A survey of the compensation for senior medical talents in four public tertiary hospitals in Jiangsu province was made,to probe into defects found with their compensation mechanism,and come up with a better compensation incentives practice, including both currency and non-current compensation.These aim at maximization of the incentives.

Trust financing is a new financial instrument on the market at present.Combined with the new health reform and macroeconomic background,the paper firstly summarized the basic theory of public hospitals'trust financing,discussed the feasibility of public hospitals'trust financing,then put forward some policy suggestions for how to perfect trust financing for public hospitals from improving external environment,increasing government support,optimizing of hospital risk mitigation mechanism and income security mechanism,regulating hospital project information disclosure,training professional talents on the basis of analysis of three models of public hospitals' trust financing.

Abstract: Objective To analyze and compare the differences in serum lipid metabolomics between patients with moderate to severe acne and healthy controls to understand the characteristics of serum lipid metabolism in acne patients. Methods Serum samples were collected from 30 patients with moderate to severe acne and 30 healthy controls matched for age, gender and body mass index in the Department of Dermatology, the Affiliated Hospital of Southwest Medical University from May 2019 to Apr. 2020. Serum lipid metabolomics was analyzed by liquid chromatography-tandem mass spectrometry. Partial least squares discriminant analysis (PLS-DA) was used for multivariate statistical analysis of differentially expressed lipid metabolites. The metabolic pathways with significant differences between the two groups were screened by Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Using Mann-Whitney U test to calculate differential metabolites. Spearman correlation analysis was used to analyze the correlation between serum PC (18: 2e/20: 2) concentration and acne severity. Results The PLS-DA results showed that the composition of serum lipid metabolites in acne patients was significantly separated from that in healthy controls. Of the top 30 lipid metabolites with the most significant differences, four kinds of triglycerides (TG), two kinds of diglycerides (DG), six kinds of phosphatidylcholine (PC), one kind of MePC, two kinds of sphingomyelin (SM), two kinds of phosphatidylinositol (PI), two kinds of ceramide (monohexosyl ceramide, Hex1Cer;dihexosyl ceramide, Hex2Cer), two cardiolipin (CL) were found to be increased in the acne group (P<0.05). The levels of one kind of DG, two kinds of lysophosphatidyl ethanolamines (LPE), one kind of dimethylphosphatidyl ethanolamine (dMePE), one kind of bismethyl phosphatidic acid (BisMePA), three kinds of phosphatidyl ethanolamine (PE) and one kind of ceramide were found to be decreased in the acne group (P<0.05), and most of them belonged to phospholipid metabolites. Spearman correlation analysis showed that serum PC (18:2e/20:2) concentration was positively correlated with acne severity (r=0.456, P=0.004). KEGG enrichment function analysis revealed that the differential lipid metabolites were primarily enriched in metabolic pathways such as sphingolipid signaling pathway, cholesterol metabolism, insulin resistance, glycerophospholipid metabolism, among which the sphingolipid signaling pathway may play an important role. Conclusion There are significant differences in serum lipid metabolism between acne patients and healthy controls. Lipid metabolism disorders may be related to the pathogenesis of acne, but it’s molecular mechanism still needs further experimental exploration.

Tort Liability Law set tougher requirements on the validity and authenticity of medical records,featuring explicit protection of patient rights of informed consent.Based on the changes in the law since its enforcement,the authors studied existing deficiencies of electronic medical records and came up with the following suggestions.Establish sound legal accreditation system for electronic medical records; perfect related laws and regulations to ensure standard application of the electronic medical records; and work out regulations to make medical staff aware of their legal responsibilities when applying electronic medical records.These recommendations will enable electronic medical records better fit the current legal environment onto the track of healthier development.

Objective By studying the different blood volume blood donors machine adopt platelet product aggregation,platelet content,the machine adopt circulating volume,etc,analysis of different blood volume machine adopt donors on appropriate conditions.Methods The base material of randomly selected 307 blood donors,through blood related index in the study of circulating volume,blood volume,gender,platelets,Hct,Pct count before collection,machine adopt of platelet aggregation and the relationship between the acquisition time;different blood volume,blood platelet count grouping machine adopt the different of platelet aggregation rate,different amount of platelets collect blood volume group,the comparison of blood circulation.The use of statistical software SPSS 17.0,data analysis,analysis including multiple regression analysis,chi-square test,t test,etc.Results 1)The lower count of platelets,Hct,Pct count before collection,the longer the acquisition time,and gender and Pct has nothing to do with the acquisition time the longer the acquisition time,the higher the machine adopt the possibility of platelet aggregation.2)Low blood volume and low platelet count group,machine mining platelet aggregation rate is higher.3)Machine adopt donors of blood volume is higher,the machine adopt the platelet collection amount,the more and the less blood circulation.Conclusion According to the different blood volume blood donors check-up indicators,further carries on the reasonable analysis,optimized machine mining scheme,especially to reasonable arrangement of low blood volume blood donors,so as to improve the quality of platelet collection.

