A comparative study on the human resources deployment of public general hospitals in Pudong New Area / 中华医院管理杂志

Objective:To compare the actual situation and measurement data of human resources deployment in public general hospitals in Pudong New Area, so as to provide a data basis for further optimizing the human resources deployment plan.Methods:The Pudong New Area Health Statistical Information System was used to collect the staffing information and business data of 9 public general hospitals in Pudong New Area, Shanghai in 2019. On such basis, the numbers of officially budgeted positions and actual positions were calculated. Descriptive analyses of the data were performed to compare the theoretical and actual quantities by paired t-test and Wilcoxn signed-rank sum test. Results:The actual number of officially budgeted positions of the 9 hospitals was less than the theoretical number( Z=-2.55, P=0.011), while the actual number of positions was less than that of theoretical number( t=3.36, P=0.010). The proportion of the officially budgeted position shortage at tertiary hospitals(72.77%)was higher than that of secondary hospitals(36.94%). The proportion of position shortage at tertiary hospitals(16.14%)was less than that at secondary hospitals(38.78%). Conclusions:Area-owned general hospitals are in shortage of human resources, while secondary and tertiary hospitals have different needs for human resources. The actual situation of a hospital should be comprehensively considered to develop an optimal deployment plan for human resources.

Analysis of Peripheral B Cell Subsets in Patients With Allergic Rhinitis

PURPOSE: Recent evidence suggests that B cells can both promote and inhibit the development and progression of allergic disease. However, the characteristics of B cell subsets in patients with allergic rhinitis (AR) have not been well documented. This study aimed to analyze the characteristics of B cell subsets in the peripheral blood of AR patients. METHODS: Forty-seven AR patients and 54 healthy controls were enrolled in this study, and the B cell subsets in peripheral blood of all subjects were analyzed by flow cytometry. Moreover, the serum total immunoglobulin E (IgE) and IgE concentrations secreted into the cultured peripheral blood mononuclear cells (PBMCs) were measured by using enzyme-linked immunosorbent assay. RESULTS: We found the peripheral blood of AR patients contained higher percentages of memory B cells, plasma cells, and CD19+CD24hiCD27+ regulatory B cells (Bregs) than those of age-matched healthy controls (P < 0.05), while the percentages of naïve B cells and CD19+CD24hiCD38hi Bregs were significantly lower in AR patients than in healthy individuals (P < 0.05). In addition, the serum total IgE and IgE concentrations secreted into the cultured PBMCs were elevated in AR patients than in the healthy controls (P < 0.05). CONCLUSIONS: Our findings indicate that AR patients were characterized by increase in terminally differentiated memory B cells or plasma cells and decreases in CD19+CD24hiCD38hi Breg cells in the peripheral blood.

Bibliometric and Visualized Analysis on BPPV Research in China / 听力学及言语疾病杂志

Objective To study the development of research about benign paroxysmal positional vertigo (BP-PV) in China and summarize certain characteristics and hot spots ,so as to provide a basis and direction for further relevant research .Methods CNKI ,CQVIP and wanfang database were used to search relevant literatures published before 2015 .The period sequence ,journal distribution ,productive authors ,research institutions ,high -frequent key words and hot spots were analyzed through bibliometric method and visualization method .Results There were 922 literatures about BPPV research from 1981 to 2015 in China ,involving 2021 authors and 309 research institu-tions ,published in 297 kinds of journal .The literature quantity showed a gradual upward trend on the whole and journals were widely distributed ;core journal group had not yet formed .Top 13 journals (4 .38% ,13/297) had published 292 relevant literatures (31 .67% ,292/922) ,major journals were relatively concentrated ;top 17 authors had published 222 relevant literatures (24 .08% ,222/922) ,top 12 research institutions had published 137 relevant literatures (14 .86% ,137/922);high productive authors mostly came from high productive authority .Through an analysis of keywords ,it is found that BPPV researches mainly focus on pathogenesis ,diagnostic method and treat-ment .New directions have emerged in recent years ,like comparative analysis of drug treatment and manual reduc-tion ,study on the secondary BPPV of sudden deafness and Meniere'sdisease .Conclusion The publishing of 2016 re-vised edition of the guidelines for BPPV diagnosis and treatment will further deepen relevant researches ;literature quantity is expected to continue to grow ;study on the secondary BPPV of sudden deafness and Meniere's disease will be a focus .

