1.LITHIUM RATIO IN LITHIUM CARBONATE TREATMENT OF MANIA
Journal of Chongqing Medical University 1986;0(03):-
This paper reports 39 cases of manic patients treated with lithium carbonate or lithium carbonate plus chlorpromazine. Levels of plasma lithium, sodium and potassium, erythrocyte lithium and lithium ratio -were determined when the blood lithium had reached the steady state and continued 4 weeks of treatment respectively. The mean duration of ditcontinuing chlorpromazine at the second time of determination in the combined drug group was 17?8.5 days.We found most lithium treated patients (83%) who got improvement or remission showed elevation of their lithium ratio. On the average, chlorpromazine can increase the erythrocyte lithium by 31 % and lithium ratio by 20%. Plasma lithium, erythrocyte lithium and lithium ratio were in positive correlation. Sex, family history, Plasma sodium and potassium level showed no correlation with their lithium ratio
2.Discussions on case-based payment practice in China and the overseas DRGs experiences
Shan WANG ; Keqin RAO ; Lihua LIU
Chinese Journal of Hospital Administration 2015;31(2):81-83
Discussed in the paper are case-based payment practice in China,and outcomes of this practice for the past ten years.The authors pointed out that compared with DRGs,such a practice is exposed to such risks as low coverage of diseases,incompatible policies,defective pricing method,and lack of comprehensive evaluation.It indicates that China is on the initial stage of case-based payment reform which should be promoted with reference to international experiences.
3.Current fundraising for NRCMS and sustainable fundraising strategies
Xiaoling YAN ; Hongguo WANG ; Hongjing CHEN ; Shan WANG ; Keqin RAO
Chinese Journal of Hospital Administration 2013;29(4):285-288
Dynamic and sustainable fundraising strategies are the prerequisite for the long-term and stable development of the New Rural Cooperative Medical Scheme(NRCMS).The paper analyzed the current situation and problems of NRCMS' fundraising,and proposed the principles for designing a sustainable financing strategy of NRCMS,and then its fundraising strategy.First,clarification of its fundraising sources and rational division of the sharing ratio of the funding bodies (individuals contributions account for 20%of the per capita fundraising) ; second,linking fundraising levels with net per capita net income(5 % ~ 6 %) of peasants; third,expansion of the service scope and level coordinated within NRCM.
4.Nicotine induced periodontal ligament fibroblasts (PDLFs) apoptosis through NF-κB and p53 path-way
Jun WANG ; Yan CAO ; Lili LI ; Keqin SUN ; Xianjiu CHEN
Journal of Chinese Physician 2011;13(1):5-8
Objective To study the signal transduction mechanism of nicotine induced periodontal ligament fibroblasts (PDLFs) apoptosis. Methods This study used 1 μg/ml, 10μg/ml and 100μg/ml nicotine to intervene PDLFs cells for 24h separately. NF-κB, p53, I-κB and Caspase3 expression were detected. Results After Nicotine was done on PDLFs cells for 24h, the transcription of p53, and Caspase3,and the translation of Caspase 3 protein were increased, while NF-κB was decreased. At the same time, the transcription of NF-κB decreased gradually with the concentration of nicotine increased ( r = 0. 707, F =33. 705, P <0. 01 ), nevertheless, I-κB was reversed ( r =0. 964, F =374. 883, P <0. 01 ). p53 expression was increased gradually with the concentration of nicotine increased ( r =0. 957, F = 153. 377, P <0. 01).Both Caspase3 mRNA (r =0.935, F =318.371, P <0.01) and protein (r =0.677, F =8. 459, P < 0. 05 )increased gradually. Conclusion Nicotine induced PDLFs apoptosis was mediated through NF-κB and p53 pathway.
5.Brain-derived neurotrophic factor gene G196A polymorphisms and the cognitive function of schizophrenia: a case-control study
Jinguo ZHAI ; Jun LI ; Min CHEN ; Jingping ZHAO ; Keqin WANG
Chinese Journal of Behavioral Medicine and Brain Science 2013;(6):494-496
Objective To explore the relationships between brain-derived neurotrophic factor gene G196A polymorphisms and psychopathology and the cognitive function in schizophrenic patients.Methods 224 patients and 220 normal controls were examined with polymerase chain reaction(PCR),denaturing polyacrylamide gel electrophoresis and silver staining to determine genotype and allele of G196A.Clinical symptoms were assessed with the Positive and Negative Symptom Scale (PANSS).Cognitive function was assessed with Wisconsin card sorting test (WCST) and Trail Making Test(CPT).To analyse the differences of the scores of Scale for the Assessment of Positive Symptoms(SAPS) and Scale for the Assessment of Negative Symptoms (SANS) among the patients with the genotype G/G,G/A and A/A.At the same time,the differences of the performance of WCST and CPT were analyzed.Results ①There were no significant differences of the genotypes G/G,G/A and A/A and allele G and A between patients and controls.②There were significant differences of the genotypes A/A between patients with Positive Symptoms and patients with Negative Symptoms (x2 =4.558,P < 0.05).③There were no significant differences in the performances of complete categorizations and persistent wrong numbers of WCST and the performances of CPT among three groups of patients with genotype G/G,G/A and A/A (One-Way ANOVA,all P > 0.05).Conclusion BDNF gene G196A polymorphisms are not associated with schizophrenia and the cognitive function but are associated with positive symptoms of schizophrenia.
