Objective: To assess and analyze the operation efficiency of 8 commission general public hospitals managed directly by National Health and Family Planning Commission and 8 municipal general hospitals managed directly by Beijing Municipal Administration of Hospitals in Beijing and to provide suggestions on improving service capacity and designing relevant health policy.Methods: Input and output data of 8 commission hospitals and 8 municipal hospitals were obtained from Beijing Direct-Reported Health Statistics data from 2011 to 2014.Data envelopment analysis was used as the hospital operation efficiency measurement tool.The CCR and BCC models were built to calculate technical efficiency (TE), pure technical efficiency (PTE), scale efficiency (SE) and the status of scale efficiency of 16 hospitals in 2011 and 2014;the Malmquist index model was built to analyze the total factor productivity change (TFPC), technological change (TC), technical efficiency change, pure technical efficiency change and scale efficiency change of the 16 hospitals from 2011 to 2014.Results: In 2011, the TE, PTE and SE of the commission hospitals were higher than those of the municipal hospitals, and the TEs of the commission hospitals and the municipal hospitals were 0.918 and 0.873 respectively.In 2014, the TE, PTE and SE of commission hospitals were lower than those of the municipal hospitals, and the TE of the commission hospitals and the municipal hospitals were 0.906 and 0.951, respectively, which was contrary to the results in 2011.According to the Malmquist index model, the average of TFPC of the municipal hospitals was larger than that of the commission hospitals, the former increased 5.9% and the latter increased 2.8% per year;the average of TC was greater than the one in both the municipal hospitals and the commission hospitals, with a growth of 3.2% and 2.9% per year, respectively;the average growth of PTE in the commission hospitals was lower than that of the municipal hospitals, and the average descent of SE in the commission hospitals was larger than that in the municipal hospitals.Conclusion: There are significant differences in the operation efficiency between different management systems and the main factors associated with operation efficiency are the technological and management level.Given scale efficiency status and macroeconomic medical policies, the commission hospitals and the municipal hospitals require further adjusting the distribution of medical resources, and it is of great significance for all the commission hospitals and the municipal hospitals to improve the management level and resource integration capability.

Objective:To explore the association between different urbanization levels and non-commu-nicable diseases (NCDs)in China and provide suggestions on designing relevant health policies in the ur-banization process.Methods:We obtained health-related data from China Health and Retirement Longi-tudinal Study (CHARLS)201 1 .This study used multistage sampling in design stage and covered 1 50 districts/counties,representative at the levels of the country.Geo-information system (GIS)method was used to get district areas data,and in combination with the Sixth National Census population data,we computed the population density which was regarded as the proxy variable of urbanization level in every city.The Logistic model was used to explore the effect of urbanization level on hypertension,diabetes, smoking,drinking,overweight and obesity.Results:Compared with other cities in China,Shanghai and Shenzhen,with the population density of more than 3 000 people per km2 ,were the cities with highest urbanization level.From the map of urbanization distribution across China,it was found that the urbani-zation levels of the northwestern districts were lower than those of the southeastern and coastal districts. The hypertension rate increased with the development of urbanization but there was no statistical signifi-cance.The proportion of patients with diabetes went up first and then saw a decrease trend in the process of urbanization.Drinking rate,overweight rate and obesity rate had similar trends,falling to their lowest point when urbanization level equaled 737,1 1 86 and 1 353 people per km2 respectively and then ex-perienced upward trends.By contrast,smoking rate declined first and then went up (the turning point was 1 029 people per km2 ).Conclusion:Different urbanization levels have different effects on NCDs, health-related behavior,overweight and obesity.Low urbanization level may create negative impact on health while high level can pose positive effect and increase people’s health condition possibly due to the improvement of health care accessibility and the quality of living environment.Policy-makers should spe-cially focus on different residents’health problems in different periods of urbanization,such as the impact of environmental pollution,health resources’allocation and accessibility of health services.It is necessa-ry to reduce or avoid the negative effect of urbanization on NCDs during the local development process to face the NCDs’threat.

