Objective To give an empirical study on the interests claims of employees in public hospitals. Methods By questionnaire investigation, to sum up data using factor analysis and pairedsamples T test, and to compare difference between different kinds of patients using ANOVA. Results The interests claims of employees can be summed up to seven factors and there is some significant difference between different kinds of employees. Conclusion At current stage, public hospitals need pay more attention to material interests claims of employees.

Objective To confirm the connotation, constitution and classification of the stakeholders in public hospital. Methods The stakeholders of public hospital were proposed through the brainstorm method and literature search. On this basis, the expert consultation scale was developed by using the score-based approach for reference The stakeholders of public hospital were confirmed and classified through two-round expert consultation. Results The research confirms 16 stakeholders of public hospital on the 80% level of support ratio by experts. There were 10 core stakeholders, 5 latent stakeholders and 1 marginal stakeholder. Conclusion Appropriate stakeholder management strategy should be taken for different types of stakeholders.

Objective To evaluate fluid responsiveness by stroke volume variation (SVV) in mechanically ventilated patients with refractory septic shock.Methods Forty-two refractory septic shock patients were enrolled in the study.According to the responsiveness of fluid loading, the patients were divided into responsive group and non-responsive group.The SVV values of two groups were retrospectively analyzed.The receiver operating characteristic curve was drafted to determine the cut-off value of SVV for predicting fluid responsiveness.Results Among the 42 refractory septic shock patients, 24 were found responsive to fluid loading, 18 were not;before the fluid loading, central venous pressure, heart rate, mean arterial pressure and global end-diastolic volume index in the both groups showed no significant differences whereas the SVV in the responsive group was much higher than that in the nonresponsive group (P =0.006).Using SVV ≥ 12% as the threshold to predict fluid responsiveness, the sensitivity was 77%,specificity was 85%.Conclusion SVV can accurately predict fluid responsiveness in refractory septic shock patients.

ObjectiveTo explore the correlation between IL-6-634C/G gene promoter polymorphism and body mass index (BMI),blood sugar (BS),25-hydroxy vitamin D (25-OH-D),and serum lipid levels by investigating in 8-12-year-old Han children in Shanxi province,China.MethodsIn Datong city of Shanxi province,214 8-12-year-old children were enrolled after obtaining informed consent from their parents.The weight and height were measured and the BMI was calculated.BS,serum lipids,and 25-OH-D were determined.IL-6-634C/G polymorphism were detected by polymerase chain reaction restricted fragment length polymorphism.The effects of genotype on BMI,BS,serum lipids,and 25-OH-D were also studied.ResultsThe genotypes of IL-6-634C/G polymorphism in 214 cases were GG ( 15％ ),GC (40％),and CC (45％).The percentages of C and G allele frequencies were 65％ and35％.The genotypes and allele frequencies showed no gender differences ( P ＞ 0.05 ).However,significantly different GG genotypes frequencies were found between overweight and obese children (38.3％) and other children ( normal weight children: 7.3％ ; thin children: 10.9％ ) (x2 =14.715,P =0.006).Multivariate logistic regression analysis showed that IL-6-634C/G polymorphisms and triglyceride were correlated with overweight and obesity (P ＜ 0.05 ).25-OH-D was not correlated with BMI (r =0.075,P =0.528),BS ( r =0.018,P =0.880 ),triglyceride ( r =- 0.097,P =0.417 ),high density lipoprotein cholesterin ( r =0.038,P =0.751 ),and low density lipoprotein cholesterin ( r =- 0.028,P =0.817 ).25-OH-D was not significantly different between overweight and obesity children.The distribution of three genotypes showed no correlation with 25-OH-D deficiency (x2 =0.622,P =0.733 ).ConclusionsIL-6-634C/G polymorphism exists in Han children in Shanxi province.IL-6 gene 634 GG genetype is a risk factor of childhood overweight and obesity,and may affect lipid metabolism.However,it has no direct impact on glucose metabolism.IL-6 gene 634C/G polymorphism and serum 25-OH-D are not relevant.IL-6 gene 634C/G polymorphism is not related to vitamin D deficiency diseases,and may be not related to bone calcium metabolism.25-OH-D is not relevant with BS and blood lipids level,and also is not associated with childhood overweight and obesity.