6.Analysis of 96 cases with cesarean scar pregnancy
Ying ZHANG ; Yisong CHEN ; Jiajia WANG ; Zhiying LU ; Keqin HUA
Chinese Journal of Obstetrics and Gynecology 2010;45(9):664-668
Objective To investigate the clinical manifestation, diagnosis, therapies and medical economics of cesarean scar pregnancy (CSP). Methods From Jan. 2005 to Dec. 2008, 96 patients with CSP treated in Obstetrics and Gynecology Hospital of Fudan University were studied retrospectively. Those cases were divided into 3 groups. Thirty-three patients were treated with methotrexate (MTX) 50 mg/m2 intravenously guttae in group A. Among that 18 cases were treated with MTX, after 5 - 10 days they underwent dilation and curettage of uterus; 15 cases were given by dilation and curettage first if the level of serum human chorionic gonadotrophin-β(β-hCG) descent less than 30% in every 48 hours for 3 times after curettage, then MTX (50 mg/m2) intravenously guttae. Sixty patients were treated with MTX 100 mg bilateral uterine artery injection and embolization in group B. After 2 days, they underwent curettage.Group C: 3 patients were treated with laparotomy lesion excision. The following clinical parameters were compared, including blood loss( M), lesion diameter (-x±s), blood β-hCG level (M)before treatment, the number of cases with myometrial thickness anterior to the CSP ≤3 mm, the resistant index (RI) ≤0. 5,expense(-x ± s), hospital days(-x ±s) in those 3 groups. The correlation of blood loss with lesion diameter and blood β-hCG level was studied. Results ( 1 ) Clinical manifestation: bleeding loss were 20 ml in MTX +curettage of group A, 10 ml in curettage + MTX of group A, 12 ml in group B and 200 ml in group C. The volume of bleeding loss in group C was significantly higher than those in group A or group B ( P < 0. 01 ).The lesion diameter were ( 23 ± 15 ) mm in curettage + MTX of group A and ( 30 ± 14 ) mm of group B ,which were higher than ( 16 ± 8 ) mm of MTX + curettage of group A (P < 0. 01 ). The lesion diameter of (52 ± 7 )mm in group C were significantly bigger than those in the other groups ( P < 0. 01 ). The level of blood β-hCG levels were 21 592 U/L in MTX + curettage of group A, 979 U/L in curettage + MTX of group A,which reach statistical difference ( P <0. 05). The level of blood β-hCG levels were 11 312 U/L in group B and 101 U/L in group C. Among 28 cases with Rl≤0. 5,there was 8 cases in group A (24% ,8/33),18 cases in group B ( 30%, 18/60) and 2 cases in group C (2/3). Among 23 cases with myometrial thickness anterior to the CSP ≤ 3 mm, there was 21 cases in group B (35%, 21/60 ), which were significantly higher than 2 in group A (6%, 2/33 ) and none in group C ( P < 0. 05 ). The expense were ( 5578 ± 3679) yuan in MTX + curettage of group A and (5346 ± 2765 ) yuan in curettage + MTX of group,which did not reach statistical difference (P>0. 05). The expense were (7860 ±2104) yuan in group B,which were significantly higher than those in group A and (5004 ± 421 ) yuan in group C (P < 0. 05 ). The hospital days were ( 15 ±8) days and ( 19 ± 14) days of group A, ( 16 ± 10) days in group B and ( 17 ±8)days in group C, there was no significant difference among those treatments ( P > 0. 05 ). (2) Correlatin:there was positive correlation between bleeding loss and lesion diameter( r = 0. 31, P < 0. 05 ) or blood β-hCG level ( r = 0. 35, P < 0. 05). Conclusions MTX intravenously guttae, MTX uterine artery injection and embolization, and laparotomy lesion excision were all properly used in treatment of CSP. MTX uterine artery injection and embolization was recommended for those with big lesion, high β-hCG level, less myometrial thickness anterior to the CSP or plentiful blood supply of the lesion but the expense might be high.
