Objective To observe the effect of hepatocyte growth factor on preserving isolated heart of rats. Methods Forty rats were random divided into two groups: Control group(n=20)which rat hearts were isolated and preserved in 4℃HTK solution, and experimental group(n=20)which rat hearts were isolated and preserved in 4℃ HTK+rh-HGF(100μg/L)solution. Before operation and rat hearts were subjected to 8 hours(groupA,C)or 12 hours(group B,D)hypothermic storage followed by 5 minutes of normothermic reperfusion onmodifiedLangendorff-Neely model. The recovery rate of cardiac function after myocardial preservation, such as LVSP and LVDP and±dp/dt max and the changes of CK,LDH,NO and ET were measured. Cell apoptosis was detected by TUNEL staining and the expression of c-met was analyzed by immunohistochemical method. The expression change of bcl-2 mRNA was examined by RT-PCR. Results Compared with control group, experimental group showed that a significantly higher recovery rate of LVSP,LVDP and±dp/dt max(P＜0.01) and lower rate of TUNEL positive cardiomyocytes(P＜0.01) after reperfusion. The leakage of CK and LDH was significant lower than that of control group(P＜0.01). Immunohistochemical analysis revealed that c-met receptor expression was stronger in the HGF-treated myocardium than that in the non HGF-treated myocardium after storage, and this was associated with a stronger expression of bcl-2 mRNA. Conclusion The administration of rh-HGF before storage improved cardiac function after prolonged myocardial preservation by preventing apoptosis and enhancing expression of bcl-2 mRNA. Thus, the addition of rh-HGF in the storage solution may be a promising strategy for prolonged heart graft preservation.

The DIP payment reform impacts the overall operational management and quality of medical services in hospi-tals.Its goal is to encourage healthcare institutions to strengthen internal management,control unreasonable medical expenses,alleviate patients'financial burdens,and ensure the safety of medical insurance funds.This article discusses the current challen-ges and financial pressures faced by hospitals amidst reform,detailing the overall situation of DIP operations.By analyzing the es-timated profitability of various medical cases and comparing actual case studies,the aim is to identify a pathway for overcoming the challenges associated with DIP payments.It advocates for the promotion of a quality control and operationally driven approach in county-level public hospitals,leveraging performance incentives,enhancing multi-department MDT collaboration,and balan-cing medical quality with costs.This exploration seeks to develop a sustainable and healthy growth model for county-level public hospitals under the DIP payment system.

To improve the effectiveness of bedside localization of nasointestinal tube(NIT)and facilitate the placement of nasointestinal tube into jejunum,we established a procedure and composed a teaching verse for bedside placement of nasointestinal tube based on relevant classical literature and our own practices.Verse content:enteral nutrition means a successful strategy to improve the outcome in critically ill patient management,never hesitate to place nasointestinal tubes when necessary.There are several methods to deal with it,but popularizing it remains a long way off.Half-sitting and swallowing into the esophagus,freely withdrawing signifies the stomach cavity.Passing through the pylorus using light tension on the tube in the right lateral decubitus position.Arriving at the jejunum with low resistance in the left lateral decubitus position.What are the signs of intragastric coiling?Tube return out of nose is the initial observation,Failure of air insufflation indicates tube coiling.Dyeing location surpasses imaging.Vacuum test is the most sensitive,Sequential change from acid to base is specific.Methylene blue test is dramatical for localization.Combining three methods is enough to navigate.Abdominal plain film is the goldan standard and can still be used in ultrasonic era.3-D image establishes overall view.CT reveals the tube route exactly.The teaching verse has become a powerful tool for clinical teaching of manual nasointestinal tube placement in a concise and easy-to-remember form.

Objective: To explore the application effect of secondary personalized chairside education on changing the knowledge and behavior of patients with oral periodontal disease. Methods: A total of 124 patients experiencing initial periodontal disease were selected. Sixty-two patients were observed in the observation group, and 62 patients were observed in the control group. After the doctor checked and determined the periodontal condition of the patients, the nurse conducted a targeted, personalized secondary one-on-one chairside mission for the observation group; in the control group, the nurses provided routine one-to-one health education to the patients before treatment. Statistical analysis was conducted to assess periodontal knowledge mastery, self-care behaviors, rate of return for periodontal treatment and patient satisfaction after 3 months. The plaque index and scale index were statistically analyzed before and 3 months after treatment. Results : No statistical difference was found in the general data between the two groups of patients (P > 0.05); however, the degree of mastery of periodontal knowledge in the observation group was higher than that in the control group. The degrees of mastery of the clinical manifestations, hazards and treatment methods were 96.7%, 93.5%, and 91.9% in the observation group and 72.5%, 48.3%, and 69.3% in the control group, respectively; the difference was statistically significant (P < 0.05). The patients in the observation group were more likely than those in the control group to brush more than 2 times daily, use dental floss and use an interdental brush; 100%, 96.7%, and 77.4% of patients in the observation group and 80.6%, 56.4%, and 40.3% of patients in the control group participated in these oral health care behaviors, respectively. The difference was statistically significant (P < 0.05). The rate of recovery and patient satisfaction were higher in the observation group than in control group at 3 months; the rate of recovery and patient satisfaction were 80.6% and 96%, in the observation group and 41.9% and 88.7% in the control group, respectively. The difference was statistically significant (P < 0.05). After 3 months, the plaque index in the observation group was lower than that in the control group (1.71 ± 1.12, 2.35 ± 0.78), and the difference was statistically significant (P < 0.05). Conclusion Secondary personalized chairside education can significantly improve the patient’s cognition of the disease, allow the formation of accurate oral health awareness, and change the patient’s bad oral hygiene habits and medical behavior. Thus, this method is an effective oral health education method and can change the knowledge and beliefs of patients with oral periodontitis.