To improve Party members management quality in public hospitals,this study established a comprehensive system based on the five core elements of system management theory.The system includes subsystems for target value,organiza-tional structure,education and training,performance assessment,supervision and review,and information technology.Further-more,the practical implementation of this system in a public hospital has highlighted three key characteristics:integrity,hierar-chy,and openness.These features underscore its potential for wider adoption in the management of Party members within public hospitals.

BACKGROUND:With the increasing demand for orthopedic implants,the search for materials with good biocompatibility and degradability has become a research hotspot.Magnesium-lithium-gadolinium(Mg-Li-Gd)alloy has good degradability,biocompatibility,and mechanical properties,providing ideal supporting conditions for fracture healing.OBJECTIVE:To evaluate the effects of Mg-Li-Gd alloy implants on bone healing in rats.METHODS:A circular half-defect model was made on the lateral side of the right mid-femoral segment in 28 SD rats,and the rats were randomly divided into two groups.The stainless steel group was fixed with a stainless steel intramedullary nail,and the magnesium alloy group was fixed with an Mg-Li-Gd alloy intramedullary nail,with 14 rats in each group.At 2,8,and 14 weeks after surgery,right femur X-ray and Micro-CT examinations,as well as hematoxylin-eosin staining,immunohistochemical staining,and western blot assay were performed.RESULTS AND CONCLUSION:(1)X-ray film:At 2 weeks after surgery,the osteotomy lines of both groups were clear,the density of the intramedullary nail in the magnesium alloy group was close to that of bone tissue,and the density of the intramedullary nail in the stainless steel group was higher than that of bone tissue.At 8 weeks after surgery,the osteotomy lines of both groups were blurred,and the intramedullary nail in the magnesium alloy group had corroded and degraded.At 14 weeks after surgery,the osteotomy lines of both groups disappeared,and the intramedullary nail in the magnesium alloy group further corroded and degraded.(2)Micro-CT:At 2 weeks after surgery,callus began to form in both groups;8 weeks after surgery,the stainless steel group entered the callus remodeling stage,and a relatively dense bone structure was formed at the bone defect site,and the magnesium alloy group showed obvious callus hyperplasia at the bone defect site.At 14 weeks after surgery,the stainless steel group showed a mature bone remodeling process,and thick cortical bone was formed at the bone defect site,and thinner cortical bone was formed in the magnesium alloy group.(3)Hematoxylin-eosin staining:At 2 weeks after surgery,a large number of osteoblasts,osteocytes,a small number of osteoclasts and trabecular structures were observed in the magnesium alloy group,while relatively few osteoblasts and osteocytes were observed in the stainless steel group.At 8 weeks after surgery,a large number of osteoblasts,osteocytes,and mature trabecular structures were observed in the magnesium alloy group,while a large number of osteocytes and lamellar bones were observed in the stainless steel group.At 14 weeks after surgery,lamellar bones were observed in the magnesium alloy group,while mature bone tissue was observed in the stainless steel group.(4)Immunohistochemical staining and western blot assay:At the same time point,the expression levels of bone morphogenetic protein 2,osteocalcin,and RUNX2 proteins in the magnesium alloy group were higher than those in the stainless steel group.(5)The results showed that compared with stainless steel materials,Mg-Li-Gd alloy had no obvious advantage in promoting the formation of fracture healing structure.

