The paper presents a definition of a hospitals overall competitiveness and expounds its action mechanism, viz. the government plays a guiding role in competition, which constitutes the means via which the subjects of competition seek survival and development, the key basis for a hospital in working out its strategies, and the driving force for a hospitals development. Then it analyzes the features of and the factors affecting a hospitals overall competitiveness and sets forth the evaluation procedure, viz. establishing an evaluation index system, determining and normalizing the standard value for evaluating each index, giving each index a corresponding weight according to its importance and conducting comprehensive evaluation. Next the paper discusses ways of predicting a hospitals overall competitiveness. The steps include: making clear that the purpose of the prediction is to enhance the competitiveness of the hospital in the future, screening the data, selecting the method of prediction, setting up a mathematical prediction model, conducting prediction with the model and evaluating and modifying the evaluation results.

Objective To investigate the functional characteristic of adolescents with conduct disorder (CD) in the resting state.Methods Resting-sate fMRI (rs-fMRI) scans were administered to 28 male adolescents with CD and 28 age-,gender-and IQ-matched healthy controls (HCs).The rs-fMRI data were subjected to amplitude of low-frequency fluctuation (ALFF) analysis and ALFF values were compared between the two groups.Additionally,the region ROIs showed significant difference and correlation analysis was conducted between ALFF in each ROI and Barratt's scores.Results ① Compared to HCs,the CD group showed decreased ALFF (P＜0.005) bilaterally in the superior frontal gyrus,right middle frontal gyrus,right posterior cingulate gyrus,right inferior parietal lobule (MNI coordinates:-21,48,27;21,24,48;36,24,33 6,-36,39;48,-45,57 respectively) as well as increased ALFF (P＜O.005) in the left thalamus and left lingual gyrus (MNI coordinates:-15,-27,-3;-18,-87,-12 respectively).② There was no significant correlation between ALFF and Barratt's scores in ROIs.Conclusion The results suggest that CD is associated with abnormal intrinsic brain activity,mainly in frontal-parietal-occipital-limbic cortices,which is related to emotional and cognitive processing and behavioral functions.

Objective To explore the relationships of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) with growth of very low birth weight (VLBW) infants in the early postnatal stage. Methods According to the individual gestational age and birth weight, 32 cases of VLBW infants were divided into small for gestational age (SGA) group and appropriate for gestational age (AGA) group. After birth, all the infants were given the same nutritional intake. The body weight, body length, head circumference and body mass index (BMI) were monitored at different time points (d0, d7, d14 and d28 after birth). Serum IGF-1 and IGFBP-3 levels were measured by radiommunoassay, and IGF-1/IGFBP-3 molar ratio was calculated. Results There was no signiifcant difference of body weight, body length, head circumference and BMI between two groups at d0, d7, d14 after birth. Body weight and BMI in SGA group were less than those in AGA group at d28 after birth (P<0.05). The levels of IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in SGA group and IGF-1/IGFBP-3 in AGA group did not change with age after birth. The levels of IGF-1 and IGFBP-3 were increased in AGA group after birth. The level of IGF-1 in AGA group at d14 and d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The level of IGFBP-3 in AGA group at d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The levels of IGF-1 and IGFBP-3 in SGA group at d28 after birth were lower than those in AGA group at d28 after birth (P<0.05). Conclusions Serum IGF-1 and IGFBP-3 levels in SGA group are lower than those in AGA group. Low levels of IGF-1 and IGFBP-3 may result in growth retardation.

