Effects of mechanical cardiopulmonary resuscitation during vertical spatial pre-hospital transport in patients with cardiac arrest: a historical cohort study / 中华危重病急救医学

OBJECTIVE@#To analyze the effect of mechanical cardiopulmonary resuscitation (CPR) on patients with cardiac arrest with the vertical spatial pre-hospital emergency transport.@*METHODS@#A retrospective cohort study was conducted. The clinical data of 102 patients with out-of-hospital cardiac arrest (OHCA) who were transferred to the emergency medicine department of Huzhou Central Hospital from the Huzhou Emergency Center from July 2019 to June 2021 were collected. Among them, the patients who performed artificial chest compression during the pre-hospital transfer from July 2019 to June 2020 served as the control group, and the patients who performed artificial-mechanical chest compression (implemented artificial chest compression first, and implemented mechanical chest compression immediately after the mechanical chest compression device was ready) during pre-hospital transfer from July 2020 to June 2021 served as the observation group. The clinical data of patients of the two groups were collected, including basic data (gender, age, etc.), pre-hospital emergency process evaluation indicators [chest compression fraction (CCF), total CPR pause time, pre-hospital transfer time, vertical spatial transfer time], and in-hospital advanced resuscitation effect evaluation indicators [initial end-expiratory partial pressure of carbon dioxide (PETCO2), rate of restoration of spontaneous circulation (ROSC), time of ROSC].@*RESULTS@#Finally, a total of 84 patients were enrolled, including 46 patients in the control group and 38 in the observation group. There was no significant difference in gender, age, whether to accept bystander resuscitation or not, initial cardiac rhythm, time-consuming pre-hospital emergency response, floor location at the time of onset, estimated vertical height, and whether there was any vertical transfer elevator/escalator, etc. between the two groups. In the evaluation of the pre-hospital emergency process, the CCF during the pre-hospital emergency treatment of patients in the observation group was significantly higher than that in the control group [69.05% (67.35%, 71.73%) vs. 61.88% (58.18%, 65.04%), P < 0.01], the total pause time of CPR was significantly shorter than that in the control group [s: 266 (214, 307) vs. 332 (257, 374), P < 0.05]. However, there was no significant difference in the pre-hospital transfer time and vertical spatial transfer time between the observation group and the control group [pre-hospital transfer time (minutes): 14.50 (12.00, 16.75) vs. 14.00 (11.00, 16.00), vertical spatial transfer time (s): 32.15±17.43 vs. 27.96±18.67, both P > 0.05]. It indicated that mechanical CPR could improve the CPR quality in the process of pre-hospital first aid, and did not affect the transfer of patients by pre-hospital emergency medical personnel. In the evaluation of the in-hospital advanced resuscitation effect, the initial PETCO2 of the patients in the observation group was significantly higher than that of the patients in the control group [mmHg (1 mmHg ≈ 0.133 kPa): 15.00 (13.25, 16.00) vs. 12.00 (11.00, 13.00), P < 0.01], the time of ROSC was significantly shorter than that in the control group (minutes: 11.00±3.25 vs. 16.64±2.54, P < 0.01), and the rate of ROSC was slightly higher than that in the control group (31.58% vs. 23.91%, P > 0.05). It indicated that continuous mechanical compression during pre-hospital transfer helped to ensure continuous high-quality CPR.@*CONCLUSIONS@#Mechanical chest compression can improve the quality of continuous CPR during the pre-hospital transfer of patients with OHCA, and improve the initial resuscitation outcome of patients.

