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Objective:To evaluate the effectiveness of internal control of government procurement at public hospitals.Methods:Literature review and Delphi method were used to construct the internal control evaluation index system of government procurement at public hospitals, and the weight of the index system was determined by analytic hierarchy process. The index system was used to evaluate the internal control of government procurement in Hospital Z.Results:The evaluation index system of government procurement internal control of public hospitals covers all aspects of the whole process of government procurement, including 2 level-1 indexes of government procurement internal control unit level and government procurement internal control business level, 11 level-2 indexes and 27 level-3 indexes. The internal control of government procurement of Hospital Z was evaluated with an evaluation score of 81.37 points, an evaluation result relatively effective.Conclusions:The evaluation index system of government procurement internal control of public hospitals constructed in this study could quantitatively evaluate the effectiveness of each sector of government procurement internal control of public hospitals. It could meet the basic evaluation requirements of internal control of government procurement at public hospitals.
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Objective:To explore the barriers of nutritional care for spouses of elderly patients with stroke, and provide reference for the home nutrition education management program and related interventions to improve the nutritional care quality of elderly spouses.Methods:Semi-structured interviews were conducted for spouses of 13 elderly patients with stroke. The Colaizzi 7-step analysis was used for analysis.Results:The barriers could be summarized into three generic categories and seven themes. Cognitive factors included poor nutrition cognitive awareness, and weakened self-maintenance. Behavioral factors included poor compliance, improper diet adjustment, and invalid personal response. Environmental factors included delayed social support and limited access to information.Conclusions:Paying attention to the barrier factors of nutritional care for spouses of elderly patients with stroke can help us understand the difficulties and problems of spouses, and provide reference for the effective implementation of family nutrition education and management.
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Objective:To test the reliability and validity of Work-ability Support Scale (WSS) in stroke patients. Methods:WSS was translated into Chinese with the standard translation-retroversion. From December, 2018 to March, 2019, 193 middle-aged and young stroke patients from two community health service centers in Zhengzhou were conveniently selected, and investigated with Chinese WSS by two nurses. The data were analyzed with item analysis, content validity, exploratory factor analysis, internal consistency reliability and inter-rater reliability. Results:The content validity was 0.94 in WSS A and 0.90 in WSS B. Three factors were extracted from 16 items in WSS A, with cumulative variance contribution of 67.747%; while three factors were extracted from 12 items in WSS B, with cumulative variance contribution of 56.056%. Cronbach's α was 0.933 and 0.778 in WSS A and WSS B, respectively. The kappa coefficient was above 0.6 between two raters in every item, except items B8 and B10. Conclusion:Chinese WSS is satisfactory in validity and reliability for using in young and middle-aged stroke patients during their return to work.
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Objective:To investigate the relationship of swallowing experience to frailty and nutrition in old stroke inpatients. Methods:From March to July, 2019, 174 stroke inpatients aged above 60 were investigated with Dysphagia Handicap Index (DHI), FRAIL Scale and Mini Nutritional Assessment Short Form (MNA-SF). The correlation of DHI score to scores of FRAIL Scale and MNA-SF was analyzed with Pearson correaltion analysis. Multiple regression was analyzed using the scores of dimensions and total score of DHI as dependent variables, and the scores of FRAIL Scale and MNA-SF as independent variables. Results:The inpatients aged (76.16±9.908) years. The DHI score was (50.34±28.325), in which the body score was (17.68±10.254), the function score was (20.31±11.085) and the emotion score was (12.36±9.193). The FRAIL Scale score was (3.16±1.301), and the MNA-SF score was (8.95±2.529). The DHI scores positively correlated with the FRAIL Scale score (r = 0.575, P < 0.001) and negatively correlated with the MNA-SF score (r = -0.544, P < 0.001). The scores of FRAIL Scale and MNA-SF explained the 34.4% of variable for body, 38.7% for function, 36.1% for emotion and 42.4% for DHI total score. Conclusion:Improving the frailty and nutrition may reduce the poor swallowing experience for old stroke inpatients.