The assessment of sequential treatment for subjective and objective benign paroxysmal positional vertigo / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the effectiveness of sequential treatment for subjective and objective benign paroxysmal positional vertigo(BPPV).@*METHOD@#The efficacy of sequential treatment for nineteen vertical semicircular canal S-BPPV patients(Group A) and forty-five vertical semicircular canal O-BPPV patients(Group B) who were admitted to our hospital between January 2014 and July 2015 was retrospectively analyzed and compared, treatment of five cases with horizontal semicircular canal S-BPPV was reported here as well.@*RESULT@#The number of repositioning maneuver for Group A was 2 - 6 times (average: 4. 21±1. 18) while 2 - 3 times (average: 2. 29 ± 0. 46) for Group B. There was significant difference between the two groups(P<0. 01). The effective rate of initial treatment for Group A was 78. 9%(15/19) while 82. 2%(37/45)for Group B. After one weeks treatment, the effective rate for Group A changed to be 89. 5% (17/19)while 88. 9% (40/45) for Group B. Non-significant difference was found in the two groups neither in the initial nor one weeks treatment. On three months' follow-up, one in Group A and two in Group B relapsed, and they were cured after treated in the initial treatment. The recurrence for Group A was 5. 3%(1/19) while 4. 4%(2/45) for Group B and there was non-significant difference. The five cases with horizontal semicircular canal S-BPPV were completely free of disease after undergoing treatment.@*CONCLUSION@#The sequential treatment is effective for both vertical semicircular canal S-BPPV and vertical semicircular canal O-BPPV, but the former needs more repositioning maneuver times. The repositioning maneuver, combined with drug therapy and head-shake-in-supine-position method is recommended for horizontal semicircular canal S-BPPV.

Analysis on the acceptance of the incentive policies for rural health workers in Pudong New Area / 中华医院管理杂志

Objective To learn the acceptance of rural community health workers (CHWs ) following the reform of rural health workers′team building in Pudong New Area.Methods 3 295 CHWs were surveyed with questionnaire for their acceptance of the incentive policies,and chisquare test analysis was used to analyze the differences among CHWs in individual areas.Results Over 80.0% of the CHWs reported that they were motivated by the incentive policies to improve their professional competence, medical service and organizational commitment;40.9% of them reported that the policies improved their social status;and 47.3% of them believed the policies could promote the rural areas to attract and retain talents.When a comparison was made of CHWs′feedbacks on different aspects,significant differences indicated that the proportion of CHWs′positive attitudes was the highest at remote rural communities. Conclusions The rural health workers′team building reform could promote incentive on the CHWs,yet with obvious regional differences.

Relationship between inflammation and blood coagulation function for the prognosis in the patients with acute exacerbation of chronic cor pulmonale / 实用医学杂志

Objective To investigate the relationship between inflammation and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale (AECCP) and discuss the potential mechanism and influence on the patients. Methods The present study was based on 30 healthy controls and 141 cases of AECCP in our hospital from January 2011 to June 2014.Levels of white blood cell (WBC), neutrophil (NEUT), high-sensitivity C-reactive protein (hs-CRP, Complement 3 (C3), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) in the patients were determined. Results Compared with the healthy controls, the patients had higher levels of WBC, NEUT, hs-CRP, PT, APTT, FIB, TT (all P < 0.001) and lower level of C3 (P < 0.001). Significant positive correlations were found between the levels of WBC, NEUT and FIB (r = 0.196 and r = 0.199, both P < 0.05); hs-CRP and APTT, FIB(r = 0.234, P < 0.01 and r = 0.466, P < 0.001); C3 and FIB(r = 0.466, P < 0.001), and significant negative correlations were observed between the levels of C3 and PT, APTT, TT (r=-0.258, P<0.01;r=-0.279, P < 0.01 and r = -0.168, P < 0.05, respectively). Compared with the survival patients, the cases of death had higher levels of WBC and NEUT (both P < 0.01). The area under receiver operating characteristic curve of WBC and NEUT, predicting the prognosis, was 0.666 (95% CI 0.552, 0.780; P < 0.01) and 0.695 (95% CI 0.558, 0.801; P = 0.001) respectively. Conclusions Inflammation and blood coagulation function disorder usually coexist in the patients with AECCP, and are closely associated with the severity. Levels of both WBC and NEUT can be used as prognosis predictors for the patients.

