The integrated management of multi-campus public hospitals is a mandate for national assessment and compul-sory requirement for high-quality advancement of public hospitals.A challenge in multi-campus hospital management is to accel-erate the standardization of various hospital campuses and facilitate the information sharing among them.Based on the manage-ment practices of multi-campus hospitals in Ningxia,this paper discussed the challenges encountered in the integrated manage-ment of multi-campus hospitals.It proposed strategies to enhance homogeneous management and inter-hospital coordination in multi-hospital and multi-campus hospital to provide valuable references.

Objective To explore the application value of"Internet+Case-based Discussion"in the standardized train-ing of traditional Chinese medicine resident physicians.Methods"Internet+Case-based Discussion"was conducted for 150 resident physicians from three grades who received training in a case hospital.K-means cluster analysis was used to group the e-valuation of resident physicians,and the teaching evaluation of different types of resident physicians was compared.Semantic net-work analysis was used to identify training suggestions and demands of resident physicians.Results There was no statistically significant difference in teaching evaluations among the three grades of resident physicians(P>0.05),and the overall accept-ance was high among resident physicians of different grades.Cluster analysis distinguished the high-scoring group from the medi-um-scoring group,and the difference was statistically significant(P<0.001).Resident physicians in the medium-scoring group believed that teaching teachers lacked close integration of teaching with case discussion and clinical auxiliary result interpretation(P<0.001).Conclusion In the standardized training of traditional Chinese medicine resident physicians,"Internet+Case-based Discussion"can effectively ensure teaching quality and promote the sharing and utilization of teaching resources.

Objective: To investigate the prevalence and influencing factors of latent tuberculosis infection (LTBI) among freshmen in a vocational college in Xinjiang Uygur Autonomous Region, so as to provide insights into tuberculosis control in vocational colleges. Methods : All freshmen enrolled in a vocational college in Xinjiang Uygur Autonomous Region in 2020 were recruited and participants' demographics, life style, history of tuberculosis contacts, frequency of ventilation and disinfection in dormitories and classrooms and awareness of core tuberculosis control knowledge were collected through questionnaire surveys. LTBI was detected among freshmen by means of purified protein derivative test (PPD skin test) and chest X-ray scans, and the factors affecting LTBI were identified using a multivariable logistic regression model. Results: A total of 5 463 freshmen were screened for LTBI, with a screening rate of 100.00%, and the participants included 2 151 men and 3 312 women, with a male/female ratio of 0.65︰1, and had a mean age of (16.83±1.05) years. A total of 388 freshmen were detected with LTBI, with a detection rate of 7.10%, and no active pulmonary tuberculosis was detected. The prevalence of LTBI was 9.44% in men and 5.59% in women. Multivariable logistic regression analysis identified males (OR=1.587, 95%CI: 1.281-1.965), smoking (OR=2.108, 95%CI: 1.355-3.278) and a history of tuberculosis of families (OR=2.851, 95%CI: 1.615-5.034) as risk factors for LTBI among freshmen, and knowing core tuberculosis control knowledge as a protective factor of LTBI among freshmen (OR=0.276, 95%CI: 0.218-0.350). Conclusions The risk of LTBI was associated with gender, smoking, history of tuberculosis of families and understanding of the core tuberculosis control knowledge among freshmen in this vocational college in Xinjiang Uygur Autonomous Region. Health education about the core tuberculosis control knowledge is recommended to be reinforced among students in vocational colleges in Xinjiang Uygur Autonomous Region.

