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Objective:Case mix index indicates the capacity of disease diagnosis and treatment, as well as the quality of health cares in related disciplines. Science and technology evaluation metrics represent the level of innovation and sustainable development of science and technology. Quality of health care and sustainable development are considered as two key evaluation indicators in the performance evaluation of national tertiary public hospitals. This study aimed to explore the effect of case mix index on the science and technology evaluation metrics.Methods:According to a cross-sectional design, the relationship between case mix index and science and technology evaluation metrics was analyzed in a tertiary public general hospital between 2017 and 2019.Results:In three years′ period time, the departments in top 100 disciplines of science and technology evaluation metrics had the case mix index 17% which was higher than other departments in non-top 100 disciplines ( P<0.05). In the multivariate analysis, higher case mix index increased a 2.29-fold higher probability to be in top 100 disciplines. They are under the receiver operative character curve between case mix index and top 100 disciplines in evaluation of departments was 0.716 ( P=0.001). Conclusions:Case mix index indicated the level of science and technology evaluation metrics and the clinical departments should improve the case mix index, service quality of health care and the motivation of sustainable development.
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BACKGROUND@#The tyrosine kinase inhibitors (TKI) treatment of non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation may have a positive effect, but most patients may develop drug resistance, therefore, the detection of the developing time in drug resistance and the research of the mechanism of drug resistance are need to be solved. While the emerge of next generation sequencing (NGS) have make it possible. The aim of this study is to monitor the efficacy of targeted therapy by studying the variation of circulating tumor DNA (ctDNA) mutation frequency and gene mutation spectrum through the targeted therapy.@*METHODS@#Our center enrolled 22 patients with EGFR mutation detected by tissue or peripheral blood, and collect 8 mL of peripheral blood of the patients for ctDNA sequencing in different phases, before systematic prior treatment, followed-up by 2 months and disease progression after TKI administration.@*RESULTS@#Patients with EGFR gene mutation may acquire a longer median survival time after receiving targeted drug therapy, due to the drop of mutation abundances, while the therapy may have a minor effect in patients which their mutation abundances have slightly decreased compared to the statistics before the cession (P=0.015,3). The significantly reduced group median progression was associated with a longer survival [progression free survival (PFS)=390 d]. At the same time, we found out that when related to TP-53 gene mutation, the effect of targeted drug therapy for EGFR-sensitive mutation was unsatisfactory (the median PFS was 120 d compared with 630 d, P=0.000,2).@*CONCLUSIONS@#Patients who has lower mutation abundance with EGFR sensitive mutations after TKI treatment may have a longer survival period (P<0.05), and the mutation abundance were not significantly dropping or accompanied by other mutations may indicating TKI resistance.
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Objective:To observe the inhibitory effect of metformin on the inflammatory response of Kupffer cells (KCs) of liver in the diabetic mice, and to explore its improvement on the phagocytic function of KCs, and to elucidate the protective mechanism of metformin on the KCs in the diabetic mice.Methods:The C57BLKS/J db/db mice were divided into diabetes group and diabetes+metformin group, and the C57BLKS/J db/m mice were divided into non-diabetes group and non-diabetes+metformin group, 8mice in each group.The KCs were cultured in vitro and the changes of ultrastrustures of KCs were observed by transmission electron microscope.The levels of interleukin 6 (IL-6) , tumor necrosis factorα (TNF-α) andγ-interferon (INF-γ) in the KCs were detected by ELISA.The expression levels of intercellular adhesion molecule 1 (ICAM-1) protein in the KCs was detected by Western blotting method.Transwell chamber assay was used to detect the neutrophil chemotaxis ability of the KCs, and the phagocytic ability of KCs was observed under inverted microscope.Results:The number of mitochondria and rough endoplasmic reticulum (RER) in the KCs of the diabetic mice was reduced, the RER expanded, the mitochondria swelled, and the lipid droplets were increased.Compared with non-diabetes group, the levels of IL-6, TNF-α, INF-γand the expression level of ICAM-1in the KCs of the mice in diabetes group were significantly increased (P＜0.05) ;the neutrophil chemotaxis ability of the KCs was enhanced (P＜0.05) , and the phagocytic ability was decreased (P＜0.05) .Compared with diabetes group, the levels of IL-6, TNF-α, INF-γand the expression level of ICAM-1in the KCs in diabetes+metformin group were significantly decreased (P＜0.05) ;the neutrophil chemotaxis ability was decreased (P＜0.05) , and the phagocytic ability was enhanced (P＜0.05) .Conclusion:Metformin can inhibit the inflammatory response of KCs in the diabetic mice and improve its phagocytic function and protect the KCs.