Objective To investigate the changes of calcium /calmodulin - dependent protein kinase Ⅱ (CAMKⅡD) gene expression in 3T3 - L1 preadipocyte diffe-rentiation and TNF - ? regulation of CAMKⅡD gene expression on matured adipocytes. Methods 3T3 - L1 preadipocytes were cultured and differentiated into adipocytes. The levels of CAMKⅡD gene mRNA expression at various times were evaluated by RT-PCR. Matured adipocytes were interfered with 0.1,1.0,10.0 ?g/L TNF - ? and the levels of CAMKⅡD gene mRNA expression were evaluated. Results The levels of CAMKⅡD gene mRNA expression in 3T3 - L1 adipocytes were significantly down- regulated at first day, compared with those at zero day (P0. 05). CAMKⅡD gene mRNA expression decreased significantly at 12 hours after treatment with 10.0 ?g/L TNF-?, treatment of matured adipocytes with TNF - ? did not have any regulation role on it. Conclusions CAMKⅡD gene is involved in the differentiation of adipocytes and related to the etiology of obesity. The changes in the level of CAMKⅡD gene mRNA expression during 3T3 - L1 preadipocyte differentiation may contribute to the differentiation and adipogenesis of adipocytes. It seems that TNF - ? does not have any regulation role on the expression of CAMKⅡD genes.

Objective To investigate the MR features of pituitary abscess.Methods The MR features of 14 cases of pituitary abscess proved by surgical pathology and clinical treatments were analyzed retrospectively.Results Pre-contrast MR showed hypointense heterogeneous intensity on T_1 WI in 12 cases and iso-hyperintense on T_1 WI in 2 cases,hyperintense on T_2 WI in all cases.Post-gadolinium MR showed the ring-like enhancement around the uneven edge of abscess and the surrounding enhanced meninges connecting to the focus.The normal pituitary could not be identified in all 14 cases.The MR specific findings include the fluid-fluid level,nodule on the edge and the enhanced patchy shadow.Conclusions The pituitary abscess has specific findings on MR examination,which can be used to combine with clinical symptoms to achieve the diagnosis before operation,so that the cases could be treated with antibiotic without operation.

Objective: To compare the efficacy of different treatment protocols in treating transient synovitis of the hip (TSH) in children and to optimize the clinical treatment strategy for this condition. Methods: Ninety kids with TSH were divided into a control group, a chiropractic group and a chiropractic plus foot bath group using the random number table method, with 30 cases in each group. The control group was treated with conventional traction; the chiropractic group was given chiropractic treatment based on the control group; the chiropractic plus foot bath group was given Chinese medicine foot bath based on the chiropractic group. Traction and foot bath were conducted once daily while chiropractic was done once every other day, all with 14 d as a treatment course for a total of two courses. Changes in the visual analog scale (VAS) score and range of motion (ROM) of the hip joint in the three groups were observed, and the efficacy was compared. Results: The total effective rate was 93.3％ in the chiropractic plus foot bath group, versus 76.7％ in the chiropractic group and 66.7％ in the control group, and the total effective rate was notably higher in the chiropractic plus foot bath group than in the other two groups (both P<0.05). Respectively after the first and second treatment course, the VAS score decreased significantly in each of the three groups compared with that before treatment (all P<0.01), and the ROM of the hip joint in flexion increased significantly (all P<0.01). After two treatment courses, the VAS score was lower in the chiropractic plus foot bath group than in the other two groups (both P<0.05), and its ROM of the hip joint in flexion was larger than that in the other two groups (both P<0.05). Conclusion: Based on traction, chiropractic plus Chinese medicine foot bath can effectively reduce pain and improve motor function of the hip joint in treating TSH.

