Objective:To explore the impact of a comprehensive intervention program that integrates transitional care with personalized discharge preparation services on discharge preparedness on the growth, development, and motor development in premature infants, providing guidance and reference for clinical practice.Methods:The 90 pairs of premature infants and their main caregivers who were treated in the neonatal department, Children ′s Hospital, Quanzhou Maternal and Child Health Hospital were studied from February 2023 to February 2024 by randomized control method. Used the table of random numbers, they were divided into the control group and the observation group, with 45 pairs in each group. The control group routinely administered care, while the observation group was implemented a transitional care combined with personalized discharge preparation services. The discharge preparedness, growth and motor development, and the disease uncertainty of caregivers were observed between the 2 groups. Results:There were 27 males and 18 females of the 45 preterm infants,with gestational age of 30.86 (29.36, 31.50) weeks in the control group, 24 males and 21 females with gestational age of 30.29(29.00, 31.07) weeks in the observation group. The main caregiver identities 43 were mothers and 2 were other identities in the control group, 42 were mothers and 3 were other identities in the observation group, with them being 31.00(28.00, 35.00) years old. There were 97.78% (44 /45) caregivers who thought the child was ready to go home in the observation group, while the control group were 84.44% (38 /45), these differences were statistically significant ( χ2=4.88, P<0.05). The total score of discharge readiness in the observation group were 240.00(237.00, 242.50) points, higher than in the control group 226.00(219.00, 229.50) points, these differences were statistically significant ( Z=-6.23, P<0.05). The head circumference and body weight of the observation group were (34.82 ± 1.14) cm and (3.60 ± 0.55) kg, while the control group were (34.25 ± 1.22) cm and (3.35 ± 0.53) kg, there were statistically significant between the two groups ( t=-2.29, -2.22, all P<0.05). The Test of Infant Motor Performance score in the observation group was 50.00(46.00, 52.00) points, while the control group was 45.00(42.00, 48.00) points, there were statistically significant between the two groups ( Z=-3.65, P<0.05). The total score of disease uncertainty in the observation was 52.00(45.50, 60.00) points, while the control group was 61.00(58.50, 65.00) points, there was statistically significant between the two groups ( Z=-4.62, P<0.05). Conclusions:The discharge preparedness of the caregivers of preterm infants was improved because of the use of transitional care combined with personalized discharge preparation services, and the growth and motor development of preterm infants were promoted, and the uncertainty of the family caregivers of preterm infants about the disease was reduced.

Objective:To explore the impact of a comprehensive intervention program that integrates transitional care with personalized discharge preparation services on discharge preparedness on the growth, development, and motor development in premature infants, providing guidance and reference for clinical practice.Methods:The 90 pairs of premature infants and their main caregivers who were treated in the neonatal department, Children ′s Hospital, Quanzhou Maternal and Child Health Hospital were studied from February 2023 to February 2024 by randomized control method. Used the table of random numbers, they were divided into the control group and the observation group, with 45 pairs in each group. The control group routinely administered care, while the observation group was implemented a transitional care combined with personalized discharge preparation services. The discharge preparedness, growth and motor development, and the disease uncertainty of caregivers were observed between the 2 groups. Results:There were 27 males and 18 females of the 45 preterm infants,with gestational age of 30.86 (29.36, 31.50) weeks in the control group, 24 males and 21 females with gestational age of 30.29(29.00, 31.07) weeks in the observation group. The main caregiver identities 43 were mothers and 2 were other identities in the control group, 42 were mothers and 3 were other identities in the observation group, with them being 31.00(28.00, 35.00) years old. There were 97.78% (44 /45) caregivers who thought the child was ready to go home in the observation group, while the control group were 84.44% (38 /45), these differences were statistically significant ( χ2=4.88, P<0.05). The total score of discharge readiness in the observation group were 240.00(237.00, 242.50) points, higher than in the control group 226.00(219.00, 229.50) points, these differences were statistically significant ( Z=-6.23, P<0.05). The head circumference and body weight of the observation group were (34.82 ± 1.14) cm and (3.60 ± 0.55) kg, while the control group were (34.25 ± 1.22) cm and (3.35 ± 0.53) kg, there were statistically significant between the two groups ( t=-2.29, -2.22, all P<0.05). The Test of Infant Motor Performance score in the observation group was 50.00(46.00, 52.00) points, while the control group was 45.00(42.00, 48.00) points, there were statistically significant between the two groups ( Z=-3.65, P<0.05). The total score of disease uncertainty in the observation was 52.00(45.50, 60.00) points, while the control group was 61.00(58.50, 65.00) points, there was statistically significant between the two groups ( Z=-4.62, P<0.05). Conclusions:The discharge preparedness of the caregivers of preterm infants was improved because of the use of transitional care combined with personalized discharge preparation services, and the growth and motor development of preterm infants were promoted, and the uncertainty of the family caregivers of preterm infants about the disease was reduced.

