Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.

Objective To establish an ultra-high liquid chromatography(UPLC)characteristic spectrum of Rheum tanguticum Maxim.ex Balf.water decoction and conduct chemical pattern recognition analysis,and to identify the medicinal materials of different origins and different processed products.Methods:UPLC was adopted to establish the characteristic spectra of 15 batches of Rheum tanguticum Maxim.ex Balf.Cluster analysis combined with principal component analysis was used to analyze their quality.Rhei Radix et Rhizoma from different origins and different processed products of Rheum tanguticum Maxim.ex Balf.were identified.Results:The characteristic spectrum of Rheum tanguticum Maxim.ex Balf.water decoction was established,18 common peaks were identi-fied,and 15 batches of Rheum tanguticum Maxim.ex Balf.were divided into 2 categories according to their origins by cluster analysis.The similarity between 15 batches of samples from different origins and the control spectrum was greater than 0.900.According to OPLS-DA analysis,a total of 6 markers(rhein-8-O-β-D-glu-cosid,resveratrol-4'-O-β-D-(6''-O-D-gallyl)glucopyranside,isolindleyin,rhein,epicatechin-3-O-D-gallate,and catechin)affecting the quality of Rheum tanguticum Maxim.ex Balf.water decoction samples were found.Rhei Radix et Rhizoma from different origins and different processed products of Rheum tanguticum Maxim.ex Balf.can be effectively distinguished.Conclusion:The established characteristic spectrum method is easy to operate and has good repeatability.It can be used for the quality control of Rheum tanguticum Maxim.ex Balf.water decoction,and can provide reference for the formulation of quality standard of formula granules of Rhei Radix et Rhizoma.

The clinical data of 3 patients with rhabdomyolysis (RM) caused by different viral infections were retrospectively reviewed. The diagnoses were established according to the clinical symptoms, physical signs, myocardial enzymes, and muscle biopsy. Case 1 was a 11-year-old boy with influenza A virus infection, whose major symptoms were fever, cough and myalgia. After the treatment of active anti-virus, hydration, and alkalinization, the patient completely recovered. Case 2 was a 10-year-old girl with Epstein-Barr (EB) virus infection who had significant musculoskeletal pain and muscle weakness symptoms with significantly elevated serum creatine kinase. After active hydration and anti-infective treatment, the patient's condition returned to normal. Case 3 was a 15-year-old boy with human cytomegalovirus infection, whose symptoms were mainly repeated fever, accompanied by myalgia and facial edema. Antibacterial therapy was ineffective, and the disease progressed with respiratory muscle weakness and multiple organ injuries. After antiviral treatment, respiratory support and hemofiltration, the symptoms relieved and patient recovered without sequela. With literature review, we believe that although influenza virus, Epstein-Barr virus and cytomegalovirus rarely cause RM in children, it should be attached attention to. With early diagnosis and treatment, the prognosis is favorable.