ObjectiveTo explore the correlation between angiotensin converting enzyme (ACE) gene polymorphism and hypertension accompanying atherosclerosis in Li people in Hainan province. MethodsTwo hundred and sixty patients with hypertension accompanying atherosclerosis were selected as hypertension plus atherosclerosis group, while two hundred and seventy-six healthy people were regarded as healthy control group. ACE I/D gene polymorphism was detected by polymerase chain reaction (PCR), and the genotype frequencies and allele frequencies of DD, DI and Ⅱ were investigated. The carotid intimal-medial thickness(IMT)was measured by high-resolution ultrasound technique and mean IMT (MIMT) was calculated. Results(1) In the hypertension plus atherosclerosis group, the genotype frequencies of DD, DI and Ⅱ were 15.0%, 37.3%, 47.7%,respectively, and the allele frequencies of D and I were 33.70% and 66.30%, respectively. In the healthy control group, the genotype frequencies of DD, DI and Ⅱ were 17.8% , 40.6% and 41.7%,respectively, and the allele frequencies of D and I were 38.0% and 62.0%, respectively. There were no significant differences both in the genotype frequencies of DD, DI and Ⅱ, and in allele frequencies of D and I between the two groups (P>0. 05). (2) The age,total serum cholesterol(TC),triglyceride (TG), systolic pressure(SBP), diastolic pressure(DBP), apolipoprotein A(apoA) and apolipoprotein B (apoB) levels were significantly higher in the hypertension plus atherosclerosis group than in the control group(P<0. 05). The high density lipoprotein cholesterol(HDL-C) level was significantly lower in the hypertension plus atherosclerosis group than in the control group(P<0. 05). Logistic regression analysis showed that TG (OR = 2.14), apoA(OR = 360. 39), SBP(OR = 1.21), DBP (OR=1.08) and ACE DD genetype (OR = 0. 30) had correlation with hypertension plus atherosclerosis(all P<0. 05). The MIMT level was significantly higher in ACE DD subset than in DI and Ⅱ subset (P<0.05). ConclusionsThe ACE DD genotype increases the susceptibility of carotid atheroselerosis, which is the risk factor for hypertension accompanying atherosclerosis in Li people in Hainan province. It may be an early predictive factor in atherosclerosis.

Objective: To explore the clinical application effects of autologous platelet-rich plasma gel in the repair of various chronic wounds. Methods: From January 2015 to January 2018, 76 patients with chronic wounds were admitted to our unit, with 39 men and 37 women, aged 28 to 75 (52±6) years. Before the operation, areas of wounds ranged from 2.0 cm×0.5 cm to 17.0 cm×5.0 cm, depths of wounds ranged from 1 to 6 cm, areas of wounds substrate ranged from 3 cm×3 cm to 17 cm×8 cm, and volumes of deep cavities ranged from 7 to 55 mL. All patients received operation 2 to 7 days after admission. Autologous platelet of 220-250 mL was collected from each patient by single extraction to make platelet-rich plasma of 10-50 mL. The cavity was filled completely by injection of platelet-rich plasma gel for 1-3 times. Wounds were sutured directly or covered by local flaps or other materials according to the conditions of wounds, and the unclosed wounds in primary stage were treated by continuous vacuum sealing drainage (VSD). Ultrasound, CT, or magnetic resonance imaging was performed to detect the healing of cavity after the operation. The healing of wound and repair of cavity after the operation and during follow-up were observed. Results: Wounds in 39 patients were closed directly after primary operation. Among them, wounds of 36 patients were healed completely, and wounds of the other 3 patients were healed completely after second debridement and topical filling of platelet-rich plasma gel. The cavities in 35 patients were filled with granulation tissue after treatment of platelet-rich plasma gel for 1-3 times combined with VSD, and the wounds were healed after skin grafting or flap transplantation. The treatment of wounds discontinued in the other 2 patients after treatment of platelet-rich plasma gel for once. Postoperative follow-up was lost in 7 patients. During follow-up of 2 and/or 4 months after the primary operation, wounds were healed well with no recurrence, and cavities were filled with fibrous tissue. Conclusions Autologous platelet-rich plasma gel has advantages in treating chronic wounds, including a large amount by single extraction, flexible use mode, ability to fully fill the complex cavity, high surgical safety, and mild secondary injury. It′s a new choice for repair of chronic wounds in clinic.

