Objective To establish a comprehensive evaluation system for clinical pathway quality for evaluation and verification.Methods Literature retrieval, clustering mergers and experts consultation method were used to determine indicators for clinical pathway quality evaluation, while gray correlation method was employed to calculate indicators weight coefficient and to evaluate indicators scoring,and sum indicators weighted scoring, so as to establish a clinical pathway quality comprehensive evaluation model.Indicator data of Shanghai′s 18 tertiary hospitals were used for verification.Results A total of 12 evaluation indicators, such as entry rate, mutation rate, completion rate and average length of stay were selected.After the weight calculation and grade scoring, the mathematical model of clinical pathway quality comprehensive evaluation was constructed.Data of these hospitals were put into the evaluation system for assigning ratings calculation, harvesting the overall score and ranking of each hospital.These data can help find out key management and key hospital intervention indicators in the next stage.Conclusions Different hospitals will be put on the same platform for comparison in this clinical pathway evaluation system, and the results can be quantified.The authors suggest that the next stage of health administration focus on the management of the hospitals and the key management of the sectors, making possible the prospective management of clinical pathways.

Objective On the basis of the lasted clinical experience,our group will discuss the treatmented mechanism of Chinese herb kang-xian-er-hao(KXEH) ameliorate hepatic cirrhosis. Methods Male wistar rats were divided into five groups,excepted for normal group N,the remnant four groups were all given intraperitoneal injection of porcine serum((0.5) ml/time,2 times/week,total 12 weeks).In KXEH early treatment group B,the rats were fed with KXEH by gavage,1 g/100 g,once a day at the third week.In KXRH late treatment group C,the rats were fed with KXEH by gavage,1 g/100 g,once a day at the ninth week.In ?-interferon treated group D the rats were subcutaneous injection ?-interferon((0.1) million) every day at the ninth week.The model group A and normal group N were fed with the same amount of saline by gavage.The rats were killed at the end of the twelfth weeks,the formation of liver fibrosis was observed with HE stain and Masson stain.The expression of Smooth muscle actin(SMA) was observed by immunohistochemistry.As well as SMA,collagen Ⅰ、Ⅲ mRNA and Smad3 mRNA,which is TGF-?1 downstream signal,were detected in liver samples with RT-PCR assay. Results In KXEH treated group B and C,the body weight was heavier,the size of liver and spleen was smaller and the ratio of liver weight/body weight and spleen weight/body weight was decreased compared with the model group A(P

Public Health ; methods ; Systems Analysis

Objective To master the technique of mouse embryonic stem (ES) cells differentiate into endothelial cells,which would be a new therapeutic approach for cardiovascular disease.Methods Expression of selfrenewal marker genes in E 14 cells was assessed.Expression of vascular endothelial growth factor receptor 2 (Flk 1) in monolayer differentiation on day 4 and vascular endothelial cadherin (VE-cadherin) on day 8 were detected.On day 8,differentiation cells were also observed under phase contrast microscopy (PCM) and transmission electron microscope (TEM).ES cells and endothelial-specific molecular markers were assessed by RT-PCR at different time-points.Results As self-renewal marker genes were expressed in E14 cells,E14 cells was identified to maintain their selfrenewal pluripotency.The marker gene of letarl,Flk1 was expressed on differentiation day 4.On differentiation day 8 the marker gene VE-cadherin was expressed and as observed under PCM endothelial cells with spindle shape and TEM with Weibel-Palade body,thus were the major populations generated after VEGF induction,and E14 cells were confirmed differentiated into mature endothelial cells.The expressions of genes octamer binding transcription factor 4 (Oct4),Flk1 and VE-cadherin were detected on differentiation day 2,4,6,8 and 10.Conclusions As VE-cadherin gene was expressed in monolayer on differentiation day 8,E14 cells were confirmed differentiated into endothelial cells,which would be a new therapeutic approach for cardiovascular disease.

To investigate the effects of different methods of treatment, including tonifying the kidney, activating blood and soothing the liver, on mice with autoimmune premature ovarian failure (POF).

Objective To compare the Helicobacter pylori (Hp) eradication rate of different therapies and to explore the effects of Hp eradication on the clinical characteristics of chronic obstructive pulmonary disease (COPD).Methods From December 2006 to December 2009,at China-Japan Union Hospital of Jilin University 89 stable COPD patients with Hp infection were divided into eradication group and non-eradication group.The eradication group was divided into clarithromycin sub group and moxifloxacin sub group.The patients of these three groups all received regular COPD treatment.Esomeprazole,amoxicillin,clarithromycin and colloidal bismuth citrate were used in clarithromycin group.Esomeprazole,amoxicillin,moxifloxacin and colloidal bismuth citrate were used in moxifloxacin sub group.Patients received pulmonary function test,exercise tolerance evaluation,dyspnea scoring and health-related quality of life scoring at recruitment and 12 months after recruitment.The onset frequenly of acute exacerbation of COPD in one year was counted.The data were analyzed by x2 test and t test.Results The Hp eradication rate of clarithromycin sub group (48.4 ％,15/31) was lower than that of moxifloxacin sub group (87.1％,27/31),and the difference was statistically significant (x2 =4.22,P=0.032).There was no significant difference percentage of forced expiratory volume in first second to forced vital capacity in (FEV1％) predicted value between 27 cases in non-eradication group and 53 patients with successful Hp eradication (t=0.677,P=0.265).Of 53 patients with successful Hp eradication,the 6-min walking distance,Borg dyspnea score and saint George's respiratory questionnaire (SGRQ) score were improved significantly (t =1.884,1.877 and 1.773 respectively; P=0.032,0.025 and 0.034 respectively),and there was no improvement in 27 non-eradication patients.There was significant difference in the frequency of COPD acute attack between 53 patients with successful Hp eradication (1.2 times) and non-eradication group (1.9 times) (t=1.812,P =0.034).Conclusions Hp eradication therapy with moxifloxacin in COPD patients reached higher Hp eradication rate.Hp eradication in COPD patients with Hp infection can improve the exercise tolerance of patients,relieve dyspnea,improve quality of life and reduce the frenquency of acute attacks.

