Based on the theory of organizational performance appraisal and the needs of developing China's hospital performance assessment system, the paper proposed the concept and emphasized the significance of establishing a comparative hospital performance assessment system in China. By sharing identical experiences from overseas, the paper also advocates that as China is building its comparative hospital performance assessment framework, it is imperative to verify the comparability of hospital performance assessment indicators, build a quality-centered comparative model for hospital performance assessment, and a three-tier comparative model to cover hospitals, departments and posts. These efforts will further improve China's performance assessment system.

Objective To construct a recombinant lentiviral expression vector for RNA interference (RNAi) of human Snail gene and to study its effects on the proliferation and invasion of nasopharyngeal carcinoma cell line 5-8F. Methods The effective sequence of short hairpin RNAs (shRNA) targeting Snail gene was designed and cloned into the linear pLVTHM vector after enzyme digestion. After confirmation by DNA sequencing, 5-8F cells were infected with the viral supernatants. The cells with stable Snail gene knock-down were separated by fluorescence activated cell sorter (FASC). The expression of Snail mRNA was detected by real time RT-PCR. MTT and cell invasion assay were used to detect the proliferation and invasion of 5-8F cells after plVTHM-siSnail transfection. Results The lentivirus vector plVTHM-siSnail was constructed successfully. The separated 5-8F-plVTHM-siSnail exhibited significant knock-down of Snail mRNA expression. Slower proliferation and decreased cells to permeate through the Matrigel were found after plVTHM-siSnail transfection (P

In this paper, the chloroplast psbK-psbI intergenic spacers of 18 species of Dendrobium and their adulterants were amplified and sequenced, and then the sequence characteristics were analyzed. The sequence lengths of chloroplast psbK-psbI regions of Dendrobium ranged from 474 to 513 bp and the GC contents were 25.4%-27.6%. The variable sites were 71 while the informative sites were 46. The inter-specific genetic distances calculated by Kimura 2-parameter (K2P) of Dendrobium were 0.006 1-0.058 1, with an average of 0.028 4. The K2P genetic distances between Dendrobium species and Bulbophyllum odoratissimum were 0.093 2-0.120 4. The NJ tree showed that the Dendrobium species can be easily differentiated from each other and 6 samples of the inspected Dendrobium species were identified successfully through sequencing the psbK-psbI intergenic spacer. Therefore, the chloroplast psbK-psbI intergenic spacer can be used as a candidate marker to identify Dendrobium species and its adulterants.
Chloroplasts ; DNA, Chloroplast ; genetics ; DNA, Plant ; genetics ; DNA, Ribosomal Spacer ; genetics ; Dendrobium ; classification ; genetics ; Plants, Medicinal ; classification ; genetics

Objective To assess the role of the different pancreatic islet β cell function index in the evaluation of glucose metabolism in different duration of type 2 diabetes mellitus (T2DM).Methods Normal glucose tolerance subjects without diabetes family history (NC group,48 cases) and T2DM patients (182 cases) were enrolled.The T2DM patients were divided into three groups:less than 5 years group (DM ＜5 group,74 cases),5-10 years group (DM5-10 group,51 cases) and more than 10 years group ( DM ＞10 group,57 cases).Oral glucose tolerance test (OGTT) and insulin release test were taken in all groups.Insulin resistance index (HOMA-IR) and whole body insulin sensitivity index [ISI(Matsuda)] were used to estimate insulin sensitivity,and early insulin secretion index ( △ I30/ △ G30) and glucose disposition index (DI) were used to evaluate the function of pancreatic islet β cell.Results HOMA-IR was increased and ISI (Matsuda) was decreased in DM ＜5 group,DM5-10 group and DM ＞10 group compared with those in NC group [HOMA-IR:8.78 ± 7.12,8.08 ± 3.67,7.84 ± 5.08 vs.4.76 ± 3.43;ISI(Matsuda):46.78 ± 29.00,36.71 ± 16.67,38.86 ±21.72 vs.61.13 ± 32.08,P ＜ 0.05],however,there was no significant difference among DM ＜5 group,DM5-10 group and DM ＞10 group.△ I30/ △ G30 and DI were decreased in DM ＜5 group,DM5-10 group and DM ＞10 group compared with those in NC group [ △ I30 △ G30:( 68.41 ± 361.52 ),(4.31 ± 3.42 ),(7.70 ± 5.78 ) mU/mmol vs.(92.65 ± 309.29) mU/mmol;DI:0.0421 ± 0.0123,0.0412 ± 0.0123,0.0363 ± 0.0116 vs.0.1151 ± 0.0236,P ＜ 0.05 ],and there was no significant difference in △ I30 / △ G30 among DM ＜5 group,DM5-10 group and DM ＞10 group,however,DI was decreased in DM＞10 group compared with that in DM＜5 group and DM5-10 group (P＜0.05).ConclusionsHOMA-IR,ISI (Matsuda),△I30/△G30 are not sensitive to evaluate the insulin resistance of different duration.DI can reflect the glucose utilization of pancreatic islet β cell earlier and the ability to regulate blood sugar steady state changes.

