Objective To explore the biomechanical characteristics of the pharynx in patients with aspiration after radiotherapy for nasopharyngeal carcinoma (NPC).Methods Clinical data on NPC patients with dysphagia admitted between July 2011 and June 2015 were retrospectively analyzed.Twenty-three patients were found who had received videofluoroscopic swallowing studies (VFSSs) and whose pharyngeal pressure and upper esophageal sphincter (UES) relaxing were tested using high-resolution solid-state manometry (HRM).The cases were divided into an aspiration group and a non-aspiration group according to the VFSS results.Differences in biomechanical parameters between the 2 groups when taking food of different viscosity were compared.Results Patients with aspiration had significantly higher UES residual pressure when taking thick liquids (20.1± 14.3 mmHg) and paste (18.0± 14.3 mmHg) than patients not aspirating (9.3±9.2 mmHg and 7.2±8.9 mmHg for thick liquid and paste respectively).But no significant difference in average pharyngeal pressure between the two groups was observed.Conclusion Aspiration after radiotherapy may be correlated with increased UES residual pressure.

The global incidence rate of nonalcoholic steatohepatitis (NASH) continues to rise. The pathogenesis of NASH is complex, and there is no effective clinical treatment. Previous study has shown that DEAD box protein 5 (DDX5) can significantly alleviate the NASH process in mice. This study screened the natural product library of the research group and found that the active compound hypercalin B (HB) in Hypericum beanii N. Robson, a traditional Chinese medicine, can upregulate the expression of DDX5 protein in a dose-dependent manner. In this study, an in vitro model of NASH stimulated by palmitic acid (PA) and an animal model of NASH induced by the methionine- and choline-deficient diet (MCD) were constructed. Different concentrations of HB were used to investigate the effect and mechanism of HB in alleviating NASH progression. All animal experiments in this paper were approved by the Ethics Committee of China Pharmaceutical University (NO: 2021-02-003). In vitro model results showed that HB significantly reduced the intracellular lipid deposition induced by free fatty acid (FFA). Animal experiments showed that HB improved liver injury by significantly reducing lipid accumulation in the liver of NASH mice, and reducing serum aspartate transaminase (AST) and alanine transaminase (ALT) levels. Moreover, HB could inhibit liver inflammation by reducing the mRNA levels of liver pro-inflammatory cytokines including interleukin 6 (IL-6), interleukin 1β (IL-1β), and tumor necrosis factor α (TNFα). Further research showed that HB could reduce the phosphorylation level of the mechanical target of rapamycin (mTOR) and reduce the expression of sterol regulatory element binding protein 1 (SREBP1) and fatty acid synthase (FASN), thereby improving lipid metabolism and alleviating NASH progression, and the effects of HB against NASH were dependent on DDX5. In conclusion, HB can improve lipid metabolism and inhibit inflammatory activation by suppressing mTORC1 pathway via upregulating DDX5 protein, and showed promising anti-NASH activity in vitro and in vivo.

Objective To study the effect of public hospitals vertical integration on scale economy in Shanghai. MethodsA total of 401 samples of 67 hospitals from 1999 to 2004 in Shanghai were collected.Median regression was performed to estimate the multi-output cost function and marginal cost of discharge patients,and scale economies were calculated.Results The independent variables Beds,W,X1,X23,Region,Level,Y03,and Y04 were all predictors of cost.Conclusion Both integrated tertiary and secondary hospitals had scale economy before and after integration.Integration enhanced the output and improved the efficiency of integrated secondary hospitals.To some extent,patients were dispersed to secondary hospitals.

Objective To explore the differences in health care quality,scale,output,efficiency,cost and financial condition between freestanding secondary hospitals and system-affiliated secondary hospitals in Shanghai,and analyse the determinants of hospital integration. Methods Eleven upper secondary hospitals in Shanghai integrated between 2000 and 2004 were selected,and another 40 secondary hospitals (including 30 upper secondary hospitals and 10 middle secondary hospitals) without integration were served as controls. Using related data of 1999,Mann-Whitney U test was performed to analyse the differences between these two groups,and Logistic regression analysis was conducted to explore the determinants of hospital integration. Results There were significant differences in health care quality,scale,and output between these two groups (P0.05). It was revealed by Logistic regression analysis that health care quality,scale,output,and financial condition were determinants of integration. Conclusion System-affiliated secondary hospitals have advantages over freestanding hospitals in health care quality,scale,output and financial condition,and those with better health care quality,larger scale,larger output and better financial condition are more likely to be integrated by tertiary hospitals.

In this paper, the SWOT analysis method is used to find out the internal strength, weakness, exterior opportunities and threats of the present medical devices' procurements in hospitals and some strategic considerations are suggested as "one direction, two expansions, three changes and four countermeasures".
Cost Savings ; Equipment and Supplies, Hospital ; economics ; Group Purchasing ; economics ; organization & administration ; Humans ; Marketing of Health Services ; methods ; Purchasing, Hospital ; organization & administration ; Quality Control

The self-designed experimental teaching method is introduced in detail in this paper,including the preparative work before class,discussion of experimental designing proposal,and accomplishment of specific experiment and so on.The teaching method innovations on pathophysiology experiment are very helpful to cultivate the students' ability to solve practical problem and lay the foundation to cultivate talented medical science personal.

Adolescent ; Female ; Humans ; Mucocele ; Nose Diseases ; pathology ; Turbinates ; pathology

Atrophy ; Disability Evaluation ; Humans ; Kidney

Objective To explore the methods of nursing quality management in order to provide safety,high quality and satisfactory nursing for patients,Methods To establish one grid management model of nursing quality combined with " double three-level".Then,the report of security events,the implemention of nursing consultation,the incidence of adverse events,and patients' satisfaction were observed and compared before and after the management model.Results Mter implementing the grid management model of nursing quality,satisfaction average scores of hospitalized patients,emergency department patients,discharged patients were ( 98.22 ± 1.12 ),( 91.97 ± 1.67 ),(97.16 ± 2.41 ) respectively,and before it was implemented the average scores respectively were ( 91.59 ± 1.67 ),( 87.92 ± 1.98 ),( 87.89 ± 1.81 ),and the differences were statistically significant ( t =3.57,2.69,4.72,respectively ; P ＜ 0.05 ).There was a significant change in the report of security events,implemention of nursing consultation and checking.The incidence of administration errors,falling down and pressure sores were significantly reduced.Conclusions Construction of the grid management system of nursing quality can ensure the implemention of nursing core institution,improve risk awareness of nurses,improve the nursing quality and increase patients' satisfaction.

Abstract: Objective - - To establish a pre column derivatization high performance liquid chromatography method for detecting Methods dimethyl sulfate (DMS) in workplace air. DMS in workplace air was collected with mercaptopyridine impregnated （ silicone tube. The derivative of DMS and mercaptopyridine was eluted by mobile phase phase A: water, phase B: acetonitrile, ∶ the volume ratio was 40 60) , and separated with a C18 column, then detected with diode array detector and quantitated by a Results - standard curve. The linear range of DMS was 0.17 40.00 mg/L, with the correlation coefficient of 0.999 95. The detection limit and the lower limit of quantitation were 0.05 and 0.17 mg/L respectively. The minimum detection concentration and minimum quantitation concentration were 0.02 and 0.04 mg/m³, respectively (air sample volume of 4.5 L, 1.0 mL sample - - - solution). The average desorption efficiency was 98.40% 102.00%. The within run and between run relative standard deviations - - were 0.61% 3.92% and 1.71% 6.00%, respectively. The samples could be stored at room temperature for at least 14 days. Conclusion This method can be used to detect DMS in workplace air.