OBJECTIVE: To explore the curative effect of nasal type extranodal NK/T-cell lymphoma by sequential chemotherapy combined radiotherapy compared with chemtherapy. METHOD: Fifty-seven cases of nasal type extranodal NK/T-cell lymphoma confirmed by pathological morphology and immuno-histochemistry were divided into chemotherapy combined radiotherapy group (34 cases) or chemotherapy group (23 cases). Twenty-three patients in the chemotherapy group alternately applied CHOP, VDLP and MEOP regimen after each two treatments into the clinical observation; Chemotherapy combined radiotherapy group of 34 patients, in addition to the above chemotherapy, applied three-dimensional conformal radiation therapy of the primary site by linear accelerators. Then all of patients were ceased treatment and followed up 3-5 years. RESULT: (1) After treatment, effective rate of two groups was 91.2% and 87.0%, there was no obvious difference (P > 0.05); After follow up about 1 year, effective rate of two groups was 76.5% and 73.9%, there was no obvious difference (P > 0.05); (3) After follow up about 3 years and 5 years, disease free survival (DFS) of two groups was 61.3%, 47.6% and 43.5%, 21.4%, there was obvious difference (P < 0.05). (4) Long-term survival is closely related to treatment mode. (5) B symptoms, advanced (III, IV) stage, the International Prognostic Index (IPI), KPS scores were correlated with prognosis, and were independent prognostic factors. CONCLUSION Treatment with chemotherapy and radiotherapy for nasal type extranodal NK/T-cell lymphoma had obvious curative effect and may improve long-term survival efficiently compared with chemotherapy alone.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; Combined Modality Therapy ; Female ; Humans ; Lymphoma, Extranodal NK-T-Cell ; drug therapy ; radiotherapy ; therapy ; Male ; Middle Aged ; Radiotherapy ; methods ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the validity, reliability, and clinical applicability of Chinese medicine syndrome diagnostic standards for coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI), which was established by expert consultation.

METHODSA total of 1 050 CHD patients after PCI were recruited from 23 hospitals. The sensitivity, specificity, accuracy, positive likelihood ratio, and area under ROC curve were used to evaluate the validity of diagnostic standards for Chinese medical syndrome types. The observable agreement rate and Kappa value were used to evaluate the reliability. Positive predictive value and negative predictive value were used to evaluate the clinical applicability.

RESULTSThe sensitivity, specificity, accuracy, positive likelihood ratio, area under ROC curve, observable agreement rate, Kappa value, positive predictive value, and negative predictive value of each Chinese medicine syndrome in CHD patients after PCI were as follows: 95.26%, 93.70%, 94.86%, 15.13, 0.924, 98.76%, 0.969, 97.76%, and 87.24% for blood stasis syndrome; 96.42%, 95.34%, 96.00%, 20.70, 0.957, 99.52%, 0.990, 97.02%, and 94.42% for qi deficiency syndrome; 88.19%, 96.46%, 94.19%, 24.89, 0.923, 96.67%, 0.915, 90.39%, and 95.58% for phlegm turbidity syndrome; 91.06%, 98.77%, 97.05%, 74.22, 0.950, 98.67%, 0.960, 95.54%, and 97.46% for cardiac blood stasis syndrome; 98.41%, 96.73%, 97.33%, 30.10, 0.976, 98.86%, 0.976, 94.40%, and 99.09% for qi deficiency blood stasis syndrome; 94.81%, 94.75%, 94.76%, 18.07, 0.948, 97.71%, 0.918, 72.73%, and 99.20% for phlegm-stasis stagnation syndrome.

CONCLUSIONThe validity, reliability, and clinical applicability of Chinese medicine syndrome diagnostic standards for CHD patients after PCI were rational and considerable in clinical practice.

Coronary Disease ; diagnosis ; etiology ; Humans ; Medicine, Chinese Traditional ; methods ; Percutaneous Coronary Intervention ; adverse effects ; Predictive Value of Tests ; Sensitivity and Specificity

Objective: To analyze the epidemiological characteristics and etiologic agent of herpangina in Xi’an in 2016. Methods: Herpangina epidemiological data and random stool samples were collected from two sentinel hospitals. The data were statistically analyzed with Excel and SPSS 18.0 and samples were detected and enteroviruses were genotyped using real-time PCR and RT-snPCR. Results: Totally 421 cases were reported and the male-to-female ratio was 1.54∶1, age ranged from 3 month to 13 years, and 90.50% were under three years of age. Herpangina showed semiannual peaks in April to October, of which the highest was in June (23.75%, 100/421). Lab result showed that 71.05% were EV positive out of 152 samples, and further genotyping indicated 60 were non-typable, and other 48 comprised of eight serotypes of EV including EV-A71, CV-A4, CV-A5, CV-A6(6.48%), CV-A10(23.15%), CV-A12, CV-A16 and CV-B3. Conclusions Male children under 3 years of age were the main population and herpangina cases were most frequently reported in June in Xi’an in 2016. CV-A6 and CV-A10 were more frequently detected in the typable ones.