Perifosine inhibits biofilm formation of Pseudomonas aeruginosa by interacting with PqsE protein / 中华预防医学杂志

To explore the biofilm inhibitory efficacy of perifosine against Pseudomonas aeruginosa (P. aeruginos) and its mechanisms. Twenty-fourwell plate was used to form biofilms at the bottom and crystal violet staining was used to determine the biofilm inhibitory effects of perifosine against P. aeruginosa, the wells without perifosine was set as control group. Glass tubes combined with crystal violet staining was used to detect the gas-liqud interface related bioiflm inhibitory effects of perifosine, the wells without perifosine was set as control group. Time-growth curved was used to detect the effects of perifosine on the bacteial planktonic cells growth of P. aeruginosa, the wells without perifosine was set as control group. The interaction model between perifosine and PqsE was assessed by molecular docking assay. The inhibitory effects of perifosine on the catalytic activity of PqsE was determined by detection the production of thiols, the wells without perifosine was set as control group. Binding affinity between perifosine and PqsE was detected by plasma surface resonance. The biofims at the bottom of the microplates and air-liquid interface were effectively inhibited by perifosine at the concentration of 4-8 μg/ml. There was no influence of perifosine on the cells growth of P. aeruginosa. The resuts of molecular docking assay indicates that perifosine could interacted with PqsE with the docking score of -10.67 kcal/mol. Perifosine could inhibit the catalytic activity of PqsE in a dose-dependent manner. The binding affinity between perifosine and PqsE was comfirmed by plasma surface resonance with KD of 6.65×10-5mol/L. Perifosine could inhibited the biofilm formation of P. aeruginosa by interacting with PqsE.

Advance in Neural Control in Eccentric Exercise (review) / 中国康复理论与实践

The nervous system controls eccentric exercise in a special way. During eccentric exercise, excitability increases in cortex, and inhibition decreases, causing excitability decrease in spinal cords. In another hand, increased cortical excitability results in extra excitatory compensation for spinal inhibition. The excitability of the corticospinal pathway depends on the balance between excitability and inhibition of the spinal cord level finally, which usually decreases. Many factors, such as the intensity of contraction, can affect the balance of corticospinal excitability. There is a cross-over effect in eccentric exercise, which promotes corticospinal excitability in untrained limbs. However, the effects and mechanisms of muscle length, fatigue and training duration are still unclear, and current researches have focused in the healthy populations. More researches are needed to explore the effects of eccentric exercise on ill populations.

Sialic acid-binding immunoglobulin-like lectin 9 as a potential therapeutic target for chronic obstructive pulmonary disease / 中华医学杂志(英文版)

Chronic obstructive pulmonary disease (COPD) has become the third-leading cause of death worldwide, which is a severe economic burden to the healthcare system. Chronic bronchitis is the most common condition that contributes to COPD, both locally and systemically. Neutrophilic inflammation predominates in the COPD airway wall and lumen. Logically, repression of neutrophilia is an essential fashion to COPD treatment. However, currently available anti-neutrophilic therapies provide little benefit in COPD patients and may have serious side effects. Thus, there is an urgent need to explore an effective and safe anti-neutrophilic approach that might delay progression of the disease. Sialic acid-binding immunoglobulin-like lectin (Siglec)-9 is a member of the Siglec cell surface immunoglobulin family. It is noteworthy that Siglec-9 is highly expressed on human neutrophils and monocytes. Ligation of Siglec-9 by chemical compounds or synthetic ligands induced apoptosis and autophagic-like cell death in human neutrophils. Furthermore, administration of antibody to Siglec-E, mouse functional ortholog of Siglec-9, restrained recruitment and activation of neutrophils in mouse models of airway inflammation in vivo. Given the critical role that neutrophils play in chronic bronchitis and emphysema, targeting Siglec-9 could be beneficial for the treatment of COPD, asthma, fibrosis, and related chronic inflammatory lung diseases.