Objective To analyze the clinical value of immature granulocytes in peripheral blood for prediction of persistent systemic inflammatory response syndrome (SIRS) in patients with acute pancreatitis (AP). Methods 1 973 patients with AP in Hunan People's Hospital from 2012 to 2017 were retrospectively enrolled and divided by SIRS duration into the persistent SIRS group, temporary SIRS group and non-SIRS group. The independent risk factor for persistent SIRS in AP patients was evaluated by Logistic regression analysis, and predictive value of immature granulocytes for persistent SIRS in AP patients was analyzed by the receiver operating characteristic (ROC) curve. Results These 1 973 AP patients (1 165 males, 59.0%) with an average age of 49 (40, 60) years old, including 288 persistent SIRS, 189 temporary SIRS and 1 496 non-SIRS cases. There was no significant difference in gender, age and etiology among three groups. Compared with non-SIRS group, more severe symptoms were observed in the temporary and persistent SIRS groups. Moreover, The acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), CT severity index (CTSI), multiple organ failure (MOF) and acute respiratory distress syndrome (ARDS) incidence, mortality and C-reactive protein (CRP), white blood cell count (WBC), procalcitonin (PCT) and immature granulocytes in persistent SIRS group were further higher than those in the temporary SIRS group [APACHEⅡ: 9 (6, 12) vs. 5 (3, 7), CTSI: 6 (4, 6) vs. 4 (3, 6), MOF incidence: 92.0% vs. 32.8%, ARDS incidence: 39.9% vs. 10.1%, morbidity: 11.1% vs. 4.2%, CRP (mg/L): 25.00 (0.80, 212.25) vs. 0.80 (0.80, 123.50), WBC (×109/L): 15.17±6.78 vs. 14.84±5.86, PCT (μg/L): 0.23 (0.10, 1.76) vs. 0.10 (0.10, 0.31), immature granulocytes: 1.95 (0.90, 4.95) % vs. 0.80 (0.40, 2.10) %, all P < 0.05]. Logistic regression analysis showed that besides pancreatic necrosis, WBC and CRP, immature granulocyte was an independent risk factor for persistent SIRS associated with AP [odds ratio (OR) = 1.844, 95% confidence interval (95%CI) = 1.372-2.220]. ROC curve showed that immature granulocytes had better predictive value for persistent SIRS, the area under the curve (AUC) was 0.806, which was significantly higher than the APACHEⅡ (AUC = 0.783), CTSI (AUC = 0.752), PCT (AUC = 0.676), CRP (AUC = 0.677), WBC (AUC = 0.644). The cut-off value of immature granulocyte was 0.65%, the sensitivity was 84.0%, the specificity was 66.3%, the positive predictive value was 62.4%, and the negative predictive value was 76.3%. Conclusion Immature granulocyte in peripheral blood is a potential indicator for persistent SIRS in AP patients.

Objective To investigate the effect of daily behavior,life habits,mental status of the resident population in Beijing City on thyroid nodules.Methods A questionnaire survey was conducted using stratified sampling method to investigate the resident population in physical examination organization of Xicheng,Chaoyang,Mentougou and Shunyi districts,who lived in Beijing for more than 15 years,ages between 45-50 years old,and they did not know whether suffered from thyroid nodules.A 1:1 case-control study was used to analyze the relationships between thyroid nodules and mobile phone using time,exercise,sleep and mental stress in males and females.Logistic regression analysis was used to analyze relationships between various factors and thyroid nodule in single factor analysis,and if the influence factors in the single factor analysis had statistical significance they will be further analyzed in the multiple factors analysis.Results The total prevalence of thyroid nodules was 35.06％ (331/944),males and females were 27.91％ (144/516) and 43.69％ (187/428),respectively.The prevalence of female was higher than that of male (x2 =25.60,P ＜ 0.05).Logistic regression analysis showed that mental stress (males,females:OR =2.106,1.653,95％CI:1.158 ～ 3.831,1.042 ～ 2.622) and using the phone ＞ 3 h (males,females:OR =12.863,5.315,95％CI:1.540 ～ 107.444,1.359 ～ 20.794) were risk factors for thyroid nodules in the male and female populations.Conclusion The occurrence of thyroid nodules maybe related to mental status and using the phone for a long time,but its mechanism needs to be further explored.