BACKGROUND:With the increasing demand for orthopedic implants,the search for materials with good biocompatibility and degradability has become a research hotspot.Magnesium-lithium-gadolinium(Mg-Li-Gd)alloy has good degradability,biocompatibility,and mechanical properties,providing ideal supporting conditions for fracture healing.OBJECTIVE:To evaluate the effects of Mg-Li-Gd alloy implants on bone healing in rats.METHODS:A circular half-defect model was made on the lateral side of the right mid-femoral segment in 28 SD rats,and the rats were randomly divided into two groups.The stainless steel group was fixed with a stainless steel intramedullary nail,and the magnesium alloy group was fixed with an Mg-Li-Gd alloy intramedullary nail,with 14 rats in each group.At 2,8,and 14 weeks after surgery,right femur X-ray and Micro-CT examinations,as well as hematoxylin-eosin staining,immunohistochemical staining,and western blot assay were performed.RESULTS AND CONCLUSION:(1)X-ray film:At 2 weeks after surgery,the osteotomy lines of both groups were clear,the density of the intramedullary nail in the magnesium alloy group was close to that of bone tissue,and the density of the intramedullary nail in the stainless steel group was higher than that of bone tissue.At 8 weeks after surgery,the osteotomy lines of both groups were blurred,and the intramedullary nail in the magnesium alloy group had corroded and degraded.At 14 weeks after surgery,the osteotomy lines of both groups disappeared,and the intramedullary nail in the magnesium alloy group further corroded and degraded.(2)Micro-CT:At 2 weeks after surgery,callus began to form in both groups;8 weeks after surgery,the stainless steel group entered the callus remodeling stage,and a relatively dense bone structure was formed at the bone defect site,and the magnesium alloy group showed obvious callus hyperplasia at the bone defect site.At 14 weeks after surgery,the stainless steel group showed a mature bone remodeling process,and thick cortical bone was formed at the bone defect site,and thinner cortical bone was formed in the magnesium alloy group.(3)Hematoxylin-eosin staining:At 2 weeks after surgery,a large number of osteoblasts,osteocytes,a small number of osteoclasts and trabecular structures were observed in the magnesium alloy group,while relatively few osteoblasts and osteocytes were observed in the stainless steel group.At 8 weeks after surgery,a large number of osteoblasts,osteocytes,and mature trabecular structures were observed in the magnesium alloy group,while a large number of osteocytes and lamellar bones were observed in the stainless steel group.At 14 weeks after surgery,lamellar bones were observed in the magnesium alloy group,while mature bone tissue was observed in the stainless steel group.(4)Immunohistochemical staining and western blot assay:At the same time point,the expression levels of bone morphogenetic protein 2,osteocalcin,and RUNX2 proteins in the magnesium alloy group were higher than those in the stainless steel group.(5)The results showed that compared with stainless steel materials,Mg-Li-Gd alloy had no obvious advantage in promoting the formation of fracture healing structure.

To improve Party members management quality in public hospitals,this study established a comprehensive system based on the five core elements of system management theory.The system includes subsystems for target value,organiza-tional structure,education and training,performance assessment,supervision and review,and information technology.Further-more,the practical implementation of this system in a public hospital has highlighted three key characteristics:integrity,hierar-chy,and openness.These features underscore its potential for wider adoption in the management of Party members within public hospitals.

