Objective To explore the application effect of the"Hospital-wide Centralized Bed Management"model in VIP wards,aiming to enhance medical service efficiency and patient experience through systematic resource integration and process optimization.Methods A VIP ward in a tertiary hospital in Southwest China was selected as the pilot site.From August 2024 to January 2025,a management model reform was implemented.Measures included the unified allocation of inpatient beds,construction of an information platform,establishment of interdisciplinary collaboration mechanisms,and optimization of medical staff responsibilities.Data on bed usage,service process indicators,and patient satisfaction were collected for three months before and after implementation.Statistical analysis was conducted using SPSS 26.0.Results After implementation,the bed utilization rate increased significantly from 20.0% to 55.0% (t=10.07,P＜0.001).The waiting time for admission was reduced from(48.0±12.5)hours to(23.5±6.8)hours(a 51.0% reduction,t=9.84,P＜0.001),and the bed transfer time decreased from(3.0±1.2)hours to(1.0±0.5)hours(a 66.7% reduction,t=7.62,P＜0.001).Patient satisfaction scores regarding bed arrangement,medical staff collaboration,and overall service significantly improved(all P＜0.001).After controlling for disease complexity,a strong positive correlation was found between bed utilization rate and overall satisfaction(r=0.68,P＜0.01).Conclusion By overcoming inter-departmental resource barriers,this model achieves efficient resource allocation and precise service process optimization in VIP wards,offering a replicable innovative approach for managing high-end medical serv-ices.

Objective To explore the application effect of the"Hospital-wide Centralized Bed Management"model in VIP wards,aiming to enhance medical service efficiency and patient experience through systematic resource integration and process optimization.Methods A VIP ward in a tertiary hospital in Southwest China was selected as the pilot site.From August 2024 to January 2025,a management model reform was implemented.Measures included the unified allocation of inpatient beds,construction of an information platform,establishment of interdisciplinary collaboration mechanisms,and optimization of medical staff responsibilities.Data on bed usage,service process indicators,and patient satisfaction were collected for three months before and after implementation.Statistical analysis was conducted using SPSS 26.0.Results After implementation,the bed utilization rate increased significantly from 20.0% to 55.0% (t=10.07,P＜0.001).The waiting time for admission was reduced from(48.0±12.5)hours to(23.5±6.8)hours(a 51.0% reduction,t=9.84,P＜0.001),and the bed transfer time decreased from(3.0±1.2)hours to(1.0±0.5)hours(a 66.7% reduction,t=7.62,P＜0.001).Patient satisfaction scores regarding bed arrangement,medical staff collaboration,and overall service significantly improved(all P＜0.001).After controlling for disease complexity,a strong positive correlation was found between bed utilization rate and overall satisfaction(r=0.68,P＜0.01).Conclusion By overcoming inter-departmental resource barriers,this model achieves efficient resource allocation and precise service process optimization in VIP wards,offering a replicable innovative approach for managing high-end medical serv-ices.

Objective:To analyze the clinical features, prognosis and risk factors of SARS-CoV-2 associated acute pancreatitis (SAAP), and provide a basis for early prevention and treatment of SAAP.Methods:Patients with coronavirus disease 19 infection (COVID-19) admitted to Zhejiang Provincial People's Hospital from December 1, 2022 to January 31, 2023 were retrospectively analyzed. Clinical characteristics such as age, gender and other data were recorded, and the indexes of blood routine, liver and kidney function, inflammatory factor, coagulation function, blood gas analysis, immunoglobulin and complement were collected after admission. Patients were divided into pancreatic injury group and non-pancreatic injury group according to the level of serum amylase/lipase. The difference of prognosis and related hematological parameters between the two groups was compared. Multifactorial logistic regression equation was constructed to analyze the risk factors of SAAP.Results:A total of 2 101 patients with COVID-19 who met the criteria were included, including 298 patients in the pancreatic injury group and 1 803 patients in the non-pancreatic injury group. 17 cases (5.7%) in the pancreatic injury group met the diagnostic criteria for AP. The age, male percentage and mortality rate of the pancreatic injury group were all significantly higher than those of the non-pancreatic injury group (all P<0.05). In the pancreatic injury group, white blood cell count, neutrophil-to-lymphocyte ratio, C-reactive protein (CRP), calcitoninogen, erythrocyte sedimentation rate, inflammatory cytokines, tumour necrosis factor, liver and kidney functions, coagulation (D-dimer and plasma fibrinogen degradation products), and lactate level were significantly higher than those in the non-pancreatic injury group (all P<0.05). Serum complement C3, albumin, albumin globule ratio and arterial oxygenation index were lower in the pancreatic injury group (all P<0.05). Multifactorial logistic regression analysis showed that gender, age, CRP, calcitoninogen, total bilirubin, creatinine, PaO 2, PaO 2/FiO 2 and lactate were independent risk factors for the occurrence of pancreatic injury in patients with COVID-19 (all P<0.05). Conclusions:Inflammation-related markers, D-dimer and fibrinogen degradation products were significantly higher in COVID-19 patients comorbid with pancreatic injury than in the patients without pancreatic injury. The risk of SAAP was significantly higher in male patients of senior age. Sex, age, CRP, calcitoninogen, total bilirubin, creatinine, oxygenation index, and lactic acid were independent risk factors for the onset of pancreatic injury in COVID-19 patients.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.

