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 To analyze the correlation between the diagnosis and treatment and the postoperative death and complication of the elderly patients.Methods A total of 1 932 cases of surgical patients (over 70 years old) were collected from a three-level general hospital 2013-2015.Their medical information of the treatment methods were recorded,including incision category,surgical approach,surgical grade and patient outcome after surgery(death or postoperative complications).Then we analyzed the incidence of death or postoperative complications,as well as the effects of treatment and postoperative outcome on complications or mortality.Results The admission status and incision type were the risk factors of postoperative death in elderly patients.Admission status pollution type,surgical approach and surgical grade were the risk factors of postoperative complications.Conclusion In order to reduce the risk of postoperative death and complications in elderly patients,the effect of admission and incision on the postoperative risk of elderly patients should be evaluated.

In present paper,we studied three kinds of method of assay for IL-1:thymocyte proliferation assay;L_(?) cell proliferation assay and pyrogen assay.Stimultaneously we used ~(125)I-UdR in stead of ~3H-TdR.The results show that all of three kinds of method of assay for IL-1 can measure IL-1 activity of supernatants from cultured rat alveolar M? stimulated by LPS in vitro.It suggests that ~(125)I-UdR can incorporate into DNA synthesis of cell and mouse fibroblast cell line L_(?) can response to IL-1 of supernatant from cultured rat alveolar M? stimulated by LPS.

Argentina ; epidemiology ; China ; epidemiology ; Cross-Sectional Studies ; Hemophilia A ; diagnosis ; epidemiology ; therapy ; Humans ; Prognosis ; Russia ; epidemiology ; Surveys and Questionnaires ; United States ; epidemiology ; Urban Population

While the medicine pattern of biomedicine turn to biological-psychology-society, the medical trouble communication becomes more and more important in the medical service. Good medical trouble communication ability is the essential condition of doctor. As oral cavity clinicians, only by gasping the principle of communication can we appropriately utilize some skills of communication exchange,establish the good medical trouble relations with the patient and achieve the good treatment result finally.

Clinical hematology and hematologic examination is a strong practical curriculum, and experimental class is very important in the aspects of teaching.In order to improve the quality of teaching and train compound laboratory talents with high quality,several effective reform mea-sures were carried out based on the years of teaching practice by the department:improving the methods of experimental teaching;using modern means of teaching;emphasizing on the analysis of experimental results,formulating the rigorous experimental evaluation system and starting the second class etc.

ObjectiveTo construct human embryonic kidney cells (HEK293) modified with human preproenkephalin (hPPE) gene.MethodshPPE gene fragments were obtained from recombinant plasmid pcDNA3.1( + )/hPPE by using restriction endonuelease Hind Ⅲ and Not Ⅰ.Homologous recombination of lentivirus and hPPE gene was produced by using recombinant DNA technology.HEK293 cells were then transfected with the recombinant lentivirus vectors.The expression of hPPE gene in HEK293 cells was detected by Western blot.ResultsThe results of DNA sequencing indicated that the positive clone of recombinant lentivirus was completely consistent with sequencing of hPPE in Genebank.The titer of the concentrated virus was 2.07 × 108 TU/ml.GFP fluorescence was not seen in HEK293 cells transfected with the lentiviral vector under fluorescence microscope.A strong fluorescence was seen in HEK293 cells transfected with Ubc-GFP-L.V.empty viral vector.Positive expression of hPPE was demonstrated in HEK293 cells transfected with lentiviral vector by Western blot.Conclusion HEK293 cells modified with hPPE gene were successfully constructed and the target gene hPPE was stably expressed in HEK293 cells.

The molecular delivery vectors used in gene therapy need provide the features of safety,stability, efficiency and capacity. The current studies on the structure and action mechanism of pRNA, a packaging RNA of phage?29, showed that pRNA with multiple binding sites can through cell membrane easily and escort exogenous molecules to target cell, without inducing immune reaction. As an ideal nano-scale gene therapy vehicle, pRNA presents a promising application in delivering multiple therapeutic components to detect and treat human diseases.

Objective To demonstrate the superiority and feasibility of using bioluminescent image to monitor the islet graft after islet transplantation.Methods Diabetic models were established by intraperitoneal injection of streptomycin into mature male C57BL/6 mice.Islets were harvested from the pancreas of C57BL/6 and Bclb/c mice by digestion and purification,and transfected with Lueiferase gene.The mouse diabetic models were divided into iso-transplantaion group (n=20) and allo-transplantation group (n=7).The islets of C57BL/6 were transplanted into iso-transplantaion mice with different doses (10,50,110 and 200,n=5 in every dose),and Bclb/c mouse islets were transplanted into allo-transplantation group.The islets were transplanted into the subcutaneous fat tis- sue near left scapula.The receptor mice were scanned with CCD camera to get bioluminescent images at different scheduled time points,and the changes in random blood glucose of allo-transplantation group were observed.Results On day 6 after transplantation,the scanning image showed that the pi- xel intensity from the region of interest (ROI) was increased with the increased number of islet grafts and they had a positive correlation.The random blood glucose was reduced to the normal level in the first 2 days,and then increased again to the diabetic level on 11 days averagely,while pixel intensity from the ROI reached the peak on day 6-7,and then reduced rapidly after islet transplantation in allo- transplantation group.The beginning of pixel intensity reduction occurred on day (6.14?0.90), while that of the random blood glucose raise occurred on day (10.00?0.82) after transplantation,and the former alteration occurred obviously earlier than the latter (P