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Objective To estimate the operational efficiency of 37 county level public general hospitals in Hubei province using the world popular method of Bootstrap-data envelopment analysis.The aim is to make up for the theory and methodology gaps on DEA research for hospitals in China,and to provide policy and management recommendations for their further improvement.Methods The input and output indicators of hospital efficiency evaluation were selected based on our previous research.R Software was used to describe the current input and output indicators,while FEAR package used to measure Bootstrap-DEA efficiency value of the sample hospitals with bias corrected,along with such applied analysis as efficiency benchmarking for the technical efficiency outcomes.Results There are great differences among the healthcare input and output of these hospitals.In particular,the difference in the number of actual beds was 4.67 times between the highest hospital and the lowest one.All of the bias corrected efficiency scores were lower than those before correction,and the average bias corrected score of the sample hospitals is 0.717 9.Moreover,only 20 hospitals(54.05%)have their efficiency scores above the median level.Conclusions The healthcare resources allocation of these hospitals needs to be further optimized.Hospitals still have big potential to improve their efficiency.Besides providing policy support,the government is advised to guide hospitals to innovate their management mechanisms,such as introducing and applying benchmarking,ranking,inter-hospital learning among others,so as to continuously improve their operational efficiency.
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Aim To study the mechanisms of the pro-tective effect of procyanidin B2 ( PCB2 ) on the myocar-dial cell apoptosis induced by lipopolysaccharide ( LPS) . Methods Using the primary culture rat myo-cardial cells, myocardial cell injury model was induced by LPS. PCB2 low, medium and high dose groups, were cultured with 6. 25 , 12. 5 , 25. 0 μmol · L-1 PCB2 respectively in DMEM medium for 24 h continu-ously. Myocardial cell survival rate was determined by MTT colorimetric method. Cardiacmyocyte NOX activi-ty was determined by lucigen chemiluminescence meth-od . Western blot analysis was used to detect myocardi-al NADPH oxidase p47phox expression. TUNEL method was used to detect apoptosis and flow cytometry was used to determine the content of myocardial cells ROS. Results Compared with control group, the cell dam-age induced by LPS group myocardial cell survival rate significantly decreased ( P <0. 01 ) , and myocardial cell NOX activity, p47phox expression, apoptotic cell number and ROS content were significantly increased (P<0. 01). PCB2 low, medium and high dose groups cell survival rates were significantly elevated, myocar-dial cell NOX activity and p47phox expression, apoptotic cell number and the ROS content decreased significant-ly in a dose-dependent manner ( P <0. 01 ) . Conclu-sion PCB2 protects myocardial cell apoptosis induced by LPS via inhibiting the expression of NADPH oxidase activation, p47phox expression and reactive oxygen spe-cies generation.
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Objective:This study aims to ensure the private hospitals development strategy in the background of new healthcare reform and put forward some scientific suggestions to help promote their sustainable development. Methods:The SWOT analysis method was adopted to analyze the private hospitals’ internal strength, weakness, exter-nal opportunity and threats. Results: The results showed a clear property right, advanced management system and other outstanding advantages in the private hospitals. Opportunities like the improved policy environment and people’s medical demand expansion are also very prominent. Meanwhile, the private hospitals development also faces some disadvantages and challenges such as illegal operation, disorder in the market competition, vague orientation, etc. Conclusions:It suggests the strengthening of the personnel and hospital culture construction, adoption of the differen-tiation strategy, improvement of the diagnosis and treatment ability, etc.
