The paper covered the self-assessment practices of the hospital in the new round of accreditation.These include principles of Promoting hospital development and reform,and Balancing accreditation and development,Emphasizing Quality,Safety,Service,Management,and Performance,Centering on patients,and Focusing on Quality of Care and Medical Care Performance.The hospital adopted such means as enhancing hospital internal development,building the hospital-department twotier management responsibility system,upgrading quality of care and safety,and promoting sustainable development.The self-assessment has improved and tested the construction of quality control system of the hospital,while a better system further supports the accreditation of the hospital on the other hand.

ObjectiveTo investigate the relationship between polymorphism in the PITX3 gene and hereditary susceptibility of Parkinson's disease (PD). MethodsThree PITX3 single nucleotide polymorphisms ( SNPs ),including rs2281983,rs4919621 and rs3758549 were examined in 509 late-onset PD patients ( LOPD ),290 early-onset PD(EOPD) and 494 healthy controls.Genotyping was carried out in all subjects using a ligase detection reaction( LDR).ResultsAllele and genotype frequencies did not differ between the 799 PD patients and 494 controls ( P values of genotype were 0.494,0.343,0.951 ; P values of allele were 0.369,0.297,0.823 ),between 509 LOPD patients and 494 controls ( P values of genotype were 0.522,0.350,0.630 ; P values of allele were 0.413,0.328,0.571 ),between 290 EOPD patients and 494 controls ( P values of genotype were 0.499,0.492,0.552; P values of allele were 0.321,0.301,0.931 ),and between 509 LOPD and 290 EOPD patients ( P values of genotype were 0.577,0.710,0.127 ; P values of allele were 0.346,0.472,0.077 ) for all three SNPs (rs2281983,rs4919621 and rs3758549).There were no association petween the three PITX3 SNPs and PD.ConclusionThree PITX3 SNPs do not contribute to the risk of developing PD in Chinese population.

BACKGROUND:In spectral CT imaging study, the selection of scanning parameters is considered by most researchers, but the effects of measuring position are often overlooked. Actual measurement found that different measurement location had significant impact on the result of the measurement. Through measurement and mathematical model of a large amount of data, we can correct the measurement results of different location. The results with real data alignment are higher. OBJECTIVE:To explore effects of different measuring positions on results in spectral CT imaging, and to optimize correction coefficients. METHODS:GE standard water phantom was applied to orderly obtain 5 combined scanning parameters with 552 groups of data. Size measurement method was divided into two measuring range:ROI1 and ROI2. We selected 10 points to measure CT value, including Center, North, South, West and East. The measurement data of ROI1 and ROI2 were classified and screened based on the same sequence. Mathematical modeling and probability statistics analysis were used to optimize correction coefficient, get calibration function and draw experimental simulation curve. RESULTS AND CONCLUSION:(1) Measuring methods of ROI1 were superior to the ROI2’s on water phantom in spectrum CT. (2) To different scanning sequences, the measuring results were different. To the same scanning sequences, the measurements for different positions on water phantom in spectrum CT had remarkable influence on the measuring results, which varied from points to points. (3) Through setting up mathematical modeling, using method of statistical analysis, we could get the correction function on different measuring positions. (4) Above results confirmed that compared with the theoretical model and the experimental data of spectral CT scanning parameters, the coefficients of position can be adjusted, which can optimize the measuring results.

Objective To study the prevalence,treatment policy and control of hypertension in patients with maintenance hemodialysis, and to analyze the influencing factors of hypertension control.Methods We studied the current status of 1382 patients with maintenance hemodialysis in 11 dialysis centers in Shanghai, among them 809 were male, and 573 were female.Hypertension was defined as systolic blood pressure(SBP) ≥ 140 and/or diastolic blood pressure (DBP) ≥90 mm Hg ( 1 mm Hg = 0.133 kPa).Those who had a history of hypertension and requiring antihypertensive therapy were also diagnosed as hypertension though their blood pressure was within normal range during the survey.Hypertension control was defined as blood pressure ＜ 140/90 mm Hg before each dialysis session.Results The prevalence of hypertension in the hemodialysis patients was 86.3%.The treatment rate and control rate in those patients were 96.8% and 25.5% respectively.More than half (50.4% ) of patients were treated with only one kind of anti-hypertensive drug, and 34.4% with 2 kinds, 14.2% with 3 kinds, 1.0% with 4 kinds or more.Calcium channel blocker (CCB) was the most frequently prescribed drug (61.0%), followed by angiotensin Ⅱ receptor blockers ( 56.4% ), centrally acting anti-hypertensive agent ( 26.4% ), beta blockers and alpha, beta-blockers( 14.0% ).The control rate of hypertension in those hemodialysis people was aggravated by the existence of coronary artery disease.The patients who need more kinds of antihypertensive agents have a poorer control rate of hypertension.The hypertension control rate elevated significantly with the adequate hemodialysis.Conclusions There is a very high prevalence of hypertension in maintenance hemodialysis patients.Although the treatment rate is high, the control rate is unsatisfactory.So the control of hypertension in hemodialysis patient is still a clinical challenge.Appropriate dialysis adequacy, reasonable use of erythropoietin, treatment of heart disease and judicious use of antihypertensive drugs may be helpful to improve the clinical outcome.

To summarize the reform measures of nursing vertical management in our hospital under the background of diagnosis related groups,including refined performance management,cancellation of nursing main pharmacy classes,implementation of attending nursing working group,establishment of DRGs nursing quality control coder position,head nurse responsible for bed allocation,deepening nursing quality management and other measures,so as to provide references for other hospitals to carry out the reform of nursing vertical management under the background of DRGs.