Objective:To explore the feasibility of screening for major fetal heart disease by training sonographers in township or county level hospitals .Methods:Training of B ultrasound scan for congeni-tal heart defects was given to the sonographers from one county hospital , and thirteen township hospitals ( or the district hospitals ) , and training of fetal echocardiography was given to sonographers from four city/county hospitals.The trained sonographers who had passed the examinations and had obtained quali-fications after six months of independent practice began to screen fetal congenital heart defects .To evalu-ate the effectiveness , sensitivity and specificity of screening was calculated by using the diagnosis of ex-pert neonatal/fetal echocardiographers as the gold standard .Results: A total of 3 425 fetuses received one fetal B ultrasound screening , one fetal echocardiography and one neonatal echocardiography from April 1, 2004 to December 31, 2005.One hundred and sixty-five B ultrasound screening images (4.9%) from township hospitals and fifty-six fetal echocardiography images (1.7%) from county or city centers couldn ’ t be reviewed because of poor quality .The sensitivity of fetal B ultrasound screening in the township and county hospitals was 30%and 0, and the specificity 93.3%and 99.9%, respectively. Nine fetuses with a major congenital heart disease were eventually found by the trained sonographers , and two cases were misdiagnosed and two unnoticed .The total sensitivity and specificity of fetal echocardio-graphy were 81.8% and 99.9%, respectively.The sensitivity in the county and city hospitals was 66 .7% and 100%, respectively .The specificity in the county and city hospitals was 99 .9%and 100%, respectively .Conclusion: Under the current circumstances , township hospitals are unable to perform effective fetal cardiac screening .Screening on fetal congenital heart disease is suggested to be taken by trained sonographers in county and city level medical centers .

Objective To investigate the effect of the extracts of Centella asiatica(L.) Urban (ECA) on the depressive-like behavior alteration in rats and mice. Method 60 Wistar rats were randomly divided into 6 groups (10 rats each), the normal group, model group, Fluoxetine group, ECA high dose group (component 10.08 mg+component 24.48 mg/kg), ECA middle dose group (component 1 0.04 mg+component 2 2.24 mg/kg) and ECA low dose group component 1 0.02 mg+component 2 1.12 mg/kg. Chronic unpredictable mild stress (CUMS) induced depression in rats and sugar consumption to detect the antidepressant effect of ECU. 60 Kunming mice were randomly divided into six groups as above. Locomotor activity, forced swim, tail suspension test were used to detect the effect of ECA on the behavioral alteration in mice. Results Compared with model group, sugar consumption in ECA groups was significant increased (P<0.01). ECA treatments also decreased duration of immobility in the tail suspension test and forced swim. Conclusion ECA could improve the depressive-like behavior in rats and mice.

Objective To analyze risk factors for diabetic kidney disease (DKD) in inpatients with type 2 diabetes.Methods A total of 930 inpatients with type 2 diabetes were enrolled in the study and grouped according to different levels of estimated glomerular filtration rate (eGFR),albuminuria,and diabetic retinopathy.Logistic regression analysis was adopted to explore the risk factors for DKD in inpatients with type 2 diabetes.Results (1) The prevalence of albuminuria in patients with type 2 diabetes mellitus was increased with declining eGFR (P ＜ 0.05).(2) The prevalences of DKD and non-diabetic renal disease (NDRD) in patients with type 2 diabetes mellitus were 22.26％ and 8.92％,respectively.Compared with patients with NDRD,patients with DKD had longer diabetic duration,higher levels of systolic blood pressure,serum creatinine,and urinary albumin excretion,and lower levels of hemoglobin[(125.40 ± 21.95 vs 138.18 ± 19.67) g/L],serum albumin[(37.45 ± 5.54 vs 40.55 ± 3.55) g/L],and eGFR[(89.66 (59.10-108.25) vs 103.15 (85.39-114.88) ml · min-1 · (1.73 m2)-1,all P＜0.05].(3) Logistic regression analysis showed that age,diabetic duration,systolic blood pressure,serum uric acid,diabetic retinopathy,and hypertension are the independent risk factors for diabetic kidney disease in inpatients with type 2 diabetes,while serum albumin was the protective factor (all P＜0.01).Conclusions A variety of clinic risk factors were associated with DKD.Better control of blood pressure,serum uric acid,and hypoalbuminemia should be performed to delay the progress of DKD.

