Objective:In order to cope with the rising risk pressure on the economic operation of public hospitals,it aims to re-search and construct a comprehensive economic operation evaluation index,and improve the comprehensiveness,scientific and dynamic nature of monitoring and analysis of the economic operation of public hospitals.Methods:Literature research,expert consultation and hierarchical analysis were adopted.Results:A comprehensive evaluation model of public hospitals'economic operation covering 5 dimensions and 25 indexes,including structural optimization,controllable risk,efficiency enhancement,smooth operation and sustain-able development,has been constructed;empirical analyses of the overall index,sub-indexes and monthly indexes have been carried out on the data of some of the tertiary hospitals in Shanghai,which have verified the validity of the above index model in enhancing the monitoring,analysis and evaluation of the hospitals'economic operation,and revealed the role of the above index model in the changes of the economic conditions of the hospitals and the factors.Conclusion:Constructing a comprehensive evaluation index can effectively complement management such as comprehensive assessment and evaluation of public hospitals and traditional financial descriptive analysis.

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

Objective To establish the GIOP model and extract BMSCs from the rat model.We aim to in-vesitigatethe effect ofrhPTH(1-34)for inhibiting β-catenin ubiquitination when combining with Micro-CT and bio-logical technology.We also investigate the influence of rhPTH(1-34)on the GIOP.Methods Female SPF emale rats wererandomly divided into normal control group,methylprednisolone group(model group),methylpredniso-lone+saline group(blankcontrol group)and methylprednisolone+rhPTH(1-34)group(test group). The proximal femoral cancellous bone was examined by Micro-CTand histopathological Staining. The expression of Wnt10b and β-catenin protein were detected. By comparing with inducedBMP-2,BMSCs were treated withrhPTH(1-34)and stained with ALP and alizarin red.Results(1)In Micro-CT,BV/TV,Tb.Th and Tb/N decreased,whereas Tb/sp increased in the test group comparedwith model group(P<0.05).ROI three-dimensional reconstruction of trabecu-lar bone in test group showed local bone repair;(2)Wnt10b and β-cateninexpression increased in the test group compared with the model model(P<0.05),indicating that rhPTH(1-34)can enhance the transcriptional activity of β-catenin(P<0.05)and promote the expression of Wnt10b andβ-catenin(P<0.05).Conclusion The inter-vention with rhPTH(1-34)can prevent GIOP by regulating the Wnt/β-catenin signaling pathway and inhibiting GIOP progress,which can improve the microstructure of bone.

Objective To investigate the value of the shear wave elastography ( SWE) in the diagnosis of biliary atresia ( BA ) in infants by ultrasonography . Methods SWE was used to measure the liver stiffness measurement( LSM ) of 138 infants . Following surgical or pathological diagnosis ,the infants were subclassified into BA and non-biliary atresia ( non-BA ) groups . ROC analysis was used to determine the sensitivity and specificity of LSM ,the ultrasonic findings in the differential diagnosis of suspected BA ,and the cut-off value to diagnose BA . Results Of the 138 infants with cholestatic hepatitis ,51 were diagnosed as BA group and 87 cases were assigned to the non-BA group . The ROC analysis showed the cut-off value of LSM for diagnosis of biliary atresia in children with jaundice was 12 .35 kPa ,the AUC was 0 .936 ,and the sensitivity and specificity were 84 .3% and 89 .7% ,respectively .In the parallel test ,the triangular cord ( TC) sign combined with abnormal gallbladder ( AbGB) had the best diagnostic performance in all patients . However ,in patients older than 30 days ,the LSM combined with TC had the best AUC ( 0 .987 ) and diagnostic performance( 98 .6% ) like with TC combined with AbGB . Conclusions Both SWE and gray scale ultrasound have higher diagnostic performance for BA . LSM can be used as a valuable index for diagnosing BA by ultrasound .

OBJECTIVETo analyze the outcome of chromosomal microarray analysis (CMA) in prenatal diagnosis for fetal abnormalities detected by ultrasonography.

METHODSAmniotic fluid samples from 477 pregnancies with abnormal ultrasound findings but without common aneuploidies were detected by CMA with Affymetrix CytoScan 750K arrays. The results were analyzed with ChAS v3.0 software.

RESULTSAmong the 477 samples, 24 (5.03%) were detected with pathogenic copy number variations (pCNVs) by CMA. Six (9.68%) among 62 cases with structural fetal abnormalities in multiple organ systems were detected with pCNVs, 11 (7.48%) among 147 cases with a single structural anomaly were detected with pCNVs, and 7 (2.61%) among 268 cases with a soft marker were detected with pCNVs.

CONCLUSIONCMA has offered a clear advantage over conventional karyotyping for the detection of fetal chromosomal abnormalities, and can provide an effective diagnostic tool for those with one or more structural abnormalities detected by ultrasound.

Adolescent ; Chromosome Aberrations ; Chromosome Disorders ; diagnosis ; embryology ; genetics ; DNA Copy Number Variations ; Female ; Fetal Diseases ; diagnosis ; diagnostic imaging ; genetics ; Fetus ; diagnostic imaging ; Humans ; Karyotyping ; Male ; Microarray Analysis ; methods ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography, Prenatal ; methods ; Young Adult

OBJECTIVETo assess the value of chromosomal microarray analysis (CMA) for the diagnosis of children with intellectual disability/developmental delay (ID/DD) but a normal karytype.

METHODSPeripheral blood samples from 92 ID/DD patients were analyzed with CMA using Affymetrix CytoScan 750K arrays. The results were analyzed by ChAS v3.0 software.