Objective:To explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive behavioral therapies (CBT) on the cognitive function and alcohol craving in patients with alcohol dependence.Methods:From March 2019 to September 2021, a total of 150 patients with alcohol dependence were enrolled and randomly divided into rTMS treatment group (rTMS+ sham CBT, n=41), CBT treatment group (CBT+ sham rTMS, n=34), rTMS+ CBT treatment group( n=36) and control group (sham rTMS+ sham CBT, n=39). At baseline (before treatment), 2nd week, 8th week, 12th week and 24th week, alcohol dependence scale (ADS) was used to evaluate the degree of alcohol dependence, the obsessive compulsive drinking scale (OCDS) was used to assess patients' drinking craving, and Montreal cognitive assessment scale (MoCA) was used to assess the overall cognitive level of patients.SPSS 23.0 statistical software was used to compare the differences of ADS, OCDS and MoCA scale scores of the four groups by repeated measure ANOVA and simple effect analysis. Results:(1)The patients in the four groups were evaluated with ADS scale at baseline, 12th week and 24th week respectively.The interaction of group×time( F=1.279, P=0.279) and the main effect of group were not significant ( F=0.882, P=0.454), and the main effect of time was significant ( F=12.925, P<0.001) .Further simple effect analysis showed that the ADS score of rTMS+ CBT group was lower than that of baseline(14.48±5.70, 10.00±6.51) ( P=0.01) at 24th week.(2)Patients in the four groups were assessed with OCDs scale at baseline, 2nd week, 8th week, 12th week and 24th week, and the interaction of group×time was significant ( F=2.015, P=0.042). Further simple effect analysis showed that the OCDs scores of rTMS group and rTMS+ CBT group at each follow-up time node were lower than those at baseline period (all P<0.05). (3)Patients in the four groups were assessed with MoCA scale at baseline, 8th week, 12th week and 24th week, and the interaction of group×time was not significant ( F=1.660, P=0.106), and the main effect of group and the main effect of time were significant ( F=2.964, P=0.038; F=14.239, P<0.001). Further simple effect analysis showed that the score of MoCA scale in CBT group at the 24th week was higher than that at baseline (21.73±5.81, 24.60±3.98)( P=0.029), the score of MoCA scale in rTMS+ CBT group at the 24th week was higher than that at the 8th week (23.50±6.01, 25.95±2.87) ( P=0.006), and the score of MoCA scale in rTMS group at the 12th week was higher than that in control group (22.08±6.64, 26.64±2.46)( P=0.009). Conclusion:rTMS combined with CBT can be effective in improving alcohol craving and cognitive function in patients with alcohol dependence, and has a good long-term effect.

Objective:To investigate the pathogenic characteristics of viral encephalitis or meningitis in children living in Shijiazhuang city and surrounding areas, and to study the relationship between pathogenic and clinical findings.Methods:A total of 132 cerebrospinal fluid specimens were randomly collected from hospitalized children diagnosed with viral encephalitis or meningitis (January 2018 to December 2018) in the Department of Neurology of Hebei Children′s Hospital in Shijiazhuang city and surrounding areas. The nucleic acids of four viruses in cerebrospinal fluid were detected by real-time quantitative PCR. SPSS 21.0 software was used for statistical analysis.Results:Among the 132 cases, 78 were boys and 54 were girls, with a sex ratio of 1.44∶1. However, in the gender composition of children in each age group, there was no significant difference (χ 2=3.901, P=0.272). Of the 132 children, 121 had signs of fever, 109 had symptoms of headache, 92 had symptoms of vomiting, 17 had abnormal electroencephalogram(EEG), and 15 had abnormal head magnetic resonance imaging(MRI). 132 cerebrospinal fluid specimens were tested for pathogenic pathogens, and 80 of them were successfully detected. There was 1 case of human herpesvirus type I(HHV-I), 2 cases of varicella-zoster virus (VZV) and 77 cases of enterovirus(EV). The age group of 1~3 years′s EV detection rate was 66.67%, it is the highest, but overall, the EV detection rate, there was no significant difference among the four age groups (χ 2=3.147, P=0.369). The detection rate of EV in summer and autumn were 65.52% and 70.83%, respectively, which were significantly higher than those in spring and winter (33.33% and 0.00%), and there was a significant difference (χ 2=22.504, P=0.000). There was no significant difference in the positive rates of fever, headache and vomiting between EV-positive and non-EV-positive children ( P>0.05). There was no significant difference in the incidence of abnormal EEG and abnormal head MRI between EV-positive and non-EV-positive children ( P>0.05). Conclusions:In 2018, EV was the main pathogen of viral encephalitis and meningitis in children in Shijiazhuang city and surrounding areas, and EV detection rate was high in summer and autumn.

