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.

Alzheimer Disease ; drug therapy ; genetics ; prevention & control ; Amyloid beta-Peptides ; genetics ; Animals ; Disease Models, Animal ; Mice ; Mice, Transgenic ; Phytotherapy ; Presenilin-1 ; genetics

Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Murine-Derived ; Antigens, CD20 ; immunology ; Antineoplastic Agents ; therapeutic use ; Child, Preschool ; Female ; Humans ; Lymphoma, B-Cell ; drug therapy ; Rituximab ; Treatment Outcome

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

ObjectiveTo explore the effect of nursing management emergency project in the treatment of batches of wounded persons in sudden disasters.Method The overall emergency system was set up,the emergency project on nursing management was made including non-stop nosocomial transmission mode,standardization of nursing management in the wards,specialized nursing and individualized nursing for critically ill patients.Result All 139 injured were successfully rescued and discharged after a quick pre-hospital care and effective in-hospital care,with effective rescue time (33.5±19.6)min and the rescue success rate 100.0%. Conclusion The nursing management emergency project for sudden disasters is effective for rescuing batches of wounded persons and improving the success rate of rescue.

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.

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.

Objective This study discusses the effect of integrating method in the international students' basic chemistry class of medical colleges.Methods The integrating method was composed of the new teaching methods,such as PBL and micro-learning resources,and traditional method.The experimental group was composed of 76 students from the Class 1 of international students of Grade 2015 in clinical medicine of China Medical University,where integrating method was used,namely the teaching methods and means of problem based learning and micro class were integrated into the experimental courses,while the control group was composed of 80 students in Class 2 from the same major and grade,which was using the traditional method of teaching and practicing.A unified examination was applied to evaluate the teaching efficiency in both two groups and the teaching effect of the experimental group was investigated by questionnaire.The data was entered into SPSS 13.0 for two independent samples t-test.Results In the exams the students in the test group got higher scores than that in the control group.The average scores were (17.6 ± 4.5) and (16.0 ± 4.8) respectively (t=4.42,P=0.00),the differences were statistically significant.The effective recovery rate of the experimental group was 100％,and among them,97.4％ (74) of the students thought that they should continue to use the integrating teaching.Conclusion The application of integrating teaching in the course of basic chemistry experiment can improve students' comprehensive ability,and the effect is better than the traditional teaching.

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.

Objective To acknowledge the quality of life (QOL) in patients after lung transplantation and to explore related factors. Methods A cross- sectional study design and a convenience sampling were performed in this research. Totally 30 patients after lung transplantation were investigated. The questionnaires which used to explore the quality of life were Short Form 36 Health Survey Questionnaires (SF-36) and Revised Airways Questionnaires 20 (AQ20-R). Related state were surveyed by questionnaires consisted of demographic questionnaires, Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Medical Coping Mode Questionnaires (MCMQ). Statistical analysis was performed by SPSS 20.0 software. Correlation analysis and multivariate analysis were performed using Pearson linear correlation analysis and multi-linear regression. Results The scores among the 8 dimensions of SF-36 were(34.48±16.73)-( 71.63±22.83), lower than those of norms(Z=-9.684--2.817, P<0.05 or 0.01). Somatic pain scored the highest (71.63±22.83), while physiological function scored the lowest (34.48±16.73). The mean score of AQ20-R was 7.93±5.21. The major two problems that manifested QOL were: uncomfortable feeling of lung caused by strong scent, smog or perfume, exhausted feeling after having a cold. The mean scores of SAS and SDS were 44.33±9.33,48.05±9.80, higher than those of norms, which were 33.80 ± 5.90, 41.88 ± 10.57 (t=6.1833, 3.4458, P < 0.01). The scores among the 3 dimensions of MCMQ were 8.93 ± 2.08, 16.10 ± 2.28, 3.63 ± 1.33 and the differences were significant in 3 dimensions compared with those norms, which were 19.48±3.81, 14.44±2.97, 8.81±3.17(t=-27.7281, 3.9885,-21.3878, P<0.01). Conclusions In SF-36, role-physical of patients after lung transplantation was the worst dimension, while bodily pain was the best dimension of QOL. The QOL of patients after lung transplantation were almost worse than normal people. The related factors of QOL in patients after lung transplantation maybe:anxiety, depression and medical coping style.