Detection of cytokeratin18 and cytokeratin19 gene expression in blood and tumor tissue of nasopharyngeal carcinoma patients by RT-PCR / 临床耳鼻咽喉头颈外科杂志

UNLABELLED@#Abstract@*OBJECTIVE@#To measure the expression of CK18 and CK19 in the cells from peripheral blood and tumor tissue of the nasopharyngeal carcinoma patients,to test whether CK 18 and CK 19 could be biomarkers of nasopharyngeal carcinoma fordiagnosis.@*METHOD@#The mRNA was extracted from the blood and carcinoma tissue of nasopharyngeal carcinoma and was reversed transcription to cDNA. The 3 pairs primers were designed for RT-PCR and the fold value was calculated to evaluated expression by ΔCT.@*RESULT@#There are no statistical differences between the CK18 and CK19 gene expression and the gender, age and metastasis in tumor tissue of 45 nasopharyngeal carcinoma patients (P>0. 05). There are significant differences among 3 pathological stages and 2 genes expressed increase as the grade malignancy (P<0. 05). The detecting of the 2 genes expression from blood cells shows that CK18 and CK19 had a high positive ratio 64% and 75% respectively. Meanwhile this method showed a same detection characteristic in tumor and blood, the positive.rate of CK18 and CK19 genes in metastasis is higher than non-metastasis. The results showed CK18 has a high specificity and CK19 has a high sensitivity for prognosis and all relapsed cases are associated with the expression of CK18 and CK19.@*CONCLUSION@#CK18 and CK19 may be used as biomarkers of nasopharyngeal carcinoma for diagnosis.

Clinical significance of miRNA-204 in nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of miRNA-204 in patients with NPC and to analyze the as- sociation of the expression with the cIinicopathologicaI features and prognosis.@*METHOD@#The expression levels of miRNA-204 in 50 patients with NPC and 40 patients with nasopharyngeal chronic inflammation were detected by using stem-loop real-time reverse transcription-polymerase chain reaction RT-PCR. Analysis of the relationship between microRNA and prognosis by Kaplan-Meier method.@*RESULT@#Expression levels of miRNA-204 were down- regulated in patients with NPC as compared with patients with nasopharyngeal chronic inflammation (P < 0.05). The expression of miRNA-204 was associated with EBV infection, differentiation, lymphatic metastasis and TNM stages (P < 0.05). Low miRNA-204 expression was significantly correlated with shorter overall survival (P < 0.05) of NPC.@*CONCLUSION@#The downregulation of miRNA-204 expression has related with disease progression and miRNA-204 can serve as a potential therapeutic target for NPC.

A pedigree analysis of pulmonary embolism caused by compound heterozygous mutations of protein C / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the molecular pathogenesis of protein C (PC) deficiency in a patient with pulmonary embolism and in his family members.</p><p><b>METHODS</b>Anticoagulated blood samples were collected from the proband and his family members to detect PC, PS and AT activities. PC antigen level was measured using ELISA. The genomic DNA was extracted to amplify all the 9 exons and their flanking sequences of PC gene using PCR, and the PCR products were sequenced. The mutated exons identified were amplified and sequenced for the other family members.</p><p><b>RESULTS</b>The proband and his parents and sister were identified as carriers of PC gene mutation, which led to type II PC deficiency. Sequencing of the proband's PC gene showed two heterozygous point mutations in exon 3 (G5540A) and exon 7 (C10230T) to cause compound heterozygous mutations of PC E29K and PC R147W, which were inherited from his father and mother, respectively. His sister was a heterozygote of PC R147W.</p><p><b>CONCLUSION</b>The proband is a compourd heterozygous mutations carrier of PC E29K and PC147W. PC E29K is a novel PC mutation, and PC R147W is a reported PC gene mutation seen in patients with type II hereditary PC deficiency and recurrent thrombosis.</p>

The tendency of PAI-1 and TAFI levels in STEMI patients after thrombolytic treatment and its predictive value to restoration of coronary perfusion / 中华急诊医学杂志

Objective To observe the tendency of the plasma concentration of plasminogen activator inhibitor type-1 (PAI-1) and thrombin activatable fibrinolysis inhibitor (TAFI) before and after thrombolytic treatment of acute ST elevation myocardial infarction (STEMI) and to explore their recanalization predictive value of PAI-1 and TAFI for acute myocardial infarction patients with thrombolytic treatment.Methods Sixty patients,who received thromobolytic treatment from January 2007 to March 2009,were prospectively recruited.The blood sample were collected within 2 hours of thromobolytic treatment ( 0,0.5 h,1 h,1.5 h and 2 h).The plasma concentration of TAFI and PAI-1 were test by ELISA.16 healthy people were recruited as control group.Results The plasma levels of PAI-1 in STEMI patients before thrombolytic treatment were higher than those of Control group ( P ＜0.01 ),however the same significant change of TAFI level was not seen.The levels of TAFI were no significant difference before and after thrombolytic therapy during whole observation periods.However,the level of PAI-1 increased at 1.5 h and 2 h after thrombolytic therapy (P ＜ 0.01 ).The plasma PAI-1 levels of no - revascularigation group at 2 h after thrombolytic therapy were significant higher than that in revascularization group ( P ＜ 0.05 ).The levels of TAFI were not significantly different between two groups (P ＞ 0.05).Conclusions The decrease of plasma PAI-1 from high level within 2 hours after thrombolysis treament may be exploring the predictive value for revascularization.The tendency of TAFI can' t forecast the result of revascularization.

