Objective A scientific evaluation of hospital culture with the Dimension organizational culture model, in view of features of China's general public hospitals.Methods Based on Denison model, according to the characteristics of the public general hospitals in China, the authors developed a tool for organizational culture assessment (TOCA) by using the survey data from 87 hospitals in three provinces from the East, Central, and West areas in China.Results This tool, an evaluation scale, comprises the four cultural characteristics of direction, consistency, participation, and adaptability, as well as 13 cultural dimensions of social responsibility and competitive consciousness. The tool is tested as having good internal reliability and validity.Conclusion The TOCA provides hospital administrators with a tool for hospital culture evaluation, diagnosis and improvement.

Objective To detect chromosomal aberrations of autism spectrum disorder (ASD), we performed karyo?types analyses in 632 ASD trios and then investigated whether copy number variants and neurodevelopment related genes are present in the regions of chromosomal aberrations. Methods Karyotypes analyses were performed in 632 ASD trios (1896 individuals). In addition, we investigated whether there were pathogenic copy number variants located in the rele?vant regions of detected aberrant karyotypes by using the database of the International Standards for Cytogenomic Arrays (ISCA) and the Genomic Variation and Phenotype in Humans using Ensembl Resources (DECIPHER) for ASD patients. Results We detected aberrant results in 22 of 632 patients (3.48%) by karyotypes analyses. Of these 22 aberrant karyo?types, 5 were de novo (0.79%), including the duplication, the translocation, karyotypes of Turner syndrome and the addi?tional material with unknown origin. Seventeen children affected with autism had aberrant karyotypes inherited from one of their parents. By using the ISCA and the DECIPHER database, we found that several copy number variants with high pathogenicity were located in 1q25 and 3p24. Further, these copy number variants consisted of several genes related to neurodevelopment such as TNR, ASTN1, and NMNAT2. Conclusion There are a few de novo chromosomal aberrations in some patients affected with ASD. Copy number variants of several pathogenic neurodevelopmental related genes may exist in the regions of chromosomal aberrations. Karyotypes analyses may be applied to explore the genetic etiology in some patients affected with ASD.

BACKGROUND:Animal experiments have demonstrated that transplanted bone marrow stem cells (BMSCs)in the myocardial infarction region can directionally differentiate into myocardial cells with normal physiological function and promote neovascularization. Clinical studies have also showed that the cardiac function can be improved in myocardial infarction and cardiomyopathy patients after stem cell transplantation.OBJECTIVE: To observe the effect of autologous BMSCs transplantation on short-term cardiac function of patients with heart failure of ischemic cardiomyopathy.DESIGN: Self-control study.SETTING: Department of Cardiology, Xiangtan Central Hospital.PARTICIPANTS: Twenty-one patients with ischemic cardiomyopathy, including 13 males and 8 females, aged (64±6)years,who received treatment in the Department of Cardiology,Xiangtan Central Hospital of Hunan Province from March 2004 to January 2006 were retrieved. Inclusive criteria: with previous myocardial infarction at least once, B-mode ultrasonic cardiac examination showed that cardiac chamber was expanded, obvious cardiac inadequacy or stenocardia existed before stent implantation and hospitalized repeatedly, underwent percutaneous coronary artery intervention for restoring blood flow of infarcted vessel to TIMI3 degree over 3 months,but cardiac inadequacy existed to different degrees.Coronary arteriongraphy showed that no stenosis was found in the stent implanted in the coronary artery.Informed consents were obtained from all the patients.METHODS:After admission, all the patients received BMSCs transplantation based on routine drug treatment.Infarction-related arterial passage was established by percutaneous transluminal catheter technique and occluded by balloon.Isolated bone marrow stem cell suspension was injected into infarction-related arterial passage through the central cavity of catheter. ① Left ventricular ejection fractions (LVEF) and left ventricular end-diastolic diameter(LVDd)were measured before and 6 months after transplantation.② 24-hour dynamic electrocardiogram evaluation was conducted before and 6 months after transplantation under the precondition of not taking antiarrhythmic drugs. ③Clinical cardiac functional grading was conducted before and 6 months after transplantation by NYHA grading method: Grade Ⅰto Ⅳ: the higher grade, the severer symptom. ④ Adverse events and side effects were observed after operation.MAIN OUTCOME MEASURES:① LVEF and LVDd were measured before and 6 months after transplantation. ②24-hour dynamic electrocardiogram evaluation results. ③ Clinical cardiac functional grading evaluation results. ④ Post-operative adverse events and side effects.RESULTS:All the involved 21 patients participated in the result analysis.①The LVEF of patients 6 months after transplantation of BMSCs was more than that before transplantation [(54.4±6.2)％, (44.6±6.4)％,t = -5.946, P＜ 0.01], and LVDd of patients 6 months after transplantation was smaller than that before transplantation [(54.6±4.2), (60.2±4.4) mm,t = 5.306, P ＜ 0.01]. ② No new arrhythmic types appeared, and case of malignant serious cardiac arrhythmias were not increased. ③ Six months after transplantation of BMSCs, there were totally 9 patients with cardiac function of grade Ⅲ and Ⅳ, while there were 18 patients before transplantation. ④ The whole transplantation was safe.No patients were found to undergo re-examination of coronary arteriongraphy, which showed stent necrosis, due to chest pain, and no dead cases were either found.CONCLUSION:It is feasible to treat ischemic cardiomyopathy by percutaneous coronary transplantation of BMSCs,which can boost LVEF and improve cardiac function after transplantation.

