Objective:To explore the factors influencing the medical service in a Chinese hospital during the period of management transformation,and to study the changes of these factors at different phases of hospital development.Methods: Data were collected from Hospital Information System(HIS) at the end of every month from Jan.2000 to Dec.2003 and 8 variables were deduced: the monthly outpatient visits and emergency visits,the monthly inpatient number,the monthly person-time of operation,bed utilization rate,the monthly cycle of bed rotation,ALS(average length of stay),proportion of cured or recovered patients and expenditure of hospitalization per person.Factor analysis was used to search for the common factors.And Kruskal-Wallis H test was used to compare the mean factor score at different phases divided by ordinal clustering method.Results: There were 2 common factors: quantity-profit factor(F_(1)) and quality-efficiency factor(F_(2)),influencing the medical service in the hospital.F_(1) score increased with the pregression of 4 stages(preliminary,initial,developmental and stable phases) of hospital management transformation and F_(2) score remained unchanged.Conclusion: The quantity-profit of this hospital increases and the quality-efficiency remains unchanged during the 4-year management transformation.Different common factors have different developmental tendency.

Objectives:To study the apoptosis-inducing effects of vitamin K3(VitK3) on human breast carcinoma cell line MCF-7,and approach its possible mechanism.Methods:MCF-7 is cultured in the presence of different concentration of VitK3 or in combination with catalase.The inhibitory effects of VitK3 and the influence of catalase were detected by MTT colorimetry.Apoptosis was observed using flow cytometry.The mRNA expression of RelA,Bcl-2,Bax and cyclin-dependent kinase inhibitor p21CIP1/WAF1,p27KIP1 were assessed by RT-PCR.Results:VitK3 can inhibit MCF-7 cell proliferation,and catalase significantly decreases the growth inhibition due to VitK3.Apoptosis is the reason of growth-inhibitory effect of VitK3.The mRNA expressions of RelA,Bax,p21CIP1/WAF1 were up-regulated after the treatment of VitK3.Conclusion:VitK3 can induce apoptosis of MCF-7 cell,at least in part by promoting the expression of Bax and inducing G1 arrest of cell cycle through up-regulation of p21CIP1/WAF1.

Objective:To explore the application of data envelopment analysis in optimal allocation of military health resources.Methods: The relative technical efficiency of 52 military health service units(MHSUs) was assessed by C~(2)GS~(2) model,a variable-return to scale,input oriented data envelopment analysis(DEA) method.MHSUs were classified with hierarchical clustering analysis.The confounding factors(geographic factor and arms of service) were analyzed using Cochran-Mantel-Haenszel ?~(2) test and the output of health service was analyzed using Kruskal-Wallis H test;then the quantity of health resources of different types of MHSUs was compared using Kruskal-Wallis H test and the structure of the resources was analyzed with ratios of different items.Results: Eighteen of the 52 MHSUs were technical efficient and the median score was 0.84.The relative technical efficiencies of 52 MHSUs were clustered into 4 types: type A,type B,type C and type D,referring to the best performance,average performance,inferior performance and the worst performance,respectively.The quantity of type D MHSUs was higher than those of other types of MHSUs and the structure of type D MHSUs was unreasonable compared with other types of MHSUs.The quantity and structure of type D MHSUs could be adjusted according to those of the type A or type B MHSUs.Conclusion: Combined with other statistical methods,DEA can be used to evaluate,classify the relative technical efficiency and analyze the resource allocation of different types of decision making units(DMUs).The quantity and structure of health resource with inferior relative technical efficiency DMUs can be adjusted to optimize the allocation of health resources.

Stem cells research has generated markedly increasing interest and liver stem cells have enormous potential for clinical applications.Based on the development of modern cell biology,molecular biology and genetics,the fundamental study and clinical application of liver stem cells have been greatly progressed.This paper reviews current development of liver stem cells for clinical application.

Clostridium butyricum was incubated in 10m mol, 30m mol 50m mol and 70m mol phosphate buffer medium (pH 7.0). With the high concentration buffer, the pH value decreased more slowly. The H_2 evolution hydrogenase kept on high activity level for a longer time, While the H_2 uptake hydrogenase kept constant. So more hydrogen was produced. The hydrogen production nearly doubled in 70m mol phosphate buffer than in 10m tool phosphate buffer. The result shows that to keep pH constant can increase the H_2 production of C. butyricum.

