Objective: To explore health resource allocation and optimization and evaluate the clinical departments efficiency in hospital. Methods: Taking a three level of first-class hospital in Beijing for example, the method of data envelopment analysis (DEA) was used for building a DEA model of clinical departments efficiency in hospital. Results: Based on the results of the DEA model, we drawn the technical efficiency and scale efficiency of the target clinical departments, obtained input redundancy rates and output deficiency rates of the non-effective decision-making units. Conclusion:By DEA evaluation results, the input redundancy and output deficiency of the target clinical departments are found. From the perspective of optimizing hospital resource allocation, measures to improve the hospital operational performance are proposed. There is important significance to improve the comprehensive competitiveness of the hospital.

Neck shoulder pain or lumbocrural pain caused by intervertebral disc degeneration (IDD) could seriously affect the qualities life of patients. Current treatments mainly focus on alleviating pain and the symptoms of nerve compression, which could not radically stop the process of intervertebral disc degeneration, but conversely lead to high recurrence rate. In recent years, scholars have turned to study the biological treatment for repair and rebuild the intervertebral disc by biological molecular therapy, gene therapy, cell therapy and tissue engineering to solve the problem of intervertebral disc degeneration, while most of the above methods are still in animal experiments or in vitro experiments and the clinical application is still a long way to go.
Animals ; Biological Therapy ; Genetic Therapy ; Humans ; Intervertebral Disc ; metabolism ; Intervertebral Disc Degeneration ; genetics ; metabolism ; therapy

Objective:This study aimed to assess the efficacy of comprehensive laparoscopic surgical staging in early-stage ovari-an cancer, and provide references for clinical practice and research. Methods: Electronic databases, such as Embase, Medline, Co-chrane Library, CBM, and CNKI, were searched for studies on comprehensive laparoscopic surgical staging versus comprehensive lapa-rotomic surgical staging. Other sources, such as related references, were also retrieved. The literature was screened according to inclu-sion criteria. Data were extracted from the selected references, and the quality of the included studies was assessed. This meta-analysis was performed using RevMan 5.2 software. Results:A total of 11 studies involving 591 cases were selected, of which 235 cases be-longed to the laparoscopy group and 356 belonged to the laparotomy group. No statistically significant differences were observed be-tween groups in age, body mass index, clinical stage, histological type, and histological grade. The laparoscopy group had less intraoper-ative blood loss, earlier general diet intake, less postoperative complications, and lower postoperative recurrence rate than the laparoto-my group. No statistically significant difference was observed between groups in operation time, pelvic lymph node number (apart from pelvic and para-aortic lymph nodes), mortality. Conclusion:The results of this systematic review show that laparoscopic surgical stag-ing of early-stage ovarian cancer demonstrated staging adequacy and accuracy that were similar to those of laparotomic surgical stag-ing. Based on the principle of minimal invasion and radical treatment to tumor, laparoscopy showed more favorable operative outcomes than laparotomy.

OBJECTIVETo detect the expression level of interleukin 17 (IL-17) in the plasma and colonic mucosa of patients with ulcerative colitis (UC), and to explore the synergistic mechanism of qingchang huashi recipe (QHR) combined with Mesalazine.

METHODSRecruited were 24 mild or moderate UC patients of damp-heat inner accumulation syndrome (DHIAS). Their samples of intestinal tissues were histologically graded. They were assigned to the combination group and the Western medicine (WM) group, 12 in each group. Besides, another 12 healthy volunteers were recruited as the healthy control group. QHR combined Mesalazine were given to patients in the combination group, while those in the WM group took Mesalazine. The therapeutic course for all was 3 months. By the end of treatment the expression level of IL-17 in the plasma and colonic mucosa was detected using ELISA. The infiltration of IL-17 in the intestinal mucosal tissue was detected by immunohistochemical SP method.

RESULTSThe expression level of IL-17 in the plasma and colonic mucosa was significantly higher in UC patients than in healthy controls (P <0. 05). The higher the histological grading the higher the expression level. The expression level of IL-17 in plasma and colonic tissues decreased after treatment in the two treatment groups (P < 0.05). Besides, the expression level of IL-17 was lower in the combination group than in the WM group (P <0.05).

CONCLUSIONQHR combined Mesalazine could synergically enhance the effect and effectively inhibit intestinal inflammation through down-regulating the expression of IL-17.

Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Colitis, Ulcerative ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Immunologic Factors ; metabolism ; Inflammation ; metabolism ; Interleukin-17 ; metabolism ; Intestinal Mucosa ; drug effects ; Intestines ; metabolism ; Mesalamine ; therapeutic use

OBJECTIVE: To evaluate the safety and efficacy of FK506-based dual therapy and CsA-based triple therapy for immunosuppression after liver transplantation. METHODS: The literature about the randomized controlled trials (RCT) on FK506 and CsA for immunosuppression after liver transplantation was retrieved for analysis using RevMan 5.0 software. RESULTS: A total of 7 RCTs were included; 3 were considered as high quality of RCT, 4 as moderate quality. The results of Meta-analysis of FK506-based dual therapy indicated the patients’ survival rate (RR=1.06, 95%CI=0.77～1.45,P=0.72), grafts’ survival rate (RR=0.99, 95%CI=0.76～1.29,P=0.92), infection rate(RR=0.98, 95%CI=0.60～1.58,P=0.93)and incidence of neurotoxicity (RR=0.59, 95%CI=0.32～1.07,P=0.08)was not significantly different. The incidence of acute rejection in CsA group was lower than in FK506 group (RR=1.57, 95%CI=1.23～2.01,P=0.000 3). CONCLUSION: The curative efficacy of FK506 group is not different from that of CsA group in respect of rate of patient/graft, infection but increase the incidence of acute rejection. Because CsA can increase incidence of neurotoxicity, it is suggestion to treat patients of nervous systerm disease with FK506.

Objective To investigate the expression of apoptosis-related neuclosome assembly protein-1(NAP-1) gene in related brain region of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP) treated mice and beta-amyloid treated rats. Methods The animal models with central nervous system degeneration were established by consecutive administration of MPTP to C57BL mice and injection of beta-amyloid to brain ventricular of SD rats. The RNA in striatum and substantia nigra of mice and the RNA in cortex and hippocampus of rats were extracted. The levels of NAP-1 mRNA in these samples were estimated by RT-PCR. Results For mice, the expression of NAP-1 were decreased after MPTP treatment in substantia nigra, while its expression showed no significant change in striatum. In contrast, no effect on NAP-1 gene expression by beta-amyloid injection can be detected in cortex and hippocampus of rats. Conclusions The apoptosis of dopaminergic neurons in nigrostriatal pathway after MPTP treatment may be related to the expression of NAP-1 gene. But the mechanism of neurodegeneration after beta-amyloid injection in rats may be different.

Objective To explore the correlation between coagulation and coagulation suppresion system disorders of portal vein thrombosis in patients of portal hypertension undergoing splenectomy.Methods Clinical data of 33 patients with postoperative portal vein thrombosis were enrolled.The clotting and coagulation inhibitor in portal vein blood and peripheral blood was detected and analyzed.Results The Hb,APTT,FIB,factor Ⅶ,protein C,AT-Ⅲ,CD62P of portal vein blood and peripheral blood before the surgery and on postoperative day 1,day 7,day 14 were no significant difference (P ＞ 0.05).The WBC,PLT,PT,D-Dimer of in portal vein blood before surgery were (2.9 ± 1.4) × 109/L,(37.5 ± 20.7) × 109/L,(16.1 ± 2.9) seconds,(0.7 ± 0.3) μg/ml,which were significantly different from those on postop day 1 (13.7 ±4.4) × 109/L,(86.3 ±34.6) × 109/L,(6.9 ±5.7) seconds,(16.1 ±2.9) μg/ml; day 7 (10.7 ±4.3) × 109/L,(312.4 ±137.2) × 109/L,(14.4 ±2.9) seconds,(7.6 ±4.4) μg/ml and day 14 (7.7 ± 3.3) × 109/L,(486.3 ± 216.7) × 109/L,(14.4 ± 2.9) seconds,(5.5 ± 4.4) μg/ml (P ＜ 0.05).WBC,PLT,PT,D-Dimer in preop peripheral blood were (2.4 ±0.8) × 109/L,(44.4 ± 25.8) × 109/L,(16.3 ± 3.0) seconds,(0.6 ± 0.4) μg/ml,which were significantly different from those on postop day 1 (13.7 ± 5.7) × 109/L,(75.1 ± 29.3) × 109/L,(13.7 ± 2.6) seconds,(6.8 ± 5.3) μg/ml; day 7 (10.6 ± 4.8) × 109/L,(337.9 ± 141.3) × 109/L,(14.0 ± 2.1) seconds,(7.6 ± 5.5) μg/ml and day 14 (7.8 ±3.9) × 109/L,(504.9 ±237.4) × 109/L,(14.0 ±2.1) seconds,(5.4 ±4.9) μg/ml postoperative (P ＜ 0.05).Conclusions The cause of postsplenectomy portal vein thrombosis is multifactorial.The dysfunction of coagulation-coagulation suppression system was just one of the conditions conducive to portal vein thrombosis after splenectomy.

