Objective To analyze the allocation efficiency of medical and health resources in 26 tertiary hospitals in Suzhou from 2017 to 2022 and perform quantitative analysis in order to provide suggestions for relevant departments to rationally coordinate the health resources allocation,regional health planning and hospital management.Methods The number of health technicians,the number of beds in health institutions and the total health expenditure were selected as input indicators,while the number of diagnostic and treatment visits and the number of discharged patients were selected as output indicators.The efficiency was measured by the SBM(Slack-Based Measure)model and the SBM window model respectively.Results Influenced by public health emergencies,the allocation efficiency of medical resources in tertiary hospitals in Suzhou city decreased first and then started to increase Under the two models,the average efficiency scores of 26 hospitals were 0.687 and 0.707,respectively.Notably,under the SBM window model,19 hospitals(73％)achieved efficiency scores near or above the average.Conclusion The two models present a conclusion that the overall efficiency of the tertiary hospitals in Suzhou is generally effective.To further enhance the allo-cation and utilization of medical resources,it is suggested that a comprehensive consideration of health needs guide the planning of medical resource distribution.Leveraging information technology to innovate medical service models,and strengthening internal de-velopment and management practices are essential strategies for promoting high-quality development in tertiary hospitals.

Objective To explore the functional changes of the glial lymphatic system in patients with spontaneous intracerebral hemorrhage(sICH)by MR diffusion tensor imaging(DTI).Methods The clinical and imaging data of 32 sICH patients(sICH group)and 31 healthy volunteers(control group)were retrospectively collected,and the diffusivity values of DTI in different direc-tions were collected from all the subjects,the diffusion tensor imaging analysis along the perivascular space(DTI-ALPS)index was calculated,the difference of DTI-ALPS index values between the sICH group and the control group was compared,the changes in the function of the glial lymphatic system in sICH patients were evaluated,and the correlation between DTI-ALPS index and clinical indi-cators in sICH patients was further analyzed.Results The DTI-ALPS index of cerebral hemispheres on the lesions side of sICH group was significantly lower than that on the unaffected side(P＜0.01,t=-5.03),and lower than that on the left side of control group(P＜0.01,t=-9.85)and the right side(P＜0.01,t=-8.80).In addition,vascular endothelial growth factor(VEGF)tes-ting was performed in 8 of the 32 patients,and the levels[(187.40±19.11)pg/mL]were significantly higher than the normal range(0-142.20 pg/mL).Conclusion Through the quantitative analysis of the DTI-ALPS index,the damage to the function of the glial lymphatic system of sICH can be reflected,and perhaps the mechanism of pathophysiological changes in the brain after sICH can be reflected from a new perspective by using MR DTI technology.

Objective:To understand the psychological status and nursing needs of maintenance hemodialysis (MHD) patients and provide reference for clinical targeted nursing.Methods:Using the phenomenological research method, a total of 15 patients with MHD in the First Affiliated Hospital of Zhengzhou University were selected as the research objects by the purposive sampling method, and they were given semi-structured individualized interviews. The Colaizzi 7-step analysis method was used to organize the data, extract the inductive themes and analyze the results.Results:The psychological status of MHD patients was repressed fear, despair and helplessness and acceptance. The nursing needs of MHD patients included disease-related knowledge needs, social support needs and health guidance needs.Conclusions:MHD patients have negative psychology. Medical staff need to understand the psychological status and nursing needs of patients and formulate targeted nursing interventions to meet the actual needs of patients and improve the quality of life of them.

Objective:To explore the effect of family-participated dietary management on dietary compliance behavior and nutritional status in elderly maintenance hemodialysis (MHD) patients.Methods:From July 2019 to December 2020, a total of 120 elderly MHD patients admitted in the First Affiliated Hospital of Zhengzhou University were selected as the research objects, and divided into the experimental group and the control group with 60 cases in each group by random number table method. The control group conducted routine dietary management, and the experimental group received dietary management based on family participation. Six months after intervention, the dietary compliance attitude, dietary compliance behavior and nutritional status were compared between the two groups.Results:Six months after intervention, the scores of social restriction attitude, self-care attitude, acceptance attitude and dietary compliance behavior attitude of the experimental group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of fluid restriction behavior, potassium intake behavior, self-care compliance, compliance in the face of difficulties, and dietary compliance of the experimental group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The serum prealbumin (PA) , albumin (ALB) , hemoglobin (Hb) , and transferrin (TRF) of the experimental group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Diet management based on family participation can enhance the attitude of dietary compliance, promote the development of dietary compliance behavior, and improve the nutritional status of elderly patients with MHD.

