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Objective:To clarify the immediate administration issues faced by hospitals in China in their implementing the diagnosis-related groups(DRG) payment as a reference for the reform.Methods:By using " DRG" , " hospital" , and " administration" as search terms, the authors systematically retrieved literature data from CNKI, Wanfang Data, PubMed, Embase and Web of Science from the establishment of the database to April 30, 2022. Based on such data, administration issues pertaining to the reform process were extracted and built into a co-word matrix. The social network analysis was used to measure the network density and network centrality of these administration issues. The entropy weight-technique for order preference by similarity to ideal solution(TOPSIS) method was used to comprehensively evaluate the indicator results of network centrality indicators.Results:Of the 32 literatures included, 25 issues in hospital administration during the reform of DRG payment method were extracted. As shown in the social network analysis, the network density was 0.717, while the top issues ranking by degree centrality, betweenness centrality and closeness centrality, were inappropriate main diagnosis selection(68, 8.842, 25), imperfect DRG grouping device setting(54, 8.361, 26), imprecise recording of other disease diagnosis and surgical operations(60, 6.885, 26), and poor professional knowledge of medical record managers(54, 6.991, 25). The top four issues as shown in the entropy weight-TOPSIS analysis were inappropriate main diagnosis selection(1.000), imperfect DRG grouping device setting(0.871), imprecise recording of other disease diagnosis and surgical operations(0.803), and poor professional knowledge of medical record managers(0.787).Conclusions:Fill-out errors of medical record homepage, imperfect formulation of DRG grouping plans and poor professional knowledge of medical record manage team, rank the tope administration issues of high priority in implementing the reform of DRG payment methods. It is imperative to strengthen quality control of the medical record homepages, to scientifically formulate the DRG grouping plans, and to improve the construction of medical records professional team, in an effort to the further smooth and orderly implementation of the reform.
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Objective:To explore the application effect of the flipped micro-lecture teaching mode in the teaching of medical biochemistry.Methods:A total of 115 clinical medicine students in Batch 2016 from Zhejiang Chinese Medical University were selected as the experimental group, and 120 stomatology students were selected as the control group. Teachers applied the "before-class, in-class, after-class" serial design to conduct flipped micro-lecture in the experimental group, and the traditional teaching was used in the control group. We evaluated the teaching effect through self-directed learning tests and questionnaire survey after the teaching experiment.Results:Flipped micro-lecture teaching improved students' learning effect, enhanced their learning enthusiasm, gradually led them into autonomous learning of medical biochemistry, and improved their team collaboration ability.Conclusion:The combination of Flipped Classroom and micro-lecture is of great significance to promote the transformation of curriculum education modes and cultivate innovative medical talents.
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Aim To explore the protective roles of lic-ochalcone A ( LA) on mice with cigarette smoke-medi-ated acute lung injury and the related mechanisms. Methods In vivo: Mice were exposed to cigarette smoke ( CS) to establish acute lung injury model. The bronchoalveolar lavage fluid ( BALF ) was conducted for cell counting. The mRNA and protein expression of keratinocyte-derived chemokine ( KC ) , tumor necrosis factor alpha ( TNF-α) , interleukin 1β ( IL-1β) and matrix metalloproteinases ( MMP)-9 in lungs were de-termined. The myeloperoxidase ( MPO ) , superoxide dismutase ( SOD ) activities and glutathione ( GSH ) levels in lungs were quantified. The paraffin sections of lungs were prepared and stained with HE. In vitro:Human lung epithelial cells (BEAS-2B) were exposed to cigarette smoke extract ( CSE ) , which induced cell injury. The releases of interleukin 8 (IL-8) and MMP-9 were assessed. The phosphorylation of mitogen-acti-vated protein kinases ( MAPKs, including ERK1/2, p38 and JNK ) and nuclear factor-κB ( NF-κB ) p65 protein were analyzed by Western blot. Results In vi-vo: The accumulation of inflammatory cells was lower in LA groups than that in model group. In comparison with normal control group, the mRNA and protein lev-els of KC, TNF-α, IL-1βand MMP-9 were significant-ly increased in model group. Following treatment with LA, the above indicators were significantly decreased as compared to model group. In the CS-exposed mice, the MPO activity in lungs was significantly increased, meanwhile the SOD activity and GSH level were signif-icantly decreased compared with the air-exposed ani-mals. CS-induced activity of MPO was significantly in-hibited, which were accompanied by increases in SOD and GSH levels by LA. In vitro: CSE-induced mRNA levels of IL-8 and MMP-9 were significantly inhibited by LA at 2 . 5 and 5 μmol · L-1 . The CSE-induced phosphorylation of ERK1/2 and nucleus NF-κB p65 protein expression were prevented by pretreatment with LA. Conclusions LA has protective effects on CS-ex-posed acute lung injury in mice by preventing CS-in-duced pulmonary inflammation, oxidative stress and protease rise. The exploration of the mechanisms sug-gests that LA exerts protective effects via suppressing ERK1/2/NF-κB pathways.
