Objective To establish a modern hospital management system with clear rights and responsibilities, scientific management, perfect management, efficient operation and strong supervision. Methods 37 tertiary hospitals in Shanghai were subject to a simulation of observation, questionnaire investigation and quantitative analysis.On such basis,core regulations were pinpointed and management risk prevention grades identified according to their importance and risk indexes.Results 109 core regulations of modern hospital management were selected along with three management risk prevention and control levels of red(67 regulations), yellow(16 regulations), and blue(26 regulations).Conclusions The basic framework of management risk prevention and control system is thus built for modern hospitals,and IT-based means were put in place against such risks.These measures can help enhance the supervision platform, for dynamic supervision and effective control of modern hospital management risks.

PURPOSE: This study aimed to probe into the associations among circular RNA ZFR (circ-ZFR), miR-130a/miR-107, and PTEN, and to investigate the regulatory mechanism of circ-ZFR–miR-130a/miR-107–PTEN axis in gastric cancer (GC). MATERIALS AND METHODS: GSE89143 microarray data used in the study were acquired from publicly available Gene Expression Omnibus database to identify differentially expressed circular RNAs inGC tissues. The expressions of circ-ZFR, miR-130a, miR-107, and PTEN were examined by real-time reverse transcription polymerase chain reaction, while PTEN protein expression was measured by western blot. The variation of GC cell proliferation and apoptosis was confirmed by cell counting kit-8 assay and flow cytometry analysis. The targeted relationships among circZFR, miR-130a/miR-107, and PTEN were predicted via bioinformatics analysis and demonstrated by dual-luciferase reporter assay and RNA immunoprecipitation assay. The impact of ZFR on gastric tumor was further verified in xenograft mice model experiment. RESULTS: Circ-ZFR and PTEN were low-expressed whereas miR-107 and miR-130a were highexpressed in GC tissues and cells. There existed targeted relationships and interactions between miR-130a/miR-107 and ZFR/PTEN. Circ-ZFR inhibited GC cell propagation, cell cycle and promoted apoptosis by sponging miR-107/miR-130a, while miR-107/miR-130a promoted GC cell propagation and impeded apoptosis through targeting PTEN. Circ-ZFR inhibited cell proliferation and facilitated apoptosis in GC by sponging miR-130a/miR-107 and modulating PTEN. Circ-ZFR curbed GC tumor growth and affected p53 protein expression in vivo. CONCLUSION: Circ-ZFR restrained GC cell proliferation, induced cell cycle arrest and promoted apoptosis by sponging miR-130a/miR-107 and regulating PTEN.
Animals ; Apoptosis* ; Blotting, Western ; Cell Count ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Proliferation* ; Computational Biology ; Flow Cytometry ; Gene Expression ; Heterografts ; Immunoprecipitation ; Mice ; Polymerase Chain Reaction ; PTEN Phosphohydrolase ; Reverse Transcription ; RNA ; Stomach Neoplasms*

Objective: To investigate the efficacy and safety of robot-assisted modified Y-shaped ileal orthotopic neobladder reconstruction，so as to provide reference for clinical practice. Methods: The clinical data of 44 patients who underwent robot-assisted laparoscopic radical cystectomy，lymph node dissection，and modified Y-shaped ileal orthotopic neobladder reconstruction during Feb.2020 and Aug.2022 were retrospectively analyzed.The surgical position，Trocar position，and key surgical steps were reported.The perioperative conditions，postoperative complications，neobladder volume，maximum urinary flow rate，postvoid residual，renal function，and urinary control function were recorded. Results: All 44 surgeries were successfully completed，with operation time of (314.32±51.02) min，modified Y-shaped ileal orthotopic neobladder reconstruction time of (103.52±9.56) min，and bleeding volume of (128.18±57.27) mL.The postoperative time for fluid intake was (4.16±0.86) days，catheter indwelling time was (14.02±3.20) days，and patients were discharged 1 to 2 days after catheter removal.Clavien-Dindo grade Ⅱ and Ⅲ complications occurred in 15 and 2 patients，respectively.During the follow-up of (20.77±5.90) months，dysuria occurred in 1 case，urethral calculi in 2 cases，and incomplete bowel obstruction in 2 cases. The postoperative neobladder capacity was (195.75±15.51) mL，maximal urinary flow rate (20.30±2.05) mL/s，postvoid residual (19.86±13.80) mL and serum creatinine (81.98±25.97) μmol/L. The incidence of daytime and nocturnal urinary incontinence 3，6 and 12 months after operation were 20.45% and 29.55%，11.36% and 18.18%，and 4.55% and 9.09%，respectively. Conclusion: Robot-assisted modified Y-shaped ileal orthotopic neobladder reconstruction has favorable efficacy and safety，and low incidence of postoperative complications，which can be applied in clinical practice.