Objective To effectively use the clinical data generated in daily operation and to realize information networking based on the existing resources of radiotherapy department. To improve quality management efficiency in radiotherapy process. Methods The radiotherapy process and required documents were analyzed. The reporting tool Microsoft Report Builder, which is based on SQL database, was applied to design the patient documents by extracting and analyzing a large number of data generated by Aria, the existing network of our radiotherapy department. PDCA Tools was used to analyze the weak links in the process. Reports with quantitative indices have been designed according to corresponding countermeasures, so as to improve quality control level of the process. Results More than one thousand patients were treated in our department since 2020. All patient documents of radiotherapy can be archived and inquired online after registration only once. 13 daily statistical reports, 5 quarters and 3 annual reports were scheduled according to practical demands. The waiting time before radiotherapy was shortened from 16.2 days to 14.8 days after operating the reporting system 3 months later. The staff could master the treatment progress of patients easily and patients who interrupted the treatment were found in time. Conclusion The reporting tools can realize patient information extraction and networked management effectively in radiotherapy process. Staff efficiency of personnel work and communication was improved. The resource allocation was optimized according to the report data in real time, improving the efficiency and quality of radiotherapy. This method is generally applicable and practical to radiotherapy department.

Monoclonal immunoglobulin deposition disease is rare in medical practice. The light and heavy chain deposition disease is characterized by deposition of monoclonal antibodies in the basement of membrane. Kidney is the most frequently involved organ. There was a male patient diagnosed as light and heavy chain deposition disease in department of Nephrology of the Second Xiangya Hospital, Central South University by renal biopsy. After treatment by oral prednisone, melphalan and thalidomide, the patient's proteinuria and serum creatinine decreased. The retrospective analysis of this case provides a guide for doctors to understand the light and heavy chain deposition disease. Early diagnosis and treatment could improve the prognosis.
Antibodies, Monoclonal ; adverse effects ; Basement Membrane ; physiopathology ; Biopsy ; Creatinine ; blood ; Heavy Chain Disease ; diagnosis ; drug therapy ; Humans ; Immunoglobulin Light Chains ; Kidney ; physiopathology ; Male ; Proteinuria

BACKGROUND:In animal experiments, transplantation of autologous nucleus pulposus cellscan effectively repair the intervertebral disk degeneration. However, nucleus pulposus cells have a poor ability of proliferation in vitro, which limits its application as seed cells in treatment of intervertebral disk disease.
OBJECTIVE:To construct recombinant adeno-associated virus type-2 vector carrying human telomerase reverse transcriptase and observe the human telomerase reverse transcriptase mRNA expression in human nucleus pulposus cells in vitro.
METHODS:After the plasmid pSNAV2.0-pRSV-hTERT was constructed and identified, recombinant adeno-associated virus type-2 vector carrying human telomerase reverse transcriptase were constructed, amplified and purified by AAVMaxTM package and purification system. The optimal multiplicity of infection for human nucleus pulposus cells was detected by recombinant adeno-associated virus type-2 vector carrying enhanced green fluorescent protein. According the optimal multiplicity of infection (5 × 104 v·g/cell), three different multiplicity of infection (1×104, 5×104, 1×105 v·g/cell) of recombinant adeno-associated virus type-2 vector carrying human telomerase reverse transcriptase were determined to transfect the first passage human nucleus pulposus cells in vitro. In control group, the cells were transfected with adeno-associated virus type-2 vector without human telomerase reverse transcriptase. At 1, 2, 4 weeks after transfection, mRNA expression of human telomerase reverse transcriptase in human nucleus pulposus cells were semi-quantitatively detected by RT-PCR.
RESULTS AND CONCLUSION:The recombinant adeno-associated virus type-2 vector carrying human telomerase reverse transcriptase was successful y constructed, and the titer of the obtained vector was more than 2×1011 v·g/mL. The optimal multiplicity of infection was 5×104 v·g/cell. The mRNA expression of human telomerase reverse transcriptase in human nucleus pulposus cells could be detected in different multiplicity of infection (1×104, 5×104, 1×105 v·g/cell). At 2 weeks post-transfection, mRNA expression of human nucleus pulposus cells was the highest (P<0.05), as detected by semi-quantitative RT-PCR. Moreover, the stable and high mRNA expression of human telomerase reverse transcriptase could be detected at 4 weeks post-transfection. In control group, no human telomerase reverse transcriptase mRNA expression was found. The recombinant adeno-associated virus type-2 vector carrying human telomerase reverse transcriptase can be successful y constructed, and can mediate a stable mRNA expression of human telomerase reverse transcriptase in human nucleus pulposus cells. Our findings provide a novel strategy of enhancing the properties of nucleus pulposus cells.

