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Objective:To explore the influencing factors and pathways of social responsibility of public hospitals, and to provide a reference for public hospitals in China to further improve the social responsibility level.Methods:From 2019 to 2020, 22 tertiary public hospitals in a region were selected as study cases. The social responsibility score was used as the outcome variable, social benefit, appropriateness, quality, and efficiency were used as the conditional variables, and the qualitative comparative analysis was applied to investigate the combination of conditions affecting social responsibility evaluation of public hospitals.Results:The consistency of the social benefit, appropriateness, and quality was less than 0.9 and greater than 0.8, indicating that they were sufficient and non-necessary conditions for high social responsibility of public hospitals. The consistency of efficiency was 0.747, indicating that it was neither sufficient nor necessary condition. The configuration analysis showed that there were three paths for public hospitals to achieve high social responsibility: co-driven social benefit and appropriateness with high quality assistance, co-driven social benefit and efficiency with high quality assistance, and co-driven appropriateness and efficiency, with a coverage rate of 92.6%.Conclusions:Social benefit, appropriateness, quality, and efficiency can be combined in different ways to achieve high social responsibility in public hospitals. Public hospitals could develop targeted social responsibility improvement strategies according to the actual situation, and strengthen the synergy between the elements to improve the level of social responsibility in hospitals.
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Objective:Based on the technology-organization-environment model and the theory of planned behavior, to construct a theoretical model for exploring the influencing factors of the adoption intention of hepatic contrast-enhanced ultrasound by clinicians in a medical alliance.Methods:By agency of self-administered scales, a questionnaire survey was conducted among the clinicians in liver disease-related departments of four medical alliances from Fujian and Jiangxi provinces between February and August, 2019.Results:Behavioral attitudes, subjective norms, perceived behavioral control, organizational atmosphere, and industry technical environment all had positive impacts on the clinicians′ intention to adopt hepatic contrast-enhanced ultrasound technology in medical alliances. The total influence of the five types of factors on the adoption intention of hepatic contrast-enhanced ultrasound was as follows: perceived behavioral control(0.779), subjective norms(0.635), industry technical environment(0.578), behavioral attitudes(0.359), and organizational atmosphere(0.218).Conclusions:It is recommended to strengthen the intention to adopt corresponding health technologies by providing adequate technical education and training, giving play to the leading role of core members, and building an organizational atmosphere of advocating technological innovation and communication.
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<p><b>OBJECTIVE</b>To observe the effect of crocetin on autophagy in rat hepatocytes exposed to lipopolysaccharide (LPS) and D-galactosamine (D-gal) and explore the mechanism.</p><p><b>METHODS</b>Cultured rat hepatocytes were exposed to LPS (1 mg/L) and Dgal (60 mg/L) to induce cell injury and treated with crocetin, 3MA, or crocetin+3MA. Twelve hours after the treatments, the cells were examined for levels of ALT, AST and LDH in the supernatant using ELISA. LC3 fluorescence in the cells following immunofluorescence staining was observed using fluorescence microscopy. Autophagosomes in the cells were observed by transmission electron microscopy, and the cellular expressions of LC3, p62 and SIRT1 were detected using Western blotting.</p><p><b>RESULTS</b>The levels of ALT, AST and LDH in the hepatocytes were elevated after LPS- and D-gal-induced injury, reached the highest levels after 3MA treatment, but were decreased significantly by crocetin treatment. LC3 fluorescence increased obviously in the injured hepatoctyes, and the increment was the most obvious in crocetin-treated cells; LC3 fluorescence was decreased significantly after 3MA treatment. Cell injury induced obvious increase in autophagy in the hepatocytes, and the number of autophagosomes increased significantly after crocetin treatment but was reduced significantly after 3MA treatment. The cell injury caused an obvious up-regulation of LC3 and SIRT1 expression and down-regulated p62 expression. LC3 and SIRT1 expression levels were the highest and the expression of p62 was the lowest in cells with crocetin treatment. 3MA treatment significantly reduced the expression of LC3 and SIRT1 and increased the expression of p62 in the injured cells.</p><p><b>CONCLUSIONS</b>Autophagy is increased in injured rat hepatocytes, and crocetin can promote autophagy in the injured cells to reduce further cell injury.</p>
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Objective To observe hepatocellular apoptosis and inflammatory cytokines expression and their mechanisms after paraquat poisoning in rat.Methods Forty Wistar rats were divided into control group (n =8) and model group (n =32) by random number table.Rats in model group were intraperitoneally injected with 30 mg/kg 20％ paraquat concentrate,while those in control group were injected with normal saline.0.5,1,3,7 days after reproduction of the model,8 rats were sacrificed,and blood was collected from inferior vena cava and hepatic tissue was harvested.The serum levels of interleukin-1β (IL-1 β) and tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbent assay (ELISA).The mRNA expressions of IL-1β,TNF-α,inducible nitric oxide synthase (iNOS) and p53 were determined by reverse transcription-polymerase chain reaction (RT-PCR).Cysteine-containing aspartate-specific proteases (caspase-3,-8,-9,-12) activity in hepatic tissue was determined on the 3rd day with chromogenic substrate method.The liver histopathological changes were observed after hematoxylin-eosin (HE) staining.Results In model group,hepatic tissue showed extensive necrosis with inflammatory cell infiltration in time dependant manner.Serum IL-1β and TNF-α levels were significantly higher in model group half a day after reproduction than those in control group [IL-1β (ng/L):220.13 ± 69.74 vs.0.14 ± 0.03,TNF-α (ng/L):102.66 ± 26.43 vs.0.16 ± 0.02,P＜ 0.01 and P＜0.05],and peaked on the 3rd day and 1st day [IL-1β:(423.72 ± 153.11) ng/L,TNF-α:(690.35 ± 229.64) ng/L].They then decreased gradually,but were still significantly higher than those in control group on the 7th day [IL-1 β:(357.47 ± 87.28) ng/L,TNF-α:(12.39 ± 5.06) ng/L,both P＜0.05].The contents of IL-1β,TNF-α and iNOS mRNA expressions in hepatic tissue were significantly higher than those in control group,and the highest values were seen on the 1st day,the 1st day,and the 3rd day [IL-1β mRNA (gray value):1.569 ± 0.057 vs.0.123 ± 0.016,TNF-α mRNA (gray value):0.683 ± 0.077 vs.0.261 ± 0.025,iNOS mRNA (gray value):3.259 ± 0.135 vs.0.002 ±0.001,P＜0.05 or P＜0.01].There was no difference in p53 mRNA expression between model group and control group at early stage,and both of them showed low expression,and p53 mRNA expression was significantly higher in model group on the 7th day (gray value:2.959 ± 0.086 vs.0.263 ± 0.032,P＜0.01).In model group,caspase activity (pmol/mg) in liver tissue were significantly higher on the 3rd day than those in control group (caspase-3:857.25 ± 309.26 vs.169.73 ± 48.21,caspase-8:199.18 ± 61.41 vs.32.26 ± 11.09,caspase-9:321.62 ± 80.73 vs.90.38 ± 29.76,caspase-12:413.13 ± 89.77 vs.26.73 ± 9.86,all P＜0.01).Conclusion Paraquat can cause acute liver injury in rats,with caspase-3,-8,-9,-12 activities markedly enhanced,and liver injury may be associated with an early high expression of TNF-α,iNOS and p53 gene.