Objective To investigate the effects of losartan on unstable angina (UA).Methods In a period of 14 days, 83 subjects with UA were randomly divided into 2 groups (group T and C). In group C, nitroglycerin 10-20mg plus 5%glucose 250ml was given by vein drips twice daily. Aspirin 150mg/day and metoprolol 12.5～25mg twice daily were given too. In group T, losartan, in a single dose of 50mg/day was given in addition to treatments of group A. Frequency of angina pectoris, rate pressure product, ST segments changes in 12 lead ECG and several heart function indexes in echocardiography were investigated at the beginning and the end of the study.Results The differences of efficacy between the two groups were significant ( P

Objective To explore the level changes of serum hypersensitive C-reactive protein (hs-CRP) in patients with cardiac syndrome X (CSX) and the effect of atorvastatin on hs-CRP level. Methods 25 patients with CSX and 10 matched healthy subjects were enrolled in this study, and the serum hs-CRP levels were compared between the patients and healthy subjects. The patients were randomly devidid into routine therapy group (n=12), which received diltiazem 30mg t.i.d and isorbide dinitrate 10mg t.i.d, and atovastatin thrapy group (n=13), which received the same dosage of diltiazem and isobide dinitrate, and atovastatin 20mg/d additionally. The course of treatment was 12 weeks. At the beginning and the end of study, standardized angina questionnaires and exercise stress test were performed in all patients, and their serum hs-CRP levels were measured. Results ⑴The serum hs-CRP levels of patients with CSX were significantly hagher than those of healthy subjects(3 7?3 2mg/L vs 0 9?0 5mg/L, P

Performance appraisal is one of the key points of hospital management. The authors introduce a comprehensive hospital performance appraisal scheme based on the concept of value transfer, including qualitative and quantitative index system, weight and appraisal method.In the pilot practice of a hospital, it is found that the appraisal scheme can effectively improve the operational efficiency, social and economic benefits, and has a strong incentive role for employees. This scheme weighs the operability and scientificity of performance appraisal, and provides a reference for clinical department performance appraisal.

Objective To evaluate the effects of day surgery on average days of stay, and to provide scientific basis for shorter average days of stay. Methods Data of average days of stay from November 2011 to December 2016 were extracted from 6 departments, Xiangya Hospital, Central South University. Segmented regression analysis of interrupted time series was used to analyze the trend of average days of stay of pre-and post-day surgery. Results Thanks to the application of day surgery, average days of stay decreased by 0. 071 days per month, and the monthly decline increased by 0. 049 days (P<0. 001) than before. Average days of stay in the department of stomatology, ear-nose-throat, general surgery and hepatobiliary & enteric surgery research center were the most obvious, and the monthly decline increased by 0. 110 days (P<0. 001), 0. 049 days (P=0. 008) , 0. 075 days (P<0. 001), and 0. 057 days (P=0. 003), respectively than before. Conclusions Day surgery could decrease average days of stay, enhancing the utilization of hospital resources.

Objective:To analyze the internal conditions and external environment of high-quality development of high-level public hospitals and establish a high-quality development strategy model, for reference of public hospitals to formulate and implement high-quality development strategies.Methods:The case hospital was a pilot in high-quality development of high-level public hospitals. SWOT method was used to analyze the influencing factors, AHP analytic hierarchy process was used to compare the importance of each influencing factor, and then the four-quadrant coordinate system method was used to establish a high-quality development strategy model.Results:The total strength(S), the total weaknesses(W), the total opportunity(O), and the total threat(T)were 0.095, 0.063, 0.065 and 0.024 respectively, reflecting that the strength of internal conditions was greater than the weaknesses, and the opportunities of external environment were greater than the threats. In the four-quadrants, the growth strategy model had the largest triangle area(0.003), and the strategic quadrilateral center of gravity was located in the opportunity area of the growth strategy.Conclusions:High-level public hospitals as represented by the case hospital had entered a period of important strategic opportunities, which the external opportunities were greater than its own strength. These hospitals were recommended to fully leverage the external opportunities, adopt a positive growth oriented(SO)strategy, formulate a development strategy with their own characteristics, promote the interaction of internal conditions and external environment to form new momentum, hence achieving high-quality development.

