Objective To identify objective methods for medical service performance evaluation,and means to improve the efficiency of medical services.Methods By means of collection of medical records from 10 tertiary hospitals in Yunnan in 2012,and Diagnosis-related groups of Beijing version(BJDRGs)as a risk-adjustment tool,medical service performance was made to such hospitals.Results The capacity,efficiency and medical safety of hospital of the hospitals were subject to a comprehensive evaluation of their medical service capabilities.In terms of discharged inpatients and total weight,hospital A were found to be the highest(77 458 cases,104 227.5 respectively),and hospital I the lowest(25 450 cases,38 162.28)among these hospitals in 2012; compared with other hospitals,DRG groups of hospitals A,b and D were found higher,while the case mix index(CMI)of hospitals e and I were higher.The expenditure index of hospital C is the lowest(0.9359,0.8514); the mortality in cases of low risk of hospitals B,c and D were the lowest,while hospital F was the highest.Conclusion DRGs as a risk adjustment tool,can significantly improve the reliability,science and continuity of medical service performance evaluation,providing reliable basic data for hospitals accreditation in Yunnan.

Adult ; Facial Hemiatrophy ; Humans ; Male

Adenocarcinoma ; metabolism ; pathology ; surgery ; ultrastructure ; Aged ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; surgery ; ultrastructure ; Cardia ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Microscopy, Electron, Transmission ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; ultrastructure ; Synaptophysin ; metabolism

Objective To establish CFPAC-1 cell lines deficient in CDC25B2 by recombinant lentivirus, and to investigate the role of this gene. Methods After CFPAC-1 cells were transduced with recombinant lentivirus producing CDC25B2 siRNA, stably transduced cells with green fluorescent protein were selected by flow cytometer. The mRNA and protein expression of CDC25B2 was examined by RT-PCR and Western blot analysis. The effect of the lentivirus on the cell proliferation, cell cycle, clone-forming, migration and invasion ability was analyzed by MTr method, flow cytometer, plate clone-forming assay and Transwell chamber method respectively. Results CDC25B2 siRNA knocked down CDC25B2 expression in CFPAC-1 cells significantly. The silencing efficiency of siRNA transduction by recombinant lentivirns was very high. Proliferation, cloneforming, migration and invasion ability of human pancreatic cancer cell line CFPAC-I were significantly in-creased, while cell cycle was not affected. Conclusion CDC25 B2 plays an important role in cell proliferation, clone-forming, migration and invasion of pancreatic cancer. This research provides experimental evidences for targeting CDC25B2 in gene therapy against pancreatic cancer.

Objective To study the general shape of anterior cruciate ligament (ACL) insertion in rabbits and establish an animal model of ACL reconstruction using oval tunnels.Methods Eighteen mature white New Zealand rabbits were used in this study.Eight of them were used for anatomy study and the other 10 were for building an animal model.After removal of the medial femoral condyle and other soft tissues around ACL,the morphology of the ACL insertion was examined and the diameter of ACL insertions was measured using a caliper.An oval-tunnel dilator (1.6 mm×2.5 mm) was designed to make an oval-tunnel in the right knee of the rabbits while a round tunnel was drilled using a 2 mm diameter Kirschner wire in the left knee of the rabbits.Their hamstring tendon grafts were harvested as grafts for both sides and the compatibility between the bone tunnel and graft was examined for both groups.Right after the surgery,the knees of both sides were given the three-dimensional CT scan.Results The shape of ACL insertion of rabbits was oval.In the femur side,the average major and minor diameter of the ACL insertion was 5.28 ± 0.83 mm and 2.61 ± 0.33 mm respectively.In the tibial side,the major and the minor diameter of the ACL insertion was 5.33 ± 0.40 mm and 2.68 ±0.11 mm.The bone tunnel was compatible with the graft in both groups.In the oval tunnel ACL reconstruction group,the cross sectional area of the femoral bone tunnel was 3.18 ± 0.09 mm2 and the cross sectional area of the tibial bone tunnel was 3.26 ± 0.15 mm2.In the round tunnel ACL reconstruction group,the corresponding measurements were 3.13 ± 0.10 mm2 and 3.11 ± 0.11 mm2 respectively.There was no significant difference between the two groups.Conclusion The shape of ACL insertion in rabbits is oval.Using the self-made oval tunnel dilator we have successfully built an oval tunnel ACL reconstruction animal model with a good compatibility between the bone tunnel and graft.This lays the foundation for further research in the future.

OBJECTIVETo investigate the change of the expression of the FasL receptor and apoptosis in the pathology of silicosis of the rats exposed to silica and their roles.

METHODSNinety-six wistar rats were randomizedly divided into the control group and the experimental group. The silicotic animal model was established by the direct tracheal instillation of silica into rat lungs surgically. The control rats underwent directly tracheal instillation of saline into lungs surgically. Eight rats from each group were sacrificed at different days. The expression of FasL receptor in the tissue of the model rats was detected by tissuechip microarray and immunohistochemistry and the cell apoptosis induced by silica was determined by TdT-mediated dUTP nick end-labeling method. The integral optical density of positive cells were quantitatively analyzed using Image-Pro Plus Version 4.5 for windows.

RESULTSThe expression of FasL in the lung tissue of the model rats on the 7th, the 14th, the 21st, and the 28th day was significantly higher than that in the control group (P < 0.05), and peaked at the 14th day after exposure to silica. Apoptotic cells in the lung tissue of the model rats on the 1st, the 3rd, the 7th, the 14th, the 21st, and the 28th day were significantly more than those in the control group, and peaked at the 7th and the 14th day after exposure to silica.