Construction of yeast one-hybrid library and screening of transcription factors regulating FPS expression in Ganoderma lucidum / 中草药

Objective: To screen the upstream regulatory transcription factors of farnesyl diphosphate synthase (FPS) in the triterpenoid synthesis pathway in Ganoderma lucidum. Methods: In this study, the FPS promoter was cloned and connected to the pAbAi plasmid to construct bait vector pAbAi-FPS, which was transformed into Y1H yeast competent cells to construct bait yeast. The yeast one-hybrid cDNA library was constructed by using SMART technology, then the purified ds-cDNA and pGADT7-Rec were co-transformed into bait yeast strain to screen the upstream transcriptional regulatory factors of PFS. Results: The bait vector containing pAbAi-FPS was constructed and the bait strain was screened, the cDNA library was constructed and transformed to the bait strain. A total of 37 positive clones were screened and sequenced. The sequences of conserved domain were predicted and performed blast search against the whole-genome database to identify their function. As a result, a total of 18 upstream regulatory factors were screened out including three transcription factors, five ribosomal proteins, and 10 other transcription regulators. Conclusion: The results indicated that transcription factors GlSNF2, GlMHR, and GlZn2Cys6 were candidate genes for regulating the expression of FPS, and this study offered data for further study on the regulation mechanism of FPS expression.

Effect of multiple-modality exercise on symptom clusters and nutritional status of nasopharyngeal carcinoma patients with radiotherapy / 中国实用护理杂志

Objective:To investigate the effect of multiple-modality exercise on symptom clusters and nutritional status of nasopharyngeal carcinoma patients with radiotherapy.Methods:A total of 92 nasopharyngeal carcinoma patients who received radiotherapy in the Panzhihua Center hospital were randomly divided into research group and control group, each group contained 46 cases. The control group received routine nursing and the research group received 4-week multiple-modality exercise. The scores of M.D. Anderson symptom inventory-head & neck module (MDASI-H&N), patient-generated subjective global assessment (PG-SGA) and other biochemical nutrition index were compared before and after intervention between two groups.Results:After intervention, the scores of fatigue, poor appetite, dry mouth, mouth/throat mucus, dysgeusia were 3.77±1.30, 3.48±1.22, 3.81±1.48, 4.24±0.83, 4.94±1.63 in the research group and 4.36±1.09, 4.52±1.25, 4.39±1.24, 4.24±0.83, 6.03±2.00 in the control group, respectively. Those scores were significantly decreased in the research group compared to the control group ( t value was 1.996-3.993, P<0.05). After 4 weeks of intervention, the PG-SGA total socres, body mass index, prealbumin, hemoglobin were 2.78±0.60, (22.08±2.61) kg/m 2, (199.60±27.16) mg/L, (105.59±17.62) g/L, those indexes were 4.14±1.08, (20.63±2.63) kg/m 2, (193.42±25.57) mg/L, (102.77±18.57) g/L, the total scores of PG-SGA were significantly decreased in the research group compared to the control group ( t value was 7.356, P<0.01). Conclusions:Multiple-modality exercise can alleviate symptom burden and promote nutritional status of nasopharyngeal carcinoma patients with radiotherapy.

Effect of Qingjin Huatantang on AECOPD Inflammatory Factors by Regulating p62 / 中国实验方剂学杂志