OBJECTIVE: To detect pathological variant in a Chinese pedigree affected with congenital contractural arachnodactyly (CCA). METHODS: Next generation sequencing (NGS) was used to scan the whole exome of the proband. Potential variant of the FBN2 gene was also detected in all members of the pedigree and 100 healthy controls by Sanger sequencing. With the determination of the genotype, prenatal diagnosis was carried out by amniotic fluid sampling. RESULTS: A c.3528C>A (p.Asn1176Lys) variant was identified in the FBN2 gene of the proband, other patients from this pedigree, as well as the fetus. The same variant was not found among healthy members from this pedigree and the 100 healthy controls. CONCLUSION The c.3528C>A (p.Asn1176Lys) variant of the FBN2 gene probably underlies the pathogenesis of CCA in our case. The new variant has enriched pathological spectrum of the FBN2 gene.
Arachnodactyly ; complications ; genetics ; Contracture ; congenital ; etiology ; genetics ; Exome ; Female ; Fibrillin-2 ; genetics ; Humans ; Mutation ; Pedigree ; Pregnancy ; Prenatal Diagnosis

Alzheimer's disease (AD) is a chronic central neurodegenerative disease. The pathological features of AD are the extracellular deposition of senile plaques formed by amyloid-β oligomers (AβOs) and the intracellular accumulation of neurofibrillary tangles formed by hyperphosphorylated tau protein. In this paper, an in vitro pathological model of AD based on neuronal network chip and its real-time dynamic analysis were presented. The hippocampal neuronal network was cultured on the microelectrode array (MEA) chip and induced by AβOs as an AD model to simultaneously record two firing patterns from the interneurons and pyramidal neurons. The spatial firing patterns mapping and cross-correlation between channels were performed to validate the degeneration of neuronal network connectivity. This biosensor enabled the detection of the AβOs toxicity responses, and the identification of connectivity and interactions between neuronal networks, which can be a novel technique in the research of AD pathological model .
Alzheimer Disease ; Amyloid beta-Peptides ; Humans ; Neurofibrillary Tangles ; tau Proteins

Objective: To investigate the pathogenic characteristics of viral encephalitis in children living in Hebei province. Methods: We randomly collected cerebrospinal fluid specimens from a total of 399 children diagnosed with viral encephalitis in Hebei Children′s Hospital from May to December 2017. Real-time fluorescence quantitative PCR and Sanger sequencing were used to detect viral nucleic acids in cerebrospinal fluid by an automatic laboratory station. Statistical analysis was performed on the experimental data using SPSS 21.0 software and the clinical data were analyzed. Comparison of infection rates of EV encephalitis in different months, using line × column chi-square test. The MRI and EEG positive rates of different viral encephalitis and viral encephalitis patients not infected with the virus were analyzed by Fisher′s exact probability test. The positive rate of infection with different viruses and non-virus agents was analyzed by Fisher′s exact probability test. Results: The result showed that 80 of 399 samples were positive, and the positive rate was 20.05%. It included 22 cases of enterovirus, 4 cases of influenza A virus, 3 cases of mumps virus, 2 cases of herpes simplex virus type 1, 1 case of herpes simplex virus type 2, 4 cases of EB virus, 7 cases of cytomegalovirus, 7 cases of herpes zoster virus, 8 cases of adenovirus, 14 cases of human herpesvirus type 6. Eight cases had combined viral infection. Eight cases had concurrent infections: 3 cases had enterovirus and herpesvirus type 6 concurrent infection, 1 case had enterovirus and Japanese encephalitis virus concurrent infection and 1 case had herpes simplex virus type 2 and adenovirus, 1 case had influenza A virus herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had herpes simplex virus type 1 and herpes zoster virus concurrent infections. Children with EV viral encephalitis in Hebei Province were highly prevalent in May and June (P=0.016). HHV6 virus encephalitis was more susceptible to infection than non-HHV6 virus (P=0.016); The rate of MRI positive findings in patients with different viral encephalitis was not statistically significant (P>0.05). The result of EEG of different viral encephalitis were P>0.05, which was not statistically significant. Conclusions EV was the most common pathogen of children with viral encephalitis in Hebei province. Encephalitis caused by influenza A virus cannot be ignored in clinical practice.

