This paper presented the practice of performance evaluation at public hospitals in Wuhu.The performance evaluation system at public hospitals should emphasize public benefits,present a true picture of work and management performance,and help build the incentive and constraint mechanism.In addition,it should encourage public hospitals to strengthen management,improve quality of care and control health care costs.The system is designed for providing a safe,effective,convenient and inexpensive medical and health services for the people.

Objective To observe the inhibition of amikacin in vitro on platelet aggregation and blood coagulation tests, and to study its effects on hemostasis and the related mechanisms.Methods Plateletrich plasma and platelet-poor plasma from donors were mixed with different concentration of amikacin, which was divided into four groups:0 mg/L, 30 mg/L, 91 mg/L and 910 mg/L group.The maximial ratio of platelet aggregation induced by ADP were measured with Platelet Aggregation Analyzer.The expression levels of P-selectin, GP Ⅱ b/Ⅲ a and Fg-R were determined with Flow Cytometer.The PT, APTT, TT and Fg of platelet-poor plasma were detected with Blood Coagulation Analyzer. The four concentration of amikacin mentioned above and two anticoagulants (62.5 U/ml of sodium heparin and 109 mmol/L of sodium citrate)were interacted with fresh whole blood, in which the blood CT and plasma Ca2+ were detected. Blood samples were collected from 10 patients with acute lower respiratory tract infection before and 30 minutes after routine amikcin treatment respectively.The maximial ratio of platelet aggregation, the expression levels of P-selectin, GPⅡ b/Ⅲa and Fg-R induced by ADP were measured; while PT, APTT, CT and plasma Ca2+ were determined.Results At 30 mg/L of amikacin group, the maximal ratios of platelet aggregation (65.8±3.9)%, the expression levels of P-selectin (9.2 ± 1.0)% and Fg-R (12.6 ± 1.7)% were statistically lower than those [(88.0 ±4.6%, (16.1 ± 1.3)% and (31.0 ±2.5)%]at 0 mg/L of amikacin group ( t = 9.442,8.432,9.993,P ＜ 0.01 ).At 30 mg/L of amikacin group, the APTT (80.5 ±6.8) s and CT ( 857 ± 66) s were significantly higher than those [(33.0 ± 3.6) s and (447 ± 35 ) s] at 0 mg/L of amikacin group ( t = 11.312, 13.211, P ＜ 0.01 ). There was a negative correlation between amikacin concentration and maximial ratio of platelet aggregation ( r = - 0.832, P ＜ 0.05 ), but a positive correlation between amikacin concentration and inhibitory rates of platelet aggregation ( r = 0.939, P ＜0.05) was observed, as well as APTT (r ＞0.870, P＜0.05).At 30 mg/L, 91 mg/L, and 910 mg/L of amikacin groups, the P-selectin and Fg-R expression were remarkably inhibited with a dose-dependent manner, the CT was notably enhanced [Fwithin subjects =21.44, 26.24, ( ＞29.81 ), P ＜0.01].At 0 mg/L,30 mg/L, 91 mg/L and 910 mg/L of amikacin groups, the PT values were ( 14.7 ± 1.9) s, ( 15.2 ± 1.7) s,(15.6±1.5) s and (22.1 ±2.1) s, respectively (F=8.21,P＜0.05), but there was no markeddifference for the levels of GP Ⅱ b/Ⅲ a, TT, Fg and plasma Ca2+ among the four groups ( P ＞ 0.05 ).After 30 minutes of amikacin treatment, the maximial ratio of platelet aggregation (51.6 ± 10.1)%, the expression levels of P-selectin (6.8 ± 1.8) % and Fg-R ( 20.1 ± 5.8 ) % were significantly lower than those [(66.8 ± 11.4)%, ( 10.9 ±3.1 )% and (28.5 ±7.4)%] before amikacin treatment, but APTT (49.8 ±5.9) s and CT (660 ±59) s were remarkably higher than those [(26.9 ±3.8) s and (410 ±45) s] before amikacin treatment, respectively ( t = 5.456,8.875,7.423,10.012,11.322, P ＜ 0.01 ), while the GP Ⅱ b/Ⅲ a expression, PT and Ca2+ concentration had no significant changes ( P ＞ 0.05).Conclusions There are inhibitory effects of amikacin on platelet aggregation mainly through the inhibition of both fibrinogen receptor activation and secretion reaction of activated platelet. Amikacin may also inhibit pathway of coagulation system factor to prevent blood coagulation.Therefore, risk of hemorrhage may be investigated in the patients with amikacin for anti-infection treatment.

Objective To compare the short-term effect of laparoscopic surgery with open surgery for gastrointesti﹣nal stromal tumor. Methods 26 patients, whose tumor were localized and the pathologic diagnosis were gastrointesti﹣nal stromal tumor in stomach after surgery, were randomly divided into laparoscopic surgery group (n=12) and open surgery group (n= 14). The age and gender level, disease duration, clinical symptom, tumor location, and the lesion diameter were similar between the two groups (P> 0.05). Surgery achievement, intraoperative blood loss, operative time, postoperative hospital stay, postoperative flatus time, postoperative liquid time, and incidence rates of postoper﹣ative complications were compared between the two groups. Results All the patients get successful R0 resection. The volume of intraoperative blood loss, operative time, postoperative hospital stay, postoperative flatus time, and postop﹣erative liquid time in laparoscopic surgery group were lower than open surgery group (P< 0.05). There was no sig﹣nificant difference in the incidence rate of postoperative complications between the two groups (P> 0.05). Conclusion Compared with open surgery, the short-term effect of laparoscopic surgery were better for patients whose gastrointestinal stromal tumor in stomach were localized, and it is worth of promoting clinical application.