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Objective: To analyze the levels of dietary intake among the normal population, the esophagitis patients, and the esophageal squamous cell carcinoma (ESCO patients, and to elucidate the relationship between the diet and the incidence of ESCC. Methods : Frequency-matched case-control study was performed. The normal esophagus population (normal group), the esophagitis patients (esophagitis group) and the ESCC patients (ESCC group) (n=72) were enrolled. The general informations, intake conditions and relationship between the intake and ESCC of the subjects among three groups were compared. Unconditional Logistic regression model was used to estimate the OR and 95 %CI when salted meat consumption or not, frenquency of salted meat consumption and time of salted meat consumption in 1 year were brought into the analysis. Results: The family cancer history and family ESCC history in first-degree relatives of the subjects among three groups had significant differences (P
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Objective To explore the cognition and demand status of order oriented nursing talents in different hospitals in Xinjiang,so as to provide a scientific basis for establishing the model in Xinjiang. Methods Using qualitative research methods and purposive sampling, 12 nursing directors from different grades of hospitals in North and South Xinjiang were selected and semi structured in-depth interviews were conducted from September 2016 to October 2016. Colaizzi phenomenological seven step analysis method was used to analyze the data and get the theme. Results Through analysis, the three themes of different types of hospitals in Xinjiang were put forward: there are different levels of hospitals in order to model the demand of nursing personnel training;different levels of hospital nursing students'needs of different orders;the hospital expects to establish order type talent training hospital-school cooperation steering committee. Conclusions Xinjiang area hospitals of different levels to construct the pattern of the urgent need for the"order"of nursing personnel training,to meet the needs of nursing professionals of different levels of hospitals, so as to improve the overall level of nursing staff, to provide quality health services along the Silk Road and the surrounding countries.
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Objective To explore the incidence and risk factors of common complications in PICC patients during chemotherapy in Xinjiang.Methods A prospective study was conducted.The patients with PICC were treated with PICC from April 2016 to April 2017 were followed up for 10 months. The incidence of PICC complication and the influencing factors were observed dynamically during chemotherapy.Results The incidence of PICC complication was 13.6%(42/208)during chemotherapy in Xinjiang patients.The incidence of PICC was higher in the third chemotherapy cycle and the incidences of the first and sixth chemotherapy cycles were lower. Age, valve type, number of punctures, maintenance time>7d, and living conditions were the influencing factors of PICC complications(P＜0.05). Conclusions The incidence of common complications of PICC in cancer patients during chemotherapy is high in Xinjiang region.The risk factors of complications include age＜18 years,number of open-end PICCs,increased number of punctures, maintenance time>7d and living conditions for rural areas. Clinical nurses should give personalized health guidance on the causes of complications in different patients to reduce the occurrence of complications of PICC,and improve the quality of PICC use.
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BACKGROUND:Hematopoietic stem cel transplantation is the main treatment for leukemia, lymphoma and other blood diseases, but there are various negative factors during the transplantation process that have important implications for the success of hematopoietic stem cel transplantation. OBJECTIVE:To analyze the psychological characteristics of patients undergoing hematopoietic stem cel transplantation and to focus on the implementation effects of psychological intervention. METHODS: From January 2012 to December 2013, totaly 92 patients were admitted at the Hematopoietic Stem Cel Transplantation Center, the majority of whom had received autologous peripheral blood stem cel transplantation. Fifty-five of 92 patients were subjected to alogeneic stem cel transplantation, including 48 cases of relative sources and 7 of unrelated peripheral blood stem cel transplantation. Bone marrow suppression and composite grafting were carried out in some patients. According to the characteristics of negative factors at the different stages of stem cel transplantation, targeted interventional measures were performed, including psychological supports, prevention, observation and treatment of complications, and whole environmental protection programs. RESULTS AND CONCLUSION:Hematopoietic stem cel transplantation was successfuly implemented in al patients who had good compliance behaviors (medication, diet, and daily schedule), and had no the folowing adverse events: psychological stress, out of emotional control, destroying objects. No significant difference was found in the incidence of complications, the incidence of adverse events, and patient satisfaction rate during 2012-2013 (P > 0.05). Because the hematopoietic stem cel transplantation has strong specificity, patients need to strictly comply with the treatment path, stay long in laminar flow wards longer, and bear a greater psychological and physiological burden, whose behaviors are severely restricted. We should strictly implement aseptic standards, strengthen ward management and provide good guidance and support for patients, so as to reduce post-transplantation complications and ensure the successful completion of hematopoietic stem cel transplantation.
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Middle east respiratory syndrome coronavirus (MERS-CoV) was recently identified as a novel human coronavirus known to infect human with high mortality. It belongs to C clade of the betacoronavirus shown the similar genomic structure as other human coronaviruses.To date, some different subtypes of the viral genome were identified but its origin was unclear. Some evidences indicated it maybe came from the bats or dromedary. And series of molecular detection methods have been established and applied in lab and clinic.