AIM: Research report that bone marrow stem cells mobilized by recombinan human granulocyte colony-stimulating factor (rhG-CSF) can migrate to lesion spot of infarction, thus decrease brain edema and brain injury after cerebral ischemia. But the report about the effect of drug on brain edema after cerebral hemorrhage is rare. This study investigated the effects of bone mar- row stem cells mobilized by rhG-CSF on reducing formation of brain edema and downregulation of matrix metalloproteinase (MMP)-9 in the peripheral area after intracerebral hemorrhage (ICH) in rats. METHODS:The experiments were performed at the Central Laboratory of Luzhou Medical College from March to November in 2006. ① 144 healthy male SD rats, (300?20)g, were provided by Animal Department of Luzhou Medical College. The experimental procedures of disposing animals were accorded with ethical standards. ②Experimental rats were assigned randomly into a sham operation group, a ICH group and a treatment group, equally. According to the method of Yang, rat models of ICH were made by the method cutting off tail of rat to obtain autoblood in the ICH and treatment groups. Rats in the sham operation group received saline instead of autoblood. Rats in the treatment group were administered with rhG-CSF (60 ?g/kg) by intrap- eritoneal injection after 1 hour. ③The water contents and MMP-9 were measured in each group by immunohistochemical method. RESULTS:Of 144 rats, 16 rats dropped out, among which 7 rats were estimated as 0 grade and 9 rats died, and all were supple- mented. ①The water contents were higher in the ICH group than in the sham operation group (P

Objective To establish radioiodine therapy in nonthyroid tumor and to investigate 131Ⅰ treatment effect on xenografted ovarian cancer. Methods Based on previous test, xenografted ovarian cancer nude model were established in nude mice. The effects of radioactive isotope 99m TcO-4 imaging and radioiodine 131Ⅰ treatment on xenografted ovarian cancer in vivo were investigated. Results After transferring human sodium/iodide symporter (hNIS) gene, the xenografted ovarian cancer in nude mice was imaged by isotope 99m TcO-4 Moreover,131Ⅰ exerted inhibitory effect on the proliferative activity. Conclusion After the transfection of hNIS gene, 131Ⅰ has inhibitory effect on proliferative activity of xenografted ovarian cancer.

BACKGROUND: Recombinant human granulocyte colony-stimulating factor (rhG-CSF) can mobilize endothelial progenitor cells and enhance new vessels at cerebral ischemia region. OBJECTIVE: To investigate the effects of rhG-CSF on the new microvascular expressions in rat perihematoma after intracerebral hemorrhage. DESIGN, TIME AND SETTING: A randomized control animal experiment was performed at the Central Laboratory of Luzhou Medical College from March to November 2006. MATERIALS: A total of 72 healthy male Sprague Dawley rats and rhG-CSF were used for this study. METHODS: Seventy-two rats were equally and randomly assigned into the sham operation group, the hemorrhage group, the treatment group. According to rat brain stereotaxic atlas, models of intracerebral hemorrhage were made by infusing autoblood from rat tails. Rats in the sham operation group were infused with saline instead of autoblood. Rats in the treatment group were administered rhG-CSF (60 ?g/kg) by intraperitoneal injection at 1 hour after operation. Rats in the sham operation and hemorrhage groups were left intact. MAIN OUTCOME MEASURES: The microvascular expressions of CD34+ in perihematoma were detected at 6, 12, 24, 48 and 72 hours, 7 days; Four rats in each time point. Microvascular production was measured by changes in CD34. The more the CD34 antigens, the more the new vessels were. RESULTS: In the hemorrhage group, the microvascular expressions of CD34+ were significantly higher compared to the sham operation group (P 0.05). Significant differences were measured at 6, 12, 24 and 48 hours (P

BACKGROUND:Administration of recombinant human granulocyte colony-stimulating factor(rhG-CSF) is known to diminish cerebral edema and to enhance the new vascularization by mobilizing endothelial progenitor cells in cerebral infarction, then to promote the neurofunctional recovery.OBJECTIVE:To investigate the effects of rhG-CSF on brain edema and new vessels after intracerebral hemorrhage(ICH) in rats.DESIGN, TIME AND SETTING:The randomized controlled animal study was performed at the Central Laboratory, Luzhou Medical College from March to November 2006.MATERIALS:A total of 144 healthy male Sprague Dawley rats were equally and randomly assigned into a sham operation group, a ICH group and a treatment group.rhG-CSF(Xinpeng, Shenzhen, China) was used in this study.METHODS:Rat models of ICH were made by the method of cutting off the tail of each rat to obtain autoblood in the ICH and treatment groups.Rats in the sham operation group were injected with saline.Rats in the treatment group were administered with rhG-CSF(60 ?g/kg) by intraperitoneal injection after 1 hour.Eight rats from each group were studied at 6, 12, 24, 48, 72 hours and 7 days.Brain water content of rats was measured by dry-wet method.CD34+ vessel expression was detected by SP and DAB coloration, immunohistochemical method.MAIN OUTCOME MEASURES:Dynamic changes in brain water content;immunohistochemical results of CD34+ vessels.RESULTS:The water contents were significantly higher in the ICH group than in the sham operation group(t=4.49, P