:There was no significant difference in the serum concentration of the VEGF, HGF, IGF-1 and GM-CSF among the groups before and after injection (P>0.05). In the same group, no statistical significant changes in the serum concentration of the VEGF, HGF, IGF-1 and GM-CSF were found among the rats before and after injection (P>0.05). Eight weeks after injection, weak positive expression of the VEGF in the cytoplasm of cardiocytes in the six groups was observed, and strong positive expression of the cTnI in the cytoplasm of cardiocytes in the six groups was observed. There was no significant difference in the VEGF and cTnI content in the myocardium among the groups (P>0.05). Intramuscular injection of hUC-MSCs or the supernatant of hUC-MSCs had no effects on the serum concentration of the VEGF, HGF, IGF-1, GM-CSF and the myocardial VEGF and cTnI expression in normal Wistar rats.

Objective　To observe the curative effect and sid e effect of the gastrokinetic agent mosapride citrate by RCT. Methods　 42 cases of functional dyspepsia (FD) were divided into two groups rando mly, the group of mosapride(21 cases):orally administrated mosapride, 5mg, t.i.d for 4 weeks, and the control (21 cases):orally administrated domperidone, 5mg, t.i.d for 4 weeks. Symptoms and side effects were recorded before and at d 14, d 28 after administration of the medicines according to GCP and double blind pri ciple. Gastric empting test was also carried out in randomly selected patients. Results　Mosapride and domperidone were significantly effective on alleviating symptoms of the patient with FD. In mosapride treated group the half emptying time was shortened and the 120 min remain rate was reduced. No sid e effect was found. Conclusion　These results suggest that mosa pride 5 mg t.i.d. is effective and safe on alleviating symptoms of patients with FD and improving the ga stric empting time.

Objective To explore and analyze the timing and postoperative effect of proximal femoral nail anti-rotation( PFNA) for the treatment of elderly femoral intertrochanteric fracture. Methods From September 2011 to March 2013, there were 36 elderly patients with femoral intertrochanteric fractures in our hospital, including 6 cases of type A1, 16 cases of type A2, and 14 cases of type A3. All the 36 pa-tients received PFNA and systematic rehabilitation exercise. Treat the underlying disease and strengthen the nursing to prevent thrombosis at the same time. Hip joint function was evaluated by the Harris score system. Results The average hospitalization of patients is 4 weeks. The wound healing was good in 30 cases and wound infection occured in 2 cases who recovered after subsequent treatment, and the other 4 pa-tients died due to complicated internal medicine diseases. 21 cases of patients were followed up,and their hip joint function recovered well according to the Harris score system, including 12 cases of excellent, 6 cases of good, and 3 cases of eligible, with an excellent and good rate of 85%. Conclusion The application of PFNA for the treatment of elderly femoral intertrochanteric fractures has the advantages of less damage to the local blood supply and better recovery of fracture healing and hip joint function, which is an ideal treatment for the elderly pa-tients with femoral intertrochanteric fractures.

BACKGROUND:So far, the short-term changes of various organs after injection of umbilical cord mesenchymal stem cells have been reported, but there are few studies on the long-term changes of various organs in healthy rats after repeated intramuscular injection of umbilical cord mesenchymal stem cells. OBJECTIVE:To observe the security of intramuscular injection of heterogeneous umbilical cord mesenchymal stem cells. METHODS:Sixty male SPF Wistar rats were divided into six groups randomly:normal group (suspension liquid of umbilical cord mesenchymal stem cells);control group with culture solution;supernatant group (supernatant of human umbilical cord mesenchymal stem cells);low concentration group (0.25×105 human umbilical cord mesenchymal stem cells);moderate concentration group (1.0×105 human umbilical cord mesenchymal stem cells);high concentration group (4.0×105 human umbilical cord mesenchymal stem cells). Each rat was injected 0.8 mL liquid in muscle, 0.2 mL in each limb, twice at weeks 1 and 4. Biochemical tests were conducted before and after injection. At the end of 8 weeks, al the rats were kil ed and hematoxylin-eosin staining was done with the liver, spleen, lung, kidney, brain and muscle.
RESULTS AND CONCLUSION:There was no abnormal change about biochemical tests and hematoxylin-eosin staining after the intramuscular injection of heterogeneous umbilical cord mesenchymal stem cells. No significant alteration was observed in the liver, spleen, lung, kidney, brain, and muscle of the limb after the injection of heterogeneous umbilical cord mesenchymal stem cells under suitable concentration. These findings indicate intramuscular injection of heterogeneous umbilical cord mesenchymal stem cells at certain concentrations is safe and reliable.

Objectives:This study aims to summarize the research progress of multiple-site physician practice to determine further research directions. Methods:Literature on Chinese multiple-site physician practice between 1949 and 2013 was obtained from CNKI, Wan fang database and CQVIP database, the annual volume distribution of se-lected documents was been described and the topics and content of literature cited at least once were summarized through literature content analysis. Results:The volume of literature increased rapidly from 2009, guided by related government policies. Content analysis is insufficient in the research areas of supporting policies, international experi-ences, relevant laws and empirical studies. Suggestions: Further research should focus on multiple-site physician practice policies themselves and supporting policy analysis, international comparisons of multiple-site physician prac-tice systems, studies into relevant laws and regulations and empirical studies based on quantitative methods.