Objective To investigate the percentage of CD4 + C125 +Tregs in peripheral blood of patients with sepsis and its effect on cell immunity so as to unravel the effect of immunomodulatory therapy on it. Method Fourty patients with sepsis in ICU were randomly (random number) divided into experimental group and control group . The patients of experimental group were treated with Ulinastatin and immunoregulation agent (Thymosin αl) as well. The blood specimens were collected just before treatment, 3 days and 8 days after treatment. The percentages of CD4 + CD25 + Tregs and lymphocyte subsets were detected by using FCM (flow cytometry), and TNF-α, IL-6 and IL-10 assayed by using ELISA, and APACHE Ⅱ scores were calculated. Results Before treatment, the percentage of CD4 + CD25 + Tregs increased, and the number of lymphocytes and the percentage of T lymphocytes decreased, especially the CD4 + T lymphocytes and CD4+/CD8+ decreased more markedly, and the levels of IL-6 and TNF-α increased. After treatment,the percentage of CD4+ CD25 + Tregs was decreased, the number of lymphocytes and CD4 +/CD8 + increased, and the levels of APACHE Ⅱ score, IL-6 and TNF-α decreased especially in the experimental group decreased more significantly (P ＜ 0. 05). Conclusions The percentage of CD4 + CD25+ Tregs in peripheral blood can reflect the immune status of patients with sepsis and become a novel indicator to estimate the progress of sepsis, and the immunity and prognosis of patients. Treating the patients with Thymosin αl and Ulinastatin can raise their immunity, decrease the levels of IL-6, TNF-α and APACHE Ⅱ score and improve their prognosis.

Objective To compare the effects and cost of peripheral intravenous catheter (PIV) and peripherally inserted central catheter (PICC) on very low birth weight infants (VLBWI).Methods From July 2013 to August 2015,95 VLBWI with PICC (PICC group) and 90 VLBWI with PIV (PIV group) admitted to the Neonatal Intensive Care Unit (NICU) of Changzhi Maternal and Child Care Hospital were included in the analysis.The two groups were compared in body mass increase,average length of hospital stay,incidence of catheter-related complications,and care cost and effect.Results The body mass increase per weak was higher in the PICC group than in the PIV group,with statistically significant difference (P ＜ 0.05).The average length of hospital stay in the PICC group was shorter than that in the PIV group [(48.2 ± 5.2) d vs.(53.2 ± 8.1) d,P ＜ 0.05].The incidence of catheter-related complications was lower in the PICC group than in the PIV group (35.4％ vs.44.9％),including phlebitis (PICC group,21 person-times;PIV group,169 person-times),liquid leakage or exosmose (PICC group,2 person-times;PIV group,185 person-times),and catheter prolapse (PICC group,3 person-times;PIV group,145 person-times) with statistically significant differences (all P ＜ 0.05),and catheter blockage (PICC group,7 person-times;PIV group,84 person-times) and other complications such as venous embolism and infection (PICC group,1 person-time;PIV group,3 person-times) with no statistically significant differences (all P ＞ 0.05).The average monthly cost in the PICC group (1 951.5 yuan) was lower than that in the PIV group (2 008.5 yuan),and the cost of single insertion in the PICC group (1 691.5 yuan) was higher than that in the PIV group (129.9 yuan),the cost-effectiveness was better in the PICC group than in the PIV group (30.22 vs.36.45).Conclusions For VLBWI,PICC can reduce the times of venous puncture,the incidence of complications,and promote body mass increase.However,the monthly cost was similar between the two groups in this study,possibly because of the short-time of this study.The advantages in cost-effectiveness of PICC may become more prominent when the catheter dwelling time extends.

Objective To study the impacts and the difference made by the pilot reform and comprehensive reform of clinic-pharmacy-separation on the medical visit behaviors of outpatients in Beijing.Methods Invoice information of outpatients′ fee payment during the December 2012 reform and April 2017 reform at the hospital was collected.Information of these patients at the same time as controls was collected to analyze patients′ fee categories, so as to study the effect on the behavior of these patients.Results The outpatient visits decreased by 5.29% as a result of the pilot reform.The ratio of medical insurance patients rose by 6.86%, and that of such patients seeking only prescriptions rose by 4.30%;number of outpatient visits decreased by 2.03% after the comprehensive reform, while the ratio of medical insurance outpatients dropped by 2.61%, and those seeking prescription only dropped by 2.54%.Conclusions The comprehensive reform of clinic-pharmacy-separation has influenced the outpatient′s medical visit behavior, evidencing a positive outcome of the healthcare reform.