RESULTSEighteen cases (19.57%) were detected with abnormalities by CMA, among which 10 cases were diagnosed with microdeletion/microduplication syndromes. These included 2 Williams-Beuren syndromes, 2 Angelman syndromes, 2 Russell-Silver syndromes, 1 Smith-Magenis syndromes, 1 Wolf-Hirschhorn syndromes, 1 15q26 overgrowth syndrome and 1 Xq28 (MECP2) duplication syndrome. In addition, 8 cases were diagnosed with pathogenic copy number variations (pCNV).

CONCLUSIONCMA can significantly improve the diagnostic rate for patients with ID/DD, which is of great value for the treatment of such children and guidance of reproduction for their parents. Therefore, CMA should become the first-line diagnostic test for patients with ID/DD.

Adolescent ; Adult ; Child ; Child, Preschool ; DNA Copy Number Variations ; Developmental Disabilities ; genetics ; psychology ; Female ; Humans ; Intellectual Disability ; genetics ; psychology ; Intelligence ; Karyotype ; Male ; Microarray Analysis ; Middle Aged ; Pedigree ; Young Adult

Objective To investigate the effect of signal transducers and activators of transcription 3(STAT-3)on sen-sitizing oral squamous cell carcinoma to cis-dichlorodiamineplatinum via downregulating miRNA-21. Methods Tscca and Tca8113P160 human tongue squamous cell carcinoma cell lines were employed in this study. WP1066 was used to suppress STAT-3 signaling pathway. Cells were divided into three groups:dimethyl sulphoxide (DMSO) group, cis-dichlorodiamine-platinum (DDP) group and WP1066+DDP group. Transcription level of miR-21 was assessed by real-time PCR, while the expression levels of STAT-3, p-STAT-3, tissue inhibitor of metalloproteinase-3 (TIMP-3) and matrix metalloproteinase-2/9 (MMP-2/9 ) were evaluated by Western blot assay. Matrigel matrix and transwell assay were used to determine cancer cell colony formation and invasive ability respectively. Expression level of miR-21 was examined by luciferase reporter gene as-say. Results Expression levels of STAT-3, pSTAT-3 and miR-21 were significantly suppressed by WP1066 treatment. The diameters of culture colony in cells treated with WP1066 and DDP were smaller than those in control group. The number of tongue cancer cells that migrated through the transwell membrane in WP1066 and DDP treated group was less than that in control group. Additionally, MMP-2/9 expression decreased while TIMP-3 increased dramatically in both cell lines in WP1066+DPP group compared to the other two groups. Conclusion Reduction of STAT-3 can sensitize oral squamous cell carcinoma to cis-dichlorodiamineplatinum via downregulating miR-21. Our study shows that DDP, in combination with WP1066, might be used as a potential target in the treatment of human oral squamous cell cancer.

Currently, a growing number of community-based organizations are providing rapid HIV testing service in various forms, some people with specific needs also purchase HIV rapid test papers through online sales channels, those imply that the demand of HIV self-test is in increasing year by year.In this paper, aims to understand the current situation of HIV rapid test led by CBOs and the approach, strategies and results of social marketing by means of expert interviews and site visits. Hope to illustrate the current situation, and make recommendations for future work.

Currently, a growing number of community-based organizations are providing rapid HIV testing service in various forms, some people with specific needs also purchase HIV rapid test papers through online sales channels, those imply that the demand of HIV self-test is in increasing year by year.In this paper, aims to understand the current situation of HIV rapid test led by CBOs and the approach, strategies and results of social marketing by means of expert interviews and site visits. Hope to illustrate the current situation, and make recommendations for future work.

OBJECTIVETo analyze willingness and influencing factors for usage of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM).

METHODS887 men who were older than 18 years old and used to have sex with men were recruited through internet between November 27 and December 17, 2013. Data were collected through self designed questionnaire, which was designed to collect information including demography features, willingness of usage of PrEP and associated factors.

RESULTSTotally 760 qualified questionnaires were collected. The ages of surveyed MSM were between 18 and 60, 58.2% (442) were single, 78.9% (600) of them have received college education, 60.4% (459) received annual income less than 60 000 yuan, 73.3% (557) only had sex with men and 77.2% (587) self reported being gay. 32.1% (243/758) of the respondent MSM said they would like to use PrEP. 61.0% (305/500) would like or possibly to take PrEP orally each day. 70.9% (354/499) would keep the same condom using frequency as current situation after using PrEP. In the univariate analysis, the willingness of taking PrEP was ('(2) = 27.61, P < 0.001) lower among those annual income less than 60 000 yuan (27.7% (127/458)) than those annual income higher (44.7% (116/260)); the willingness was significantly ('(2) = 10.99, P = 0.001) higher among those understanding PrEP (35.4% (196/554)) than those not understanding (22.8% (44/206)). In multivariate logistic regression analysis, it suggested that annual income under 60 000 yuan (OR = 0.64 (95% CI: 0.45-0.92)) and understanding PrEP (OR = 1.98 (95% CI: 1.36-2.88)) were influencing factors for usage of PrEP among MSM.

CONCLUSIONMSM didn't understand the PrEP sufficiently currently, economic consideration and worries about the side effects will affect their willingness of using PrEP.

Adolescent ; Adult ; Condoms ; utilization ; HIV Infections ; prevention & control ; Health Knowledge, Attitudes, Practice ; Homosexuality, Male ; Humans ; Male ; Middle Aged ; Patient Acceptance of Health Care ; Pre-Exposure Prophylaxis ; utilization ; Surveys and Questionnaires ; Young Adult