ObjectiveTo explore the establishment of performance assessment indicators for the classification and grading of public health staff in district-level Centers for Disease Control and Prevention (CDCs), and to provide a basis for such evaluations. MethodsThrough literature review and group interviews, performance evaluation indicators were developed based on competency evaluation. Experts were invited to evaluate the weight of performance evaluation indicators for public health staff from different categories, with the average value used to represent the weight of each indicator. ResultsTwenty-nine experts from universities in Shanghai, municipal CDCs, and district CDCs participated, yielding an expert authority coefficient of 0.86. The performance evaluation indicators for department managers were categorized into three levels, with 4 indicators at the primary level, 16 indicators at the secondary level, and 42 indicators at the tertiary level, while those for general staff included 4 primary indicators, 15 secondary indicators, and 36 tertiary indicators. Significant differences were observed in the weight coefficients of the primary indicators (internal operations, professional work, and learning and growth) between department managers and general staff. The top three secondary indicators for department managers were department management, monitoring and prevention, and level of expertise. For mid-level and senior staff, the top three secondary indicators were monitoring and prevention, level of expertise, and research work. The top three secondary indicators for junior staff were monitoring and prevention, professional expertise, and professional attitude. No significant statistical differences were found among tertiary indicators. ConclusionThe developed performance evaluation indicators are reliable. Staff at different levels and classifications should be evaluated using different performance evaluation standards to accurately reflect individual performance and contributions.

ObjectiveTo analyze the reported cases of infectious diseases across different tiers of public medical and healthcare institutions in Minhang District, Shanghai from 2013 to 2023, to investigate the status and changes in reported infectious diseases in this district from a temporal, etiological, and demographic perspectives, so as to provide a scientific basis for the construction of a hierarchica early-warning surveillance system under the grading diagnosis and treatment model in medical institutions, as well as for optimizing sentinel surveillance at facilities of different levels. MethodsA retrospective analysis was performed using surveillance data from the China Disease Prevention and Control Information System in Minhang District from 2013 to 2023. Reported infectious diseases were categorized into three categories based on transmission routes: respiratory infectious diseases, intestinal infectious diseases, and sexually transmitted and blood borne infectious diseases. According to the implementation phase of the grading diagnosis and treatment policy, the research time was divided into four time periods: 2013‒2016, 2017‒2019, 2020‒2022, and 2023. The distribution and temporal changes of reported cases of infectious diseases were compared across community health service centers (CHCs), secondary hospitals, tertiary grade-A hospitals and tertiary grade-B hospitals. Chi-square test was used for univariate analysis of differences in the number of reported cases. Quantitative data with normal distribution were analyzed using parametric tests, otherwise, Kruskal⁃Wallis H tests were used. ResultsThe proportions of total reported cases of infectious diseases in medical institutions at all levels in Minhang District, Shanghai from 2013 to 2023 were 10.66% in CHCs, 9.10% in secondary hospitals, 64.95% in tertiary grade-B hospitals, and 15.29% in tertiary grade-A hospitals, with an overall decline and then rebound trend in the reported cases. After the implementation of grading diagnosis and treatment policy, the number of reported cases in CHCs and secondary hospitals showed a trend of first decreasing and then increasing, while that in tertiary grade-B hospitals showed a steady decreasing trend and that in tertiary grade-A hospitals showed an increasing trend. In terms of the research periods divided above, a total of 10 392 cases were reported in 2013‒2016 (70.34% from tertiary grade-B hospitals and 12.59% from CHCs), including 2 922 cases of respiratory infectious diseases, 1 241 cases of intestinal infectious diseases, and 6 229 cases of sexually transmitted and blood-borne infectious diseases. Between 2017 and 2019, a total of 6 967 cases were reported (73.49% from tertiary grade-B hospitals and 11.84% from tertiary grade-A hospitals), including 2 983 cases of respiratory infectious diseases, 279 cases of intestinal infectious diseases, and 3 705 cases of sexually transmitted and blood-borne infectious diseases. Between 2020 and 2022, a total of 4 599 cases were reported (69.92% from tertiary grade-B hospitals and 24.57% from tertiary grade-A hospitals), including 1 627 cases of respiratory infectious diseases, 123 cases of intestinal infectious diseases, and 2 849 cases of sexually transmitted and blood-borne infectious diseases. In 2023, a total of 4 648 cases were reported (35.20% from tertiary grade-B hospitals and 27.50% from tertiary grade-A hospitals), including 3 165 cases of respiratory infectious diseases, 69 cases of intestinal infectious diseases, and 1 414 cases of sexually transmitted and blood-borne infectious diseases. The proportion of reported cases from tertiary grade-B hospitals was the highest in all the four research periods, but exhibited an obvious decrease in 2023. The differences in the reported cases of infectious diseases with different transmission routes among medical institutions at all levels were statistically significant (χ²=3 225.628, P<0.05). The differences in the mean age of patients among medical institutions at all levels were statistically significant (H=1 325.927, P<0.05). ConclusionThere are significant differences in the number of reported cases of infectious disease in the medical institutions at different levels. Tertiary grade-B hospitals have historically dominated the number of reported cases, but its share has declined recently. Whereas, CHCs and tertiary grade-A hospitals have played an increasingly important role in the surveillance and early warning of respiratory and intestinal infectious diseases. Therefore, it is recommended to leverage the strengths of grading diagnosis and treatment to establish targeted sentinel sites and deploy specialized teams tailored to the epidemiological characteristics of specific disease categories.