Purpose/Significance To summarize the research results of network pharmacology in traditional Chinese medicine(TCM)in recent years,and to propose a large-scale biomedical data analysis method in the era of artificial intelligence(AI),so as to provide ideas and references for the development trend and future application of network pharmacology in TCM.Method/Process Based on literature analysis,the research process of network pharmacology and its research progress in the material basis of TCM efficacy,mechanism of TCM efficacy and analysis of molecular mechanism of disease are reviewed.The application and trend of AI represented by graph neural network in TCM network pharmacology are discussed.Result/Conclusion The graph neural network is introduced into the research of TCM network pharmacology,and the AI model is used to further enrich the research methods of network pharmacology,ana-lyze the mechanism of TCM in depth,and provide technical support for the construction of modern TCM basic theoretical system.

Artificial joint replacement is an important means for the treatment of severe joint end-stage diseases such as hip and knee joint,which has obtained satisfactory clinical efficacy,but the postoperative periprosthetic osteolysis (PPO),which is mediated by wear particles,restricts the long-term effect of artificial joints.It is found that wear particles increase the expression of cytokines and inflammatory factors by stimulating the cells around the prosthesis,activate different signaling pathways,promote the imbalance between bone formation mediated by local osteoblasts and bone resorption mediated by osteoclast so as to lose of the local bone mass,and eventually produce osteolysis and aseptic loosening.This article reviews the different signal pathways activated by wear particles in recent years,in order to explore the pathogenesis of PPO and to open up new avenues for its prevention and treatment.

OBJECTIVETo observe the curative effects of platelet-rich plasma (PRP) combined with negative-pressure wound therapy (NPWT) on patients with sternal osteomyelitis and sinus tract after thoracotomy.

METHODSSixty-two patients with sternal osteomyelitis and sinus tract after thoracotomy, hospitalized from March 2011 to June 2015, were retrospectively analyzed. Based on whether receiving PRP or not, patients were divided into two groups, group NPWT ( 22 patients hospitalized from March 2011 to December 2012) and combination treatment group (CT, 40 patients hospitalized from January 2013 to June 2015). After debridement, patients in group NPWT were treated with continuous NPWT (negative pressure values from -15.96 to -13.30 kPa), while those in group CT were treated with PRP gel (blood platelet counts in PRP ranged from 1 450×10(9)/L to 1 800×10(9)/L, with 10-15 mL in each dosage) made on the surgery day to fill the sinus tract and wound, followed by NPWT. Negative pressure materials were changed every 5 days until 20 days after surgery in patients of both groups. PRP gel was replenished before changing of negative pressure materials in patients of group CT. The sinus tract sealing time, wound healing time, number of patients who had secondary repair surgery, number of patients who had recurrence of sinus tract within three months after wound healing, and length of hospital stay were recorded. Data were processed with t test, Fisher's exact test, and chi-square test.

RESULTSThe sinus tract sealing time, wound healing time, and length of hospital stay in patients of group CT were (16±8), (27±13), and (43±13) d respectively, which were all significantly shorter than those in group NPWT [(29±14), (41±17), and (60±20) d, with t values from 3.88 to 4.67, P values below 0.01]. The number of patients who had secondary repair surgery in group CT was less than that in group NPWT (P<0.01). There was no statistically significant difference in the number of patients who had recurrence of sinus tract between two groups (P>0.05).

CONCLUSIONSCompared with NPWT only, PRP combined with NPWT has great curative effects on patients with sternal osteomyelitis and sinus tract after thoracotomy, for it shortens sinus tract sealing time, wound healing time, and length of hospital stay, and avoids the secondary repair surgery. This method is simple and safe with little injury.