OBJECTIVETo observe the clinical effects of two different circumcision procedures with the Shang Ring and compare their advantages and disadvantages.

METHODSA total of 527 adult males with phimosis or redundant prepuce underwent Shang Ring circumcision by conventional outward replacement (n = 254) and inward placement (n = 273), respectively. We observed the in-ring nocturnal pain, complications, ring-removal pain, degree of edema, recovery time, and patients' satisfaction after surgery, and compared them between the two groups.

RESULTSCompared with the conventional outward placement (5.9%) of the Shang Ring, the inward placement method showed the advantages of mild in-ring nocturnal pain, a low complication rate, significantly reduced ring-removal pain, and mild edema, but exhibited longer healing time.

CONCLUSIONIn Shang Ring circumcision for phimosis and redundant prepuce in adult males, each of the outward and inward placement methods has advantages and disadvantages of its own, but the latter is more advantageous and feasible.

Adult ; Circumcision, Male ; adverse effects ; instrumentation ; Edema ; etiology ; Foreskin ; abnormalities ; surgery ; Humans ; Male ; Pain, Postoperative ; Patient Satisfaction ; Penile Diseases ; etiology ; Penis ; abnormalities ; surgery ; Phimosis ; surgery ; Prostheses and Implants ; Wound Healing

Objective To explore the individualized treatment strategies for ureterovesical junction (UVJ) stricture with stones. Methods The clinical data of 75 patients with UVJ stricture accompanied by stones in our department from Jan. 2010 to Jan. 2018 were retrospectively analyzed. Fifty cases were treated with internal urethrotomy and placed F5 double J tube, including 7 cases with dilation of UVJ through cystoscopy (2 cases were cut open 3-5 mm at UVJ), 41 cases with dilation plus lithotripsy through ureteroscopy (or holmium laser), and 2 cases accompanied by cysts at UVJ undergoing lithotripsy after transurethral ureterocele cystotomy. Twenty-five patients received conservative treatment, such as spasmolysis, diuresis and lithagogue after controlling renal colic. Results No stone or ureteral reflux was found in 7 cases with small stones treated with dilation of UVJ or the 2 cases accompanied by cysts at UVJ after one month of follow-up. No stone was found in 41 cases treated by dilation plus lithotripsy under ureteroscope after one month of follow-up. No stone was found in 25 cases with conservative treatment after 1-2 months of follow-up. Conclusion The stricture of UVJ should be regarded as a kind of disease and should be treated with internal urethrotomy or conservative methods according to the stone size and obstruction. For the patients with cyst at the UVJ, cutting cyst is appropriate.

