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.

BACKGROUND:It is unclear whether intramuscular injection of human umbilical cord mesenchymal stem cells wil increase regeneration of normal myocardial cells and play adverse effects on normal myocardium. OBJECTIVE:To observe the effects of intramuscular injection of human umbilical cord mesenchymal stem cells on expression of the myocardial ki-67, phh3 and cTnT in normal Wistar rats. METHODS:A total of 60 male Wistar rats were divided into six groups randomly:normal group, solution group, supernatant group, low concentration group, moderate concentration group, and high concentration group. These groups were intramuscularly injected different liquid, respectively, as fol ows:PBS, DMEM, the supernatant of human umbilical cord mesenchymal stem cells, human umbilical cord mesenchymal stem cells with amount of 0.25×105, human umbilical cord mesenchymal stem cells with amount of 1.0×105, human umbilical cord mesenchymal stem cells with amount of 4.0×105 . After 4 weeks, each rats received the second same intramuscular injections of human umbilical cord mesenchymal stem cells. Four weeks after the second injection, al rates were kil ed to obtain myocardial tissues which were fixed, embedded and sectioned. Final y, the ki-67, phh3 and cTnT expressions of the myocardium were detected by immunohistochemical technique. RESULTS AND CONCLUSION:In the normal group, negative expression of the ki-67 was observed in the caryon of myocardial cells, weak positive expression of the phh3 was observed in the caryon of myocardial cells, and positive expression of the cTnT was observed in the caryon of myocardial cells. Compared with the normal group, the expression of the ki-67, phh3 and cTnT in the myocardium had no significant difference among the other groups (F=1.076, 0.167, 0.300;P>0.05). Human umbilical cord mesenchymal stem cells or the supernatant of human umbilical cord mesenchymal stem cells via intramuscular injection have no effects on the expression of the ki-67, phh3 and cTnT in normal Wistar rats.

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.

Objective:This study aims to ensure the private hospitals development strategy in the background of new healthcare reform and put forward some scientific suggestions to help promote their sustainable development. Methods:The SWOT analysis method was adopted to analyze the private hospitals’ internal strength, weakness, exter-nal opportunity and threats. Results: The results showed a clear property right, advanced management system and other outstanding advantages in the private hospitals. Opportunities like the improved policy environment and people’s medical demand expansion are also very prominent. Meanwhile, the private hospitals development also faces some disadvantages and challenges such as illegal operation, disorder in the market competition, vague orientation, etc. Conclusions:It suggests the strengthening of the personnel and hospital culture construction, adoption of the differen-tiation strategy, improvement of the diagnosis and treatment ability, etc.

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.