Objective Through testicular sperm aspiration (TESA),testicular biopsy,and detection of serum reproductive hormone levels and testicular volume in azoospermia patients,to explore the correlation between spermatogenic function of testis and serum FSH,LH,INHB levels,and testicular volume.Methods 76 cases of azoospermia patients were collected as the research objects.Chemiluminescence method was employed to detect the levels of serum reproductive hormone,and testis model was used to detect testicular volume.Routine disinfection was given to make TESA.According to TESA results,patients were divided into sperm group (group A),and azoospermia group (group B).According to testicular biopsy results,patients were divided into normal spermatogenic function group (group C),sperm maturation block group(group D),permatogenic dysfunction group (group E),and sertoli-cell-only syndrome group (group F).At the same time,40 cases of healthy male were selected as the control group (group G),and they received sperm routine examination,serum reproductive hormone and testicular volume detection.Results The level of serum FSH,LH,INHB and testicular volume in group A and C had no significant difference compared with that in group G(P＞0.05).The level of serum FSH and LH was significantly higher in group C than that in group G.The level of serum INHB and testicular volume was significantly lower than that in group G (P＜0.05).The level of serum FSH in group E was higher than in group G.The level of serum INHB in group D and E was lower than that in group G,and the difference was statistically significant (P＜0.05).Spearman correlation analysis showed that the spermatogenic function of testis was negatively correlated with serum FSH and LH levels,and positively correlated with serum INHB level and testicular volume (P＜0.05).Conclusion The detection of serum FSH,LH,INHB levels and testicular volume has important clinical value for predicting testicular spermatogenie function in azoospermia patients,and can be used to guide clinical testicular sperm aspiration.

Objective To explore the change of serum Apelin level and its relationship with insulin resistance (IR) in infertility patients with polycystic ovarian syndrome (PCOS). Methods Ninety-eight infertility patients with PCOS (PCOS group) and 72 infertility patients without PCOS (non-PCOS group) visiting our hospital for the first time from January 2011 to June 2012 were selected. The BMI , serum Apelin level (detected by ELISA), fasting blood glucose (FPG, detected by glucose oxidase method), fasting insulin (Fins, detected by chemiluminescence), and homeostasis model assessment of insulin resistance index (HOMA-IR) of the two groups were detected. Results The serum Apelin level and HOMA-IR in PCOS patients were higher than those in non-PCOS patients (3.28 ± 1.24 vs. 1.94 ± 0.78, P < 0.05; 3.84 ± 1.23 vs. 2.14 ± 0.77,P < 0.05). Pearson correlation analysis showed that serum Apelin level was positively correlated with HOMA-IR in PCOS patients (r=0.65, P<0.01). Conclusions The serum Apelin level in infertility patients with PCOS increased evidently, and was positively correlated with HOMA-IR; which indicated that Apelin may involve in the development of IR in infertility patients with PCOS.

OBJECTIVEThis study aimed to explore the secular trends of overweight and obesity prevalence between 2007 and 2011 in children and adolescents in Guangzhou.

METHODSThe data of physical examination was collected from the routine measurements carried out by the Health Care Facilities of Primary and Secondary schools between 2007 and 2011. Random stratified cluster sampling was conducted, all the students aged 5-18 years old form 19 primary and secondary schools from 4 districts (Tianhe district, Yuexiu district, Baiyun district and Haizhu district) were included in this survey, including 27 944 students in 2007 and 38 284 students in 2011. Body mass index reference norm established by Working Group on Obesity in China (WGOC) and the WHO cut-off criteria were employed for overweight and obesity screening, and the trend was analyzed.

RESULTSPrevalence of obesity in children and adolescents (7-18 years old) significantly increased from 5.96% (1 553/26 055) in 2007 to 6.56% (2 339/35 664) in 2011, and the difference showed statistical significance (χ(2) = 9.195, P < 0.05). Overweight and obesity was more common in boys (overweight: 13.25% (1 766/13 329) in 2007 and 13.87% (2 559/18 451) in 2011; obesity: 7.82% (1 042/13 329) in 2007 and 8.63% (1 592/18 451) in 2011) than in girls (overweight: 7.43% (946/12 726) in 2007 and 8.17% (1 406/17 213) in 2011; obesity: 4.11% (523/12 726) in 2007 and 4.48% (771/17 213) in 2011), and the difference showed statistical significance (overweight:χ(2) = 236.123 in 2007 and χ(2) = 292.892 in 2011; obesity:χ(2) = 158.533 in 2007 and χ(2) = 247.794 in 2011. All P values < 0.05). Further analysis found that significant increases occurred in boys aged 16 and 17 years old and in girls aged 12 years old (boy: 16 years old,χ(2) = 6.820, P < 0.05. 17 years old, χ(2) = 4.893, P < 0.05. girl: 12 years old,χ(2) = 5.921, P < 0.05).