Objective:To regulate autophagy protein p62 of airway epithelial cells in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) rats with Qingjin Huatantang, in order to explore its effect on interleukin (IL) -1β and tumor necrosis, tumor necrosis factor-α (TNF-α), leukotriene B4 (LTB4), and leukotriene C4 (LTC4). Method:Airway epithelial cells and AECOPD airway epithelial cells were cultured. Sixty SPF male SD rats were randomly divided into 6 groups, namely high, medium and low-dose Qingjin Huatantang groups, western medicine group, model group and normal group. Except for the normal group, the remaining groups were included into the AECOPD model by lipopolysaccharide (LPS) tracheal instillation method + fumigation method. After modeling, the dosage of the high-dose traditional Chinese medicine group was 30 g·kg-1·d-1, that of the middle-dose group was 15 g·kg-1·d-1, that of the low-dose group was 7.5 g·kg-1·d-1, the positive control group was given luo erythromycin (0.017 5 g·kg-1·d-1), the model group and the blank control group were orally given normal saline with the volume of 20 mL·kg-1·d-1. Serum was extracted two weeks after administration, and the cells were intervened with drug-containing serum. The content of interleukin IL-1β, TNF-α, and LTB4 in cell supernatants were detected by enzyme-linked immunosorbent assay (ELISA). And LTC4 content, p62 mRNA and protein expressions in lung airway epithelial cells were detected by quantitative real-time fluorescence polymerase chain reaction (Real-time PCR) and Western blot. Result:Compared with the normal group, ELISA results showed that IL-1β, TNF-α, LTB4, and LTC4 in the model group were significantly increased (P<0.01). Compared with the model group, IL-1β, TNF-α, LTB4, LTC4 in cell supernatants in each administration group were significantly reduced (P<0.01), mRNA and protein expressions in p62 showed that compared with the normal group, mRNA and protein expressions in p62 of model group significantly decreased (P<0.01). Compared with the model group, the mRNA and protein expressions of p62 in each administration group significantly increased to different degrees (P<0.01). The expression of autophagy in Qingjin Huatantang high-dose group and western medicine group was comparable. Conclusion:Qingjin Huatantang can reduce the inflammatory response in airway epithelial cells, which may be related to the regulation of autophagy protein p62.

Analysis of eHealth literacy and its influencing factors among the elderly / 中华疾病控制杂志

Objective To investigate the current status and influencing factors associated with the health literacy of the elderly. Methods 24 communities were randomly selected from Jinan City, and 1 201 elderly people were surveyed by the eHealth literacy scale. Univariate analysis was performed using the Chi-square test and multivariate analysis was performed using binary Logistic regression. Results The qualification rate of eHealth literacy among 1 201 older adults was 11.1%. Multivariate analysis showed that primary school education and below (OR=4.50, 95% CI:1.924-10.530, P=0.001), family pension (OR=3.08, 95% CI:1.326-7.165, P=0.009), poor self-rated health (OR=2.12, 95% CI:1.022-4.406, P=0.044), great self-rated life pressure (OR=4.09, 95% CI:1.686-9.938, P=0.002) were risk factors for eHealth literacy in the elderly; urban household registration (OR=0.52, 95% CI:0.337-0.815, P=0.004), the main person to taking care of grandchildren (OR=0.43, 95% CI:0.273-0.682, P<0.001 ), urban basic medical insurance or NCMS medical insurance (OR=0.22, 95% CI:0.047-0.998, P=0.05), commercial medical insurance (OR=0.10, 95% CI:0.019-0.552, P=0.008) and the parents being alive (OR=0.44, 95% CI:0.264-0.719, P=0.001) were protective factors for the elderly eHealth literacy . Conclusion The type of household registration, the level of education, the type of medical insurance, the way of caring for grandchildren, the way of providing for the elderly, the self-rated of health status, with the parents being alive, and the self-rated life pressure are the influencing factors of the eHealth literacy of the elderly.

Effect of Qingjin Huatan Tang on COPD of Rat Inflammatory Response by Regulating Autophagy / 中国实验方剂学杂志

Objective: To explore the effect of Qingjin Huatan Tang (QJHTD) on the inflammatory response of chronic obstructive pulmonary disease(COPD) rats by observing the autophagy regulating effect of QJHTD on COPD rats. Method: The 50 SPF grade male rats were randomly divided into 5 groups, with 10 rats in each group. In addition to the normal group, the remaining 40 male rats were randomly divided into 5 groups. After the establishment of the hematoxylin and eosin(HE) staining identification model, the drugs were given to the 5 groups by gavage for 2 weeks, high and low-dose QJHTD groups were give the drug at 30, 10 g·kg-1. Roxithromycin positive control group was given the drug at 0.017 5 g·kg-1. The model control group and the normal group were given the same volume of normal saline. At 1 h after the last gavage, the rats were put to death to extract the airway, and the expressions of autophagy microtuble-associated protein light chain 3 (LC3),Beclin-1 were detected by Real-time quantitative PCR (Real-time PCR) and Western blot. Changes of inflammatory cytokines interleukin-6 (IL-6) and interleukin-8(IL-8) were detected by enzyme linked immunosorbent assay (ELISA). Result: Real-time PCR analysis showed that compared with the normal group, Beclin-1 and LC3 mRNA expressions of autophagy factors in the model group were increased to varying degrees(PPPPPConclusion: QJHTD can alleviate the bronchial inflammation in COPD rats, and its mechanism may be related to the inhibition of autophagy in airway epithelium by QJHTD.