Objective To investigate the methods used for evaluating the severity of the patients with acute pancreatitis induced by hyperlipidemia in order to find out some simple and practical biomarkers for predicting the severity of the illness.Methods Sixty-two patients with acute pancreatitis resulted from hyperlipidemia were selected from the in-patients of our hospital from January 2007 to July 2011 and were divided into two groups,namely the mild acute pancreatitis group(MAP,n =32)and the severe acute pancreatitis group(SAP,n =30)as per the Chinese Acute Pancreatitis Guideline.Two groups were comparable verified by the test of homogeneity of variance after grouping.Arterial blood gas analyses were done immediately after admission:Venous blood was taken from forearm for determining renal function and blood coagulation at 6 o＇lock of next day after admission.The data of base excess(BE),creatinine(CR),C-reactive protein(CRP),fibrin(FIB)and D-Dmmer(D-D)were documented.The contrast CT imaging of pancreas was done within 48 hours after admission in all patients.APACHE Ⅱ scores and computed tomography severity index(CTSI)were calculated.The differences in BE,CR,CRP,FIB and D-D between 2 groups were analyzed by using t-test,and the correlation among them and APACHE Ⅱ score and CTSI were analyzed by Spearman test done with SPSS 18.0 software.As BE ＜-4.5 mnol/L,CR ＞ 120μmol/L,CRP ＞ 100 mg/L,FIB ＞5.5 g/L and D-D 800 ng/L were set respectively as a positive screening criterion,positive prediction value(PPV),negative prediction value(NPV),sensitivity and specificity of each marker and combined markers were calculated after they were set at different positive scales in order to get the optimal predictors for evaluating the severity of acute pancreatitis induced by hyperlipidemia.Results The absolute values of BE,CR,CRP,FIB and D-D in group SAP were much higher than those in group MAP(P ＜ 0.01).Each of them had good correlation with APACHE Ⅱ score and CTSI,especially BE and D-D more significant.Each of them used separately for predicting the severity of acute pancreatitis showed PPV and NPV with high specificity but the sensitivity was hot high.The joint use of BE,CR and CRP,and joint use of FIB and D-D could be more valid as PPV and NPV with high specificity for predicting the severity of acute pancreatitis,but the sensitivity decreased.Conclusions BE,CR,CRP,FIB and D-D were good biomarkers for quickly and accurately evaluating and predicting the severity of the acute pancreatitis caused by hyperlipidemia.

Objective To study the effect of sodium hyaluronate on the expression of transforming growth factor-β3(TGF-β3) and Smad 6 of the epidural scar tissue. Method Totally 60 male SD rats were randomly divided into two groups:the control group(A, n = 30), sodium hyaluronate group(B, n = 30). 0.25 × 1 cm2 dura mater uncovered area laminectomy was performed at L4 and L5, covered with 0.3 ml sodium hyaluronate in group B, covered with same amount of saline in group A. The animals were sacrificed at 2, 4 and 8 weeks after operation. The specimens were prepared for determination of the expression of TGF-β3 and Smad 6 at scar tissue and the degree of scar adhesion according to Rydell method, and observed the ultrastructure changes of scar tissue with transmission electron microscope. Results At 2 weeks after operation, the expression of TGF-β3 mRNA of two groups were 0.22 and 0.257 ( P = 0.027), respectively. At 4 weeks, group B was was increased significantly, and the mean numbers were 0.362 and 0.411 (P = 0.006). At 8 weeks, the expression of TGF-β3 mRNA of group A was increased significantly, too, but the difference between two groups was significantly, they were 0.427 and 0.470 (P =0.015), respectively. The trend of the expression of TGF-β3 and Smad 6 mRNA was similar. At 2, 4, 8, weeks, the expression was 0.169 and 0.205 (P = 0.089), 0.294 and 0.351 (P = 0.031), and 0.469 and 0.543 (P = 0.021), respectively.In group B the duramater adhesion was decreased (P ＜ 0.05), the proliferation of fibroblasts and fihroblastic function were inhibited (P ＜ 0.05). Conclusions Sodium hyaluronate up-regulated the expression of TGF-β3 and Smad6 and reduced the proliferation and collagen synthesis in fibroblast culture in the scar tissue.

This paper described a rapid and se nsitive HPLC method to analyze (E)-3, 5,4'-trimethoxystilbene (BTM-0512) in rat plasma and tissues. The analysis used a BDS Hypersil C18 analytical column (250 mm×4.6 mm ID, 5 μm) and acetonitrile / water as the mobile phase. The UV detection wavelength was 319 nm. Proteins were precipitated with acetonitrile and diethylstilbestrol as internal standard. The method was validated according to State Food and Drug Administration of China and ICH of Technical Requirements for Registration of Pharmaceuticals for Human Use Guidelines. The limit of interday precision values (%RSD) were in the range of 2.6% -5.1% and 2.4% -4.8%, respectively.Mean accuracy and absolute recoveries of BTM-0512 ranged from 95.3% - 100. 1% and 95.9% -100.9% for plasma and tissues, respectively. This method can be quite useful for BTM-0512 pharmacokinetic and tissue distribution studies, for purpose which multiple plasma and tissue samples can be analyzed quickly with high reproducibility.