Expression and clinical significance of insulin like growth factor-1 protein in nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the expression of IGF-1R protein and its clinical signification in nasopharyngeal carcinoma.@*METHOD@#SP immunohistochemical staining was performed to detect the expression of IGF-1R in 63 cases of NPC and 21 inflammatory nasopharyngeal mucosa; and the expression of IGF-1R in three NPC cell lines and chronic nasopharyngitis tissues was examined by western blots.@*RESULT@#The positive rates of IGF-1R were 82.5% and 14.3% respectively in 63 cases of NPC and 21 inflammatory nasopharyngeal mucosa; it also showed stronger positive expression in Stage III-IV of NPC than that in stage I-II (P < 0 01); IGF-1R positive expression in cases of NPC with cervical lymph node metastasis was significantly higher than that of NPC without lymph node metastasis (P < 0.05); it more often appears in recurrent cases than in primary cases (P < 0.05); IGF-1R positive expression had a significantly stronger in patients whose survival time less than 5 years than that in patients whose survival time over 5 years (P < 0.01).@*CONCLUSION@#Over-expression of IGF-1R is related to poor differentiation of NPC, also may be linked with oncogenesis and development of NPC. The over-expression of IGF-1R may be one of a prognostic factors in NPC. The IGF-1R might be a potential therapeutic target in nasopharyngeal cancer.

Analgesic effect of nimesulide in withdrawing nasal packing after endoscopic sinus surgery / 中华全科医师杂志

Sixty four patients undergoing endoscopic sinus surgery were randomly divided into two groups.In nimesulide group (n=32) patients were given nimesulide capsule 100 mg after surgery and 32 patients in control group were given 100 mg vitamin C as placebo.The visual analogue scale (VAS) was used to evaluate the degree of pain during withdrawing nasal packing.The VAS value of the nimesulide group was 2.8±1.1 3 h after surgery and 2.7±1.2 during with drawing nasal packing,that of control group was 6.7±0.6 and 8.3±0.6,respectively (both P<0.01).The results revealed that nimesulide had a siguificant analgesic effect in endoscopic sinus surgery.

Clinical significance and expression of FLIP and PTEN protein in laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of FLIP and PTEN in laryngeal Squamous cell carcinoma (LSCC), and the relationship between FLIP and PTEN.@*METHOD@#The protein expression of FLIP and PTEN were examined by using immunohistochemical method in 45 cases of LSCC and 15 cases of para-carcinoma tissues.@*RESULT@#FLIP protein positive expressive rate in the laryngeal squamous cell carcinoma cases (77.8%) was higher than that in the para-carcinoma tissues cases (33.3%, P < 0.05). The protein expression of FLIP was correlated with cervical lymph node metastasis, clinical stage and prognosis. On the other hand, PTEN positive expressive rate in the laryngeal squamous cell carcinoma (65.0%) was higher than that in the para-carcinoma tissues (0%, P < 0.01). The protein expression of PTEN was associated with tumor differentiation grade, clinical stage, cervical lymph node metastasis and prognosis. There was a negative relationship between the expression of FLIP and PTEN in LSCC.@*CONCLUSION@#The protein expression of FLIP may be an important prognostic marker for LSCC. The protein expression of PTEN was correlated with clinical stage, tumor differentiation grade, and cervical lymph node metastasis . Consequently, it could be used as a valuable marker for the prognosis of LSCC.

Research on DPOAE of guinea pigs under awake and anesthetic conditions / 生物医学工程学杂志

In order to observe the DPOAE of guinea pigs under awake and anesthetic conditions, we invesitigated the amplitude of distortion product emission and I/O function curves and made a comparative analysis of their changes under different conditions. It was found that the amplitude of DPOAE and I/O curves did not show difference in the guinea pigs under awake and anesthetics conditions. We deem it credible and simple to measure DPOAE in the guinea pigs under awake condition, which is similar to measuring DPOAE in the guinea pigs under physiological condition.