Objective: To explore health resource allocation and optimization and evaluate the clinical departments efficiency in hospital. Methods: Taking a three level of first-class hospital in Beijing for example, the method of data envelopment analysis (DEA) was used for building a DEA model of clinical departments efficiency in hospital. Results: Based on the results of the DEA model, we drawn the technical efficiency and scale efficiency of the target clinical departments, obtained input redundancy rates and output deficiency rates of the non-effective decision-making units. Conclusion:By DEA evaluation results, the input redundancy and output deficiency of the target clinical departments are found. From the perspective of optimizing hospital resource allocation, measures to improve the hospital operational performance are proposed. There is important significance to improve the comprehensive competitiveness of the hospital.

AIM: To investigate the effect of sodium nitrite (SN) on lipopolysaccharide (LPS)-induced acute lung injury (ALI) and its underlying mechanism in mice. METHODS: All male Institute of Cancer Research (ICR) mice were randomly divided into five groups: Control group;LPS group;and SN 4.8 nmol/L, SN 48 nmol/L, SN 480 nmol/L (ip) groups. Lung wet weight/dry weight (W/D) ratio and permeability were detected. Neutrophil infiltration in bronchoalveolar lavage fluid (BALF) was measured by cel1 counting and morphological changes in lung tissues were assayed by hematoxylin-eosin staining. The 1evels of interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in lung were detected. Nitric oxide (NO) level and nitric oxide synthase (NOS) activity in lung were measured according to the specification. RESULTS: Compared to lung in LPS-induced ALI mice, at doses of 4.8 nmol/L and 48 nmol/L, not 480 nmol/L, SN markedly decreased the lung W/D ratio, total leukocyte number and neutrophil percentage in the BALF, lung permeability, and TNF-α/IL-10 ratio, in lung. SN at dose of 480 nmol/L markedly increased the lung NO level compared to control group. In addition, SN decreased the total NOS and inducible NOS (iNOS) activities compared to LPS-induced ALI mice. CONCLUSION: These results indicate that the protective effect of SN against LPS-induced ALI in mice is associated with the low dose SN-induced NO, as well as the subsequent decrease in iNOS activity and TNF-α/IL-10 ratio.

Objective To investigate the protective role of losartan,an angiotensin Ⅱ receptor(AT1 type)blocker,in the mechanical ventilation-induced lung injury(VILI).Methods Forty Sprague-Dawley rats weighing 300-350 g were randomly divided into the following four experimental groups(10 rats in each group):control group(group A),normal tidal volume venti-lation group(group B),large tidal volume mechanical ventilation group(group C),large tidal volume mechanical ventilation plus Losartan pretreatment group(group D).The pulmonary tissues were removed for pathological examination and detection of NF-κB activity,and the lung lavage fluid was collected for analysis of white blood cell count,total protein concentration and the level of MIP-2,after the rats were sacrificed.Results The pathology of lung tissues was normal in groups A and B.There was obvi-ous inflammatory damage in lung tissues in group C.The pathological inj uries of lung tissue were significantly reduced in group D compared with group C.The NF-κB activity and the level of p65 were significantly higher in group C than in groups A and B (P<0.01);they were significantly reduced in group D compared with group C(P<0.05).Total protein concentration,the MIP-2 level and the white blood cell count were significantly higher in group C than in groups A and B(P<0.01).They were significantly reduced in group D compared with group C(P<0.05 or 0.01).Conclusion Losartan,a selective inhibitor of sub-type AT1 receptors for angiotensin Ⅱ,can relieve VILI by inhibiting the activity of NF-κB.

Sepsis is a severe systemic inflammatory response syndrome, and is common in the patients with infection, extensive burn injury and major surgery. As it may cause multiple organ dysfunction and septic shock, it is always accompanied with high mortality and poor prognosis. Currently there's no effective medication available for treatment of sepsis. During the process of killing bacteria, the classical antibiotics lead to release of a large quantity of proinflammatory cytokines, such as lipopolysaccharide, which exacerbates the malfunction of immune system. Furthermore, the growing number of multiresistant bacteria present a new challenge to the management of sepsis. Antimicrobial peptides (AMPs) are small, cationic, and amphipathic peptides with broad-spectrum microbicidal activity against bacteria, fungi and viruses. In addition, they also can neutralize endotoxin and suppress inflammatory cascade through multiple immunomodulation, which potentially serves as a promising alternative approach for sepsis treatment. This review briefly summarizes the progress of AMPs in the treatment of sepsis as well as the relevant mechanisms.

Aggregatibacter actinomycetemcomitans ; physiology ; Bacterial Adhesion ; Biofilms ; Periodontal Diseases ; microbiology ; Porphyromonas endodontalis ; physiology

OBJECTIVETo detect the expression level of interleukin 17 (IL-17) in the plasma and colonic mucosa of patients with ulcerative colitis (UC), and to explore the synergistic mechanism of qingchang huashi recipe (QHR) combined with Mesalazine.

