Objective To measure and predict the hospital resources to be saved by reducing one day of stay in average in China,predict its future impacts,and to probe into the importance of less average days of stay for hospital resource deployment.Methods A mathematical model was used for quantitative analysis of the actual impacts of one less day of stay in China′s hospitals for the hospital resources,and the gray forecasting model was used to predict the hospital resources so saved by achieving so during 2013 to 2025.Results One hospital day less could save 9.41% of a hospital′s total bed resources.According to the growing trend of hospital beds in China and the deployment relationship,it is predicted that more hospital resources will be saved by one hospital day less in average from 2013 to 2025.Conclusions Shorter average days of stay and optimal deployment of hospital resources,should be based on quality of care.Less ineffective waiting time to shorten average days of stay can be breakthrough to improve the comprehensive efficiency of health resources.

Objective To investigate the selective killing effect of adenoviral mediated herpes simplex virus-thymidine kinase/ganciclovir (HSV-tk/GCV) suicide gene system controlled by human telomerase reverse transcriptase (hTERT) promoter on bladder cancer cells in vitro. Methods Bladder cancer cell line 253J and human fibroblast cell line MRC-5 were transfected by the recombinant adenovirus of different multiplicities of infection (MOI),and the infection rate was measured by observing the expression of enhanced green fluorescent protein (EGFP) under the fluorescent microscopy.Ad-hTERT-HSV/tk and Ad-CMV-HSV/tk were transduced into 253J and MRC-5,followed by GCV treatment. The relative survival rate of cells in presence of prodrug GCV was measured with MTT method. Results Recombinant adenovirus Ad-hTERT-EGFP could selectively infect 253J cells,with the infection rate associated with the increasing MOI of recombinant adenovirus (P

BACKGROUND:Menstrual blood-derived mesenchymal stem cels are proved to be a new type of adult stem cels. To date, little is reported on the methods of establishing this kind of cel lines systematicaly.
OBJECTIVE:To isolate, culture, identify and finaly establish menstrual blood-derived mesenchymal stem cel lines.
METHODS:Menstrual blood-derived mesenchymal stem cels were isolated from the menstrual blood of healthy female donors and cultured accordingly using density gradient centrifugation method. Cel morphology and proliferation characteristics were observed, and proliferative ability was detected by cel counting kit-8 assay. Cels were colected periodicaly for karyotype analysis. Expressions of cel surface antigens such as CD34, CD38, CD44, CD45, CD73, CD90, CD105 and Oct-4 were analyzed using flow cytometry. Cel pluripotency were identified by inducing adipogenesis and osteogenesis in vitro.
RESULTS AND CONCLUSION:We successfuly established four menstrual blood-derived mesenchymal stem cel lines from the menstrual blood of six healthy volunteers. The cultured cel lines had a typical spindle shape and kept normal 46, XX karyotype. The cels grew rapidly and entered into the logarithmic growth phase at 48 hours after passaging. The results of flow cytometry showed that menstrual blood-derived mesenchymal stem cels were positive for CD44, CD73, CD90, CD105 and Oct-4, while negative for CD38, CD34 and CD45. Menstrual blood-derived mesenchymal stem cels were positive for oil red O staining at 22 days after adipogenic induction and also positive for alizarin red staining at 2 weeks after osteogenetic induction. In conclusion, our study suggests that menstrual blood-derived mesenchymal stem cels with stable karyotype and pluripotency can proliferate quickly, and we can provide a new resource for stem cel therapy and regenerative medicine through establishing the menstrual blood-derived mesenchymal stem cel lines.

Objective To compare the strengths and limitations of the old and revised guidelines for the diagnosis in patients with idiopathic pulmonary fibrosis(IPF).Methods Patients who were admitted and diagnosed as interstitial lung diseases (ILDs) in our hospital from 2009 to 2014 were enrolled in our study.Eachpatient was reevaluated respectively according to the old and revised guidelines of IPF.Results A total of 553 cases were initially reviewed,among whom 355 cases were excluded for pulmonary fibrosis secondary to definite underlying diseases,28 excluded due to high resolution computed tomography(HRCT) not done,26 excluded because serum immunology examination was not available.The remaining 144 cases were finally enrolled in this study including 92 males and 52 females with median age 21-92 (68 ± 11) years old.Twenty five patients (17.4％,25/144) met the diagnostic criteria of IPF by the old guideline.While by the revised guideline,53 patients (36.8％,53/144) were diagnosed as classical IPF,29 patients (20.1％,29/144) as probable cases,another 69 non-IPF patients accounting for 43.1％ (62/144).The result revealed that there's a significant difference between the two guidelines in the diagnosis of IPF.Conclusions The revised guideline favors an early diagnosis of IPF and simplifies the diagnostic process.However the possibility of over diagnosis or missed diagnosis by the revised guideline does exist.On the other hand,despite of the delayed diagnosis by the old guideline,it may reduce the misdiagnosis of IPF in some circumstance.