BACKGROUND:There is a lack of the research concerning the biocompatibility of nano-hydroxyapatite/polyphenylene sulfide (nHA/PPS) composites.OBJECTIVE:To evaluate the in vivo biocompatibility of nHA/PPS composites based on the completed research in vitro.METHODS:Systemic toxicity test:Sprague-Dawley rats were given the intraperitoneal injection of nHA/PPS extract or normal saline.The general situation,body mass and the histological changes of the liver and kidney were observed at 72 hours after injection.Delayed type hypersensitivity test:nHA/PPS extract or normal saline was injected subcutaneously into the back of the rats.Afterwards,skin irritation symptoms were observed at 72 hours.Local reaction experiment:nHA/PPS composites and polyethylene were respectively implanted into the back of the rats.The pathological changes of the implanted materials and their surrounding tissues were observed at 15 and 30 days after implantation.RESULTS AND CONCLUSION:(1) The rats were in good situation after nHA/PPS injection;the body mass increased steadily,which showed no significant difference from the control group (P ＜ 0.05);the morphology and color of the liver and kidney were normal,and the systemic toxicity of the composite materials was normal according to the degree of toxicity classification.(2) There were no obvious skin irritation symptoms after the subcutaneous injection of nHA/PPS composites,and the primary irritation index was less than 0.4,suggesting a low hypersensitivity.After implantation of nHA/PPS composites,there was no obvious degradation,absorption and rejection,and both the degree of inflammatory reaction (15 days ≤ level Ⅲ,30 days ≤ level Ⅱ) and the thickness of fibrous capsule (15 days ≤ level Ⅲ,30 days ≤ level Ⅱ) revealed the good biocompatibility of the composites.These results suggest that the nHA/PPS composites hold an excellent biocompatibility in vivo.

Recurrent laryngeal nerve (RLN) injury can result in unilateral or bilateral vocal cords paralysis, thereby causing a series of complications, such as hoarseness and dyspnea. However, the repair of RLN remains a great challenge in current medicine. This study aimed to develop human umbilical mesenchymal stem cells (HuMSCs) and nerve growth factor (NGF)-loaded heparinized collagen scaffolds (HuMSCs/NGF HC-scaffolds) and evaluate their potential in the repair of RLN injury. HuMSCs/NGF HC-scaffolds were prepared through incorporating HuMSCs and NGF into heparinized collagen scaffolds that were prefabricated by freeze-drying in a template. The resulting scaffolds were characterized by FTIR, SEM, porosity, degradation in vitro, NGF release in vitro and bioactivity. A rabbit RLN injury model was constructed to appraise the performance of HuMSCs/NGF HC-scaffolds for nerve injury repair. Electrophysiology, histomorphology and diagnostic proteins expression for treated nerves were checked after application of various scaffolds. The results showed that the composite scaffolds with HuMSCs and NGF were rather helpful for the repair of broken RLN. The RLN treated with HuMSCs/NGF HC-scaffolds for 8 weeks produced a relatively normal electromyogram, and the levels of calcium-binding protein S100, neurofilament and AchE pertinent to nerve were found to be close to the normal ones but higher than those resulted from other scaffolds. Taken together, HuMSCs/NGF HC-scaffolds exhibited a high score on the nerve injury repair and may be valuable for the remedy of RLN injury.
Collagen* ; Dyspnea ; Electrophysiology ; Heparin* ; Hoarseness ; Humans* ; In Vitro Techniques ; Intermediate Filaments ; Mesenchymal Stromal Cells* ; Nerve Growth Factor* ; Paralysis ; Porosity ; Recurrent Laryngeal Nerve Injuries* ; Recurrent Laryngeal Nerve* ; Spectroscopy, Fourier Transform Infrared ; Umbilical Cord* ; Vocal Cords