Objective To evaluate the feasibility of 80 kVp tube voltage combined with adaptive statistical iterative reconstruction (ASiR)in low dose contrast media split-bolus 2-phase CTU.Methods Sixty patients with hematuria were recruited in this study.All the patients (80 kVp Group,n=30;120 kVp Group,n=30)underwent split-bolus 2-phase CTU (80 kVp Group:35 mL and 60 mL;120 kVp Group:50 mL and 70 mL).CTU images were reconstructed with 30％ ASiR in 80 kVp Group and with filtered back projection (FBP)in 120 kVp Group.Subjective and objective analysis of CTU images were accomplished by two qualified and independent readers.The radiation dose was evaluated by ED and SSDE.The image score,noise,attenuation value and CNR of urinary tract,and radiation dose were compared by Mann-Whitney rank sum test.Results There was no significant difference in the image quality between two groups (Z =-1.791,P =0.073).The noise of 80 kVp Group were higher than that of 120 kVp Group (Z =-6.299,P <0.001 ), while there was no significant difference of attenuation value between the two groups (Z =-1.204 --0.163,P =0.228 -0.871,except bladder),as well as the CNRs (Z =- 1.818 --0.202,P =0.069 -0.840).The ED and SSDE of 80kVp Group were significantly lower than those of 120 kVp Group (Z =-6.655--6.653,P <0.001).Conclusion The protocol of 80 kVp tube voltage combined with iterative reconstruction in low dose contrast media split-bolus 2-phase CTU is feasible for clinical application,with reduction of radiation dose and acceptable diagnostic image quality.

Objective To explore the application effect of self-made micro-video in practical teaching of mental and psychological nursing.Methods Two classes in major Nursing enrolled in 2013 were selected randomly. A total of 51 students from Class 12 were designated as the experimental group, and were taught assisted by self-made micro-videos, while another 53 students from Class 11 belonged to the control group, and were taught assisted by traditional instructional video. The students were surveyed by questionnaire on knowledge awareness rate on mental disease prevention, regulated in mental health work index investigation and evaluation scheme, formulated by General Office of National Health and Family Planning Commission of the People's Republic of China, basing on which, teaching effect was compared.Results After practical teaching, total accuracy rate of case examination by students in the experimental group was 94.12% (compared with 39.22% before the practice), and in control group, 81.13% (compared with 33.96% before the practice). Scores of attitude towards mental disease in the experimental group were (54.39±4.68), and in the control group (35.15±7.69) (t=15.49, P<0.01).Conclusions Applying self-made micro-video in practical teaching of mental and psychological nursing can effectively improve accuracy rate of mental disease recognition of the students, correct their attitude towards patients with mental disorders, with satisfying effect in practice.

Objective To assess the test-retest reliability of pressure biofeedback in measuring intra abdominal pressure in the lumbar region for normal subjects .Methods We choosed 33 subjects (20 to 27 years old) and asked them to do four movements (movement A :prone position ;movement B :supine position with flexion hip and knee joint ;movement C :supine position with single flexion hip and knee joint ;movement D :prone position with flexion shoulder joint ;) by using pressure biofeedback twice totally ,and the last measurement should be done after 24 h .The indicator of test-retest reliability of joint position was intraclass correlation co-efficient (ICC) .Results The test-retest reliability of intra abdominal pressure was modest in the four movements in the lumbar re-gion ,and the values of ICC were from 0 .786 - 0 .848 .The test-retest reliability of intra abdominal pressure was good in Movement A [ICC(95% CI)= 0 .817(0 .630 - 0 .910)] ,Movement B [ICC(95% CI)= 0 .848 (0 .692 - 0 .925)] ,Movement D [ICC(95% CI)= 0 .841(0 .678 - 0 .921)] .And the test-retest reliability of intra abdominal pressure was good in Movement C [ICC (95% CI) =0 .786(0 .566 - 0 .894)] .Conclusion The test-retest reliability of intra abdominal pressure was modest and good in the lumbar re-gion ,and pressure biofeedback could be useful to assess intra abdominal pressure .

Dendritic Cells ; cytology ; metabolism ; Enzyme-Linked Immunosorbent Assay ; HEK293 Cells ; Humans ; Interferon Regulatory Factor-7 ; metabolism ; Interferon Type I ; metabolism ; Interferon-gamma ; analysis ; Interleukin-6 ; analysis ; Oligonucleotides ; metabolism ; RNA Interference ; RNA, Small Interfering ; metabolism ; Real-Time Polymerase Chain Reaction ; Receptors, Tumor Necrosis Factor ; antagonists & inhibitors ; genetics ; metabolism