Clinical research of iron protein succinate on treatment of pregnant iron deficiency anemia / 中国实用妇科与产科杂志

OBJECTIVE:To evaluate the efficacy and safety of proteinsuccinic iron oral liquid on treatment of irondeficiency anemia in pregnant women by using polysaccharide iron complex as a control drug.METHODS:A total of 28724-28 weeks pregnant women that were diagnosed of IDA were randomly selected from six qualified Grade Ⅲ Ahospitals in Sichuan Province,Shaanxi Province,Guangdong Province,Shandong Province,and Jiangsu Province in2016. 144 cases were randomly Assigned in the control group and 143 cases in the test group. After 2 weeks and 4 weeksof treatment,various efficacy and safety indicators were detected and recorded.RESULTS:The improvement rate ofhemoglobin at 2 weeks and 4 weeks after treatment in the study group were 31.43% and 15.89%,respectively,which werehigher than 7.19% and 3.05% of the control group(P0.05). There was no significantdifference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION:Protein iron succinateoral solution has less adverse reactions,easy absorption,good taste,and has a good therapeutic effect on pregnant irondeficiency anemia.

Application of PDCA for improving cognition of primary cardiopulmonary resuscitation of medical assistants / 中国中西医结合急救杂志

Objective To explore the effect of PDCA [plan (P), design (D), check (C), act (A)] cycle on primary cardiopulmonary resuscitation (CPR) training for medical assistants in hospitals. Methods PDCA cycle was used to enhance continuous quality improvement (CQI) of team members to carry out brain storming to find out the root causes of the training difficulty, and directing to the 3 main root causes: lack of emergency rescue consciousness, without systematic training system and improper education procedure, it was proposed to arrange 3 great strategies: emergency rescue knowledge training, design of systematic training system and proper arrangement of training process. The changes of medical assistants' subjective willingness to perform the first aid, the accurate rates of answering questions on CPR location, frequency, depth, ratio of compression to breathing and awareness degree of CPR before and after training were observed. Results After training, the medical assistants' subjective willingness to perform the first aid was higher than that before training [91.7% (121/132) vs. 2.3% (3/132), P＜0.05]. The accurate answer rates on questions concerning CPR basic knowledge, such as location, frequency, depth and compression-breathing ratio had been greatly improved after training compared with those before training [location: 65.2% (86/132) vs. 4.5% (6/132), frequency: 40.2% (53/132) vs. 0 (0/132), depth: 90.2% (119/132) vs. 0 (0/132), compression-breathing ratio: 84.8% (112/132) vs. 1.5% (2/132 ), all P＜0.05]. After training, the percentage of medical assistants having very familiar awareness degree of CPR was significantly higher than that before training [65.2% (86/132) vs. 3.0% (4/132), P＜0.05]. Conclusion Via CPR training PDCA cycle, not only the efficiency of CPR training management is greatly improved, but also the training effect of participants is significantly elevated.