0.05).Myocardial perfusion defect scores were decreased significantly from 14.8?3.0 to 10.5?1.8(P

ObjectiveTo compare the effects on left ventricular remodeling of bone marrow mononuclear cells transplantation one week and three months after acute myocardial infarction.MethodsAcute myocardial infarction models were successfully established in 15 swine,which were randomly divided into three groups:placebo group,early transplantation group and late trasplantation group.One week after model had been established,early transplantation group underwent bone marrow mononuclear cells transplantation,and then so did the late trasplantation group three months after acute myocardial infarction.B-ultrasound and single photon emission computed tomography (SPECT) examinations were performed to assess the left ventricular end diastolic dimension( LVd),left ventricular end diastolic volume(EDV) and left ventricular ejection fraction(EF) before and one week,three months,six months after acute myocardial infarction.ResultsThe LVd of late transplantation group [ (54.20:t:3.70) mm] was lower than placebo group [ (63.20 ±5.63)mm],but higher than early transplantation group [ (47.40 ± 1.14)mm].The EDV of late transplantation group [ ( 163.00 ±6.96)ml] was lower than placebo group [ (209.40 ± 18.69)ml],but higher than early transplantation group [ ( 135.40 ± 4.93 ) ml ].The EF of late transplantation group (0.25 ±0.02) was higher than placebo group (0.19 ±0.02),but lower than early transplantation group (0.37 ±0.02).ConclusionsBone marrow mononuclear cells transplantation can alleviate progressing ventricular remodeling,even it is performed three month after acute myocardial infarction,but its therapeutic effects are inferior to early transplantation's.

Objective To investigate the effects of bone marrow stem cells autologous transplantation on left ventricular remodeling after acute myocardial infarction. Methods Acute myocardial infarction models were successfully established in 10 swines, which were ran-dom divided into two groups, placebo group and trasplantation group. One week after operation, bone marrow stem cells autologous transplan-tation was performed, and control group was administrated with placebo. B-ultrasound and emission computed tomography aexaminations were performed to assess the left ventrieular end diastolic dimension, left ventricular tip wall thickness, left ventricular end diastolic volume and left ventricula ejection fraction before operation, one week, three months after acute myocardial infarction. Results Compared with that of control group, three months after acute myocardial infarction, transplantation group witnessed smaller left ventricular end diastolic dimension, thicker left ventricular tip wall, smaller left ventricular end diastolic volume and higher left ventricular ejection fraction. Conclusions Bone marrow autologous transplantation after acute myocardial infarction can alleviate left ventricular remodeling.

Objective:To investigate the genetic association of single nucleotide polymorphisms (SNPs) in gamma-aminobutyric acid type A (GABAA) receptor genes cluster on chromosome 15q12 with autism in Chinese Han population.Methods:Totally 502 autism trios of Chinese Han ethnicity (including 502 autism individuals and 1004 healthy biological parents) were selected.All children met the autism diagnosis of Diagnostic and Statistical Manual of Mental Disorders,Fourth edition (DSM-Ⅳ).Genotyping for 15 selected tag SNPs in three GABAA receptor genes (GABRB3,GABRA5,and GABRG3) was performed using Agena Bioscience MassARRAY platform.The family-based association test for 15 tag SNPs was performed to compare the transmitted frequency of al leles of heterozygous genotypes from parents to offspring in autism trios.Results:The C allele of rs7180500 in GABRG3 and the A allele of rs4906902 in GABRB3 exhibited the preferential transmission from parents to affected offspring (Z =3.573,P ＜0.001;Z =3.141,P =0.002),and the association was significant after Bonferroni correction.Conclusion:It suggests that GABRG3 and GABRB3 which located in chromosome 15q12 might be susceptibility genes in Chinese Han population.