Uncovering the risk factors of pulmonary hypertension and its mechanisms is crucial for the prevention and treatment of the disease.In the current study,we showed that experimental periodontitis,which was established by ligation of molars followed by orally smearing subgingival plaques from patients with periodontitis,exacerbated hypoxia-induced pulmonary hypertension in mice.Mechanistically,periodontitis dysregulated the pulmonary microbiota by promoting ectopic colonization and enrichment of oral bacteria in the lungs,contributing to pulmonary infiltration of interferon gamma positive(IFNγ+)T cells and aggravating the progression of pulmonary hypertension.In addition,we identified Prevotella zoogleoformans as the critical periodontitis-associated bacterium driving the exacerbation of pulmonary hypertension by periodontitis,and the exacerbation was potently ameliorated by both cervical lymph node excision and IFNγ neutralizing antibodies.Our study suggests a proof of concept that the combined prevention and treatment of periodontitis and pulmonary hypertension are necessary.

OBJECTIVE To investigate the effects of the compo nents of traditional Chinese medicine （TCM）（total ginsenoside，total ketone ester of Ginkgo biloba ，total glucoside of Crocus sativus ）for invigorating qi and activating blood circulation on cognitive function of mice with chronic cerebral ischemia （CCI）and its related mechanisms . METHODS CCI model was established by stimulating bilateral common carotid arteries of C 57BL/6J mice with temperature controlled current . Model mice were randomly divided into model group ，aspirin group （positive control 10 mg/kg）and TCM group （the components of TCM for invigorating qi and activating blood circulation 33 mg/kg），sham operation group was set up additionally ，with 16 mice in each group. Except that the mice in model group and sham operation group were given water intragastrically ，the mice in the other groups were given corresponding medicine liquid intragastrically，once a day ，for 8 weeks. The latency of step down and the number of step -down errors of mice in each group were detected ；the ultrastructure of neurovascular units（NVU）in cerebral cortex and hippocampus was observed ；the protein and mRNA expressions of vascular endothelial growth factor（VEGF）and α7 nicotinic acetylcholine receptors （α7nAChRs） in cerebral tissue were detected ；the contents of VEGF，angiopoietin 1 （Ang1） and basic fibroblast growth factor（bFGF）were detected . RESULTS Compared with model group ，the latency of step -down was significantly prolonged （P＜ 0.05），and the number of step -down errors was significantly reduced （P＜0.05）in TCM group . The ultrastructural abnormalities of NVU in cerebral cortex and hippocampus were significantly improved ，and the protein and mRNA expressions of VEGF and α7 nAChRs and the contents of VEGF ，Ang1 and bFGF in cerebral tissue were significantly increased （P＜0.05）. CONCLUSIONS The components of TCM for invigorating qi and activating blood circulation can improve CCI -induced cognitive dysfunction in mice，the mechanism of which may be associated with protecting NVU ，recovering ultrastructural abnormalities of injured NVU ， and regulating the expression of proteins closely related to NVU and memory function .