The application of nanotopography in the development of tissue engineered tissues using mesenchymal stem cells / 生物医学工程学杂志

Tissue engineering has emerged as a promising approach for the repair and functional reconstruction of damaged tissues. The bionic and intelligentized scaffolds provide the structural support for cell growth and differentiation as well as tissue regeneration. The surface properties of the biological material implant, the nanotopology in particular, become key aspects in determining the success of the implant. Mesenchymal stem cells (MSC) are widely favored by researchers as the seed cells in tissue engineering. Recently, it has been shown that nanotopographical characteristics of biomaterials regulate a wide range of MSC properties from their cellular behavior and differentiation potential. Herein, this review will provide an update on studies investigating the roles of nanotopography in the development of tissue engineering using MSC.

Effects of Clinical Pharmacists' Intervention on Rational Drug Use Index of Neurosurgery Department / 中国药师

Objective: To explore the effect of clinical pharmacists participating in the clinical pharmacy work in neurosurgery de-partment and the influence on the rational drug use index. Methods: A retrospective analysis on the monthly drug proportion, antibac-terial drug utilization rate and intensity, and the other indicators before and after the intervention performed by clinical pharmacists in neurosurgery department was carried out, and the consumption sum, DDDs and medical records were statistically analyzed in April and June 2017. Results: After the intervention, the proportion of medicine, hospital days per capita, use rate and intensity of antimicrobial drugs, and the other rational drug use indices were significantly improved in neurosurgery department, and the differences in the indi-ces before and after the intervention were significant (P<0. 01). Conclusion: Consultation practice of clinical pharmacists in neuro-surgery department can effectively assist and guide the clinical treatment and improve the level of rational drug use.

Effectiveness evaluation of the Thyroid Imaging Report and Data System proposed by American Radiological Society (2017) (ACR-TIRADS) for differential diagnosis in thyroid nodules / 中华超声影像学杂志

Objective@#To evaluate the effect of the Thyroid Imaging Report and Data System proposed by American Radiological Society (ACR-TIRADS) for differential diagnosis in thyroid nodules, and compare ACR-TIRADS to the TIRADS proposed by Kwak et al.(K-TIRADS) and the ultrasound-based risk stratification system evaluated by American Thyroid Association (ATA-Risk Stratification).@*Methods@#The clinical data of 1 760 patients with 1 912 thyroid nodules from 8 hospitals in Jiangsu province were retrospectively analysed. All of them were categorized based on ultrasound-based risk stratification systems. The ROC curve was established to assess and compare the diagnostic value of the systems.@*Results@#The area under the ROC curve (AUC) of ACR-TIRADS was 0.830, with high sensitivity and negative predictive value (86.9% and 87.5%, respectively), and relatively low specificity and positive predictive value (64.1% and 62.9%, respectively). The sensitivity and specificity of K-TIRADS were up to 84.9% and 76.1%, respectively. The AUC of ATA-Risk Stratification was 0.852, with relatively high specificity (83.4%), and low sensitivity (79.4%). There were significant differences in the AUC among the three ultrasound-based risk stratification systems, of which K-TIRADS was the highest (P<0.001). There was no significant difference in sensitivity of ACR-TIRADS and K-TIRADS (P=0.137), but significantly higher than that of ATA-Risk Stratification (P<0.001). There were significant differences in the specificity among the three systems, of which ATA-Risk Stratification was the highest (P<0.001). In addition, there were 109 nodules (5.7%) couldn′t be classified based on ATA-Risk Stratification, with high malignancy rate of 31.2%.@*Conclusions@#The diagnostic efficiency of ACR-TIRADS is good, but lower than K-TIRADS and ATA-Risk Stratification. ACR-TIRADS has the highest sensitivity, and ATA-Risk Stratification has the highest specificity, while the overall diagnostic efficiency of K-TIRADS is the best.

