3.Evaluation of medical efficiency before and after Sanming healthcare reform
Liang FANG ; Hao LI ; Zongfu MAO
Chinese Journal of Hospital Administration 2016;32(9):650-653
Objective To evaluate the medical efficiency of sample hospitals in Sanming city before and after Sanming health care reform.Methods One tertiary hospital,two general county hospitals and two TCM county hospitals in Sanming were sampled for the study.Two dimensions(the intensity index of medical work and work efficiency index)were selected.In addition,six indexes were identified,namely the number of discharged patients,number of outpatients and emergency diagnostics,doctor′s daily workload per capita for inpatients,bed turnover times,bed utilization rate and average days of stay.Descriptive trend analysis and comprehensive index method were applied in turn to evaluate the longitudinal changes in medical efficiency at the sample hospitals before and after the medical reform.Results The five sample hospitals in Sanming were found with less days of stay in average,and three were found with year-by-year rise of medical efficiency index,with one of them rising from 1.57 to 2.42.Conclusions Sanming′s health care reform has effectively improved internal operational efficiency at the sample hospitals,and has well addressed the relationship of medical service efficiency and scale expansion.On the other hand,the relationship between work intensity and medical efficiency needs to be further balanced,resource allocation to be further optimized,and more priority to be put in the development of TCM hospitals.
4.Biological Characteristics of Human Colon Cancer Cell Line CW-2 Stem Cells
Mei LIU ; Liang AI ; Mi CHEN ; Hao LONG ; Shaolin LI
Journal of China Medical University 2010;(6):417-419
Objective To isolate cancer stem cells from human colon cancer cell line CW-2,and observe the biological characteristics.Methods The percentage of CD44+EpCAM+ cancer stem cells which were isolated by multi-combination method was evaluated by flow-cytometry.The biological characteristics of the stem cells were analyzed by cell cycle analysis,in vitro invasion assay and in vivo tumorigenicity assay.Results The percentage of CD44+EpCAM+ cancer stem cells was 89.57%,and their capabilities of generation,invasion,tumorigenicity were higher than non-cancer stem cells(P 0.05).Conclusion CD44+EpCAM+ cancer stem cells showed low generation,high invasiveness,high tumorigenesis,and they could be isolated by multi-combination.
5.Expression of p53 protein and Ki-67 antigen and their significance in appendiceal mucinous neoplasms and pseudomyxoma peritonei
Zhenjun WEI ; Hongyi LI ; Hao LIANG ; Hongyan ZHANG ; Aitao GUO
Cancer Research and Clinic 2013;(4):234-237
Objective To investigate the relationship between the expression of p53 protein and Ki-67 antigen in order to detect its clinical characters and the significance of them in them occurrence and development of appendiceal mucinous neoplasms.Methods 42 tissues of appendiceal mucinous neoplasms were selected by pathological diagnosis in the department of pathology of the PLA general hospital from May 1993 to October 2007.The 10 samples of control group were obtained from simple appendicitis after surgery.Applied PV6000 immunohistochemical method,the expressions of p53 protein and Ki-67 antigen were detected.Results The expression of p53 protein in appendiceal mucinous neoplasms was higher than that in appendicitis tissue [31.0 % (13/42) vs 0 (0/10),x2 =4.127,P =0.042).The positive rate of p53 protein in appendiceal mucinous adenocarcinoma was higher than that in low-grade appendiceal mucinous neoplasm tissue (40.0 % vs 8.3 %,x2 =4.0218,P =0.044).The positive rate of p53 protein in appendiceal mucinous neoplasms tissue with pseudomyxoma peritonei was higher than that in tissue without PMP (45.5 % vs 15.0 %,x2 =4.5464,P =0.033).The expression of Ki-67 antigen in appendiceal mucinous neoplasms was higher than that in appendicitis tissue (45.2 % vs 10.0 %,x2 =4.2374,P =0.039).Considering the different factors (such as gender,age,pathological type and PMP),Ki-67 antigen expressions were still not significantly different (P > 0.05).In appendiceal mucinous neoplasms,the difference of positive rates of Ki-67 between the p53 positive expression group and the p53 negative group was statistically significant (x2 =7.6299,P =0.0057).Conclusion The expression of p53 protein was correlated with the expression of Ki-67 antigen.It's valuable that both p53 protein and Ki-67 antigen are used to evaluate the biological behavior of appendiceal mucinous neoplasms and predict the malignant degree.