Objective To observe the pathological infrastructure changes of lung tissue in diabetic rat with pulmonary fibrosis and the preventive effect of rosiglitazone intervention. Methods The experimental type 2 diabetic rats were yielded by high-sugar, high fat diet plus intraperitoneal injecting streptozotocin (STZ). The pathological infrastructure changes of lung tissue were observed by transmission electron microscopy in the control, diabetes mellitus group and rosiglitazone treatment group respectively, and the hydroxyproline contentswere determined simultaneously. Results We observed accumulation of collagen fibers and extracellular matrix in the lung tissue of simple diabetic rat, which indicated pulmonary fibrosis. The hydroxyproline contents were significantly higher in diatetes mellitus group when compared to the control at 12 weeks[ 0. 77 ± 0. 03μg/(mg·prot) vs.0.63 ±0.03 μg/(mg·prot)] and 20 weeks [0.93 ±0. 10 μg/(mg·prot) vs.0.87 ±0.10μg/ (mg·prot) ]. (Ps < 0.05) , but the rosiglitazone intervention significantly reduced the hydroxyproline 3contents in diabetes mellitus rats [0.85 ±0.08 μg/(mg·prot) vs.0.87 ±0. 10 μg/(mg·prot) ,P<0.05].Conclusion Pulmonary fibrosis occurred in diabetic rats lung tissue,while rosiglitazone can alleviate it.

Adolescent ; Adult ; Age Factors ; Child ; Child, Preschool ; Electroencephalography ; Epilepsy, Temporal Lobe ; diagnosis ; etiology ; Humans ; Infant ; Male ; Middle Aged

Objective:To study the occlusion characteristics of the young subjects with bruxism before and after treatment by elastic occlusal splint. Methods:10 patients with bruxism and aged 22-27 years(n=10) were treated by elastic occlusal splint, before and 6 months after treatment they were examined by T-Scan occlusion detector. The occlusion time( OT) , disclusion time( DT) , oc-clusion force( OF) , the perentage of occlusion force( POF) , the changes of the position of center occlusal force( COF) and the asym-metry index of occlusion force(AOF) were observed and compared with those of the healthy controls(n=10). Results: ① In the case group there was significant difference in the OT and DT between left and right anterior teeth before treatment (P<0. 05), but not after treatment (P>0. 05). There was significant difference in the momevent of COF of left and right side, the POF of right side and the AOF between the 2 groups before treatment, but not after the treatment(P>0. 05). ② In the case group after treatment the OT and DT of left and right anterior teeth were shortened(P<0. 05). The POF of right side and the AOF were significantly improved. In the case group DT, OF center excursion, the left POF and the AOF showed no significant difference before and after treatment( P>0. 05). Conclusion:The occlusal factors such as early contact, lateral teeth synthetic interference, occlusal force center excursion have close relationship with bruxism. Elastic occlusal splint can effectively correct muscle dysfunction and make occlusal relationship more coordinated and stable, and therefore is effective in the treatment of bruxism.

Objective To evaluate the efficacy and safety of therapeutic drug monitoring (TDM ) based vancomycin dose adjustment in patients with gram‐positive infections .Methods A cohort study was designed with 128 inpatients undergoing TDM in Huashan Hospital from January 2005 to September 2014 .The clinical data of these patients were used to analyze the efficacy and safety of vancomycin therapy by Cox model and survival analysis .Results The patients undergoing TDM‐based dose adjustment had a higher daily dose and blood trough concentration ,which may lead to better bacteriological efficacy and overall efficacy .Cox proportional hazards model analysis showed that TDM‐based dose adjustment is a protective factor .No safety‐related risk factor was found .Conclusions TDM‐based vancomycin dose adjustment is important for patients to achieve better outcomes in fighting gram‐positive infections .

Objective To explore the resilience and its influencing factors of nurses.Methods I 356 nurses from 11 comprehensive hospitals of Guangzhou were assessed by Conner-Davidson Resilience Scale,General Self-Efficacy Scale,Simplified Coping Style Questionnaire and Chinese Nurse Job Stress Scale.Results ①The score of nurses' resilience was (59.99± 13.59) and it was significantly lower (t=-t4.656,P＜0.001) than that of the domestic norm (65.4±13.9,n=560).There were statistic difference (P＜0.05) among the total score and 3 dimensions scores of resilience on different educational level and professional rank of nurses.②Nurses' resilience had a obvious positive correlation with the educational level,professional rank,self-efficacy,positive coping(P＜ 0.01),and a obvious negative correlation with the negative coping and job stress(P＜0.01).It can be assumed that educational level,self-efficacy,coping style and job stress had good predictive ability (47.4％).Conclusion The nurses have low resilience than general population.Educational level,self-efficacy,coping style and job stress are influencing factors of resilience.