Comparative study on genotype distribution of HPV infection in the tissues of cervical squamous cell carcinoma and cervical adenocarcinoma / 医学研究生学报

Objective There are few large sample data reports of comparative study on genotype distribution of human papillomavirus (HPV) infection in the tissues of cervical squamous cell carcinoma and cervical adenocarcinoma in China. This study aimed to investigate the clinical value of genotype distribution of HPV infection in the tissues of cervical squamous cell carcinoma and cervical adenocarcinoma in regional (mainly in Jiangsu Province) patients.Methods We collected 1044 paraffin tissue specimens of female cervical squamous cell carcinoma (826 cases) and cervical adenocarcinoma (218 cases) in 29 hospitals from November 1978 to December 2017. HPV DNA was extracted from the tissues and through the combination of gene-chip and polymerase chain reaction technology, 23 genotypes of HPV were detected in all the tissues of cervical squamous cell carcinoma and cervical adenocarcinoma, and comparative study was conducted on the genotype distribution of HPV infection.Results Among 1044 cases of cervical squamous cell carcinoma and cervical adenocarcinoma, 901 were found with HPV and the detection rate was 86.30%. The detection rate of cervical squamous cell carcinoma was 91.53% (756/826), among which 16，18，58，33，52，31 types were the most common and the detection rate of 16 type was significantly higher than that of 18 types (56.84% vs 9.93%, P0.05).Conclusion The HPV detection rates are different in the regional female cervical squamous cell carcinoma and cervical adenocarcinoma tissues. 16,18,31,33,52 and 58 types are the most common genotypes in cervical squamous cell carcinoma and cervical adenocarcinoma. The detection rate of 16 type is overly higher than that of 18 type in cervical squamous cell carcinoma, while the detection rates of 16 type and 18 type in cervical adenocarcinoma are very close.

The present situation of hospital efficiency evaluation in China:Based on bibiometrics analysis / 中国卫生政策研究

This paper analyzed the present situation on efficiency in hospitals and reasons for the failure of im-plementation. The analysis found that the research experienced a stage of fragmentation-dualization-systematic phase. The research subjects mainly included integrated or general hospitals (84. 21% ), hospitals of Grade II or above (55. 79% ), mixed and local systems (95. 26% ), and public hospitals dominated with 97. 89% , all of the subjects being covered from 22 provinces and municipalities. The comprehensive, technical and pure technical efficiencies had propor-tions of 87. 89% , 68. 84% and 86. 84 respectively and were concentrated in the research content, the evaluation meth-od being mainly DEA and and/or BCC (67. 89% ). The selection of indicators was mainly qualitative (47. 36% for pure literature analysis) and the main indicators were almost internally set. The first three were used in the frequency divi-sion outpatient emergency number (55 visits), number of beds and fixed assets (44) and total expenditures (42). The main sources of data were public access (27. 89% ), internal data (31. 05% ), investigations or various surveys (30. 53% ) and the hospitals’ own data reports (15. 26% ), and more than half (54. 21% ) was single road. Conclusion:The hospital efficiency evaluation focused on the integrated public hospitals above the grade two, mainly based on the relative efficiency of DEA, which involves many contents, wide geographical area and large span but the selection of in-dicators, data sources, and quantification of factors still restrict the quality of the results. The imbalance between the needs of researchers and managers for efficiency evaluation, inadequate understanding ad unbalanced knowledge togeth- er with the lack of relevant policies hindered the transformation of results. Therefore, the consistent mechanism for hospi-tals efficiency evaluation should be established from the angle of top-level design and actual situation of hospitals in China.

Study on the Mechanism and Path of Population Aging Effecting Medical Insurance Fund / 中国卫生经济

Objective:To explore the mechanism and influences of population aging on medical insurance expenditure in China and put forward the improvement strategy of medical insurance.Methods:It constructed the structural equation model based on some related indicators in 31 provinces and cities of China from 2005 to 2015.Results:The indirect effect of population aging on medical insurance fund was higher than the direct effect.Medical expenses had the most influence degree of medical insurance fund.There were action and reaction between per capita GDP and medical insurance fund,while the reaction was much stronger.Conclusion:The government should construct a multi-level mode of disease prevention and control,further increase the government fiscal subsidies for medical insurance,improve the care coverage,and improve the financing mechanisms to develop the sustainable operation of medical insurance fund in China.