The teaching laboratory is the central place to teach lab courses to undergraduate students. It is thus critical to evaluate how lab skills of students will be affected by the management of this lab. This study attempts to introduce the 6S concept, referring to "Seiri", "Seiton", "Seiso", "Seiketsu", "Shisuke", and "Safety", to the management of teaching laboratory, in particular, to the management of environments, safety, item deposition, reagents and consumables in the laboratory. We find that applying the "6S" management maintains a tidy lab environment, facilitates teaching the lab skills, and improves the quality of teaching, which together achieves the goal of education with the atmosphere. This study can provide a guideline for establishing and managing teaching laboratories in universities.
Education ; organization & administration ; standards ; Environment Design ; Humans ; Laboratories ; organization & administration ; standards ; Students ; Universities ; organization & administration ; standards

The authors compared and analyzed the guidelines and the index system of public hospitals as stated in such papers as " State Council′s Opinions on Performance Evaluation of Tertiary Hospitals" (No.4 Document of State Council, 2019)and " Guidance on Strengthening the Performance Evaluation of Public Hospitals" (No.94 Document of Guo Wei Ren, 2015). Based on their studies, this paper summarized the commonness and law of development of the two editions of the indexes. They proceeded on such basis to collect data from over 3 600 medical institutions of tertiary hospitals in Beijing and the rest of China before and after the drug-clinic-separation reform in Beijing, National tertiary public hospitals and analyzed key indexes to learn the guidelines and impacts of the 2019 edition on hospital management. The performance indexes of the 2019 edition highlight the public welfare of public hospitals, strengthen the functional orientation of tertiary public hospitals, and point out the direction for further healthcare reform. These papers have a far-reaching impact on hospital strategy and management mode, guiding public hospitals to change their concepts and take on dual responsibilities of public welfare and self-development.

In order to explore the role of the opening and sharing management mode (OSMM) of undergraduate experiment teaching instruments in fostering talents under the "Double first-class" initiative, the importance of laboratory information management system (LIMS) in the OSMM was discussed, in light of the experience and shortcomings of developing an OSMM in the experimental teaching center of environment and ecology college at Xiamen university. Some approaches were put forward to promote OSMM development and improve the utility of teaching equipments, so as to maximize the utility of the instruments, guarantee the regular teaching and scientific research, promote the sustainable and healthy development of colleges and universities, and achieve the desirable progress of the ongoing national "Double first-class" initiative.
Humans ; Information Management ; Laboratories ; Students ; Universities

Objective:To explore the differences of clinical features and surgical efficacy between the elderly and the middle-aged and young patients with meningiomas in the central cortex area.Methods:Forty-three elderly patients with meningiomas in the central cortex area (≥60 years old) and 63 middle-aged and young patients with meningiomas in the central cortex area (18-59 years old), accepted surgery in Department of Neurosurgery, Guangdong 999 Brain Hospital from January 2011 to December 2020, were chosen. The differences of symptom, gross tumor volume, peritumoral edema degrees, intraoperative blood loss, tumor resection degrees, complications, and hospital stays between the 2 groups were analyzed.Results:The elderly patients had significantly higher proportion of preoperative muscle strength decline, lower proportion of preoperative headache, larger preoperative tumor volume, more severe peritumoral edema degrees before and after surgery, small volume of intraoperative blood loss, and longer hospital stays compared with the middle-aged and young patients ( P<0.05). However, no significant differences in distributions of tumor resection Simpson grades, proportion of new neurological dysfunction, incidence of postoperative complications, and proportions of reoperations and tumor recurrence were noted between the 2 groups ( P>0.05). Significant difference in distributions of peritumoral edema degrees among patients with different WHO grades was noted in the elderly group ( P<0.05), and significant difference in distribution of peritumoral edema degrees among patients with different tumor volumes was noted in the middle-aged and young group ( P<0.05). Conclusions:Although differences in clinical characteristics exist between the elderly and the middle-aged and young patients with meningiomas in the central cortex area, no significant difference in surgical efficacy is noted between the 2 groups. The peritumoral edema degree in the elderly patients is related to tumor pathological grades, while that in middle-aged and young patients is related to tumor volumes.