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Animals , Humans , Camelus , Chiroptera , Coronavirus , Coronavirus Infections , Genome, Viral , Genomics , Middle East Respiratory Syndrome CoronavirusABSTRACT
Objective:To obtain the full length cDNA sequences of hepatoma associated gene HTA, analyze its alternative splicing, detect the expression pattern of 2 HTA gene transcripts in different hepatic cell lines, and to establish a base for further study of HTA gene function in hepatocellular carcinoma (HCC) occurence and development. Methods:The full length cDNA of HTA gene was cloned by rapid amplification of cDNA 3' ends (3'-RACE), rapid ampliifcation of cDNA 5' ends (5'-RACE) and DNA sequencing. The gene structure and alternative splicing were analysed. Northern blot assay was performed to detect the expression pattern of 2 HTA gene transcripts in different hepatic cell lines. Results:The full length of HTA gene was 1414 bp, composed of 3 exons and 2 introns, and the second intron could be retained in mRNA. Northern blot assay showed that 2 transcripts of HTA mRNA(1.4 kb and 1.7 kb) could express in the HCC cell lines HepG2 and QGY-7703, but not in the non-malignant cell line L-02 and HUVEC. The expression level of 1.4 kb transcript was much higher than 1.7 kb one. Conclusion:This study successfully has obtained the full length cDNA of HTA gene, and analysed the gene sequence and alternative splicing, 2 transcripts of HTA mRNA specifically expressed in HCC cell lines. As a hepatoma associated gene, HTA deserves further investigation.
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Objective:The poor prognosis of patients with malignant gliomas (MG) has led to the search for new therapeutic strat-egies. Recently, nimotuzumab has been studied as a new anti-EGFR-receptor humanized monoclonal antibody in patients with MG, who showed improvement of outcome and good tolerability. We conducted phase I of our study to determine the toxicity, tolerated dose, and clinical feasibility of nimotuzumab in combination with concurrent chemoradiotherapy for Chinese MG patients after surgical resection. Methods:Patients with pathologically proven grades 3 and 4 glioma were enrolled in the study. The protocol included infu-sions of nimotuzumab plus standard Stupp schedule (postoperative radiotherapy in a total dose of 60 Gy in combination with daily te-mozolomide). Patients received 6 weekly infusions of nimotuzumab at three levels (100, 200, and 400 mg/week). If none of the first three patients enrolled at a dose level experienced dose-limiting toxicity (DLT), the dose was increased, as appropriate. If DLT was ob-served, another three patients were added to the dose level. Results:Nine patients with MG were enrolled, including 7 with grade 3 MG and 2 with glioblastoma. The treatment was well tolerated, and no evidence of grade 3 or 4 adverse events was detected, even at the highest level (400 mg/week). Grade 1 or 2 myelosuppression was the most common toxicity. Three months after treatment, stable dis-ease occurred in 5 patients, whereas progression disease was observed in 4 patients. Conclusion:Nimotuzumab combined with concur-rent chemoradiotherapy was associated with mild toxicity in Chinese MG patients.
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Objective To investigate the incidence of autoimmune and nonautoimmune thyroid diseases in patients with breast cancer.Methods Clinical and ultrasound evaluation of thyroid gland,detection of serum thyroid hormone and related antibodies,and fine-needle aspiration of thyroid gland were performed in 100 breast cancer patients and 100 control individuals during the period from 2004 to 2008.Results The mean values of anti-thyroid peroxidase antibodies were significantly higher in breast cancer patients than that in control individuals [(104.56±21.54) U/ml vs (22.16±4.65) U/ml,(P=0.030)].The incidence rates of autoimmune and nonautoimmune thyroid diseases were higher in breast cancer patients than that in control individuals[38 ％ (38/100) vs 17 ％ (17/100),P=0.0009,26 ％ (26/100) vs 9 ％ (9/100),P =0.0016,respectively].Conclusion The results indicate an increased incidence of autoimmune and nonautoimmune thyroid diseases in breast cancer patients.
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Objective To investigate the neural mechanism of the reduction of switch cost induced by short presentation of the task cue.Methods The event-related potentials (ERP) was recorded from 19 subjects while they performed a Chinese Stroop switching task.The factorial design of repeated-measures was adopted with the cue presentation time (100/1000 ms) and the type of succeeding task (repeat/switch).Results For the switch cost of reaction time (the switch subtracts the repeat),the difference between the long cue group (15.0 ± 33.3 ms) and the short group (0.80 -±40.7 ms) had the significantly tendency( t (18) =- 1.77,P=0.09).During the stage of cue processing,the ERP effects of cue reveal in the frontal-occipital areas ( 100 ～ 200 ms),frontoparietal and tempo-occipital regions (200 ～500 ms),frontoparietal network and centro-occipital regions (500 ～900ms).During the stage of task execution,the ERP effects of the cue were observed from the left fronto-occipital areas ( 300 ～ 400 ms) to parieto-occipital areas (400 ～ 900 ms).The ERP effects of the task started from the right hemisphere (500 ～600 ms ) and extended to bilateral prefrontal and centro-parietal area (600 ～900 ms ).Conclusion The short cue presentation can not only start up the preparation of frontoparietal network earlier during cue processing stage but also enhance its retrieval in the left dorsal lateral frontal cortex during task executive stage.