6.P300 event-related potential of patients with vascular dementia
Lüli LI ; Xinjing LIN ; Hao LIANG ; Jidong XIAO ; Lixiang ZHANG
Chinese Journal of Tissue Engineering Research 2005;9(13):220-221
BACKGROUND:It is crucial for us to find an objective and sensitive means for the assessment ofthe severitv and development of dementia,so as to make instant diagnosis and examination of therapeutic effect on patientswith vascular dementias(VD).Event related potential endogenetic eomponent P300 is proved closely correlated with the cognitive management of examinees but not with stimulus property,thereby considered as one of the most valuable and objective index for brain superior psychological activity.OBJECTIVE:To study the role and significance of events related potential P300,providing objective basis for clinical diagnosis and therapeutic assessment for patients with VD.DESIGN:Non-randomized simultaneous controlled explorative study based on patients. SETTING:Neurological department and electromyography department in aprovincial hospital and neurological department in a medical college hospital.PARTICIPANTS:Between February 2000 and June 2001,64 patients were of VD at neurological clinic and ward ofthe Second Affiliated Hospital of Chongqing Medical College,including 38 males and 26 females with theaverage age of(66.0±4.6)years(VD group).Culturallevel:19 cases re-ceiyed over senior school education,31 cases of junior school education and14 cases of illiteracy.Meanwhile 60 inpatients without VD were enrolled(non-VD group)including 35 males and 25 females withthe average age of(68.0±3.7)years.Culturallevel:senior school or above,15 cases,junior school, 29 cases and illiteracy,16 cases.METHODS:Mental sate of both VD and non-VD groups were assessed with mini-mental state examination(MMSE),and tested with P300 potential observing the variability of latency and amplitude of P300 in patients.Both methods were compared between VD group and non-VD group, moreover relationship between P300 latency and MMSE scores was also explored.MAIN OUTCOME MEASURES:Variability of P300 latency and amplitude Relationship between P300 latency and MMSE scores.RESULTS:P300 latency was found prolonged in 74% and 7% of VD group and non-VD group respectively,with obvious significance between them,meanwhile prolonged P300 latency was proved closely correlated with the MMSE scores(r=0.609 6,P<0.05).CONCLUSION:P300 latency can be considered as an obiective predictor for the earlier diagnosis and the assessment of therapeutic effects in patients with VD.
