Objective Maternal-and-child health(MCH)hospitals simultaneously provide clinical care and manage community-based public-health projects for women and children.We aimed to design and test a performance-based salary and e-valuation system that recognizes this dual responsibility and incentivizes high-quality public-health work.Methods Aligned with the national tertiary-level MCH-hospital performance appraisal standards and local project realities,we applied four industrial-en-gineering techniques—empirical time-and-motion estimation,classification,analogy and work-study—to convert every public-health project into quantifiable modules with pre-set labor-hour quotas.Bonuses were calculated under"more work,more pay"and"increment incentive"rules,while appraisal covered two dimensions:(ⅰ)project-specific indicators(coverage,timeliness,completeness)and(ⅱ)outcome evaluation(health impact and user satisfaction).Performance pay was then approved and dis-tributed to staff responsible for project management.Results Analysis of the 2022-2024 implementation period showed clear gains:① Work-force mobilization:departments managing MCH projects grew from 17 to 22 and staff from 22 to 73;all core pro-ject indicators improved significantly.② Service expansion:valid service volume generated by jurisdiction-level MCH project ac-tivities rose by 62.31％.Conclusion The scientific,standardized and operable performance and evaluation system for maternity and child projects developed in this study can help effectively improve the management efficiency of maternity and child projects in the jurisdiction and promote the high-quality development of the hospital.

Objective Maternal-and-child health(MCH)hospitals simultaneously provide clinical care and manage community-based public-health projects for women and children.We aimed to design and test a performance-based salary and e-valuation system that recognizes this dual responsibility and incentivizes high-quality public-health work.Methods Aligned with the national tertiary-level MCH-hospital performance appraisal standards and local project realities,we applied four industrial-en-gineering techniques—empirical time-and-motion estimation,classification,analogy and work-study—to convert every public-health project into quantifiable modules with pre-set labor-hour quotas.Bonuses were calculated under"more work,more pay"and"increment incentive"rules,while appraisal covered two dimensions:(ⅰ)project-specific indicators(coverage,timeliness,completeness)and(ⅱ)outcome evaluation(health impact and user satisfaction).Performance pay was then approved and dis-tributed to staff responsible for project management.Results Analysis of the 2022-2024 implementation period showed clear gains:① Work-force mobilization:departments managing MCH projects grew from 17 to 22 and staff from 22 to 73;all core pro-ject indicators improved significantly.② Service expansion:valid service volume generated by jurisdiction-level MCH project ac-tivities rose by 62.31％.Conclusion The scientific,standardized and operable performance and evaluation system for maternity and child projects developed in this study can help effectively improve the management efficiency of maternity and child projects in the jurisdiction and promote the high-quality development of the hospital.