AIM: To discuss the protective effects and possible mechanisms of 17β-estradiol on human retinal pigment epithelial ( RPE) cells induced by high glucose. ·METHODS: RPE cells were cultured and divided into four groups according to randomized controlled method:blank control group:the cells were treated with 5. 5mmol/L routine glucose medium for processing; high glucose group: cells were treated with 100mmol/L glucose for 12h;17β-estradiol low concentration group: after treated with 10 μmol/L 17β-estradiol, cells were treated with 100mmol/L glucose for 12h; 17β-estradiol high concentration group: after treated with 100 μmol/L 17β-estradiol, cells were treated with 100mmol/L glucose for 12h. Cell viability were tested by MTT colorimetric detection. Cells apoptosis were detected by Hochest33258 staining. Intracellular reactive oxygen species( ROS) level were detected by H2 DCFDA staining. Expression of CAT, SOD and MDA were tested by colorimetric detection. · RESULTS: RPE cell activity decreased with the concentration of glucose increased; 17β-estradiol inhibited high glucose-induced cell viability decrease in RPE cells, decreased the apoptosis rate of RPE cells and intracellular ROS generation; besides, 17β-estradiol significantly increased the expression of CAT, SOD and decreased the expression of MDA in RPE cells. ·CONCLUSION: The 17β-estradiol effectively inhibited high glucose -induced RPE cells damage, which provide reliable experimental basis for the treatment of injuries in RPE cells.

Glioma is the most common primary intracranial tumor, among which glioblastoma (GBM) is the most malignant subtype. Because of its high heterogeneity and invasiveness, GBM can't be completely removed by surgical resection and is also resistance to chemotherapy and radiotherapy. Even after a standard therapy, the median survival time is only 14.6 months, the five-year survival rate is less than 10%, and the relapse of GBM is common. Immunotherapy, a new treatment paradigm, treats cancer through regulating the autologous immune system and the tumor microenvironment. As a promising method to improve the prognosis of GBM, immunotherapy has attracted more and more attention. This paper gives a review to the difficulty, the mainly existing strategies and the bottlenecks in GBM immunotherapy, aiming at providing new direction to improve the prognosis of GBM patients.

BACKGROUNDIntertrochanteric femur fracture is common in elderly population. Though multiple treatment options are available, the choice of implant remains controversial. The reverse less invasive stabilization system (LISS) plating was introduced for treatment of a patient with ipsilateral intertrochanteric and midshaft femoral fractures. The aim of this research was to compare such technique to intramedullary nailing (proximal femoral nail, PFN) for intertrochanteric fractures.

METHODSFifty-six patients with an age of at least sixty-five years and an AO/OTA type-A1 or A2 fractures were included and divided into LISS and PFN treatment group.

BACKGROUNDparameters, fracture and surgery details were documented. Follow-up time was at least 12 months. Radiology, complication, Harris Hip Score and Rapid Disability Rating Score (RDRS) were recorded to evaluate fixation status and hip function for each patient during follow-up.

RESULTSThere was no significant difference between the two groups in surgical time ((48.0 ± 8.6) minutes, vs. (51.8 ± 10.8) minutes, P = 0.3836) and intraoperative blood loss ((149.1 ± 45.1) ml vs. (176.4 ± 25.4) ml, P = 0.0712). The LISS group had less postoperative haemoglobin (Hb) reduction ((10.2 ± 4.5) g/L Hb, vs. (15.1 ± 5.9) g/L Hb, P = 0.0475). There was no complication observed in PFN group. All 31A1 type fracture in LISS group showed 100% maintenance of reduction. One nonunion with locking screw breakage and 2 varus union were found in the LISS group. Postoperative hip function was similar between the two groups.

CONCLUSIONSThough reverse LISS plating may not be recommended as a routine fixation method for elderly unstable intertrochanteric fractures compared to PFN, it may possibly be reserved for rapid fixation and damage control in polytrauma patients and ORIF of subtrochanteric and reverse oblique intertrochanteric fractures.

Aged ; Aged, 80 and over ; Female ; Femoral Fractures ; surgery ; Femur ; surgery ; Fracture Fixation, Intramedullary ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Prospective Studies ; Treatment Outcome

This paper describes the design process and implementation process of electronic film system. The establishment of electronic film system allowed us to aggressively reduce film use and costs and to demonstrate a positive return.
Medical Records Systems, Computerized ; Radiology Information Systems ; instrumentation ; X-Ray Film