Objective To investigate the related factors for the survival of the patients with pancreatic cancer.Methods A total of 1 620 patients confirmed as pancreatic cancer admitted in Sun Yat-sen Memorial Hospital affiliated with Sun Yat-sen University,Tumor prevention and treatment center affiliated with Sun Yat-sen University and People's Hospital of Guangdong Province from 2004 to 2016 were retrospectively analyzed,and the effects of TNM staging,surgical treatment,palliative chemotherapy and postoperative assisted chemotherapy on the survival of the patients with pancreatic cancer were examined by life table and Log-rank test.Results The median survival time of all 1 620 cases was 7.15 months.The median survival time of TNM stage Ⅰ,Ⅱ,Ⅲ and Ⅳ was 12.50 months,10.12 months,9.56 months and 5.43 months,and there was statistically significant difference (P =0.001).The median survival time of cases who did not undergo surgery was 6.10 months,which of patients who underwent radical surgery was 13.67 months,and the difference was statistically significant (P =0.001).The median survival time of cases without chemotherapy was 5.55 months,which of patients who underwent palliative chemotherapy was 7.58 months,and the difference was statistically significant (P =0.001).The median survival time of cases with pure radical surgery without chemotherapy was 12.38 months,which of patients who underwent adjuvant chemotherapy was 14.50 months,and the difference was no statistically significant (P =0.561).Conclusions Early diagnosis followed closely by radical surgery is the key to prolong the survival of pancreatic cancer patients.And adjuvant chemotherapy for patients who lose surgery opportunity may improve clinical prognosis to a certain extent.

Objective To investigate the incidence and related factors of postoperative hemorrhage, so as to provide data support for preventing its occurrence and developing reasonable risk assessment tools. Methods The retrospective analysis of clinical data of 50 patients with postoperative hemorrhage after surgical operation in a 3A hospital in Shanghai from January to December 2016 was conducted. A 1:2 matching case-control study was conducted to explore the risk factors of postoperative bleeding in surgical patients by univariate and multivariate regression analysis.Results The total number of surgical operations (excluding obstetrics and gynecology, five senses) was 18942. Postoperative hemorrhage occurred in 50 cases, including 6 deaths. The incidence of postoperative hemorrhage was 0.26％ and the mortality rate was 12％. The incidence of postoperative bleeding in the top four departments were gastrointestinal surgery (13 cases), hepatobiliary and pancreatic surgery (11 cases), cardiac surgery (10 cases), neurosurgery (9 cases). The statistical analysis of binary Logistic in the case group and the control group showed that postoperative albumin<35g/L, postoperative AST abnormality, postoperative ALT abnormality, postoperative hypertension were independent risk factors of postoperative bleeding.Conclusions The incidence of postoperative bleeding in this hospital is relativelylow, but the mortality is relatively high. Medical staff should pay more attention to the patients undergoing gastrointestinal, liver, pancreas, heart and brain surgery. It is also necessary to pay more attention to the blood pressure, albumin and liver function of the patients after operation,and establish the evaluation of prevention of hemorrhage, which has a certain early warning effect on the prevention of postoperative hemorrhage.

Objective To investigate the mmu-miR-3475-3P possible participating in biology process and signal pathway.Methods The expression of mmu-miR-3475-3P in the mature mouse heart and in the embryonic mouse heart was measured by qRT-PCR.The target genes were predicted through comprehensively using the common microRNA on-line databases such as TargetScan,miRDB and miRanda,and then the obtained targeted genes were performed the gene function annotation and signal pathway analysis.Results There was significant difference between the expression of mmu-miR-3475-3P in the embryonic mouse heart and the expression in the mature heart.Bioinformatics analysis by using TargetScan,miRDB and MiRanda on miR3475-3P revealed that microRNA was likely to regulate 441 target genes.Conclusion mmu-miR-3475-3P is highly expressed in the embryonic mouse heart.The target genes predicted by mmu-miR-3475-3P are enriched in multiple signal pathways and cellular biological processes.