Objective:To evaluate the efficacy and safety of less invasive surfactant administration (LISA) combined with caffeine citrate in the treatment of respiratory distress syndrome (RDS) in preterm infants receiving continuous positive airway pressure (NCPAP) ventilation.Methods:From August 2019 to April 2021, a total of 112 preterm infants with RDS (26 weeks≤gestational age ≤32 weeks) who were hospitalized in the Neonatal Intensive Care Unit of Xuzhou Central Hospital, were chosen as research subjects. The patients were randomly divided into the LISA combined treatment group ( n=58) and the INSURE group ( n=54). In the LISA combined treatment group, a LISA tube was inserted through the vocal cords under direct vision with a direct laryngoscope and then infused with pulmonary surfactant (PS) into the lung when NCPAP ventilation was applied, and caffeine citrate was given intravenously. In the INSURE group, the patients were endotracheally intubated and infused with PS into the lung through an endotracheal tube, and then extubated and put on NCPAP again. The following indicators were examined: the general clinical data, results of blood gas analysis at 1 h and 6 h after infusion of PS into the lung, clinical efficacy and related complications. Results:①No significant differences were found between the two groups in the general clinical data (all P>0.05).Intra-group comparison within LISA combined treatment group or INSURE group showed that partial pressure of arterial carbon dioxide (PaCO 2), partial pressure of arterial oxygen (PaO 2) of blood gas analysis and PaO 2/fraction of inspired oxygen (P/F) at 1 h and 6 h after infused PS into the lung were all improved compared to those of before treatment, and the differences were statistically significant (all P<0.05). The PaO 2 and P/F in the LISA combined treatment group at 1 h and 6 h after breath support therapy were higher than those in the INSURE group, while PaCO 2 was lower than that in the INSURE group, and the differences were statistically significant (all P<0.05). The duration of noninvasive ventilation, total oxygen inhalation, re-administration of PS, failure rate of machine withdrawal, the rate of tracheal intubation within 72 h and the times of apnea in the LISA combined treatment group were significantly shorter, or lower, or less than those in the INSURE group [3.0 (1.0, 18.0) d vs. 7.5 (2.0, 22.0) d, 5.5 (3.0, 21.0) d vs. 10.5 (4.0, 28.0) d, 9 (15.5%) vs. 17 (31.5%), 6 (10.3%) vs. 14 (25.9%), 5 (8.6%) vs. 12 (22.2%), 5.0 (3.0, 21.0) times vs. 15.0 (4.0, 28.0) times], and the differences were all statistically significant (all P<0.05). The incidence of bronchopulmonary dysplasia in the LISA combined treatment group was less than that in the INSURE group [(5 (8.6%) vs. 13 (24.1%)], and the difference was statistically significant ( P<0.05). There was no significant difference between the two groups in other complications( P>0.05). Conclusions:Compared with INSURE, the LISA technique combined with caffeine citrate can effectively improve oxygenation, reduce the mechanical ventilation rate, shorten the duration of noninvasive mechanical ventilation, and reduce the incidence of BPD in the treatment of premature infants with RDS at the gestational age of 26-32 weeks.

Objective:To analyze the clinical characteristics in patients with persistent positive pharyngeal swab of 2019 novel coronavirus Omicron variant and results of nucleic acid testing of anal swabs to provide basis for prevention and control measures.Methods:This study included 93 patients whose pharyngeal swab nucleic acid test were persistent positive and admitted to the ward of Daping Hospital in the National Exhibition and Convention Center (Shanghai) Makeshift Hospital from May 1 to May 24, 2022. The gender, age, underlying diseases, vaccination status, clinical symptoms, interval between infection onset and anal sampling, length of hospital stay, the nucleic acid test result of pharyngeal swabs and anal swabs and the time turning negative were collected and analyzed.Results:The age of 93 patients ranged from 8 to 72 years old with a median of (46.0±16.0) years old. Among them, 30 cases (32.3%) were male and 63 cases (67.7%) were female. Sixty-five patients (69.9%) received 2-3 shots of vaccine, 2 patients (2.1%) received 1 shot, and 26 patients (28.0%) did not receive any vaccination. Twenty patients (21.5%) had underlying diseases, of which hypertension (13 cases, 14.0%) and type 2 diabetes mellitus (6 cases, 6.5%) were the most common. Twenty-four patients (25.8%) had asymptomatic infection and the rest (69 cases, 74.2%) had mild symptoms. Cough (50 cases, 53.8%) and sore throat (28 cases, 30.1%) were the most common clinical manifestations of the upper respiratory tract in these patients. Only 6 patients (6.5%) had gastrointestinal symptoms (including diarrhea in 5 patients and diarrhea with vomiting in 1 patient). Pharyngeal and anal swabs were collected simultaneously from all 93 patients at 8-16th days [(11.55±2.27) days] after 2019 novel coronavirus Omicron variant infection. The pharyngeal swabs were positive in 79 patients (85.0%) and the anal swabs were positive in 5 patients (5.4%). The time of pharyngeal swabs turning negative was (14.7±2.9) days, and that of anal swab turning positive was (14.2±1.9) days. The median length of hospital stay was (16.7±2.9) days.Conclusions:In patients with persistent positive nucleic acid of the 2019 novel coronavirus Omicron variant, there were more mild infection than asymptomatic. The upper respiratory tract symptoms such as cough and sore throat were the most. The likelihood of transmission of 2019 novel coronavirus Omicron variant through the digestive tract may be low. The correlation between gastrointestinal symptoms and 2019 novel coronavirus Omicron variant RNA in the digestive tract is uncertain.