7.The Inhibitory effect of dendritic cells modified by sCD40 on lymphocytes phenotypes and cytokines production
Jie-Feng HE ; Hao-Liang ZHAO ; Sheng-Li DONG ;
Chinese Journal of Organ Transplantation 2005;0(08):-
Objective To study the inhibitory effects of dendritic cells modified by sCD41)gene on T lymphocytes phenotypes and cytokines production and the mechanism of inducing donor-specific immune tolerance in vitro.Methods T lymphocytes prepared with Nylon Fiber Column from Balb/c mice(as reaction cells)and DCs of different groups(as stimulation cells)were subjected to primary mixed lymphocyte culture(MLC).After incubation for 7 days,the responsiveness of the cells was de- tected by MTS method at the indicated time points,and supernatants were assayed for IFN-?,IL-2, IL-4,IL-10 by ELISA kits.On the day 5,the cultured cells were assessed for the expression of CD4, CDS,CD25 and CD69 by using flow cytometry(FCM).After secondary MLC for 5 days,the same indexes were assayed hy using the same methods.Results Dendritic cells modified by sCD40 could in- duce the hyporesponsiveness to alloantigen in primary and secondary MLC.In primary MLC,the ex- pression of CD4~+ and CD8~+ T cells and CD4~+ CD25~+,CD8~+ CD25~+,CD4~+ CD69~+,CD8~+ CD69~+ T cells in IX;modified by sCD40 group were less than those in control group(P
8.Peroxisome proliferator-activated receptor γ nuclear translocation induced by focal cerebral ischemia-reperfusion in rats
Li SUN ; Yanwei XU ; Hao LIANG ; Guomin SUN ; Yan CHENG
Chinese Journal of Neurology 2010;43(7):512-515
objective To examine nuclear transIocation of peroxisome proliferator-activated receptor γ(PPARγ)in rats following focal cerebral ischemia/reperfusion(I/R),and to explore the significance of altered PPARγ,nuclear translocation in ischemic brain injury.Methods Healthy adult male SD rats underwent 60-min cerebral artery occlusion followed by reperfusion of 4,8,or 24 h,respectively.The cytoplasmic-to-nuclear shuttling of PPARγ was characterized by Western blot,immunohistochemical and immunofluoreseence staining.The effects of PPARγ agonist rosiglitazone (Ros) and antagonist GW9662 on I/R-induced PPARγ nuclear translocation were also examined in the present study. Furthermore,TTC staining war adopted to determine the change in cerebral infarction volume. Results (1)Western blot analysis revealed an increase of PPARγ in the nucleus and a simultaneous reduction in the cytosol following ischemia and reperfusion for 4 h(tcytosol=9.03,tmuclear=27.19,P=0.00).Prolonged the reperfusion further enhanced this I/R induced PPARγ translocation in a time-dependent manner.Using immunohistochemistry and immunofluorescence,nuclear PPAR γ positive staining increased from 48.3%in the sham control to 80.3% following ischemia and reperfusion for 24 h.(2)Western blot analysis revealed that PPARγ agonist Ros further increased I/R-induced nuclear enrichment of PPARγ,whereas PPARγ antagonist GW9662inhibited I/R-stimulated change in PPARγ.(3)When compared to the L/R group using TTC staining,Ros treatment significantly decreased the infarction volume by 48.40%(15.46±4.94 versus 29.96±3.39,t=5.93.P=0.00),whereas GW9662 increased by 58.95%(47.62±4.93 versus 29.96±3.39,t=7.23,P=0.00).Conclusions Cerebral I/R injury induces PPARγ translocation from the cytosol to the nucleus.This change may represent an intrinsic neuroprotective response against brain I/R injury.
9.The protective function of peroxisome proliferator-activated receptor gamma agonist to focal cerebral ischemia-reperfusion injury in mice model
Jinlin SHANG ; Li SUN ; Hao LIANG ; Yan CHENG
Chinese Journal of Neurology 2009;42(3):190-194