Objective:To understand the basic characteristics of COVID-19 cases and the virus carrying status of different samples in Ma′anshan.Methods:Descriptive epidemiological method was used to describe the distribution of 2019-nCoV infections in Ma′anshan. Real-time fluorescence RT-PCR was used to detect 2019-nCoV nucleic acid in sputum and/or throat swabs. Data was analyzed by EXCEL and SPSS 20.0. P<0.05 was considered to be statistically significant by using χ2 test. Results:Until 14 March 2020, 38 confirmed cases and no death had been reported in Ma′anshan, there were also 11 asymptomatic infections. 2019-nCoV infection was first detected on January 23, and the last was on February 20. No new infections have been found for 23 consecutive days until March 14; 77.55%(38/49)of the infections were in He county. Among the 1 447 subjects, the positive rate was 4.50% (27/600) in females and 2.60% (22/847) in males (χ 2=3.886, P=0.049). The minimum age of the infections was 4 years and the maximum was 85. There was no significant difference between age groups ( χ2=10.675, P=0.058). Among the 49 infections, 20 of them (40.82%) were from Wuhan, 24 (48.98%) were locally infected, and 5 (10.20%) were imported from other places. For the first positive infections, the positive rate of sputum (100%, 36/36) was higher than the throat swab (77.78%, 28/36), and the difference was statistically significant (χ 2=6.125, P<0.05). Conclusions:In Ma′anshan, 2019-nCoV infections were concentrated in He county, sputum was beneficial to the detection of 2019-nCoV.

Hospitals need to explore based on their own specifics how to establish a modern hospital governance system and how a lean hospital administration level be achieved. This paper introduced the practice and exploration of modern hospital governance system construction in Beijing Tsinghua Changgung Hospital as follows. The hospital is run by a board of administration featuring co-administration by both Beijing Municipal Hospital Administration Center and Tsinghua University; A hospital charter is developed and agreed upon to regulate decision-making, day-to-day operations and supervision; The hospital president′s responsibility is under the leadership of the hospital′s Communist Party Committee; Benefiting from best practices of Taiwan Changgung′s medical system, the hospital′s specialized medical teams and professional administrative teams operate in cooperative governance, and under professional management model and a lean operation management system. The practice and exploration of Beijing Tsinghua Changgung Hospital can serve as references for building and perfecting a modern hospital governance system.

The reform experiences of physician fee system ( PF ) practiced at a hospital in Nanjing were analyzed to come up with key influencing factors to make the reform a success,including income level,income makeup and income equity.Most noteworthy of the authors' points was income equity,proposing such reforms as target physician salary and inter-departmental balance,especially the two key factors of implementing the price target factor and inter-departmental balance.Their efforts aim at exploring a brand new idea and successful experiences in making PF system a success in China's hospitals.

Objective By detecting vascular cysteine-rich 61(Cyr61) related factor,connective tissue growth factor (CTGF),vascular endothelial growth factor (VEGF) and CD105 markers of microvascular density (MVD) of muscle tissue in patients with PM/DM,the role and significance of the expression of Cyr61,CTGF,VEGF and CD105 in the process of vascular lesions of dermatomyosits (DM) and polymyosits (PM) were discussed.Methods The expression of Cyr61,CTGF,VEGF and CD105 markers of micro vascular density (MVD) were detected in 10 cases of DM,10 cases of PM and 20 controls by using immunohistochemical Envision two step method.Data were analyzed using Statistical Product and Service Solutions (SPSS) statistical software.Fisher's exact probability analysis and Spearman correlation analysis were conducted.Results Compared with the control group,Cyr61,CTGF,VEGF positive expression rate in muscle tissue of patients with DM and PM group were significantly different (P＜0.01),the positive expression rates of Cyr61,CTGF,VEGF in DM group and PM group were 90％,70％,90％,80％,80％,70％,and the control group (5％,10％,5％) respectively.In the muscle tissue of patients with DM and PM group,CD105 markers of capillaries could be seen,and MVD in DM and PM group were higher than that in the control group,the difference was statistically significant (F=8.103,P=0.001).Cyr61,CTGF and VEGF protein expression levels in muscle tissueof patients with DM and PM were positively correlated with MVD.Conclusion The muscle tissue of PM/DMpatients may have new blood vessels formation.Cyr61,CTGF,VEGF may be involved in the formation of newblood vessels in the PM/DM muscle tissue.The results of this study suggest that microvascular lesion plays animportant role in the immune pathogenesis of inflammatory myopathy such as PM/DM.