Objective:To investigate the triggering factors of ischemic stroke and their correlation with stroke severity and traditional risk factors.Methods:The clinical data of patients with ischemic stroke within 2 weeks of the onset were collected retrospectively. They were divided into two groups according to the questionnaire of triggering factors. The demographic and baseline data of the two groups were compared. According to the National Institutes of Health Stroke Scale (NIHSS) score, the patients were divided into low NIHSS score group (≤8) and high NIHSS score group (>8). The demographic and baseline data were compared. Multivariate logistic regression analysis was used to determine the independent related factors of the existence of triggering factors in patients with ischemic stroke and the correlation between the existence of triggering factors and the severity of stroke. Results:A total of 217 patients were enrolled in the study. Their age was 63.4±12.8 years and 148 were male (68.2%). One hundred and nine patients had at least one triggering factor. Common triggering factors were sleep disorders (46.8%), infection (18.4%), and missed medication (13.8%). Multivariate logistic regression analysis showed that after adjusting for confounding factors, diabetes mellitus (odds ratio [ OR]2.496, 95% confidence interval [ CI]1.347-4.626; P=0.047), large artery atherosclerosis ( vs. small vessel occlusion: OR 2.168, 95% CI 1.060-4.343; P=0.034) and baseline NIHSS score (the fourth quartile vs. the first quartile: OR 2.320, 95% CI 1.043-5.162; P=0.039) were independently associated with the existence of triggering factors in patients with ischemic stroke, and any of the triggering factors was independently associated with stroke severity ( OR 2.042, 95% CI 1.106-3.770; P=0.023). Conclusion:Diabetes and the severity of stroke are associated with the existence of triggering factors in patients with ischemic stroke. Stroke severity in ischemic stroke patients with triggering factors is more severe.

Objective To explore the effects of pigmentary epithelium derived factor (PDEF) on the phenotypic and immunologic function of murine-derived dentritic cells(BMDCs) .Methods Mononuclear cells(MNCs) isolated from murine bone marrow were cultured in RPMI1640 medium containing rmGM-CSF and rmIL-4 for 5 d ,and were divided into five groups .MNCs were stimulated for 3 d with either 50 ,100 ,200ng/mL PEDF ,1 μg/mL LPS(positive control) or RPMI1640(negative control) .The expression of CD11c ,CD80 and CD86 on DCs surface were analyzed by the fluorescence activated cell sorting (FCM ) .The ability of PEDF-induced BMDCs to stimulated T cell maturation were determined by the CCK-8 method and the level of IL-12 in the culture supernatant was detected by ELISA .Results The PEDF-treated BMDCs expressed high levels of CD11c ,CD80 and CD86 ,enhanced the immunolog-ical activities of T lymphocyte and its secretion of IL-12 when compared with untreated DCs .Conclusion PEDF can significantly up-regulate the expression of DCs immunological labelled molecule in in vitro cultured murine and increase its immunological com-petence .