CONCLUSIONSilica can lead to apoptosis in lung tissues. FasL is expressed in all kinds of cells in the pulmonary tissues of the rats exposed to silica and leads to apoptosis. From the 7th day to 14th day, inflammatory cells dominate in apoptotic cells.

Animals ; Apoptosis ; Disease Models, Animal ; Fas Ligand Protein ; biosynthesis ; Female ; Lung ; metabolism ; pathology ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Silicon Dioxide ; toxicity ; Silicosis ; metabolism ; pathology

Adult ; Antibodies, Monoclonal ; metabolism ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Male ; MyoD Protein ; metabolism ; Pneumonectomy ; Pulmonary Veins ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism ; Sarcoma, Alveolar Soft Part ; metabolism ; pathology ; surgery ; Vascular Neoplasms ; metabolism ; pathology ; surgery

Objective To explore the role of NF-kB activation on spontaneous formation of germinal centers in spleen in BXSB mice and it's mechanisms.Methods Eighteen BXSB mice were divided to control group and pyrrolidine dithiocarbonate(PDTC)group randomly.PDTC group was given PDTC 120 mg/kg?BW ip every other day and control group was given the same dose of dissolving solution.NF-kB activity was deter- mined by electrophoretic mobility shift assay.Two color flow cytometry were used to detect CD154 expression on splenic B cells and germinal center B cells apoptosis.Germinal centers were stained for histochemical analysis.Results PDTC could inhibit the NF-kB activity in spleen tissue in BXSB mice.It decreased the NF-kB activity by 62.82%.Spontaneous germinal center formation was detected in spleen in BXSB mice.In- hibiting NF-KB activation could down-regulate CD154 expression on splenic B cell,retard spontaneous germi- nal center formation and increase germinal center B cell apoptosis.Conclusion NF-kB activation may induce spontaneous germinal center formation in spleen in BXSB mice by upregulating CD154 expression on splenic B cell and decreasing germinal center B cell apoptosis.The autoreactive B cells generated during spontaneous germinal center formation may escape apoptosis and then differentiate to autoantibody-producing plasm cells.It suggests that NF-kB can be a therapeutic target.

Objective The incidence rate of sacrococcygeal tumor is low , however , due to its special position , clinical symptoms are inclined to be more severe .The aim of the article was to explore the methods and therapeutic effects of operative treat-ment for sacrococcygeal tumors . Methods A retrospective analysis was made on 44 cases of sacrococcygeal tumors treated in our hospital from January 2008 to December2012 .Of all the cases , there were 11 chordomas , 9 neurinoma , 4 malignant fibrous histioto-ma, 4 giant cell tumor, 7 metastases tumors and 9 others.All the patients had definite pathological diagnosis after operation .Operative treatments involved simple resection of rumors , simple resection of lesions and resection of lesions plus screw-rod system internal fixa-tion. Res ults No patients died in perioperative period .Follow-up was made in all patients for the average time of 3.3 years(4 months to 59 months).Except for 4 patients'delayed healing of incision operation and 1 patient′s healing of operation incision after de-bridement , all the other patients healed after enhancing the wound dressing , among which there are 3 cases of chordoma recurrence , 1 case of giant cell tumor recurrence , 3 death cases of malignant fibrous histiotoma in 2 years and 1 case alive with tumor .All patients with metastases tumor died in 3 years.Except 1 patients with osteosarcoma alive with tumor , all patients′symptoms had been alleviated after operation. Conclusion Chordoma and giant cell tumor still have a high recurrence rate after operation . The extent of rumor resection and nerve preservation are determined by the range of tumors.Preoperative embolization of the internal iliac artery can clearly reduce bleeding and improve the operation safety .

OBJECTIVETo investigate the clinical and pathological features, differential diagnosis of granulocytic sarcoma.

METHODSThe clinical manifestations, histopathological features, immunohistochemistry, treatment and prognosis were analyzed retrospectively in 10 cases of granulocytic sarcoma.

RESULTSThe age of patients ranged from 10 to 56 years (means = 35.8 years). The male-to-female ratio was 1.5:1. Histologically, the malignant cells of granulocytic sarcoma grew in a diffuse pattern. The cytoplasm was scanty, with eosinophilic fine granularity in some cells. The nuclei were round or focally irregular, and had finely dispersed chromatin. The mitotic figures were visible. Immunohistochemical stains for MPO, CD43, CD117, CD34 and CD99 were positive.

CONCLUSIONSGranulocytic sarcoma can occur in patients of all ages with a male predominance. The diagnosis of granulocytic sarcoma is assisted by the cytochemical stain for naphthol-ASD-chloroacetate esterase and/or immunophenotypic analyses for MPO, CD43, CD117, CD34, CD99. These stains aid in the distinction of granulocytic sarcoma from: lymphoblastic lymphoma, Burkitt lymphoma, diffuse large B-cell lymphoma, small round cell tumours, particularly in children, and blastic plasmacytoid dendritic cell neoplasm.

12E7 Antigen ; Adolescent ; Adult ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Burkitt Lymphoma ; metabolism ; pathology ; Cell Adhesion Molecules ; metabolism ; Child ; Dendritic Cells ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Leukosialin ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Male ; Middle Aged ; Peroxidase ; metabolism ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; pathology ; Proto-Oncogene Proteins c-kit ; metabolism ; Retrospective Studies ; Sarcoma, Myeloid ; metabolism ; pathology ; Skin Neoplasms ; metabolism ; pathology ; Young Adult