METHODSRecruited were 24 mild or moderate UC patients of damp-heat inner accumulation syndrome (DHIAS). Their samples of intestinal tissues were histologically graded. They were assigned to the combination group and the Western medicine (WM) group, 12 in each group. Besides, another 12 healthy volunteers were recruited as the healthy control group. QHR combined Mesalazine were given to patients in the combination group, while those in the WM group took Mesalazine. The therapeutic course for all was 3 months. By the end of treatment the expression level of IL-17 in the plasma and colonic mucosa was detected using ELISA. The infiltration of IL-17 in the intestinal mucosal tissue was detected by immunohistochemical SP method.

RESULTSThe expression level of IL-17 in the plasma and colonic mucosa was significantly higher in UC patients than in healthy controls (P <0. 05). The higher the histological grading the higher the expression level. The expression level of IL-17 in plasma and colonic tissues decreased after treatment in the two treatment groups (P < 0.05). Besides, the expression level of IL-17 was lower in the combination group than in the WM group (P <0.05).

CONCLUSIONQHR combined Mesalazine could synergically enhance the effect and effectively inhibit intestinal inflammation through down-regulating the expression of IL-17.

Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Colitis, Ulcerative ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Immunologic Factors ; metabolism ; Inflammation ; metabolism ; Interleukin-17 ; metabolism ; Intestinal Mucosa ; drug effects ; Intestines ; metabolism ; Mesalamine ; therapeutic use

Objective:To study the change of plasma cyclic nucleotide in patients of rheumatic heart disease with pulmonary hypertension and to evaluate the relationship between plasma cyclic nucleotides and hemodynamics. Methods:Plasma cGMP and cAMP were examined by radioimmunoassay, hemodynamic data were obtained with Swan Ganz catheter and the HP compact configurable monitors. Results:Plasma cyclic nucleotide increased in patients of rheumatic heart disease with pulmonary hypertension and had an obvious correlation with the level of PAPM, PVR, PAWP and CI. Conclusion:Increased cAMP and cGMP is one of the pathophysiological characters of pulmonary hypertension, cAMP and cGMP, as the second messenger, may play an important regulating role in the development of pulmonary hypertension.

Objective To investigate the role of 2B subunits-containing N-methyl-D-aspartate receptors (NR2B) in the arcuate nucleus in the development of inflammatory pain (IP) in rats.Methods One hundred and eight male Sprague-Dawley rats, aged 9 weeks, weighing 200-250 g, were randomly divided into 4 groups using a random number table: sham operation group (group S, n =47);group IP (n =47);dimethyl sulfoxide control group (group DMSO, n =7);selective NR2B antagonist Ro25-6981 group (group Ro25-6981, n=7).IP was induced by injecting complete Freund's adjuvant (CFA) 0.1 ml into the plantar surface of the left hindpaw.Ro25-6981 400 pmol was injected into the arcuate nucleus at 3 days after CFA injection.Seven rats in each group were selected for measurement of the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) at 1 day before CFA injection (T1) and at 2 days after CFA injection (T2), at 30 min before administration on 3rd day (T3) , at 30 min after administration on 3rd day (T4) , and on 5th day (T5).In S and IP groups, The rats were sacrificed at T1-3 and T5 , and the arcuate nucleus of the hypothalamus was removed for determination of NR2B mRNA expression (by real-time reverse transcriptase polymerase chain reaction) and NR2B and phosphorylated NR2B (p-NR2B) expression (by Western blot).Conclusion Compared with group S, the MWT was significantly decreased, and the TWL was shortened at T2-5 in IP, DMSO and Ro25-6981 groups, and the expression of p-NR2B was up-regulated at each time point (P＜0.05) , and no significant change was found in NR2B protein and mRNA expression in group IP (P＞0.05).Compared with group IP, the MWT was significantly increased, and the TWL was prolonged at T4in group Ro25-6981 (P＜0.05) , and no significant change was found in MWT and TWL at each time point in group DMSO (P＞0.05).Conclusion The activation of NR2B in the arcuate nucleus is involved in the development of IP in rats.

BACKGROUND: With the prevalence of total knee arthroplasty, periprosthetic joint infection as a serious complication has been an issue of concern.OBJECTIVE: To summarize the advances in the diagnosis and treatment of infection after total knee arthroplasty.METHODS: The first author searched the PubMed and CNKI databases for the literatures related to the diagnosis and treatment of infection after total knee arthroplasty using the keywords of total knee arthroplasty,infection in English and Chinese, respectively. The repetitive articles were excluded, and the risk factors,diagnosis, classification and treatment of infection after total knee arthroplasty were summarized.RESULTS AND CONCLUSION: (1) The infection after artificial knee replacement is closely related to the patient's preoperative condition, operation skills and postoperative status. (2) Diagnosis of infection is based on the detailed understanding of the patients' situation and complete auxiliary examinations. (3) The treatment methods include antibiotics, debridement and retention, reversion, arthrodesis, as well as amputation. (4) Periprosthetic infection is a serious complication after total knee arthroplasty, and early diagnosis and treatment are critical. Furthermore,choosing an appropriate individualized treatment scheme for different patients is important.