Objective To summarize and evaluate the characteristics of current recurrent spontaneous abortion (RSA) animal models at home and abroad, and to provide reference and guidance for the standardized preparation of RSA models. Methods"Recurrent spontaneous abortion" and "animal model" were used as co-keywords in CNKI, Wanfang, VIP, PubMed and Web of Science databases to search the RSA animal experimental literature, covering the period up to January 20, 2024, and a total of 1 411 articles were collected. The analysis focused on construction methods and essential elements of RSA animal models, the modeling process and result evaluation, as well as the application of these models in pharmacological and pharmacodynamic research. An Excel table was established for systematic analysis and discussion. Results A total of 138 experimental studies were obtained after screening. In constructing RSA animal models, immunological models were the most widely used in Western medicine (96.92%), with the Clark model being the main one (92.31%). In traditional Chinese medicine (TCM) models, 70.00% were kidney deficiency-luteal inhibition-syndrome combination models, 20.00% were kidney deficiency and blood stasis models, and 10.00% were deficiency-heat syndrome models. Most animals were selected at 6-8 weeks (33.86%) and 8 weeks (32.28%) of age. The majority of animals were paired for mating at 18:00 on the day of cage pairing. In 81.03% of literatures, vaginal plugs were checked once the following morning, with 8:00 being the most common time (17.02%). The most commonly used drug administration cycle was 14 days of continuous gavage after pregnancy. Among the tested drugs, Western drugs were mainly protein-based (29.17%), while TCM drugs were mainly TCM decoction (81.11%). The most frequently used methods for detecting indicators included visual observation of embryos (22.54%), western blot (15.96%), PCR (13.58%), ELISA (12.91%), HE staining (10.80%) and immunohistochemistry (9.39%). Conclusion The etiology of RSA is complex, and corresponding animal models should be established based on different etiologies. Clark model is commonly used in the construction of Western medicine model, while the kidney deficiency-luteal inhibition-syndrome combination model is predominant in TCM. RSA animal model is widely used in related research, but systematic evaluation needs to be strengthened.

OBJECTIVETo evaluate the influence of extreme ambient temperature on mortality and years of life lost (YLL) in Chongqing.

METHODSThe daily mortality, meteorology and air pollution index data in Chongqing from the 1(st) January 2010 to the 31(st) December 2013 were collected. Distributed lag non-linear model (DLNM) was used to assess the influence of daily ambient temperature on daily number of deaths and daily YLL respectively. The delayed and cumulative effects of extreme temperature on sex, age, and cause-specific mortality were also assessed.

RESULTSThe relationships between ambient temperature and non-accidental, cardiovascular disease and respiratory disease mortalities and YLL were U-shaped or W-shaped. The effect of heat was obvious on that day, peaked on day 7, and lasted for two weeks, whereas the effect of cold was obvious a week later and lasted for a month. As 1 ℃ increase of ambient temperature, the cumulative relative risks (CRR) of high temperature across lag 0-7 days on non-accidental, respiratory disease and cardiovascular disease mortalities were 1.05 (95%CI: 1.03-1.07), 1.08 (95%CI: 1.05-1.11) and 1.05 (95%CI: 1.01-1.09) respectively. The effects of heat on YLL for each cause were 23.81 (95%CI: 12.31-35.31), 14.34 (95%CI: 8.98-19.70) and 4.43 (95%CI: 1.64-7.21), respectively. On cold days, 1 ℃ decrease of ambient temperature was correlated with an increase in CRR of 1.06 (95%CI: 1.04-1.08), 1.09 (95%CI:1.06-1.12) and 1.06 (95%CI: 1.02-1.11) from lag 0 to 14 for non-accidental, respiratory disease and cardiovascular disease mortalities, respectively. The estimated YLL were 23.34 (95%CI: 10.04-36.64), 16.39 (95%CI: 10.19-22.59) and 2.61 (95%CI: -0.61-5.82). People aged ≥65 years tend to have higher CRR and YLL than those aged <65 years. On high temperature days, the CRR in women was higher than that in men, while the YLL in women was lower than that in men. On low temperature days, both the CRR and YLL in women were higher than those in men.

CONCLUSIONSBoth high and low ambient temperature have adverse health effects. People aged ≥65 years are more sensitive to both high and low ambient temperature. Younger men are more sensitive to high ambient temperature and women and elder men are sensitive to low ambient temperature. It is necessary to take targeted measures to protect the population in Chongqing from the adverse influence of extreme ambient temperature.

Adult ; Aged ; Cardiovascular Diseases ; mortality ; China ; epidemiology ; Cold Temperature ; adverse effects ; Female ; Hot Temperature ; adverse effects ; Humans ; Life Expectancy ; trends ; Male ; Mortality ; trends ; Nonlinear Dynamics ; Respiratory Tract Diseases ; mortality ; Temperature

Objective    To investigate the diagnostic value and safety of electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound in peripheral pulmonary nodules. Methods    The clinical imaging, surgical and pathological data of 60 patients with 76 peripheral pulmonary nodules who underwent electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound guided biopsy in the Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from June 2020 to June 2021 were retrospectively analyzed. The diagnosis rate and complications were analyzed and summarized. The 76 pulmonary nodules were divided into a small pulmonary nodules group (10 nodules, diameter≤1 cm) and a pulmonary nodules group (1 cm