Objective:To construct and validate a risk prediction model for major complications 30 days after surgery in the elderly patients with hip fracture.Methods:A retrospective study was conducted to analyze the clinical data of 276 elderly patients with hip fracture who had been admitted to Department of Trauma and Orthopaedics, The Hospital Affiliated to Chengde Medical University from June 2019 to December 2021. There were 96 males and 180 females with an age of (74.5±9.3) years, and 139 femoral neck fractures and 137 intertrochanteric fractures. The outcome of this study was whether major complications occurred within 30 days after surgery. Multiple logistic regression analysis identified the risk factors for major complications in the elderly patients with hip fracture within 30 days after surgery. The forward step-by-step method and likelihood ratio test were used to screen the best prediction model. A nomogram was constructed to display the model. The stability and effectiveness of the model were evaluated by the receiver operating characteristic curve (ROC), Hosmer-Lemeshow goodness-of-fit test, clinical decision curve and clinical impact curve analysis.Results:Logistic regression analysis showed that decreased preoperative hemoglobin ( P< 0.05), time from admission to surgery >72 hours ( OR=3.001, 95% CI: 1.564 to 5.758, P<0.001), control of nutritional status (CONUT) score >4 points ( OR=3.394, 95% CI: 1.724 to 6.680, P<0.001), and age-adjusted modified frailty index (aamFI) >2 points ( OR=2.875, 95% CI: 1.548 to 5.339, P= 0.001), increased operation time ( OR=1.016, 95% CI: 1.006 to 1.025, P=0.001), and surgical bleeding >60 mL ( OR=2.373, 95% CI: 1.016 to 5.540, P=0.046) were independent risk factors for major complications within 30 days after surgery in the elderly patients with hip fracture. The area under the ROC curve in the logistic risk prediction model was 0.846 (95% CI: 0.799 to 0.889), and the results of Hosmer-Lemeshow goodness-of-fit test showed ( χ2=8.080, P=0.426). The clinical decision curve and clinical impact curve showed that the prediction model was accurate and effective. Conclusion:Based on the patients' preoperative hemoglobin, time from admission to surgery, control of nutritional status score, age-adjusted modified frailty index, operation time and surgical blood loss, this study has constructed successfully a risk prediction model for complications 30 days after surgery in the elderly patients with hip fracture which enables medical staff to predict the occurrence of major postoperative complications.

An 11-day-old female neonate was admitted for cough with mouth foaming and feeding difficulties. The laboratory results indicated hyperlactatemia, elevated markers of myocardial injury and inflammation, and high levels of acylcarnitine octanoylcarnitine and decanoylcarnitine in tandem mass spectrometry. Ultrasonography and MRI suggested cardiac insufficiency and hypertrophic cardiomyopathy. Whole exome sequencing showed that both the proband and her elderly sister had a compound heterozygous variant of c.1492dup (p.T498Nfs*13) and c.1376T>C (p.F459S) in the ATAD3A gene, inherited from their father and mother, respectively. The diagnosis of Harel-Yoon syndrome was confirmed. The proband and her sister were born with clinical manifestations of metabolic acidosis, hyperlactatemia, feeding difficulties, elevated markers of myocardial injury as well as cardiac insufficiency, and both died in early infancy.
Humans ; Infant, Newborn ; Female ; Aged ; Mutation ; Hyperlactatemia ; ATPases Associated with Diverse Cellular Activities/chemistry* ; Membrane Proteins/genetics* ; Mitochondrial Proteins/genetics*

Objective: To investigate the effects of cathepsin S(Cat S) on proliferation, migration and invasion of osteosarcoma cells and its potential regulatory mechanism. Methods: Normal osteoblasts(hFOB) and osteosarcoma cells(SAOS2 and MG63) were selected as the subjects of this study.Cat S small interfering(si) RNA(si-Cat S) and negative control sequence(si-NC) were transfected into SAOS2 and MG63 cells to modulate the expression of Cat S in osteosarcoma cells.The experimental cells were randomly divided into four groups: hFOB group(hFOB cells),Control group(untransfected SAOS2 or MG63 cells),si-NC group(SAOS2 or MG63 cells transfected with si-NC) and si-Cat S group(SAOS2 or MG63 cells transfected with si-Cat S).The expression of Cat S in SAOS2 and MG63 cells was detected by RT-PCR and Western blot.Effect of Cat S knockdown on the proliferation of SAOS2 and MG63 cells was assessed by CCK-8 and clone formation assays.And effects of Cat S knockdown on the migration and invasion of SAOS2 and MG63 cells were determined by wound-healing and Transwell assays, respectively.Western blot assay was performed to measure the effects of SAOS2 knockdown on the expressions of apoptosis-related proteins(Bcl-2,Bax and Caspase-3) and Wnt/β-catenin pathway related proteins(LRP5,β-catenin, C-myc and Cyclin D1) in SAOS2 cells. Results: Compared with hFOB group, the expression of Cat S in SAOS2 group and MG63 group was upregulated(P<0.001).In addition, compared with si-NC group, the proliferation, migration and invasion of cells in si-Cat S group were reduced(P<0. 001). Results of Western blot showed that compared with si-NC group,the expression of Bcl-2 in si-Cat S group was downregulated,while the expression of Bax and Caspase-3 were upregulated(P<0. 001). Meanwhile,compared with si-NC group,the expression of LRP5,β-catenin,C-myc and Cyclin D1 in si-Cat S group was downregulated(P<0. 001). Conclusion Cat S siRNA knockdown can inhibit the proliferation,migration and invasion of osteosarcoma cells and induce apoptosis by regulating Wnt/β-catenin pathway,indicating that Cat S may be one of the potential targets for the treatment of osteosarcoma.