BACKGROUND:Preliminary studies have showed that vacuum sealing drainage based on wound surface dressing biomaterials is a good method to cover the wound as succedaneous peau when the soft tissuedefects along with open fracture cannot be completely repaired during the first operation. OBJECTIVE:To explore the efficacy of vacuum sealing drainage based on wound surface dressing biomaterials in repair of soft tissue defects of foot and ankle. METHODS:Fourteen patients with soft tissue defects of foot and ankle were treated using free skin graft combined with vacuum sealing drainage technique. Meanwhile, the traditional skin graft after wound dressing changes was applied in another 11 patients. The clinical outcomes were compared between two groups. RESULTS AND CONCLUSION:The transplanted skin in 10 cases of the vacuum sealing drainage group survived. The total survival rate was 71%, and surgical dressing change was applied in the left four patients to finaly cover the wound. By comparison, the transplanted skin in four cases of the traditional group survived. The total survival rate was 54%. To finish the wound, three of the left patients were turned to surgical dressing change and two of them stil needed skin graft operation once more. The total survival rate between the two groups has no statistical significance(P > 0.05). The therapeutic procedure noted that the time waiting for the secondary surgical visit, times for dressing change before the second intervention and the time for final union between the two groups were statisticaly different (P < 0.05). So the vacuum sealing drainage based on wound surface dressing biomaterials may accelerate the repair of soft tissue defects of foot and ankle when using the free skin graft operation.

Objective To investigate the clinical effects and complications of uterine artery embolization (UAE) therapy using different embolic agents in treating uterine adenomyosis. Methods During 2004—2011, a total of 45 female patients with uterine adenomyosis were admmitted to authors’ hospital to receive uterine artery embolization therapy. The embolic agents used in the procedures included domestic iodized oil, sodium alginate microspheres and Embosphere microspheres. The patients were randomly divided into group A (n=15, using domestic iodized oil as embolic agent), Group B (n=13, using sodium alginate microspheres as embolic agent) and group C (n = 17, using Embosphere microspheres as embolic agent). After the treatment, all the patients were followed up for over 2 years, focusing on the observation of the clinical symptoms such dysmenorrheal, changes of MRI signs and severe complications. The results were analyzed and compared among the three groups. Results After UAE, the clinical symptoms such as the degree of dysmenorrhea, menstrual quantity, etc. were improved in all patients. Six months after UAE, the obvious remission rate of dysmenorrheal in group A, B and C was 33.3% (5/15), 30.8% (4/13) and 41.1%(7/17) respectively. Twelve months after UAE, MRI scanning showed that the uterine sizes in group A, B and C were reduced to 49.19%, 48.25% and 50.05% respectively. Follow-up examination at 24 months after UAE showed that recurrence of dysmenorrheal in group A, B and C was seen in 2, 4 and 2 cases respectively, and amenorrhea was seen in 2 cases of group A and one case in group C. Conclusion The use of domestic iodized oil, sodium alginate microspheres or Embosphere microspheres as embolic agents in performing super-selective uterine artery embolization for adenomyosis can effectively relieve the degree of dysmenorrheal, decrease the uterine size. In addition to ovarian dysfunction, the uterine cavity adhesion may be also a possible cause of amenorrhea occurring after UAE may. In order to ensure a similar clinical efficacy, the use of granular solid embolic agent is preferred as its safety is possibly higher than the liquid embolic agents.

OBJECTIVE To investigate the genes associated with the drug-resistance to ?-lactam antibiotics in Pseudomonas aeruginosa(PAE) isolated from clinical patients in Huaibei,Anhui Province.METHODS Antibiotic sensitivity test was performed by VITEK-AMS.The three-dimensional method was taken to differentiate various beta-lactamases.The ?-lactamases and the outer membrane protein D2(oprD2) genes were detected by polymerase chain reaction(PCR) in 36 PAE strains.RESULTS In 36 PAE strains,the positive rates of genes of TEM,DHA,CTX-Ge and CARB were 77.8%,69.2%,27.8% and 25.0%,respectively,that of the OXA-1,OXA-10,VIM-2 and IMP-1 were 16.7%,16.7%,13.9% and 2.8%,respectively.The rate of lacking oprD2 gene was 58.3%,and none possessed VEB,SHV,GES,PER,GIM and SPM-2 genes.CONCLUSIONS P.aeruginosa carries various beta-lactamase genes in clinical patients of Huaibei,and the deletion ratio of oprD2 gene is higher.