Research progress on thymus reconstruction / 中国免疫学杂志

Thymus,a main organ for T cell development,plays a pivotal role in adaptive immune response and dealing with the threaten from pathogens and tumors.With the deep understanding of the thymus,people have been realizing that the thymus is extremely sensitive to acute and chronic injuries as well as involution with age.Thymus regeneration can recover its function to a certain level.Up to now,these methods including adoptive thymic epithelial progenitor cells immunotherapy,injection of IL-2 and angiogenesis factor and regulation of c-Met signal are able to promote thymus recovery and T cell regeneration.

Effects of Speech Therapy in Group on Children with Autism Spectrum Disorders / 中国康复理论与实践

Objective To observe the effect of speech therapy in group on children with autism spectrum disorders(ASD). Methods From July,2014 to July,2015,60 children with ASD were randomly divided into control group(n=30)and ex-perimental group(n=30).Both groups accepted regular rehabilitation training,while the experimental group ac-cepted speech therapy in group in addition,for six months.They were assessed with Autism Behavior Checklist (ABC)and Autism Treatment Evaluation Checklist(ATEC)before and after training,. Results The scores of ABC in both groups decreased after training(t>3.079,P<0.01),and decreased more in the experi-mental group(t=3.149,P<0.01).The score of Health/Physical/Behavior and total score of ATEC decreased in the control group(t>3.018,P<0.01),while the scores of all the items of ATEC decreased in the experimental group (t>2.498,P<0.05)after treatment.The scores of all the items of ATEC decreased more in the experimental group than in the control group(t>2.027,P<0.05). Conclusion The addition of speech therapy in group can further improve the behavior in children with ASD.

Clinical distribution and heterogeneity of antimicrobial resistance of Pseudomonas aeruginosa / 中国感染控制杂志

Objective To understand clinical distribution and antimicrobial resistance characteristics of Pseudomonas aeruginosa(P.aeruginosa)isolated from hospitalized patients, so as to provide reference for the empiric use of antimicrobial agents and control of healthcare-associated infection(HAI).Methods Clinical distribution and antimicrobial susceptibility testing results of P.aeruginosaisolated from patients in a hospital between 2012 and 2016 were analyzed retrospectively, statistical analysis were conducted based on different wards, specimen types and age groups.Results A total of 2 432 strains of P.aeruginosa were isolated from2012 to 2016, most of which were isolated from intensive care unit(ICU)(n=727, 29.89％), the main specimen was sputum(n=2 064, 84.87％). Resistance rates of P.aeruginosa to other antimicrobial agents except piperacillin/tazobactam in each year from 2012 to 2016 were significantly different(all P＜0.05).Resistance to piperacillin, ceftazidime, cefepime, imipenem, meropenem, levofloxacin, and ciprofloxacin decreased after peaked in2014;resistance rates to amikacin, gentamicin, and tobramycin were all low, showing decreased trend year by year(all P＜0.05).Except resistance rates to cefepime and tobramycin, resistance rates of P.aeruginosafrom sputum specimen were all higher than other specimens(all P＜0.05).Resistance rates of P.aeruginosaisolated from patients aged≥65 years to most antimicrobial agents were significantly higher than those isolated from patients aged＜65 years(all P＜0.05).Except resistance rates to gentamicin and tobramycin, resistance rates of P.aeruginosaisolated from ICU were higher than those isolated from other departments, which were 7.71％-66.02％.Resistance rate of P.aeruginosaisolated from department of surgery were relatively low, which were 1.69％-11.86％.Conclusion Clinical distribution of antimicrobial resistance of P.aeruginosais obviously heterogeneity, empiric antimicrobial use and formulation of HAI monitoring measures should be based on the data of antimicrobial resistance in different wards, different infection sites, and different age.