Objective To assess the reproducibility of long-term blood pressure variability in ischemic stroke and the association between the variability and cerebral microbleeds.Methods Patients with ischemic stroke at the previous 1-6 months were consecutively recruited and followed up 12-18 months.Blood pressure measurements were taken at every interview.Blood pressure variability indicated visit-to visit variability and was quantified by calculating the maximum ( Max),standard deviation (SD) and coefficient of variation (CV).For these variability might positively correlated with mean of blood pressure,the additional variability measure,SD independent of mean (SDIM),was also calculated.To determine the reproducibility of mean and variability measurements,the intraclass correlation (ICC) was also calculated.MRI was performed at baseline and the end of the study.Cerebral microbleeds were rated using Microbleed Anatomical Rating Scale (MARS).Multiple Logistic regression was used to assess the association between the visit-to-visit blood pressure variability and cerebral microbleeds.Results A total of 720 patients were recruited,of whom 595 (82.6％) subjects were present for 14 blood pressure readings during follow-up.The visit-to-visit blood variability measurements were moderately reproducible according to the ICC:0.46-0.72 for systolic blood pressure (SBP) and 0.42-0.69 for diastolic blood pressure ( DBP),respectively,P ＜0.01 for all measures.Patients with cerebral microbleeds were more likely to have higher mean blood pressure and variability for both SBP and DBP regardless the distribution of cerebral microbleeds.Being SBP Max,SBP SD,SBP CV,SBP SDIM(OR=1.036,95％ CI l.021-1.052,P=0.000; OR=1.060,95％CI 1.001-1.122,P =0.046; OR =1.084,95％ CI 1.000-1.175,P =0.049; OR =1.065,95％ CI 1.002-1.132,P =0.044) and DBP SD,DBP CV ( OR =1.111,95％ CI 1.000-1.233,P =0.049;OR =1.091,95％ CI 1.001-1.190,P =0.047) were the independently risk factors of cercbral microbleeds at deep region; SBP Max( OR =1.049,95％ CI 1.029-1.068,P =0.000) and DBP SD、DBP CV(OR =1.236,95％ CI 1.107-1.379,P=0.000;OR =1.188,95％ CI 1.087-1.298,P=0.000)independently associated with cerebral microbleeds at infratentorial location.There was no significant relation between the long-term variability of blood pressure and cerebral microbleeds at lobar region. Conclusions This study indicates that long-term blood pressure variability is substantial and independently associated with cerebral microbleeds in deep or infratentorial but not with that in lobar region.The different relations between the variability and cerebral microbleeds might indicate the heterogenic mechanisms of cerebral microbleeds.

Objective To investigate the synergic ratio of sorafenib (SO) and sulforaphane (SF) against the hepatocellu‐lar carcinoma cell line HepG2 in vitro .Methods The synergic effect of SO combined with SF against HepG2 cells was deter‐mined by the CCK8 assay (the synergic effect was determined by combination index (CI) value:CI>1 .1 ,antagonistic;0 .91 .1) ,whereas 20∶1 ,5∶1 and 1∶5 ratio resul‐ted in synergistic activity (CI<0 .9) .Furthermore ,10∶1 ratio acted as an additive effective (0 .9