Objective To study the relationship between nasopharyngeal carcinoma and positive IgA antibodies of EB virus nuclear antigen 1 (NA),EB virus capsular antigen (VCA) and EB virus Zta protein.Methods The serum EB virus VCA-IgA,NA1-IgA and Zta-IgA antibody in 17 175 cases were detected by ELISA.782 cases of EB virus antibody-positive subjects were further given nasopharyngeal CT imaging,electronic nasopharyngoscopy.Finally confirmed by biopsy and immunohistochemistry.Comparison of serology results EB antibody-positive individual,while the two antibody-positive and antibody while three positive nasopharyngeal carcinoma detection rate,combined with evaluation of EB virus antibody detection in nasopharyngeal carcinoma screening value of high-risk groups.Results 17 175 cases of medical groups,the EB virus antibodies were detected in 782 cases,with the most positive individual,accounting for 535 cases (68.41％),nasopharyngeal cancer diagnosed in 15 cases (2.80％);two antibody positive while 213 cases (27.24 ％),diagnosed 49 cases of nasopharyngeal carcinoma (23.00％);least three antibody positive while only 34 cases (4.35％),nasopharyngeal cancer diagnosed 18 patients (52.94％);by physical examination,in 16,393 cases of EB virus antibody negative population by nasopharyngoscopy and throat CT and other medical examination,the final diagnosis of nasopharyngeal carcinoma in 6 cases (0.04％).Conclusion Three EB virus antibody combined detection greatly improves the rate of nasopharyngeal cancer diagnosis;we must also do other physical examination to prevent EB virus antibody-negative nasopharyngeal crowd missed.

OBJECTIVETo study the clinical characteristics, pathogenic bacteria, and antibiotics resistance of neonatal purulent meningitis in order to provide the guide for early diagnosis and appropriate treatment.

METHODA retrospective review was performed and a total of 112 cases of neonatal purulent meningitis (male 64, female 58) were identified in the neonatal intensive care unit of Yuying Children's Hospital of Wenzhou Medical University seen from January 1, 2004 to December 31, 2013. The clinical information including pathogenic bacterial distribution, drug sensitivity, head imageology and therapeutic outcome were analyzed. Numeration data were shown in ratio and chi square test was applied for group comparison.

RESULTAmong 112 cases, 46 were admitted from 2004 to 2008 and 66 from 2009 to 2013, 23 patients were preterm and 89 were term, 20 were early onset (occurring within 3 days of life) and 92 were late onset meningitis (occurring after 3 days of life). In 62 (55.4%) cases the pathogens were Gram-positive bacteria and in 50 (44.6%) were Gram-negative bacteria. The five most frequently isolated pathogens were Escherichia coli (32 cases, 28.6%), coagulase-negative staphylococcus (CNS, 20 cases, 17.9%), Streptococcus (18 cases, 16.1%, Streptococcus agalactiae 15 cases), Enterococci (13 cases, 11.6%), Staphylococcus aureus (9 cases, 8.0%). Comparison of pathogenic bacterial distribution between 2004-2008 and 2009-2013 showed that Gram-positive bacteria accounted for more than 50% in both period. Escherichia coli was the most common bacterium, followed by Streptococcus in last five years which was higher than the first five years (22.7% (15/66) vs. 6.5% (3/46), χ(2) = 5.278, P < 0.05). Klebsiella pneumoniae was more common isolate in preterm infants than in term infants (13.0% (3/23) vs. 1.1% (1/89), χ(2) = 7.540, P < 0.05). Streptococcus (most were Streptococcus agalactiae) was the most common bacteria in early onset meningitis and higher than those in late onset meningitis (35.0% (7/20) vs. 12.0% (11/92), χ(2) = 4.872, P < 0.05). Drug sensitivity tests showed that all the Gram-positive bacterial isolates were sensitive to linezolid. Staphylococci were resistant to penicillin, and most of them were resistant to erythromycin, oxacillin and cefazolin; 77.8%of CNS isolates were methicillin-resistant staphylococcus. No Streptococcus and Enterococcus faecalis was resistant to penicillin. None of enterococci was resistant to vancomycin. Among the Gram-negative bacterial isolates, more than 40% of Escherichia coli were resistant to commonly used cephalosporins such as cefuroxime, cefotaxime and ceftazidime, and all of them were sensitive to amikacin, cefoperazone sulbactam and imipenem. Isolates of Klebsiella pneumoniae were all resistant to ampicillin, cefuroxime, cefotaxime and ceftazidime, but none of them was resistant to piperacillin tazobactam and imipenem. Of the 112 patients, 69 were cured, 23 improved, 9 uncured and 11 died. There were 47 cases (42.0%) with poor prognosis, they had abnormal head imageology, severe complications and some cases died, 13 of 18 (72.2%) patients with meningitis caused by Streptococcus died.

CONCLUSIONEscherichia coli, CNS and Streptococcus are the predominant pathogens responsible for neonatal purulent meningitis over the past ten years. There were increasing numbers of cases with Streptococcus meningitis which are more common in early onset meningitis with adverse outcome, therefore careful attention should be paid in clinic. Linezolid should be used as a new choice in intractable neonatal purulent meningitis cases caused by gram positive bacteria.

Anti-Bacterial Agents ; pharmacology ; Cefotaxime ; Child ; Drug Resistance, Bacterial ; Female ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Imipenem ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; Intensive Care Units, Neonatal ; Male ; Meningitis, Bacterial ; diagnosis ; drug therapy ; microbiology ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Penicillins ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus ; Streptococcal Infections ; Streptococcus ; Streptococcus agalactiae