An exploration of the value orientation of public hospital reform,probes into an innovation of the existing system in the principles ofnature of public welfare,popularity of public welfare,and commonweal.Based on a discussion on whether the nature of public welfare decides value orientation,it is proposed that popularity of public welfare should be the orientation of such a reform;and the commonweal by socialization means ought to be the strategy for the value orientation,focusing on the resources,supervision and operation requirements of public hospitals.

Objective To investigate influence of ginsenoside Rb1 on the proliferation and bioactivity of olfactory ensheathing cells (OECs).Methods OECs were primary cultured and purified from olfactory bulb of the adult SD rats.MTT assay was used to detect proliferation of OECs treated with ginsenoside Rb1 (intervention concentrations of 0,10,20,40,and 80 μg/ml and intervention time of 12,24,36,48,and 60 hours).Optimal concentration and intervention time of ginsenoside Rb1 was determined and performed in the succedent experiments.Purified cells were divided into blank control group and ginsenoside Rb1 group.RT-PCR was utilized to determine mRNA expressions of nerve growth factor (NGF),brain-derived neurotrophic factor (BDNF),glial derived neurotrophic factor(GDNF) and neural cell adhesion molecule (N-CAM) in the two groups.ELISA analysis was performed to measure secretion levels of NGF,BDNF and GDNF in the cultural supernatant.Results MTF analysis suggested ginsenoside Rb1 promoted proliferation of OECs with optimal effect at 20 μg/ml concentration for 48 hours (0.648±0.019,P ＜ 0.05).RT-PCR analysis demonstrated that mRNA expressions of NGF,BDNF,GDNF and N-CAM were significantly up-regulated in ginsenoside Rb1 group compared to those in blank control group (0.620 ± 0.011 vs 0.180 ± 0.011,0.511 ± 0.090 vs 0.293 ± 0.051,0.343 ± 0.042 vs 0.064 ± 0.005,0.839 ± 0.017 vs 0.717 ± 0.044) (P ＜ 0.05).ELISA analysis confirmed that secretions of NGF,BDNF and GDNF was increased in Rb1 group compared to those in blank control group (200.167 ± 8.361 vs 51.467 ± 3.815,156.700 ± 4.190 vs 96.500 ± 2.707,26.264 ± 5.864 vs 4.917 ± 10.894,P ＜ 0.05).Conclusion Ginsenoside Rb1 significantly promotes proliferation and bioactivity of OECs and hence benefits to spinal cord injury repair.

Objective:To investigate the predictive value of Graeb score for the outcome of high-grade aneurysmal subarachnoid hemorrhage (aSAH) patients with intraventricular hemorrhage (IVH).Methods:Consecutive high-grade aSAH patients with IVH admitted to the No. 1 People's Hospital of Jiujiang from January 2012 to March 2020 were enrolled retrospectively. High-grade aSAH was defined as grade Ⅳ to Ⅴ according to the World Federation of Neurological Surgeons (WFNS) scale. The outcome of patients was evaluated by the modified Rankin Scale (mRS) at 3 months after discharge. A score of ≤2 was defined as a good outcome and a score of >2 were defined as a poor outcome. Multivariate logistic regression model was used to evaluate the correlation between Graeb score and clinical outcome, and the receiver operating characteristic (ROC) curve was used to determine the predictive value of Graeb score for clinical outcome. Results:A total of 86 high-grade aSAH patients with IVH were enrolled. Aneurysm treatment: craniotomy clipping in 42 patients (48.8%), intravascular embolization in 21 (24.4%), and conservative treatment in 23 (26.7%). Twenty-nine patients (33.7%) had a good outcome and 57 (66.3%) had a poor outcome. Multivariate logistic regression analysis showed that the Graeb score >6 (odds ratio [ OR] 26.360, 95% confidence interval [ CI] 4.106-169.235; P<0.001), the modified Fisher grade 3-4 ( OR 11.674, 95% CI 1.540-88.512; P=0.017) and complicated with chronic hydrocephalus ( OR 21.236, 95% CI 2.883-156.431; P=0.003) were the independent risk factors for the poor outcome. ROC curve analysis showed that the area under the curve of the Graeb score predicting for poor outcome was 0.843 (95% CI 0.760-0.926; P<0.001), the best cut-off value was 6.5, and the corresponding sensitivity and specificity were 71.9% and 86.2%, respectively. Conclusion:The Graeb score is an independent influencing factor affecting the clinical outcome of high-grade aSAH patients with IVH. Graeb score >6.5 had higher predictive value for the poor outcome in such patients.

Objective:To investigate the influencing factors for prognoses of patients with high-grade aneurysmal subarachnoid hemorrhage (aSAH).Methods:A retrospective analysis was performed on clinical data of 104 patients with aSAH, admitted to our hospital from January 2012 to March 2010. According to the modified Rankin scale (mRS) scores 3 months after discharge, these patients were divided into good prognosis group (mRS scores≤2) and poor prognosis group (mRS scores >2). Clinical data of patients from the 2 groups were compared. Multivariate Logistic regression analysis was used to analyze the influencing factors for prognoses.Results:Forty patients (38.5%) were with good prognosis and 64 (61.5%) were with poor prognosis. As compared with patients in the poor prognosis group, patients in the good prognosis group had significantly lower proportion of patients>60 years old, and significantly lower Graeb scores, cast fourth ventricle (CFV) incidence, Fisher grading, blood glucose content, diastolic blood pressure, systolic blood pressure and mean arterial pressure, and statistically higher serum potassium content ( P<0.05). There were significant differences in treatment methods and incidence of complications between the two groups ( P<0.05). Multivariate Logistic regression analysis showed that age>60 years ( OR=13.470, 95%CI: 2.177-83.347, P=0.005), Fisher grading ( OR=6.649, 95%CI: 1.141-38.736, P=0.035), conservative treatment ( OR=6.348, 95%CI: 1.048-38.742, P=0.044), mean arterial pressure at admission ( OR=29.721, 95%CI: 3.177-278.012, P=0.003), serum potassium ( OR=5.296, 95%CI: 1.138-24.653, P=0.034), CFV ( OR=9.855, 95%CI: 1.785-51.456, P=0.008), and chronic hydrocephalus ( OR=19.298, 95%CI: 3.294-113.069, P=0.001) were influencing factors for prognoses of high-grade aSAH patients. Conclusion:Severe aSAH patients with advanced age, high Fisher grading, high mean arterial pressure, low serum potassium content, fourth ventricle casting and chronic hydrocephalus under conservative treatment are more likely to have poor prognosis.

Adolescent ; Adult ; Child ; Cord Blood Stem Cell Transplantation ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Leukemia, Myeloid, Accelerated Phase ; therapy ; Male ; Middle Aged ; Siblings ; Tissue Donors ; Transplantation, Homologous ; Young Adult

Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.