Debridement ; Humans ; Length of Stay ; Negative-Pressure Wound Therapy ; Osteomyelitis ; surgery ; therapy ; Paranasal Sinuses ; pathology ; Platelet-Rich Plasma ; Retrospective Studies ; Sternum ; surgery ; Thoracotomy ; Wound Healing

Objective:To investigate the effect of intranasal oxytocin administration on empathy in male adolescents with conduct disorder.Methods:The male adolescents with conduct disorder in the Psychological Counseling Clinic of the Second Xiangya Hospital of Central South University from September 2015 to August 2016 were selected.And they were randomly assigned to oxytocin group ( n=46) and placebo group ( n=51) by random number table. Subjects in oxytocin group were given nasal spray of 24 IU oxytocin twice per day for two weeks, while those in placebo group were given nasal spray of 0.9% sodium chloride solution for two weeks. The empathy of patients was assessed with a pain-related empathy task and interpersonal reactivity index (IRI) before and after two weeks′ administration. SPSS 20.0 software was used for statistical analysis, and repeated measurement analysis of variance was used to compare the empathy ability of the two groups before and after intervention. Results:Repeated measurement analysis of variance showed that there were significant time×group interaction effects in the scores of painful expressions during the pain-related empathy task ( F=13.86, P<0.001), IRI ( F=5.59, P=0.020) and empathic concern subscale ( F=4.99, P=0.028). There was significant between-group effect in the score of perspective-taking subscale of IRI( F=4.22, P=0.043). Simple effect analysis revealed that after two weeks of intervention, the score of needle-pain expression in oxytocin group was significantly higher than that at baseline ( t=-2.08, P=0.040). And the score of needle-pain expression in oxytocin group was significantly higher than that in placebo group ( t=2.33, P=0.022). After two weeks of intervention, the total IRI score ( t=-2.58, P=0.011) and empathy factor score ( t=-3.15, P=0.002) of oxytocin group were both higher than those at baseline. After intervention, the total IRI score ( t=2.30, P=0.024) and perspective-taking factor score ( t=2.57, P=0.012) in oxytocin group were higher than those in placebo group, and the differences were statistically significant. Conclusions:Oxytocin may improve the cognitive and emotional empathy in male adolescents with conduct disorder.

Objective:To explore the clinical strategies for preservation of the exposed implant in chronic wounds and wound repair.Methods:From January 2016 to January 2019, totally 8 patients (4 males and 4 females, aged 10 to 73 years) sustaining postoperative chronic wounds with exposed implants were admitted to the Fourth Medical Center of PLA General Hospital. There were 2 cases of abdominal patch exposure after abdominal trauma surgery, 2 cases of titanium plate exposure post craniocerebral surgery, 3 cases of internal fixator exposure post orthopedic surgery, and 1 case of cerebrospinal fluid drainage tube exposure after craniocerebral surgery. The wound exudate was collected for bacterial culture on admission. On the basis of glycemic control and correction of anemia and hypoproteinemia, thorough wound debridement was performed as soon as possible and the wound area after debridement ranged from 2.0 cm×0.5 cm to 6.0 cm×5.0 cm. The wounds of 4 patients were immediately closed after debridement, including 1 case by primary closure, 1 case by primary closure after local filling of platelet rich plasma gel, and 2 cases by local flap transplantation, with flap size of 10.0 cm×8.0 cm and 12.0 cm×8.0 cm, respectively. The donor sites of flaps were sutured directly and all the incisions were treated with continuous vacuum sealing drainage (VSD) after surgery. The other 4 patients were treated with continuous VSD after debridement to improve the wound bed. The wound of 1 case healed gradually, 1 case received direct wound suturing, and the wounds of 2 cases were repaired with thin split-thickness skin grafts from the thigh or the head. The results of bacterial culture of wound exudate on admission, wound healing post surgery, and follow-up were observed and recorded.Results:The bacterial culture of wound exudate on admission was positive in 6 patients, and 10 strains of bacteria were isolated with Staphylococcus epidermidis as the main pathogen. All the skin grafts or flaps of patients survived post surgery, with the incisions and wounds healed and all the implants preserved. After 1 to 3 years of follow-up, no recurrence of wound was found in any patient. Conclusions:The postoperative chronic wounds with exposed implants can be closed in primary stage by direct suturing or flap transplantation if it is clean enough on the basis of thorough debridement. The wounds with large defects or serious infection can be treated with continuous VSD firstly and then closed with direct suturing or skin grafting for delayed wound closure, thereby to reach the treatment goal of preserving the implants and repairing the wounds simultaneously.