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ObjectiveTo investigate the neural mechanism of processing the salient target during the visual search task with spatiotemporal patterns of event-related potential(ERP).MethodsSixteen subjects were asked to judge the existence of a low or high salient target from 4 items,in which one distractor might be also salient or not.A two-way repeated-measure ANOVA was carried out for behavioral performance and ERP data( distractor saliency:YES,NO)*( target:none,low salient,high salient).ResultsSignificant interaction was found between target and distractor for the reaction time (F( 1.99,29.79) =21.56,P=0.00).For the low salient target,significant difference of reaction time was found between the YES (552.57 ± 82.32 ms) and NO (540.47 ± 75.68 ms)of distractor saliency( t (15) =- 2.489,P =0.025 ).However,such difference of reaction time was not significant for the high salient target.The statistical parametric mapping of F-value of ERP suggested the effect of the distractor saliency revealed in the right fronto-parietal-temporal areas related to stimulus novelty and the effect of the target saliency appeared in the parietal-occipital regions related to visual processing during the same stage ( 350 ～ 450ms ).The significant interaction occurred in the left temporal regions (450 ～ 600 ms ) related to stimulus familiarity and its classification.ConclusionDue to both mechanisms of the parallel processing for the target and the distractor during the perceptual stage and the effective classification of the familiar network within left hemisphere during the stage of pattern classification,the salient target can be processed quickly in spite of the interference from the salient distractor.
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<p><b>OBJECTIVE</b>To investigate the effects of task probability on context processing using AX-type continuous performance test (AX-CPT) and event-related potential (ERP).</p><p><b>METHODS</b>We set 3 groups of complementary probabilities (AX/AY: 0.55/0.15, 0.35/0.35, and 0.15/0.55) for AX task and AY task and kept the probability 0.15 for both BX and BY tasks. Eighteen subjects were asked to press the button only when the go-probe (X: green "<" or ">") followed the go-cue (A: blue "ooo") and withdraw response when the go-probe or a nogo-probe (Y: red "<" or ">") followed the nogo-cue (B: blue "xxx").</p><p><b>RESULTS</b>As the task probability increased, the reaction time of AX task was shortened and the rate of false alarm of BX task increased significantly. The probability effects of ERP revealed by statistical parametric mapping occurred in many regions during both cue and probe stages: cue A in the parietal central (300-350 ms) and the left occipital area (450-500 ms); cue B in the right frontal pole (350-500 ms) and the left frontal pole (750-950 ms); AX probe in the right frontoparietal area (200-250 ms), the left frontal pole, the right dorsal prefrontal and bilateral parietal region (300-400 ms), and the bilateral occipital area and parietal region (400-650 ms); AY probe in the fronto-central area (350-500 ms) - the P3 effect; BX probe in the right temporal and the left occipital areas (300-350 ms); BY probe in the left temporal area (150-250 ms).</p><p><b>CONCLUSION</b>The task probability not only influences both the encoding of go-cue and expectancy of nogo-cue but also modulates the neural assemblies of probe processing differentially.</p>
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Adult , Female , Humans , Young Adult , Cues , Evoked Potentials , Physiology , Spatio-Temporal AnalysisABSTRACT
Objective To evaluate the application of a puncture guidance supporter in CT guided biopsy and interventional therapy. Methods Totally 468 patients underwent CT interventional biopsy (n=110) or treatment (n=358) using a puncture guidance supporter. The size of lesions was 2-15 cm. CT scanning was performed to determine the entry point, data of bi-directional needle angle α, θ and depth d before operation. After local anesthesia, the needle was punctured into skin through the puncture guidance supporter, the needle overlap CT positioning laser line in tilt angle (α) was adjusted and the puncture direction at angle θ. After CT scanning confirmed the needle aiming at target lesion, punctures were performed with the needle into the depth to hit the target. Results The total puncture hit rate was 100%, and one step hit rate was 96.79%. The average time from location scanning to hit the target was 8.4 min. The incidence of pneumothorax occurred in thorax management was 1.56%. Conclusion The application of puncture guidance supporter in CT interventional diagnosis and treatment makes operation more accurate, safe and convenient.