RESULTSof Join-point regression showed that for boys less than 10 years old the prevalence increased with age increasing (in 2007, APC = 3.75; in 2011, APC = 1.76), while over 10 years old the prevalence decreased with age increasing (in 2007, 10-18 years old's APC = -18.58; in 2011, 10-18 years old's APC = -15.95). While for girls the prevalence of obesity increased with age increasing between 7-9 years old (APC = 12.16), decreased with age increasing through 9 to 18 years old (APC = -17.23) in 2007. The prevalence decreased with age increasing for girls in 2011 (APC = -4.66).

CONCLUSIONThe prevalence of obesity is high and still increasing in children and adolescents in Guangzhou, and it is higher in boys than in girls. It is more likely to become obesity at 10 years for boys, and for girls the prevalence decrease with age increasing.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Obesity ; epidemiology ; Overweight ; epidemiology ; Prevalence

ObjectiveTo determine the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism in Han ethnic patients with type 2 diabetes in Chenzhou area of Hunan province,and to assess the assoeiation between this polymorphism and diabetes.MethodsThis study was cross-sectional designed.Samples were taken by random sampling method from diabetes, prediabetes and euglycemia subjeers.ACE gene polymorphism I/D were examined by PCR.Genotype was classified as I1, ID, or DD based on positive or negative insertion/deletion allele.ResultsThis study showed significant differences of ages (X2 =32.09, P ＜0.01), body mass index (BMI) (X2 =16.10, P ＜0.01), family history (X2 =20.42, P ＜0.01) and serum triglyceride (F =21.289, P ＜0.01) among three groups, and diabetes group tended to have higher value.Frequency of genotype II, ID, DD were 72(56.3％) ,52(40.6％) and 4(3.1％) in diabetes, 64(64.0％) ,30(30.0％) and 6(6.0％) in pre-diabetes subjects, 81 (72.3％),29(25.9％)和 2(1.8％) in euglycemia subjects, consecutively.Chi-square analysis showed statistically significant association between ID + DD vs.Ⅱ genotype and diabetes (x2 = 6.68, P ＜ 0.05).Logistic regression analysis showed four variables that significantly influence to diabetes, namely ACE gene polymorphism, family history of diabetes, BMI, and serum triglyceride level.ConclusionsACE ID + DD genotype had significant relationship with diabetes in Chenzhou Han ethnic population, Hunan province, China.

OBJECTIVETo study the antitumor activities of the triterpene glycoside colochiroside A (CA) from the sea cucumber Colochirus anceps.

METHODThe tests of antitumor activities in vitro and in vivo were applied to demonstrate the effect of CA.

RESULTThe preliminary cytotoxic assay of CA exhibited significant cytotoxic activity against 6 types cultured tumor cell lines of p388, HL60, A-549, SpC-A4, MKN-28, and SGC-7901, the mean of IC50 were (3.61 +/- 0.55) mg x L(-1). The preliminary antitumor assay of CA indicated that this saponin exhibited high inhibiting activity against the H22 live cancer and the S180 sarcoma cells in mouse. The inhibition ratio to H22 liver cancer were 34.8%, 43.9% and 52.2%, while the ratio to S180 sarcoma were 36.4%, 70.0%, the immunoregulatory founction study indicated CA has not significant effect on the developments of thymus and spleen.

CONCLUSIONThe saponin CA exhibited remarkable antineoplastic activities in vitro and in vivo, and could not reduce the immunoregulatory founction of mice.

Animals ; Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Glycosides ; pharmacology ; Mice ; Neoplasms, Experimental ; drug therapy ; Sea Cucumbers ; chemistry ; Triterpenes ; pharmacology