Objective:To investigate the prevalence of hyperuricemia (HUA), patients′ awareness of HUA, and related factors among elderly in community.Methods:The health check-up data of 6 897 residents aged over 65 years in Gumei Community of Shanghai were collected from January 2019 to January 2020. There were 1 156 subject with increased serum uric acid levels (HUA group) and 5 741 with normal uric acid levels (non-HUA group). The differences of clinical indicators between HUA group and non-HUA group were analyzed and the risk factors of HUA was determined by multivariate logistic stepwise regression. A questionnaire survey on the knowledge of HUA and the adoption of relevant health behaviors was conducted among HUA patients.Results:The overall prevalence was 16.8% (1 156/6 897) in this population. The prevalence in males was significantly higher than that in females[26.4%(842/3 195) vs. 8.5%(314/3 702), P<0.001); and the prevalence in females increased with age (χ 2=7.56, P=0.023). Body mass index(BMI), waist circumference(WC), total cholesterol(TC), triglyceride(TG), serum creatinine, alanine aminotransferase(ALT) and albumin/urine creatinine ratio(UACR) in the HUA group were significantly higher than those in the non-HUA group, while estimated glomerular filtration rate(eGFR) and high-density lipoprotein(HDL) were lower than those in the non-HUA group (all P<0.01). The prevalence of hypertension, decreased renal function, overweight or obesity, abdominal obesity, fatty liver and renal cyst in HUA group was significantly higher than that in non-HUA group (all P<0.01). High values of TG, low-density lipoprotein(LDL), WC, hypertension and fatty liver were risk factors for HUA( OR=1.14, 1.20, 1.03, 1.43, 2.19; P<0.01); while female gender, eGFR, HDL and glycosylated hemoglobin A1c(HbA1c) were protective factors for HUA( OR=0.32, 0.94, 0.65, 0.78; P<0.01). The questionnaire survey was conducted among 1 090 HUA patients, and the results showed that 73.2% (798 cases) were aware of the disease after the health check-up results released; only 30.9% (337 cases) knew the diagnostic criteria of HUA, 21.1% (230 cases) knew that HUA needed life-long follow-up care, 56.3% (614 cases), 49.2% (536 cases) and 47.9% (522 cases) thought that HUA should eat less seafood, broth and soya bean products, 17.0%(185 cases) were atcohol drinker and the awareness rates of above questions in patients with gout were higher than those in patients without gout ( P<0.05). Conclusion:The study shows that the prevalence of HUA among the elderly in Gumei community of Shanghai is high, and the HUA related knowledge levels and health behavior performance are not ideal, especially for HUA patients without gout, therefore health education should be strengthened for elderly residents in the community.

Objective To investigate the effect of intestinal mucosal Toll-like receptor 4/nuclear factor κB (TLR4/NF-κB) signaling pathway on renal damage in pseudo-sterile IgA nephropathy (IgAN) mice. Methods C57BL/6 mice were randomly divided into experimental group (pseudosterile mouse model group), control group (IgAN mouse model group), pseudosterile mouse blank group, and normal mouse blank group. Pseudosterile mice were established by intragastric administration of quadruple antibiotics once a day for 14 days. The pseudosterile IgAN mouse model was set up by combination of oral bovine serum albumin (BSA) administration and staphylococcal enterotoxin B (SEB) injection. The pathological changes of renal tissue were observed by immunofluorescence staining and PAS staining, and the intestinal mucosa barrier damage indicators lipopolysaccharide(LPS), soluble intercellular adhesion molecule 1(sICAM-1) and D-lactate(D-LAC) were analyzed by ELISA. Biochemical analysis was used to test 24 hour urine protein, serum creatinine and blood urea nitrogen. The mRNA and protein levels of Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear factor κB (NF-κB) were detected by reverse transcription PCR and Western blot analysis. Results The kidney damage of pseudosterile IgAN mice was more severe than that of IgAN mice, and the expressions of intestinal mucosal barrier damage markers (LPS, sICAM-1 and D-LAC) were significantly increased in pseudosterile IgAN mice. In addition, the expressions of TLR4, MyD88, and NF-κB level were all up-regulated in the intestinal tissues of IgAN pseudosterile mice. Conclusion Intestinal flora disturbance leads to intestinal mucosal barrier damage and induces activation of TLR4 signaling pathway to mediate renal injury in IgAN.
Animals ; Mice ; Mice, Inbred C57BL ; Glomerulonephritis, IGA ; NF-kappa B ; Toll-Like Receptor 4/genetics* ; Lipopolysaccharides ; Myeloid Differentiation Factor 88/genetics* ; Kidney ; Intestinal Mucosa ; Infertility ; Disease Models, Animal

Plant stem cells are the cells that are located in meristems and are kept in a state of undifferentiation. Plant stem cell possesses lower vacuolization, higher mitochondrial activity, more genetic stability and stronger self-renewal capacity compared with calli. Plant stem cell culture has a wide application in pharmaceutical, functional food as well as cosmetic industries. Here we describe the procedure of induction, isolation and identification of plant stem cells, to provide a reference for further research in this field.
Meristem ; cytology ; Plant Cells ; Stem Cells ; cytology ; Tissue Culture Techniques