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Studies have shown that many complex diseases are sex-determined. When conducting genetic association studies on Xchromosome, there are two important epigenetic factors which should be considered simultaneously: X-chromosome inactivation and genomic imprinting. Currently, there have been several association tests accounting for the information on X-chromosome inactivation. However, these tests do not take the imprinting effects into account. In this paper, we propose a novel association test simultaneously incorporating X-chromosome inactivation and imprinting effects based on case–parent trios and control–parent trios for female offspring and case–control data for male offspring, denoted by MLRXCII. Extensive simulation studies are carried out to investigate the type I error rate and the test power of the proposed MLRXCII . Simulation results demonstrate that the proposed test controls the type I error rate well andis more powerful than the existing method when imprinting effects exist. The proposed MLRXCII test is valid and powerful in genetic association studies on X-chromosome for qualitative traits and thus is recommended in practice.
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Objective To analyze the correlation between polymorphisms at position 4 and 14 in exon 2 of the p73 gene and susceptibility to human papillomavirus (HPV) infection.Methods Tissue specimens were obtained from the lesions of 83 patients with condyloma acuminatum and 11 patients with bowenoid papulosis,and blood samples from all the patients as well as 150 health checkup examinees with high risk for sexually transmitted diseases (STDs) at STD clinics (negative control group).PCR was performed to detect HPV DNA in lesional tissue specimens,followed by direct sequencing and nucleotide alignment using the BLAST program for the determination of HPV genotypes.To assess polymorphisms at position 4 and 14 in exon 2 of the p73 gene,DNA was extracted from all the blood samples,and the p73 gene was amplified by PCR with the primer shP73 followed by gene sequencing.The association between the polymorphisms and susceptibility to HPV infection was analyzed.Results Of the 83 tissue specimens from patients with condyloma acuminatum,42.2％ (35/83) were positive for HPV 6,and 41.0％ (34/83) for HPV 11.Among the 11 tisssue specimens from bowenoid papulosis lesions,5 were positive for HPV 16,and 3 for HPV 6.The p73 gene was successfully amplified and sequenced from all the patients with condyloma acuminatum or bowenoid papulosis as well as from 132 out of 150 health checkup examinees.There were three genotypes at position 4 and 14 in exon 2 of the p73 gene,including A4T14/G4C14,A4T14/A4T14,G4C14/G4C14,of which,A4T14/A4T14 was associated with a higher risk for condyloma acuminatum (OR 4.89,95％ CI 1.50-15.91) as well as bowenoid papulosis (OR 7.11,95％ CI 1.144-44.20),and G4C14/G4C14 with a lower risk for bowenoid papulosis (OR 0.16,95％ CI0.04-0.65),in patients with HPV infection.Conclusions The A4T14 allele in exon 2 of the p73 gene increases the risk for bowenoid papulosis and condyloma acuminatum,but no significant correlation is found between the susceptibility to high-or low-risk HPV infection and polymorphisms at the two positions in the p73 gene.
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[Objective] To observe the effects of autophagy induced by different doses of ultraviolet B (UVB) irradiation on the apeptosis in human skin fibroblasts.[Methods] Skin fibroblasts were isolated from the circumcision specimen of a 23-year-old healthy male,and subjected to a primary culture.After 3 to 10 passages,the cells were collected and applied in the following experiment.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation of some fibroblasts treated with different concentrations (0,0.5,2.0,5.0and 10.0 mmol/L) of 3-methyladenine (3-MA).To qualitatively and quantitatively detect the autophagy in fibroblasts treated with different concentrations of 3-MA and in fibroblasts treated with 3-MA of 0.5 mmol/Lfollowing UVB irradiation,monodansylcadaverine (MDC) staining was carried out,and immunofluorescence was used to detect the expression of microtubule-associated protein 1 light chain (LC3).Some fibroblasts were classified into 8 groups to remain untreated,be irradiated with UVB of 30,50 and 100 mJ/cm2 alone,treated with 3-MA of 0.5 mmol/L alone,or treated with 0.5 mmol/L 3-MA following irradiation with UVB of 30,50 and 100 mJ/cm2,respectively,then,cell apoptosis was qualitatively detected by Hoechst and propidium iodide (PI)staining,and quantitatively detected by flow cytometry with annexin V and PI.