OBJECTIVE： To explore the role of clinical pharmacist in individualized treatment for osteosarcoma patients with periprosthetic joint infection （PJI）. METHODS： An osteosarcoma patient was admitted to our hospital and then suffered from PJI after operation. Clinical pharmacist adjusted the initial anti-infection plan and carried out pharmaceutical care according to the results of patients’ etiology and drug sensitivity. According to the PK-PD principle， combined with the therapeutic drug monitoring （TDM）， the dose of antibiotics was adjusted. With the occurrence of ADR， the antibiotic therapeutic regimen was adjusted again. RESULTS： The patient was administrated cefotiam for empiric therapy initially after the diagnosis of PJI. After obtaining the results of etiology and drug sensitivity， the clinical pharmacist suggested that vancomycin sensitive to penicillin-resistant Staphylococcus epidermidis should be used for targeted anti-infection treatment. After adjusting the dosage according to the steady-state valley concentration， the patient had slight liver function damage， accompanied with chest tightness and shortness of breath. After analysis， the clinical pharmacist considered the adverse drug reactions related to vancomycin， and again suggested that the patient should be treated with teicoplanin. After the doctor adopted the treatment plan recommended by the clinical pharmacist， PJI of the patient was effectively controlled， and the adverse reaction symptoms disappeared. The patient was effectively cured for PJI and discharged eventually. During the treatment period， the clinical pharmacist also carried out medication education for the drugs used by the patient. CONCLUSIONS： Clinical pharmacist should master the principle of antibiotic drug PK-PD theory and evaluate the clinical efficacy and safety of anti-infective drugs dynamically based on the guidance of TDM， so as to develop individualized anti-infection therapeutic regimen for osteosarcoma patient with PJI， improve the effect of clinical treatment and guarantee the safety of drug use.

Objective::To explore the effects of the biomimetic network membrane prepared by chitosan/gelatin/pectin on the proliferation and mineralization of mesenchymal stem cells (MSCs) , and to evaluate its feasibility of constructing tissue engineering bone.Methods:Chitosan, gelatin and pectin were made into a new biomimetic network membrane in a certain ratio by biomimetics.The experiment was divided into control group (MSCs+conventional medium) , material group (MSCs+network membrane+conventional medium) and material+OS group (MSCs+network membrane+OS medium) .The cell morphology was observed by inverted phase contrast microscope;the growth and secretion of extracellular matrix of the MSCs were observed under scanning electron microscope (SEM) .The proliferation of cells was determined by MTT assay (The MSCs were divided into negative control group and material group, and they were cultivated with blank medium and medium including materials) .The expression of calcium in MSCs was detected by Alizarin Red staining.Real-time polymerase chain reaction (RT-PCR) was used to determine the expression levels of osteocalcin (OC) mRNA and osteopontin (OPN) mRNA in the MSCs.Results:The network membrane was semitransparent thin film.The MSCs were short shuttle and clustered under inverted phase contrast microscope.After cultured for 7d, the MSCs were shuttle;after cultured for 14d, the number of MSCs was increased, with pseudo feet on the membrane;after cultured for21d, the MSCs clustered with a lot of neo-formed extracellular matrix.The MTT results showed that there was no significant difference in the proliferation level of MSCs between material group and negative control group (P＞0.05) .The Alizarin Red staining results showed that the MSCs in the network membrane were dyed orange red.The RT-PCR results showed that the expression levels of OC mRNA in the MSCs in material group and material+OS group were lower on the 7th and 14th days, but on the 21th day, the expression levels were significantly increased and reached the peak;the expression level of OC mRNA in the MSCs in material group was significantly increased on the 7th day, and the expression level reached the peak on the 14th day, then fell slightly on the 21th day;compared with control group, the expression levels of OC mRNA and OPN mRNA in the cells in material group and material+OS group at different time points were significantly increased (P＜0.01) , but there were no significant differences between material group and material+OS group (P＞0.05) .Conclusion:Chitosan/gelatin/pectin biomimetic network membrane has good biocompatibility, and MSCs can grow and proliferate well on the membrane.The membrane can induce the MSCs to express mineralization-related genes and proteins without inducers.