7.Job satisfaction degrees and influencing factors among community nurses
Xiaohong REN ; Keqin HU ; Miaoqin WANG ; Miao LI ; Lingli REN
Modern Clinical Nursing 2017;16(7):1-5
Objective To explore job satisfaction degrees and the influencing factors among community nurses. Method General information questionnaire and the revised job satisfaction questionnaire were adopted in the investigation among 124 nurses from 28 community health service centers in Nanchong City between February to October 2016. Results The total score was (119.62 ± 15.37), at the moderate to high level. Of the eight dimensions, relationship with colleagues was scored the highest, and personal growth was the lowest. The influencing factors of the nurse's job satisfaction were found to be employment type, work positions, service duration in the community and whether they have been trained on community nursing position (all P<0.05). Conclusions The job satisfaction degree of community nurses is generally at middle level. Therefore, measures should be taken to improve the job satisfaction for the development of community nursing services.
8.Comparative study on satisfaction of young medical workers in Shanghai
Meng WANG ; Hong LIU ; Lan ZHOU ; Keqin RAO ; Chunlin JIN
Chinese Journal of Hospital Administration 2016;32(10):797-799
Objective To find out the satisfaction changes among young medical workers and explore the influence of the healthcare reform on such people.Methods A survey was conducted by means of random sampling among 716 medical workers under 45 years old from 6 hospitals,and combined with the survey data in 2009,young medical workers′satisfaction changes and the influencing factors were analyzed.Results Young medical workers′satisfaction is generally low,with declining satisfaction of social respect as well;satisfaction of medical workers in community medical institutions and secondary medical institutions was found declining dramatically.Conclusions Healthcare reform should pay more attention to these young people in terms of their own satisfaction,especially for those working at primary healthcare institutions.
9.Studies on the reform of payment system of grass-roots health care institutions in China
Linlin HU ; Yingnan CAO ; Ban WANG ; Yuanli LIU ; Keqin RAO
Chinese Journal of Hospital Administration 2015;31(2):87-90
The paper presented the payment system theory of the primary health care service in China,the current status of the health service system,and analyzed main challenges for the time being.Based on such studies,the authors made the following policy proposals.The first is adjustment of the fiscal payment method of the government to such institutions in line with the classification guidance principle; the second is to shift the payment method of primary public health services to the post payment of fee-for-service; the third is reform of the performance-based salary system to link payment to medical workers directly with the amount and quality of their services; the fourth is a set of result-oriented performance appraisal indicators,with rising proportion of performance pay; the fifth is to integrate the outpatient clinic fund covered by medical insurance and the primary public health service fund,into a capitation payment.
10.Effects of different doses of ulinastatin on platelets during normothermic cardiopulmonary bypass in rabbits
Keqin CHANG ; Daxuan YANG ; Guyan WANG ; Qinghua XUE ; Lihuan LI
Chinese Journal of Anesthesiology 2009;29(12):1079-1082
Objective To investigate the effects of different doses of ulinastatin on platelet counts and function after normothermic cardiopulmonary bypass (CPB) in rabbits. Methods Fifty lung-ear white rabbits aged 5-6 months weighing 2.3-3.0 kg were randomly assigned to one of 5 groups (n = 10 each) : control group (group C) and4 ulinastatin groups (group U~1, U_2,U_3,U_4). The rabbits received ulinastatin 1×10~4, 3×10~4, 5×10~4 and 10×10~4 U/kg before CPB in group U~1, U_2, U_3 and U_4 respectively while equal volume of normal saline was given instead of ulinastatin in group C. All rabbits underwent CPB for 30 min at perfusion flow of 72-120 ml·kg~(-1) ·min~(-1). The rectal temperature was maintained at 36.5-37.5℃. Hemodynamic parameters were recorded and blood platelet count, platelet adhesion rate and platelet membrane glycopretein Gp Ⅰ b, Gp Ⅱ b, Gp Ⅲ a receptors were determined before CPB (baseline), at termination of CPB and at 1, 2 and 3 h after CPB. Results The platelet counts were significantly decreased after CPB in all 5 groups (P< 0.05), but there was no significant difference among the 5 groups. The platelet adhesion rates were significantly decreased after CPB as compared with the baseline value before CPB in all 5 groups but the platelet adhesion rates were significantly higher after CPB in group U_4 than in group C. The number of molecules of Gp Ⅰ b, Gp Ⅱ b and Gp Ⅲ a receptors was significantly decreased after CPB in all 5 groups. The number of molecules of Gp Ⅰ b, Gp Ⅱ b and Gp Ⅲ a receptors after CPB was significantly higher in group U_2, U_3 and U_4 than in group C, and there was no significant difference between group U_3 and U_4 . ConclusionUlinastatin 3×10~4-5×10~4 U/kg administered before CPB can inhibit breakdown of platelet membrane glycoprotein receptors. Ulinastatin 10×10~4 U/kg can preserve the platelet adhesion function.