[Results] The percentage of autophagic cells was (63.037 ± 5.876) ％ in fibroblasts treated with starvation condition,significantly decreased to (34.425 ± 5.183) ％ in fibroblasts treated with 3-MA of 0.5 mmol/L.The expression of LC3 showed a gradually increasing trend from untreated fibroblasts,to fibroblasts irradiated with UVB of 30,50 and 100 mJ/cm2,while the increase was attenuated by the 4-hour treatment with 3-MA immediately after the irradiation.Compared with the other concentrations,the 3-MA of 0.5 mmol/L showed the least influence on the viability of fibroblasts.The addition of 3-MA of 0.5 mmol/L increased the percentage of cells both positive for Hoechst and PI staining in fibroblasts irradiated with UVB of 50 mJ/cm2,but decreased that in fibroblasts irradiated with UVB of 100 mJ/cm2.Similarly,the percentage of middle and late apoptotic cells was significantly higher in fibroblasts irradiated with UVB of 50 mJ/cm2 followed by treatment with 3-MA of 0.5 mmol/L than in those irradiated with UVB of 50 mJ/cm2alone ((10.933 ± 0.839) ％ vs.(7.267 ± 0.473) ％,t =5.20,P＜ 0.05),but lower in fibroblasts irradiated with UVB of 100 mJ/cm2 followed by treatment with 3-MA of 0.5 mmol/L than in those irradiated with UVB of 100 mJ/cm2alone ( (7.100 ± 0.781 ) ％ vs.( 1 0.133 ± 0.681 ) ％,t =6.29,P ＜ 0.05 ).[Conclusion]s The irradiation with UVB of 50 mJ/cm2 may protect fibroblasts by inducing autophagy and suppressing apoptosis,while the high level of autophagy induced by UVB of 100 mJ/cm2 may lead to autophagic cell death in fibroblasts.
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<p><b>BACKGROUND</b>During the process of bone cement joint replacement, some patients show a series of complications, such as a sudden drop in blood pressure or dyspnea. The cause of the complication is considered to be due to emboli caused by the femur prosthesis insertion. The purpose of the present study was to detect the pulmonary embolism in rabbits after bone cement perfusion by radioimmunoimaging, and to explore its protective measures.</p><p><b>METHODS</b>Forty rabbits, 2.5 - 3.0 kg weight, were randomly assigned to four groups, with ten rabbits in each group. Group I (no intervention): Bone cement perfusion was done after medullary cavity reaming and pressurizing. Group II (epinephrine hydrochloride intervention): The medullary cavity was rinsed with a 1:10 000 normal saline-diluted epinephrine hydrochloride solution followed by bone cement perfusion after medullary cavity reaming and pressurizing. Group III (fibrin sealant intervention): The medullary cavity was precoated with fibrin sealant followed by bone cement perfusion after medullary cavity reaming and pressurizing. Group IV (blank control group): The medullary cavity was not perfused with bone cement after reaming. In each group, the rabbits underwent femoral head resection and medullary cavity reaming. Before bone cement perfusion, 2 ml of developing tracer was injected through the ear vein. Radionuclide imaging was performed at 60, 120, and 180 minutes after bone cement perfusion, and the pulmonary radioactivity in vivo was measured. The rabbits were immediately sacrificed, and the pulmonary tissue was removed and its radioactivity was measured in vitro. Pulmonary tissue was then fixed and the pulmonary embolism and the associated pathological changes were observed.</p><p><b>RESULTS</b>The pulmonary radioactivity in vivo was measured at 60, 120, and 180 minutes after bone cement perfusion. The radioactivities of the four groups were 11.67 ± 2.16, 14.59 ± 2.92 and 18.43 ± 4.83 in group I; 8.37 ± 3.05, 10.35 ± 2.24 and 11.48 ± 2.96 in group II; 3.91 ± 1.19, 5.53 ± 2.95 and 7.25 ± 1.26 in group III; 1.04 ± 0.35, 1.14 ± 0.87 and 1.43 ± 0.97 in group IV. The radioactivities of groups I, II, III at 60, 120 and 180 minutes were significantly higher than group IV (P < 0.05). The pulmonary embolism could be detected. Pretreatment with epinephrine hydrochloride and fibrin sealant significantly decreased the pulmonary radioactivity in group II and group III, but it was still higher than in the group IV.</p><p><b>CONCLUSIONS</b>Radioimmunoimaging is an alternative method for the dynamic observation of rabbit pulmonary embolism after bone cement perfusion. Radioimmunoimaging is the optional way to evaluate the effect of pretreatment with epinephrine hydrochloride or fibrin sealant on pulmonary embolism after bone cement perfusion.</p>