Objective To isolate and identify the photoreceptor precursor cells isolated from newborn mouse retina. Methods Fourteen newborn littermate mice were randomly divided into seven groups (P1-P7,2 each). The retinal cells were isolated from the newborn mice on postnatal 1-7d respectively,and then cultured in vitro. The cellular growth state was observed under inverted phase contrast microscope. After in vitro expansion,5-bromo-2-deoxy-uridine (BrdU),neuroepithelial stem protein (Nestin),neural retina leucine zipper (Nrl) and Opsin in cultured cells were detected by immunohistochemistry and immunofluorescence techniques. Results Most of retinal cells isolated from the seven groups (P1-P7) of newborn mice proliferated and adhered to the plate in the particular medium. Most of the growing cells were BrdU-positive cells. A part of the cells could express neural stem cell specific antigen-Nestin,the positive expression rate of Nestin in the seven groups (P1-P7) were 31.0%,31.6%,32.3%,30.2%,31.2%,30.9% and 29.5%,respectively,with no significant difference. Some growing cells expressed Nrl,and the expression of Nrl was increased significantly on the third day after birth,and then increased in small range,the positive expression rate of Nrl in the seven groups (P1-P7) were 20.6%,35.2%,65.5%,68.6%,71.6%,73.0% and 73.3%,respectively. The positive expression of Opsin was found only in a few cells of P5-P7,while the cells in groups P1-P4 did not express Opsin. Conclusions The photoreceptor precursor cells are presented in neonatal mouse retina. They have the ability of proliferation and may differentiate into retinal photoreceptor cells,having a potentiality of expressing Opsin. The photoreceptor precursor cells are increased significantly on the third day after birth,and then differentiate into mature retinal photoreceptor cells gradually.

Seventy-six cases of Asherman's syndrome (traumatic amenorrhea) were analyzed clinically. 70% of the patients were young women of the ages from 20 to 30. There was the history of previous abortion with once or twice of curettage in 81.2% of the cases. 66 out of the 76 cases complained of amenorrhea, 57 of periodic lower abdominal pain, and 10 of hypomenorrhea.When the intrauterine adhesions are explored, diagnostic curettage to get some endometrium for histologic study should be done since it is essential to diagnosis as well as to treatment. 57 out of the 76 were cured with one procedure of probe isolation of the adhesions and dilatation. The remained 19 cases were treated with combined Chinese traditional and Western medicine and 15 were cured and 4 improved. 24 women of those cured underwent a normal full term pregnancy and gave birth to a normal child. No vaginal bleeding or adhesion of placenta was observed after delivery in those women.

ObjectiveTo summarize the experience in diagnosis and treatment of malignant change in choledochal cyst patients in the past 20 years. MethodsThe clinical data of 16 patients admitted from 1980 to 2000 were analyzed retrospectively. Results9 patients had had a previous internal drainage procedure,12 patients had biliary tract infection, 4 cases presented with abdominal masses. All suffered body weight loss and general malaise. ERCP was performed in 5 cases with no previous operation, in which abnormal pancreatobiliary duct junction was found in 4 patients. Laparotomy plus metastatic lymph node biopsy was performed in 4 patients, choledochotomy with T-tube drainage for 4 patients, cyst excision and pancreatoduodenectomy for 3 cases, partial cyst excision with left lobectomy for 2 patients, cyst excision with Roux-en-Y hepaticojejunostomy for 3 patients. Pathology proved carcinoma was located in cyst wall in most cases.Postoperative survival time ranged from 4 to 31 months with a mean of 12.7 months. ConclusionsThe clinical symptoms of malignant change in congenital choledochal cyst were non-specific. The preoperative diagnosis for canceration was difficult, and the prognosis was poor.Total extrahepatic choledochocele resection should be adopted for the prevention of canceration.Intraoperative frozen section is helpful to confirm diagnosis. Cyst excision with pancreatoduodenectomy is the treatment of choice for carcinoma invading pancreatic head.

Child ; Humans ; Male ; Melanoma ; Melanosis ; Meningeal Neoplasms ; Neurocutaneous Syndromes

Objective: To explore the application of data envelopment analysis in optimal allocation of military health resources. Methods: The relative technical efficiency of 52 military health service units (MHSUs) was assessed by C2GS2 model, a variable-return to scale, input oriented data envelopment analysis (DEA) method. MHSUs were classified with hierarchical clustering analysis. The confounding factors (geographic factor and arms of service) were analyzed using Cochran-Mantel-Haenszel χ2 test and the output of health service was analyzed using Kruskal-Wallis H test; then the quantity of health resources of different types of MHSUs was compared using Kruskal-Wallis H test and the structure of the resources was analyzed with ratios of different items. Results: Eighteen of the 52 MHSUs were technical efficient and the median score was 0.84. The relative technical efficiencies of 52 MHSUs were clustered into 4 types: type A, type B, type C and type D, referring to the best performance, average performance, inferior performance and the worst performance, respectively. The quantity of type D MHSUs was higher than those of other types of MHSUs and the structure of type D MHSUs was unreasonable compared with other types of MHSUs. The quantity and structure of type D MHSUs could be adjusted according to those of the type A or type B MHSUs. Conclusion: Combined with other statistical methods, DEA can be used to evaluate, classify the relative technical efficiency and analyze the resource allocation of different types of decision making units (DMUs). The quantity and structure of health resource with inferior relative technical efficiency DMUs can be adjusted to optimize the allocation of health resources.