The five core indicators(the case mix index, the proportion of level-4 surgery, the proportion of technical service income in medical income, the proportion of personnel expenditure in business expenditure, and the proportion of fixed part in personnel salary) and target values determined by the pilot goal of high-quality development of high-level public hospitals jointly built by National Health Commission and Provincial Government had become the core indicators for evaluating the quality and efficiency of public hospital development. The authors proposed the optimization and improvement measures for the five core indicators one by one from the internal reform and innovation in hospitals, as well as the synergetic development and governance of " insurance-medical-medicine linkage", combined with the current situation of a pilot hospital. The authors also proposed the starting points and driving force for promoting the high-quality development of public hospitals through the synergetic development and governance of " insurance-medical-medicine linkage", including implementing government investment responsibilities, streamlining the price evaluation of medical services, deepening the reform of medical insurance payment, accelerating the expansion of drug and consumable procurement, and promoting the application of advanced technologies and products, in order to provide reference for the in-depth promotion of high-quality development of public hospitals.

With the genomic DNA of strain EJS-3 as the template, we amplified the gene of fibrinolytic enzyme from Paenibacillus polymyxa (PPFE-I) by PCR. We purified the PCR product and ligated it into pMD19-T. After DNA sequencing, we cloned the PPFE-I gene into expression vector pET-DsbA and transformed it into Escherichia coli BL21(DE3). Upon induction of IPTG, we found that the activity of recombinant fibrinolytic enzyme fused with DsbA expressed in Escherichia coli was 228 IU/mL. SDS-PAGE analysis showed that the recombinant enzyme was soluble and accounted for about 18.4% of total cell protein. Western blotting demonstrated that the recombinant protein was DsbA-PPFE-I. We purified the recombinant enzyme by Ni affinity chromatography, thrombin digestion and sephadex G-100 gel-filtration, and identified the molecular weight of purified product to be 66.3 kDa with MALDI-TOF mass spectrometry. The purified enzyme exhibited distinct fibrinolytic activity on fibrin plate.
Antifibrinolytic Agents ; pharmacology ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Fibrinolytic Agents ; metabolism ; Genetic Vectors ; genetics ; Paenibacillus ; chemistry ; enzymology ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; pharmacology

Xiangya Hospital of Central South University has reconstructed its key nodes of the clinical pathway information system in order to promote efficient and extensive implementation of the clinical pathway. Its methods include introduction of new classification of clinical pathways, enriched contents of clinical pathway forms, and design of such concepts as "Standard stage date", "Big category of drugs","Grouping prescriptions" and "Concreted mutation".

Objective This paper focuses on the field of clinical medicine,with the aim of verifying the feasibility of interdisciplinary literature evaluation model based on feature matching method,to provide support for further interdisciplinary scientific research evaluation.Methods Feature matching method,Delphi expert enquiry,and normalization method were adopted to establish an evaluation system in clinical medicine,which was further verified by case studies.Results The normalization coefficient reflects the difficulty of publishing articles with high impact factors.Through the process of feature matching and normalization,it was found that compared with the fields of Neurology,Psychiatry and Surgery,researchers in the fields of Oncology and Internal Medicine were more likely to publish articles with high impact factors.Conclusions Through case analysis,this study verifies the feasibility of interdisciplinary scientific paper evaluation system.The interdisciplinary paper evaluation system based on feature matching method and normalized evaluation method comprehensively considers the characteristics of various disciplines of clinical medicine and provides a new idea for the evaluation of clinical scientific research talents.

Objective:To investigate the effects of anxiety and depressive symptoms in mediation of pain catastrophizing on disability in patients with low back pain.Methods:A cross-sectional survey was conducted among 97 patients with low back pain in the Changjiang Subdistrict community health center from July to October 2021. Oswestry Disability Index, pain catastrophic subscale in Coping Strategies Questionnaire-24, Generalized Anxiety Disorder Scale-short version, Patient Health Depression Questionnaire-short version were used to evaluate the activity dysfunction, pain catastrophic cognition and anxiety and depression levels of patients,respectively. Path analysis was implemented to test the mediation model, and the indirect effects were assessed using the bootstrap procedure with bias-corrected 95 %CI. Results:Results suggested significant positive correlations among pain catastrophizing, anxiety, depressive symptoms and disability of patients. In addition, both anxiety and depressive symptoms significantly mediated the impact of pain catastrophizing on disability (standardized indirect effects were 0.183 and 0.197, P<0.05). Patients with higher levels of pain catastrophic cognition showed higher levels of anxiety and depressive symptoms (β=0.757, 0.720; P<0.01), and reported more severe motor dysfunction (β=0.241, 0.274; P<0.05). Conclusions:Our findings suggest that anxiety and depression may be the psychological pathways through which pain catastrophizing predicts disability in patients with low back pain. Effective psychological interventions, such as emotion regulation and stress reduction strategies should be considered in treatment and supportive care for patients with low back pain.