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Aim To investigate the effect of bufalin on proliferation and expression of WT1 in K562 cells. Methods The colony number of K562 cell was detec-ted with semi-solid culture assay. The cell cycle was measured by flowcytometry, and the expression of WT1 was observed with immunocytochemistry. Subcutaneous tumor models established by K562 cells in BALB/C nu/nu mice were divided into three groups, including model group, bufalin group and positive control group. After 21 days, the subcutaneous tumors were removed for calculating the inhibitory rate of tumor growth. HE staining and immunohistochemistry were used to ob-serve the morphological changes and the expression of WT1 . Results ① Bufalin could significantly decrease the colony number of K562 cell, arrest it at G0/G1 phase and down-regulate its expression of WT1 in a dose-dependent manner. ② Compared with the model group, the tumor inhibitory rate was much higher, while the volume and the weight were obviously lower in the other two groups. ③Bufalin could induce apop-tosis, necrosis, hemorrhage and fibrosis with HE stai-ning, and down-regulate the expression of WT1. Con-clusion Bufalin could inhibit the proliferation, arrest the cell cycle at G0/G1 phase and down-regulate the expression of WT1 in vitro. Bufalin could inhibit the tumor inhibitory rate, the volume and the weight of the subcutaneous tumors, induce apoptosis, necrosis, hemorrhage and fibrosis with HE staining and down-regulate the expression of WT1 .
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Aim To investigate the effect of resveratrol on proliferation and differentiation in K562 cells. Methods K562 cells were treated with different con-centrations of resveratrol for 6d. The colony number of K562 cells was detected with semi-solid culture assay. Expression of GATA-1 and PU. 1 in K562 cells was re-spectively measured with immunocytochemistry and Western blot. Expression of differentiation related anti-gen, CD11b, CD14 and CD42b, was measured with flowcytometry on K562 cells. Results Resveratrol could significantly decrease the colony number of K562 cells in a dose-dependent manner, and enhance the ex-pression of GATA-1,PU. 1,CD11b, CD14 and CD42b in K562 cells. Conclusion Resveratrol could inhibit the proliferation and induce differentiation of K562 cells via up-regulating the expression of GATA-1 and PU. 1 protein.
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OBJECTIVE: To comprehensively analyze the feasibility of neural differentiation from human umbilical cord blood cells and the transplantation in treating rats with hypoxic-ischemic brain injury. DATA SOURCES: A computer-based online search of Pubmed was undertaken for articles about neural differentiation from human umbilical cord blood cells in the treatment of rats with hypoxic-ischemic brain injury via transplantation published in English between January 2000 and December 2005 by using the keywords of "mesenchymal stem cells, umbilical cord blood, transplantation". Meanwhile, we searched the Wanfang database for related Chinese literature published between January 2002 and December 2005 with the same key words in Chinese. STUDY SELECTION: The articles about neural differentiation from human umbilical cord blood cells and transplantation in treating rats with hypoxic-ischemic brain injury were arranged to select those with strong points. As to those in the same field, the articles published recently or in authorized journals were included. DATA EXTRACTION: Totally 37 articles were collected, of which 31 ones were accorded the criteria and 6 were excluded. DATA SYNTHESIS: Many studies showed that mesenchymal stem cells with strong plasticity could be isolated from umbilical cord blood. Also, mesenchymal stem cells from umbilical cord blood have many merits: ①It is primitive with inferior antigenicity and few primary cells with toxicity, so the incidence rate of graft versus host disease is low, and the adverse effect is slighter; moreover, the blood has strong differentiated ability, can express stably exogenous target gene in vivo and in vitro. ②With widespread source, large quantity, easy to collect, prepare and store, not involving in the problem of society, ethics and law and so on. Therefore, mesenchymal stem cells can be used as a new source to treat central nervous system disease. CONCLUSION: Though mesenchymal stem cells have wide application prospect, the research on the transplantation in treating nervous system disease is emerging and vacant in many areas, so we need to do further study to provide a new channel for treating central nervous system disease.