The department of radiology, as one of the public platforms for standardized residency training, is very crucial to the training of high level clinicians and essential to improve quality of medical care. According to the present situation and existing problems of standardized residency training for the non-imaging professional residents in the department of radiology in China, combining with our practice, this article primarily explores the improvement of the rules and regulations, the specific arrangement of the rotation, daily and graduation examination forms, and training quality supervision, etc. We hope to improve the training quality of the non-imaging professional residents' rotation in the department of radiology and explore more suitable and effective medical educative strategies.

OBJECTIVE: To explore effects of different delivery and storage conditions on concentrations of amino acids and carnitines in neonatal dried blood spots (DBS), so as to provide evidence for improving accurate and reliable detection by tandem mass spectrometry. METHODS: A total of 1 254 616 newborn DBS samples in Newborn Screening Center of Zhejiang Province were delivered and stored at room temperature (group A, RESULTS: The concentrations of amino acids and carnitines in the three groups were skewed, and the differences in amino acid and carnitine concentrations among groups were statistically significant (all CONCLUSIONS Cold-chain logistics system and storage in low temperature and low humidity can effectively reduce degradation of some amino acids and carnitines in DBS, improve the accuracy and reliability of detection, and thus ensures the quality of screening for neonatal metabolic diseases.
Amino Acids/analysis* ; Carnitine/analysis* ; Dried Blood Spot Testing/standards* ; Humans ; Humidity ; Infant, Newborn ; Neonatal Screening ; Reproducibility of Results ; Specimen Handling/standards* ; Tandem Mass Spectrometry ; Temperature ; Time Factors

Objective:To investigate the application feasibility of Region 4 Stork (R4S) system, an international collaborative newborn screening data platform, combined with cut-off value analysis in the neonatal screening for very long chain acyl-CoA dehydrogenase deficiency (VLCADD) by tandem mass spectrometry (MS/MS).Methods:The retrospective study was performed in 2, 040 072 neonates screened by MS/MS in Neonatal Screening Center of Zhejiang Province, China from October 2013 to July 2018. Nine hundred and ten cases were determined and identified as suspected positive VLCADD neonates by traditional cut-off method of tandem mass spectrometry. The original data of these 910 screened neonates were further analyzed by R4S system. Based on clinical diagnosis and ACADL gene test results, the screening efficiency between two methods was statistically compared.Results:The data of 910 suspected VLCADD-positive cases interpreted by cut-off method were further analyzed by R4S system, and the positive interpretation was reduced to 238 cases (including 9 confirmed positive cases). A total of 16 different mutations were found in ACADL gene sequencing among the confirmed children. The screening false positive rate (FPR) declined from 0.44‰ (901/2 040 072) to 0.11‰ (229/2 040 072), the rate of positive predictive value (PPV) increased from 0.99% (9/910) to 3.78% (9/238), and the specificity increased from 99.96% (2 039 162/2 040 063) to 99.99% (2 039 834/2 040 063). There was a statistically significant difference between cut-off method alone and cut-off method combined R4S system analysis (χ2=393.5, P<0.05). Conclusions:The R4S system combined with cut-off method applied in VLCADD neonatal screening by MS/MS can effectively improve screening performance, reduce false positive rate, and has certain value in clinical application.