Objective To explore and analyze the related factors of nosocomial infection in patients after total laparoscopic hysterectomy.Methods A total of 231 patients undergoing total laparoscopic hysterectomy were enrolled in this study and their data were retrospectively analyzed.The related factors such as uterus size,operation duration,intraoperative blood loss,type of disease,drainage tube,hospital duration before surgery,and history of pelvic surgery were analyzed.Results Among the 231 cases undergoing total laparoscopic hysterectomy,23 cases had infection and the infection rate was 9.96％.Univariate analysis showed uterus size,operation duration,intraoperative blood loss,hospital duration before surgery,and history of pelvic surgery had influence on postoperative infection and the difference had statistical significance (P＜0.05),while the difference of age and drainage tube had no statistical significance on postoperative infection (P＞0.05).Conclusion The incidence of infection after laparoscopic hysterectomy is related to uterus size,operation duration,intaoperative blood loss,hospital duration before surgery,and history of pelvic surgery.

Objective To observe serum and callus leptin expression in rats model with fracture and traumatic spinal cord injury (SCI). Methods 72 male SD rats were randomized equally into 4 groups: control, SCI group, fracture group, and fracture/SCI group. Rats were sacrificed at 7, 14, 21 and 28 days after fracture/SCI. Serum leptin was detected by radioimmunoassayat 1, 7, 14, 21 and 28 days, and callus formation was measured radiologically at 14, 21 and 28 days. Callus leptin was analyzed with immunohistochemistry. Results Serum leptin in the fracture group, SCI group and combined fracture/SCI group were all higher than in control group at the 1, 7, 14 and 21 day time-point (P < 0.05). Serum leptin in the combined fracture/SCI group was significantly higher than the fracture group at 7, 14 and 21 days (P < 0.05), and higher than SCI groups at 14 and 21 days after operation (P < 0.05). The percentage of leptin-positive cells in the fracture/SCI callus, and callus volume was significantly higher than the fracture-only group (P < 0.001). Conclusions Leptin expression increases in the recovery process after SCI, and the recovery of fracture becomes sooner.

BACKGROUNDPeople's attitude toward organ donation after cardiac death (DCD) has not come to an agreement in different countries and regions. Influenced by the local culture in China for thousands of years, the general public has different ideas about this issue. The purpose of this study was to investigate the current attitudes trend and characteristics of transplantation with organs donated after cardiac death in northwest China.

METHODSThis largest single-center cohort study was performed by an interview or by telephone using a questionnaire. The family members of potential DCD donors were recruited from the First Affiliated Hospital, medical college of Xi'an Jiaotong University located in a metropolitan area of northwest China. The 12-item attitude questionnaire was specifically developed from the literature review with coordinator, physician, and donor's family feedback. The participants were asked to rate the queries on a 5-point Likert intensity scale.

RESULTSThe 174 participants included 56 (32.2%) women and 118 (67.8%) men. Most people were aged between 41 and 50 years (n = 63, 36.2%), 31 and 40 years (n = 59, 33.9%), and less than 30 years (n = 36, 20.7%). The top five attitudes of participants were the best person to suggest organ donation to a family was ranked as the DCD coordinator of Red Cross Organization (RCO, n = 160, 92%), donor is a hero (n = 143, 82.2%), honor to be a donor's family member (n = 136, 78.2%), improved relationship with colleagues (n = 124, 71.3%), and with recipient after donation (n = 123, 70.7%). The best person to suggest organ donation to a family was ranked as the coordinator of RCO (n = 160, 92%), doctor unrelated to transplantation (n = 104, 59.8%), social worker (n = 36, 20.7%), and doctor related to transplantation (n = 25, 14.4%). The top two reasons for non-consent to donation were that the family insisted on intact body after patient death and did not want to have surgery again (n = 51, 41.5%), and feared that they would be misunderstood by neighbors, relatives, and friends about donation (n = 28, 22.8%).

CONCLUSIONSThis study revealed initial attitudes toward DCD in China. Some data afford insight into the decision-making procedure. The concerns of potential DCD donors and their families may help professionals provide better interventions in the future.

Adult ; Attitude ; China ; Death ; Decision Making ; Female ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires ; Tissue and Organ Procurement ; statistics & numerical data