Stenosis with 55.2% cross section area reduction was introduced into the rabbit aorta. Using Evans blue dye and scanning microscope, we observed the morphology of endothelial cells and the permeability of endothelium to albumin in the stenotic aorta. Numerical simulation of blood flow in the stenotic aorta was performed to obtain the distribution of wall shear rate. The results showed that in the immediately proximal and distal vicinity of stenosis, blood flow was disturbed significantly, resulting in apparent changes in the morphology of endothelial cells and the permeability of endothelium to albumin. These changes were not only attributed to the value of wall shear stress, but also attributed to the flow pattern in the stenosis. The result therefore is in good consistent with the clinical observation that atherosclerosis often occurs in the areas where blood flow is disturbed and flow separation occurs.
Animals ; Aorta, Abdominal ; pathology ; Aortic Diseases ; pathology ; physiopathology ; Atherosclerosis ; etiology ; physiopathology ; Blood Flow Velocity ; Blood Pressure ; Capillary Permeability ; Constriction, Pathologic ; Endothelium, Vascular ; pathology ; physiology ; Hemodynamics ; physiology ; Hemorheology ; methods ; Male ; Models, Cardiovascular ; Permeability ; Pulsatile Flow ; physiology ; Rabbits ; Stress, Mechanical ; Tensile Strength

OBJECTIVETo understand the distribution of diarrheagenic Escherichia (E.) coli in population in Shanghai and discuss the practice model of cooperation in enteric infectious disease prevention and control between public health institution and hospital.

METHODSSentinel hospitals were assigned, standard detection and identification of diarrheagenic E. coli were conducted, incidence curve of diarrheagenic E. coli infection was drawn and epidemiologic survey and laboratory detection were conducted for suspect diarrheagenic E. coli infection outbreaks.

RESULTSA total of 7 204 stool specimens were collected from diarrhea patients in 4 hospitals during 2012-2013, in which 712 (9.9% ) were diarrheagenic E. coli positive, including 351 enteropathogenic E. coli (EPEC) strains, 292 enterotoxigenic E. coli (ETEC) strains, 32 enteroinvasive E. coli(EIEC) strains and 6 Shiga toxin-producing E. coli (STEC/EHEC) strains, as well as 31 mixed strains. EPEC infection mainly occurred in children aged 1-5 years; and all of these infections were caused by aEPEC. The incidence peak of ETEC infection was during August, the positive rate was >20%. The ETEC infection mainly occurred in infants aged 1-28 days in 2012 and in people aged 20-60 years in 2013 (P<0.05). ST was the major type (59.6%), followed by LT (27.8%) and ST/LT (12.6%). EIEC infection increased in children obviously in 2013 (P<0.01). No EHEC O157:H7 case was detected, but two EHEC O26:H11 (eae-hlyA-stx1a) cases in children were reported for the first time in Shanghai. The survey result indicated that the multidrug-resistant ETEC (STh-CS21-CFA/I-ClyA-EatA-ST2332-SHNL0005) strain causing outbreak in 15 newborns in Shanghai in 2012 was in the same clone as the strain detected in Zigong in Sichuan province.

CONCLUSIONSignificant change has occurred in diarrheagenic E. coli distribution in Shanghai in recent years, ETEC has potential risk to cause outbreak of hospital acquired infection in neonates and food borne infection. The active surveillance on ETEC and other enteric pathogens by both public health institutions and hospitals need to be improved.

Adult ; Child, Preschool ; China ; epidemiology ; Diarrhea ; microbiology ; Disease Outbreaks ; Enteropathogenic Escherichia coli ; isolation & purification ; Enterotoxigenic Escherichia coli ; isolation & purification ; Escherichia coli Infections ; epidemiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Middle Aged ; Sentinel Surveillance ; Young Adult

The BCL6 (B-Cell Lymphoma 6) gene is a proto-oncogene that is often expressed in diffuse large B-cell lymphomas (DLBCLs). BCL6 loss of function can kill DLBCL cells, demonstrating that BCL6 is necessary for the survival of DLBCL cells and could be a therapeutic target. In this study, we found that BCL6 protein levels were consistently upregulated in DLBCL tissues, whereas its mRNA levels varied randomly in tissues, suggesting that a post-transcriptional mechanism was involved in BCL6 regulation. We used bioinformatics analysis to search for miRNAs, which potentially target BCL6, and identified specific targeting sites for miR-10a in the 3'-untranslated region (3'-UTR) of BCL6. We further identified an inverse correlation between miR-10a levels and BCL6 protein levels, but not mRNA levels, in DLBCL tumor tissue samples. By overexpressing or knocking down miR-10a in DLBCL cells, we experimentally validated that miR-10a directly recognizes the 3'-UTR of the BCL6 transcript and regulated BCL6 expression. Furthermore, we demonstrated that negatively regulating BCL6 by miR-10a suppressed the proliferation and promoted apoptosis of DLBCL cells.
3' Untranslated Regions ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Gene Knockdown Techniques ; Humans ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; therapy ; MicroRNAs ; genetics ; metabolism ; Proto-Oncogene Proteins c-bcl-6 ; biosynthesis ; genetics