Objective To investigate the effect of immunotherapy of recombinant chimeric epitopes of major allergen group 1 from Dermatophagoides farina on asthma of mice. Methods Forty mice were randomly divided into 4 groups:a negative con?trol group,an asthma group,an immunotherapy group of Der f 1,and an immunotherapy group of Der f 1A. On the 1st,7th and 14th day,the mice in the asthma group,immunotherapy group of Der f 1,and immunotherapy group of Der f 1A were injected intraperitoneally with the extract of D. farina 3 times to sensitize;and on the 21st day,the atomized inhalation was carried out for 7 days. In the control group,phosphate buffer solution(PBS)was applied for sensitization and inhalation. In the immunother?apy groups,Der f 1 and Der f 1A were applied to carry out the specific immunotherapy respectively for 30 min before the inhala?tion. Then,the leukocytes in the bronchoalveolar lavage fluid(BALF)were numbered and the pathological sections of lung tis?sues were observed;IL?5 and IFN?γin BALF and spleen cell culture supernatants(SCCS)as well as the specific IgE,IgG2a in the sera were detected. Results Compared with the asthma group,the lung inflammation of mice in the immunotherapy groups was lightened,and the total numbers of leukocytes in BALF were significantly reduced;IL?5 was significantly reduced and IFN?γwas significantly increased in BALF and SCCS of mice in the immunotherapy groups;and the specific IgE was significantly re?duced and IgG2a was significantly increased in the sera of mice in the immunotherapy groups(all P<0.01). Conclusion The recombinant chimeric epitopes of major allergen group 1 from D. farina could effectively relieve the symptom of asthma in mice, so as to provide the evidence for specific immunotherapy.

Objective To construct and express a chimeric gene with T-/B-cell epitopes of the major allergen group 1 from Dermatophagoides farina(Der f 1). Methods Two chimeric genes,Der f 1A and Der f 1B,were synthesized as B1-T1-B2-T2-B3-T3-B4-T4-B5-T5-B6 and B1-B2-B3-B4-B5-B6-T1-T2-T3-T4-T5 pattens. Two recombinant vectors,pET-28a(+)-Der f 1A and pET-28a(+)-Der f 1B,were constructed for prokaryotic expression. These chimeric genes were induced by 1 mmol/L IPTG (final concentration),digested with restriction enzymes and sequenced. The chimeric proteins were analyzed by SDS-PAGE and Western blotting. Results After digestion by restriction enzymes and sequencing,the recombinant vectors were constructed successfully. The specific bands for chimeric proteins were visible by SDS-PAGE and Western blotting,suggesting that these proteins were purified successfully. Further analyses were performed for IgE-binding properties of Der f 1A and Der f 1B to sera from patients sensitized to house dust mite. Compared with the parental allergens Der f 1,Der f 1A and Der f 1B had reduced IgE-binding capacity(both P<0.05),whereas the difference between Der f 1A and Der f 1B was not statistically significant(P>0.05). Conclusion Two chimeric proteins are expressed successfully,which contain T-/B-cell epitopes of Der f 1 and provide a basis for specific immunotherapy.

‘Two-way’ training of teaching basic skill and medical education method was conducted for young and middle-aged teachers according to characteristics of clinical teachers in teaching hospitals.After two years of training,clinical teachers' teaching ability and teaching enthusiasm and the quality of classroom teaching have obviously improved based on the analysis of related data.Clinical teacher training strengthen the teaching faculty quantitatively.This thesis discussed the importance of clinical teachers' training and further explored the improvement of clinical teacher education mode.

ObjectiveThis study explored the change of IL-18,and IFN-γ and their role in the pathogenesis of primary Sj(o)gren's syndrome (pSS) by determining the expression of IL-18,IFN-γ in labial glands and blood of patients with pSS.MethodsThe levels of IL-18,IFN-γ in labial glands of patients with pSS were determined by immunohistochemical method.The level of serum IL-18 was determined with enzyme linked immunosorbent assay ELISA.The level of γ globulin was measured by the cellulose acetate membrane method.SPSS 17.0 statistical software was used for data analysis.The t test,Fisher's exact probability test and index correlation analysis were performed with linear correlation analysis.Spearman's test was used to examine the association between the expression of IL-18 and IFN.ResultsThe positive rate of IL-18 and IFN-γ in patients with pSS was much higher than normal control group(P＜0.05).And the IL-18 and IFN-γ levels were positively correlated withpatients with pSS (P＜0.05).The level of serum IL-18 in patients with pSS was (216±85) pg/ml,which was much higher than normal control group(39±8) pg/ml.The IL-18 level and γ globulin(23.2±2.6)％ was positively correlated in patients with pSS (r=0.538,P＜0.05).ConclusionThe expression of IL-18 and IFN-γ in labial glands of patients with pSS are much higher in patients with pSS than those of the normal controls.Theresults have shown that IL-18 and IFN-γ may be involved inthe pathogenesis of pSS.