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Aim To explore the protective effects of LPPC ( procyanidins extracted from the litchi pericarp) on cardiomyocyte apoptosis in septic rats and its mech-anisms. Methods The rats were randomly divided in-to 5 groups, and were given orally the drug for two weeks continuously. The control group ( control) and sepsis model group ( LPS ) were given distilled water once a day. LPPC low, medium and high dose groups were given LPPC 50 , 100 , 200 mg · kg-1 · d-1 re-spectively which were prepared freshly every day. After the treatment, sepsis animal models were established. Except for the control group, other groups were injec-ted LPS (lipopolysacchride, 10mg·kg-1) intraperito-neally to induce acute sepsis model. 4hrs later, rat se-rum was collected, isoenzyme ( CK-MB ) , lactate de-hydrogenase ( LDH ) and activity of aspertate amin-otransferase ( AST/GOT) were detected. Then rat car-diac tissue was obtained and cardiac tissue malondial-dehyde ( MDA ) , total antioxidant capacity ( T-AOC ) and reduced glutathione ( GSH ) content were deter-mined. TUNEL staining was performed to analyze the apoptosis of myocardial cells. Cleaved caspase-3 and TNF alpha protein expressions were analyzed by West-ern blot. Results Compared with the control group ( control) , serum of sepsis model group rats CK-MB, LDH, AST/GOT and cardiac tissue MDA content were significantly increased (P<0. 01). At the same time, the activity of cardiac tissue T-AOC and GSH de-creased obviously ( P<0. 01 ) . The apoptotic myocar-dial cells increased significantly ( P<0. 01 ) , and the expression level of cleaved caspase-3 and TNF alpha decreased obviously ( P <0. 01 ) . LPPC pretreatment significantly decreased the serum CK-MB, LDH, AST/GOT and tissue MDA content, increased tissue T AOC and GSH activity, attenuated apoptosis of rat myocardi-al cells significantly, and decreased expression level of cleaved caspase-3 and TNF alpha. Conclusion LPPC pretreatment can significantly attenuate rat myocardial cell apoptosis induced by sepsis, and the underlying mechanisms may be related to its anti-oxidative effects.
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Objective To observe the changes of peripheral blood interleukin-2(IL-2) ,interleukin-4(IL-4) ,interleukin-10(IL-10) ,tumor necrosis factor-alpha(TNF-α) and interferon gamma (IFN-γ) in chronic hepatitis B(CHB) patients with positive e-anti-gen(HBeAg) treated by Bushenqingtou Decoction .Methods 60 cases of CHB with positive HBeAg were randomly divided into the treatment group and the control group ,30 cases in each group .The CHB treatment group received Bushenqingtou Decoction with the treatment course of 48 week ,while the CHB control group did not received the medication therapy .In the beginning and at 48 weeks of treatment ,the blood in the two CHB groups were collected for detecting HBV DNA ,IL-2 ,IL-4 ,IL-10 ,TNF-αand IFN-γ. Results Compared with before treatments ,the levels of IL-2 ,TNF-αand IFN-γafter treatments in the CHB treatment group were obviously increased ,while the levels of HBV DNA ,IL-4 and IL-10 were remarkably decreased (P0 .05) .Conclusion Bushenqingtou Decoction could inhibit the replication of HBV DNA in the CHB patients with positive HBeAg and improve the body immune func-tion .
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Objective of this study is to re-compute the national hospitalization rate in China using the second-hand data and explore the practical use of systematic review in health policy research field.Methods Domestic literatures on hospitalization rate in the last six years were collected and quality assessment was done.Merging analysis was used based upon systematic review approach.Results 25 reported literatures on hospitalization rate of urban and rural residents were included into the study.After merging analysis,the hospitalization rates were 4.70% for the country,5.31% for the urban and 4.26% for the rural.They are higher than the reported hospitalization rate in National Health Services Survey (NHSS)in 2003.After merging with the NHSS data,the hospitalization rate were 4.12%,4.85% and 3.82% respectively.Conclusions Systematic review can be applied in health service and policy research field.Data merging and information processing methods are diversified and could be selected upon research purpose and data attribute.Computation methods in systematic review in health policy research still need to be developed.
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Objective To explore the assessment of precision, accuracy, and quality control(QC) procedures needed to satisfy the external quality assessment criteria with "operational process specifications" (OPSpecs) derived from an analytical quality-planning model. Methods The routine operating specifications were presented in the form of an OPSpecs chart, which described the operational limits for imprecision and inaccuracy when a desired level of quality assurance was provided by a specific QC procedure. Results OPSpecs charts could be used to compare the operational limits for different QC procedures and to select a QC procedure that was appropriate for the precision and accuracy of a specific measurement procedure. The inaccuracy and imprecision observed for a measurement procedure was plotted on the OPSpecs chart to define the current operating point, which was then compared with the operational limits of candidate QC procedures. Conclusion The general design approach is applicable in all instrument systems.