OBJECTIVE: To investigate the genetic causes of nonsyndromic deaf patients in special educational school of Chifeng city. Inner Mongolia by genetic screening testing method. This study focused on analyzing mutations of coding sequence of GJB2, GJB3 and GJB6 gene. METHOD: DNA were extracted out from peripheral blood of 134 nonsyndromic deaf probands of Chifeng special educational school and 100 normal hearing controls in northern China. First, GJB2 gene mutation was analyzed by direct sequencing for its only exon in the open reading frame. Individuals found with heterozygous GJB2 mutation were given further testing for GJB6 del(GJB6-D13S1830) and direct sequencing for its exon. In 91 probands with unknown genetic cause (excluding probands who carried mtDNA A1555G mutation and GJB2 gene bi allele mutation and probands who were diagnosed as enlarged vestibular aqueduct by temporal CT), GJB3 gene mutation was analyzed by direct sequencing for its exon. RESULT: The sequencing results revealed that forty-one cases carried GJB2 mutation. of which twenty-two were homozygous or compound heterozygous and nineteen were heterozygous. Further testing for GJB6 del(GJB6-D13S1830) and analysis of its coding sequence in GJB2 heterozygous cases showed no positive result. Four subjects in control group carried pathogenetic mutation of GJB2 gene. Six types of novel variants of GJB2 gene were detected. Of the 91 deaf probands with unknown etiology. two probands were found carrying heterozygous pathogenetic mutation of GJB3 gene. one of whom also carried GJB2 235delC heterozygous mutation. One subjects in the control group carried pathogenetic mutation of GJB3 gene. Three types of novel variants of GJB3 gene were found. CONCLUSION By screening GJB2.GJB3 and GJB6 gene, we found 32.1% probands carrying GJB2, GJB3, and GJB6 mutations and we are able to determine genetic cause related to these three genes from one family for 16.42 percent of nonsyndromic deaf probands in special educational school of Chifeng city. The discovery of novel variants of GJB2 and GJB3 gene makes the mutational and polymorphic spectrum more plentiful in Chinese population.
Adolescent ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Child ; Child, Preschool ; China ; Connexin 26 ; Connexin 30 ; Connexins ; genetics ; DNA Mutational Analysis ; Education, Special ; Female ; Genetic Testing ; Genotype ; Hearing Loss ; genetics ; Heterozygote ; Humans ; Male ; Mutation ; Polymorphism, Genetic ; Students ; Young Adult

OBJECTIVE To investigate the genetic causes of deaf patients in a special educational school of Chifeng city, Inner Mongolia by SLC26A4 whole gene sequencing. This study focused on analyzing mutations of coding sequence of SLC26A4 gene and their relevant phenotype. METHODS DNA were extracted from peripheral blood of 134 deaf patients of Chifeng special educational school and 100 normal hearing controls in Northern China. SLC26A4 gene mutation was analyzed by direct sequencing for its 20 coding exons. All individuals found with SLC26A4 mutation were given temporal bone CT scan, and those with confirmed enlarged vestibular aqueduct and/or other malformation of inner ear were then given further ultrasound scan of thyroid and thyroid hormone assays. RESULTS The sequencing results revealed 32 cases carried SLC26A4 mutation. Twenty-nine cases underwent temporal bone CT scan. Twentycases were confirmed to have malformation of inner ear by CT scan (eighteen were EVA, one was EVA and other inner ear malformation and one was Mondini Syndrome). The shape and function of thyroid were confirmed to be normal by ultrasound scan of thyroid and thyroid hormone assays in nineteen of these 20 patients except one who had cystoid change in the right side of thyroid. Twelve types of novel variants of SLC26A4 gene were found. CONCLUSION Byscreening SLC26A4 gene coupled with temporal bone CT scan ,we could determine genetic cause related to this gene up to 14.93 % of deaf patients in special educational school of Chifeng city. SLC26A4 is another common gene besides GJB2 that cause deafness in this area. The discovery of novel variants of SLC26A4 gene makes the mutational and polymorphic spectrum more plentiful in Chinese population.

Objective:To observe neurotransmitter changes of post cerebral infarction depression (PCID) before and after being treated with amitriptyline or acupuncture of Baihui,in order to explore a good way with a less toxicity and good effect of treatment on PCID.Methods:The 60 patients were divided into treatment group and control group.Besides the basic treatment,the treatment group was given acupuncture of Baihui (DV20) and point injection therapy,the control group was given amitriptyline. Both before and after treatment,compared the two groups with HAMD score,neurologic impairment score,plasma 5-HT and NE,and observed the adverse events and side effects.Results:The results of two groups in monoamine neurotransmitter 5-HT(5-HT),norepinephrine (NE) and the HAMD scale were significantly improved.Conclusion:Acupunture of Baihui and point injection of Herba Erigerontis had equal effect to the amitriptyline on PCID.Furthermore,it had fewer venenosus side effects.It provided a new way for the use of the traditional Chinese medicine in treating PICD.