OBJECTIVE:To improve high-alert medication management in our hospital. METHODS:According to assessment criteria of JCI,referring to the problems of high-alert medication management in our hospital,PDCA(plan,do,check,action)cy-cle method,reverse fishbone diagram and other methods were adopted to formulate and implement relevant countermeasures. Com-pliance rate of 29 departments was evaluated within 12 months after the implementation of countermeasures. RESULTS:Relevant emergency measures were formulated for 2 negative factors by reverse fishbone diagram;whole-course and orderly quality control of high-alert medication was conducted through establishing high-alert medication management institutions,formulating high-alert medication management system and quality measurement criteria,strengthening staff training and education,improving hospital in-formation system,etc. The compliance rate of departments increased from 53% in Jan. to 100% in Jun.(P<0.05),and kept sta-ble until Dec. CONCLUSIONS:PDCA cycle improves the systemization and standardization of high-alert medication management and multiple department cooperation,and contributes to the safety of drug use.

Post-stroke cognitive impairment (PSCI) refers to a clinical syndrome that occurs after a stroke and meets the diagnostic criteria for cognitive impairment, lasting for more than 6 months, and seriously affecting the daily life of patients. The complement system has been confirmed to be associated with PSCI. This article reviews the correlation between complement system and PSCI, as well as the possibility of complement system as an intervention target for PSCI.

Objective To investigate the current situation of quality of care for people with disabilities and the related factors. Methods In November, 2015, 399 disabled persons from five special service institutions in Hubei, China were conveniently sampled, and investigated with the Chinese version of Quality of Care and Support (QOCS) for people with disability scale and demographic questionnaire. Results The total score of QOCS was (38.11±6.24), and the proportion of total score in the dimensions of caring provision, caring environment and caring information were more than 70%. The score of QOCS was various with the age, domicile, employment, medical insurance, monthly household expenditure and expenditure for food of the people with disabilities, and the age (β=0.06, P<0.01) and medical insurance (β=-0.850, P<0.001) were the independent factors related with the score of QOCS. Conclusion People with disabilities self-reportedly satis-fied in the quality of care in Hubei, and it can be improved from the increase of medical insurance level.

Objective: To investigate the effect of caffeine citrate administering at different time on outcome and neurodevelopment of premature infants. Methods: A total of 113 preterm infants with gestational age less than 32 weeks and birth weight less than 1 500 g who were hospitalized and treated in the neonatal intensive care unit from January 2018 to June 2018 were enrolled.According to the time when caffeine citrate treatment was started, they were divided into early treatment group(≤1 days) with 53 infants and late treatment group(1 to 10 days) with 60 infants.A retrospective analysis was performed for their clinical data.The perinatal conditions, treatment process and clinical outcomes of the two groups were compared and the neurological development was followed up at 12 months old. Results: Compared with the late treatment group, the early treatment group had a significantly shorter durations of mechanical ventilation time, oxygen therapy time, hospitalization days and a significantly lower incidence of bronchopulmonary dysplasia, patent ductus arteriosusand intraventricular hemorrhage or periventricular leukomalacia, and there were significant differences between two groups(P<0.05, respectively). The neonatal behavioral neurological assessment score in the early treatment group was higher than that in the late treatment group at 40 weeks of gestational age, and there was significant difference between two groups(P<0.05). The mental developmental index at 3 months of corrected age, the mental developmental index and psychomotor developmental index at 12 months were significantly better in the early treatment group than those in the late treatment group, and there were significant differences between two groups(P<0.05, respectively). Conclusion Early use of caffeine citrate can improve the outcome of premature infants and improve the prognosis of nervous system.

Epicurus’ view of life and death is based on the atomism of naturalism and the epistemology of sensationalism in ancient Greek. He advocated that people should face death calmly, and separate death from the pain of feeling by explaining the true meaning of death to break people’s fear of death. He claimed that people should face desires with rational thinking and pursue a happy life. His view of life and death helped people to treat life and death rationally, alleviate death anxiety, make people actively face the difficulties in life, correctly identify desires and needs, and help individuals pursue a healthy and happy life.

Breast milk contains a lot of lactose,whey protein,fat and other nutrients and a variety of bioactive ingredients.In recent years,with the improvement of detection methods,more and more studies on the determination of breast or breast milk microbes indicate that there is unique microbiota in breast milk.Some strains colonize the intestine of newborns through breastfeeding to promote gut microbiota formation.According to the relevant articles published in recent years,the effects of breast milk microorganisms on neonatal intestinal microbiome are reviewed.