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State-owned capital not only had the social public welfare characteristic, but also the vitality and driving force of capital. In this research, Zhejiang Medical and Health Group was studied based on analyzing questions of state-owned corporate hospitals. We also introduced practice and effectiveness of state-owned capital in the reform of 3 state-owned corporate hospitals in this group. This paper aimed to explore a new way for state-owned capital to participate in public hospital reform. At the same time, it also provided suggestions for the transformation and development of state-owned corporate hospitals.
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Objective To survey the distribution pattern and subject domain knowledge of the literatures about ventilator-associated pneumonia (VAP). Methods Literatures about VAP published until December 2017 were identified in SinoMed database for statistics and analysis. The information of author, organization and province was extracted by BICOMS software for generating co-occurrence matrix, at the same time, the topic words were cluster analyzed by Gcluto software to generate topical visual surface maps and visualization matrices, and the current research hotspots were analyzed. NetDraw from Ucinet 6.0 software was used to arrange the relationship among topic words according to the centrality, and the social network diagrams of authors, authors' provinces and institutions were draw to analyze the current status of VAP research cooperation. Results 4 851 VAP-related literatures were retrieved preliminarily, and 43 were excluded from abstracts, news reports, information and missing literatures. Finally, a total of 4 808 articles were enrolled in the visual analysis. From 2001 to 2004, the number of VAP-related literatures published was less than 10. Since 2009, the number of VAP documents had increased steadily, from 2010 to 2017, the peak period of publications reached 91.7% (4 411/4 808). According to the analysis of the amount of publications, the top three of 34 provincial administrative regions that published VAP-related literature in China were Guangdong Province (n = 628), Jiangsu Province (n = 478) and Zhejiang Province (n = 404), the number of hospitals issued by the First Affiliated Hospital of Chongqing Medical University was the largest (n = 20); there was only one journal with more than 100 articles, and there were 154 journals with only one article, accounting for 34.8% of the total number of journals. A total of 9 921 authors participated in the VAP-related literature writing, the number of high-yielding authors was not large, and the institution could not establish an effective social network diagram, suggesting that communication and cooperation should be strengthened in hospitals and outside hospitals. The results of the topic words social network analysis showed that the VAP research field was centered around the core of "mechanical ventilation", "intensive care unit (ICU)", "risk factor analysis", "nursing", "etiological analysis", "preventive measures" and "pathogens". The current research hotspots were at the edge of the network map, such as "drug sensitivity analysis", "Acinetobacter baumannii", "bronohoalveolar lavage (BAL)" and "acute exacerbation of chronic obstructive pulmonary disease (AECOPD)". By clustering 80 high-frequency topic words, at present, VAP research hotspots were mainly focus on five topics: obstructive pulmonary disease, especially in acute exacerbation, was prone to VAP; concerned about newborns and children's VAP; types, drug resistance and selection of antimicrobial agents for VAP pathogens in ICU; clinical efficacy and prognosis of VAP through preventive measures, pulmonary supportive care and comprehensive care interventions; oral care and airway management during mechanical ventilation was also the key aspect of the treatment of VAP. Conclusions In recent years, the academics had attached great importance to the study of VAP, the number of publications had reached a historical peak, and the research direction was diverse. However, it was necessary to strengthen cooperation among research institutes, collect and count epidemiological data, improve and expand the research quality and scale of clinical diagnosis, nurse, prevention, pathogen distribution and drug resistance analysis.
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OBJECTIVE To clarify the long-term toxicity to the respiratory system in a rat model of acute lung injury (ALI) induced by a single low-dose of perfluoroisobutylene(PFIB) inhalation expo?sure,and observe the possible beneficial effect of early intervention via Qingkailing(QKL) injection. METHODS Totally 224 male Wistar rats were randomly divided into 4 groups:normal control group in which air exposure was followed by a saline 10 mL · kg-1(ip),QKL control group in which QKL 10 mL · kg-1 was ip given after air exposure,PFIB exposure group in which rats were exposed to PFIB 280 mg·m-3 for 5 min only,and QKL treatment group in which QKL 10 mL·kg-1 was given ip at 1 h after PFIB exposure. Lung functions of rats were measured at 24 h,3,6,12,24,36 and 48 weeks after exposure. The arterial blood gas,lung coefficient,protein content in bronchoalveolar lavage fluid(BALF),hydroxy?proline(HYP) content in lung tissue and plasma,and other indicators were detected or analyzed. RESULTS Within 24 h after PFIB exposure,the lung coefficient and protein content in BALF were increased significantly(P<0.01),whereas the PaO2(P<0.01) and SaO2(P<0.05) indices in arterial blood decreased significantly in PFIB group compared with normal control. The inhalation time , exhalation time,tidal volume(TV),expired volume(EV)and relaxed time were reduced significantly (P<0.01). However,all the above indicators returned to normal in 3 weeks,but TV,EV and peak expiratory flow were significantly lower than in normal group at 48 weeks(P<0.05). HYP contents in lung tissues,compared with normal control(P<0.05),were reduced significantly within 24 h after PFIB exposure,increased significantly in 6 weeks(P<0.05),then returned to normal in 12 weeks. HYP contents in plasma increased significantly compared with normal control(P<0.05) within 24 h after PFIB exposure but returned to normal in 3 weeks. The protein contents in BALF of QKL treatment group were significantly lower than those in PFIB group(P<0.01) within 24 h after PFIB exposure. From 24 h to 24 weeks after PFIB exposure,changes of pulmonary functions were similar to those in PFIB group. At 48 weeks,TV and EV in QKL treatment group were more significantly increased than those in PFIB group(P<0.05). CONCLUSION Rats with ALI induced by a single low dose of PFIB exposure undergo compensatory repair except for pulmonary capacity and pulmonary ventilation functions. Early treatment with QKL reduces protein content of BALF and alleviates pulmonary edema,and has some beneficial effect on lung function recovery later.