The success of implementation research is closely tied to the institution's pre-implementation readiness. This study aims to explore the organizational readiness for change (ORC) and its influencing factors on primary healthcare settings in the implementation of the "Shared Medical Appointment for Diabetes (SMART) in China: design of an optimization trial" and to enhance ORC and provide insights to support the effective implementation of the program.

This study aimed to localize the workplace readiness questionnaire (WRQ) and validate its applicability for assessing readiness for implementation of evidence-based practices (EBP) in primary care settings in China. The localization of the instrument will provide a practical instrument for assessing organizational readiness for change (ORC).

Growth arrest DNA damage-inducible protein 45 β (GADD45B) has been reported to be a regulatory factor for active DNA demethylation and is implicated in the modulation of synaptic plasticity and chronic stress-related psychopathological processes. However, its precise role and mechanism of action in stress susceptibility remain elusive. In this study, we found a significant reduction in GADD45B expression specifically in the ventral, but not the dorsal hippocampal CA1 (dCA1) of stress-susceptible mice. Furthermore, we demonstrated that GADD45B negatively regulates susceptibility to social stress and NMDA receptor-dependent long-term potentiation (LTP) in the ventral hippocampal CA1 (vCA1). Importantly, through pharmacological inhibition using the NMDA receptor antagonist MK801, we provided further evidence supporting the hypothesis that GADD45B potentially modulates susceptibility to social stress by influencing NMDA receptor-mediated LTP. Collectively, these results suggested that modulation of NMDA receptor-mediated synaptic plasticity is a pivotal mechanism underlying the regulation of susceptibility to social stress by GADD45B.
Animals ; Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors* ; CA1 Region, Hippocampal/drug effects* ; Male ; Stress, Psychological/physiopathology* ; Mice ; Neuronal Plasticity/drug effects* ; Long-Term Potentiation/drug effects* ; Mice, Inbred C57BL ; Antigens, Differentiation/metabolism* ; Dizocilpine Maleate/pharmacology* ; Excitatory Amino Acid Antagonists/pharmacology* ; GADD45 Proteins

High mobility group box 1 (HMGB1), when released extracellularly, plays a pivotal role in the development of spinal cord synapses and exacerbates autoimmune diseases within the central nervous system. In experimental autoimmune encephalomyelitis (EAE), a condition that models multiple sclerosis, the levels of extracellular HMGB1 and interleukin-33 (IL-33) have been found to be inversely correlated. However, the mechanism by which IL-33 deficiency enhances HMGB1 release during EAE remains elusive. Our study elucidates a potential signaling pathway whereby the absence of IL-33 leads to increased binding of P300/CBP-associated factor with HMGB1 in the nuclei of astrocytes, upregulating HMGB1 acetylation and promoting its release from astrocyte nuclei in the spinal cord of EAE mice. Conversely, the addition of IL-33 counteracts the TNF-α-induced increase in HMGB1 and acetylated HMGB1 levels in primary astrocytes. These findings underscore the potential of IL-33-associated signaling pathways as a therapeutic target for EAE treatment.
Animals ; Encephalomyelitis, Autoimmune, Experimental/metabolism* ; Astrocytes/metabolism* ; Interleukin-33/metabolism* ; HMGB1 Protein/metabolism* ; Acetylation ; Mice, Knockout ; Mice, Inbred C57BL ; p300-CBP Transcription Factors/metabolism* ; Mice ; Spinal Cord/metabolism* ; Cells, Cultured ; Female ; Signal Transduction

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective To explore the efficacy of retropubic midurethral synthetic sling(RMUS)in relieving urgency and urge urinary incontinence(UUI)symptoms in patients with mixed urinary incontinence(MUI).Methods Clinical data of 44 female MUI patients treated with RMUS during Jan.2018 and Dec.2020 in Shanghai Renji Hospital were retrospectively analyzed.All patients had positive results in stress test and Marshall-Marchetti test before operation,and 27 of them completed ICIQ-FLUTS-LF questionnaire.Urodynamic(UDS)tests suggested that 9 patients(20.5％)presented detrusor overactivity(DO).During RMUS procedure,the tension of the sling was adjusted based on the anatomical landmarks.The postoperative efficacy and improvement of urinary incontinence were analyzed.Results The patients aged(58.59±9.08)years,with a body mass index of 24.71±2.77.Among the 40 patients who completed telephone interview 2 years after surgery,the subjective cure rate was 85.0％(34/40).Among the 27 patients with records of questionnaires before and after surgery,there were significant differences in the incidence of urine leakage[100％(27/27)vs.18.5％(5/27)],stress urinary incontinence(SUI)[100％(27/27)vs.18.5％(5/27)]and UUI[70.4％(19/27)vs.29.6％(8/27)](P＜0.05).However,no statistical differences were found regarding nocturia voiding episode(≥1 times),urgency,dysuria,hesitancy,strain to void,intermittent stream and enuresis(P＞0.05).Based on preoperative UDS test,there were significant differences regarding the subjective cure rate in patients with or without preoperative DO[55.6％(5/9)vs.93.5％(29/31)],incidence of SUI[66.7％(4/6)vs.4.8％(1/21)],and UUI[66.7％(4/6)vs.19.0％(4/21)](P＜0.05),while there was no statistical difference regarding urgency[66.7％(4/6)vs.33.3％(7/21)](P＞0.05).Conclusion RMUS is effective in treating MUI patients with positive stress test and Marshall-Marchetti test results,which can relieve SUI and UUI symptoms,but has no effects on urgency symptoms.DO on preoperative urodynamics results in poorer subjective outcomes.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.