Objective To investigate neuroprotective function of peroxisome proliferator-activated receptor gamma (PPARγ) agonist, rosiglitazone against reperfusion injury after focal cerebral ischemia in mice model.Methods To establish cerebral isebemia-reperfusion injury mice model, adult male mice underwent 2 hours of middle cerebral artery occlusion followed by 22 hours reperfusion (MCAO/R). One hour before MCAO/R, mice were treated with either vehicle (MCAO/R group) or rosiglitazone (6 mg/kg, rosiglitazone group). 2,3,5-triphenyhetrazolium chloride (TIC) staining was applied to determine the volume of cerebralinfarction.TheneurologicaldeficitwasscoredatZeaLonga 5-pointscale. Myeloperoxidase (MPO) activity was measured in brain tissue as an index of neutrophil accumulation. RT-PCR, immunohistochemistry and Western blot were performed to examine the mRNA and protein expression of pro-inflammatory mediators (ICAM-1, IL-1β and COX-2).Results (1) The volume of cerebral infarction in rosiglitazone group was significantly decreased from that of MCAO/R group ( 29. 1 ± 6. 6 vs 57.8 ± 9. 7 ,t = 5. 980, P < 0. 01 ), and rosiglitazone markedly improved neurological function in treated mice than MCAO/R mice(1.2 +0.4 vs 3.3 ±0.8, t =5.812, P<0.01). (2) Compared with MCAO/R group, MPO activity in the rosiglitazone-treated group was significantly lower ((0. 049 + 0. 005 ) U/g vs (0. 083 ±0. 008) U/g,t =5. 904, P <0. 01 ). (3) The mRNA and protein expression of pro-inflammatory mediators (ICAM-1, IL-1β and COX-2) in rosiglitazone group were also significantly decreased from those in MCAO/R group, as demonstrated by RT-PCR (0.313 ±0.024, 0.205 ±0.007, 0.359 ±0.060, t = 7.464, 19.656, 29.319, P <0.01, respectively) and Western blot (0.274±0.014, 0.205±0.025, 0. 146±0.015, t=79.909, 21.392, 95. 105, P<0.01, respectively). ConclusionThe present study suggests that PPARγ agonist, rosiglitazone, has neureprotective properties to cerebral ischemia-reperfusian injury and that the protection is partially mediated via anti-inflarmmatory actions.
10.Clinical characteristics of elderly patients on maintenance hemodialysis in Anhui Province
Hu CHEN ; Deguang WANG ; Liang YUAN ; Li HAO
Chinese Journal of Geriatrics 2016;35(1):50-55
Objective To understand the clinical characteristics of elderly patients aged 60 years and over in Anhui Province who receive maintenance hemodialysis (MHD).Methods Clinical data of MHD patients in hemodialysis centers of 26 hospitals in Anhui Province from March 31, 2014 to January 1, 2014 were collected.With non-elderly MHD patients (aged over 18 old and under 60) serving as controls, similarities and differences in the primary disease, vascular access, nutritional status, mineral and bone disorders (MBD), and other related aspects in MHD patients were compared.Results The top three original diseases for elderly patients were chronic glomerulonephritis (CGN) (32.8 %), hypertensive nephrosclerosis (HNS) (27.7 %) and diabetic nephropathy (DN) (26.2%).The proportion of patients with DN and HNS in the elderly was higher than in the control group (P < 0.001).Vascular access types in elderly MHD patients were arteriovenous fistula (AVF) (89.4 %), tunneled cuffed catheter (TCC) (8.9 %), and temporary venous catheter (1.3%).The proportion of patients with AVF was lower (P<0.001) and the proportion of patients with TCC was higher (P<0.001) in the elderly group than in the control group.The incidence of anemia was higher in the elderly patients than in the control group (P<0.05);the proportion of elderly patients with hemoglobin (Hb) levels was 30.3%, in which had no significant difference as compared with the control group (P > 0.05).The incidence of hypoalbuminemia was 21.2% in elderly patients, which was higher than in the control group.The proportions of elderly MHD patients with normal levels of adjusted serum calcium, serum phosphorus, and intact parathyroid hormone (iPTH) were 52.0%, 27.9% (higher than in the control group, P<0.001), and 47.9%, respectively, while there was no difference in adjusted serum calcium and iPTH between the two groups (P>0.05).The treatment rates for low serum calcium,hyperphosphatemia and secondary hyperparathyroidism (SHPT) in elderly patients were 50.6%,51.6% and 71.5%, respectively, which had no significant difference as compared with those in the control group (P>0.05).Conclusions Elderly patients with MHD show distinct characteristics in primary diseases, vascular access types, and nutrition and MBD status, including higher proportions of HNS and DN as their primary diseases.The type of vascular access is still dominated by AVF, and the proportion of TCC is higher.The nutritional status is poor, with a lower incidence of high phosphorus and a higher incidence of low iPTH.Efforts should be made to promote compliance in elderly patients to better control MBD, improve nutritional status and increase safety and effectiveness of treatment.