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1.
Article in Chinese | WPRIM | ID: wpr-912827

ABSTRACT

Objective:To analyze the application effect of cluster management measures in improving the quality of emergency medical treatment.Methods:By analyzing the problems existing in the work of emergency department, the cluster management scheme was formulated and the intervention measures were implemented from the aspects of intelligent information system, patient management system and medical service process. The accuracy and efficiency of emergency triage, the satisfaction of patients and medical staff, the incidence of medical complaints and disputes and the rate of sudden death were compared before and after cluster management.Results:Before and after the implementation of cluster management, the accuracy of triage classification was 95.0% and 98.7% respectively, and the triage time was (68.3±12.8) s and (50.5±7.2) s respectively( P<0.001). The satisfaction of patients, doctors and nurses increased, the number of complaints decreased from 15 to 5 in half a year, and the number of sudden death decreased from 39 to 23 with a significant difference( P<0.05). Conclusions:The application of cluster management measures in emergency management can improve the medical quality, the satisfaction of medical staff and patients, and ensure the safety of patients.

2.
Article in Chinese | WPRIM | ID: wpr-912724

ABSTRACT

Objective:To analyze the gastroscopy treatment technology in a Children′s Medical Center based on the diagnosis-related groups(DRG) and put forward suggestions for resource optimization.Methods:The data of the front pages of medical records of 22 medical institutions in a Children′s Medical Center in 2018 were divided into DRG groups. The patients in gastroscope treatment operation group(GK3)were selected, and the disease diagnosis, operation and payment methods of the patients in this group were analyzed.Results:Of the 22 medical institutions, 16 had GK3 group cases, and the number of cases was significantly different, ranging from 2 to 917. Among them, the institution with code M was characterized by multiple endoscopic treatment of esophageal stricture, but most other institutions rarely carried out the treatment of esophageal stricture. In GK3 group, the main payment method of children in Institution M with the highest constituent ratio was at one′s own expense, followed by non-local medical insurance. The main payment type of O and P institutions with the second and third constituent ratio was local medical insurance.Conclusions:The gap of the technology of gastroscopy in the treatment of esophageal stricture is large in all institutions. The high-quality medical resources can be sunk through the construction of pediatric medical alliance, and the gap between the regional medical technology can be continuously leveled.

3.
Clinical Medicine of China ; (12): 39-45, 2021.
Article in Chinese | WPRIM | ID: wpr-884137

ABSTRACT

Objective:To investigate the clinical efficacy of budesonide formoterol combined with tiotropium bromide in the treatment of asthma chronic obstructive pulmonary disease(COPD) overlap (ACO).Methods:From January 2016 to December 2018, 160 ACO patients who met the inclusion criteria in the Department of Respiratory Medicine, Linxi Hospital, Kailuan General Hospitalwere selected as the observation objects.Prospective cohort study was used for observation and analysis.The patients were divided into study group and control group with 80 cases in each group by random number table.Both groups received conventional treatment, on this basis, control group received budesonide and formoterol powder inhalation, 1 inhalation/time, 2 times/d, study group received tiotropium bromide 1 granule/time, once a day based on the control group.Both groups were treated for 12 months.The clinical efficacy, lung function, blood gas analysis, inflammatory factors and T lymphocyte levels were compared between the two groups.Results:The total control rate in study group was 87.5%(70/80), significantly higher than that in control group (70.0%(56/80)), the difference was statistically significant (χ 2=7.32, P<0.05). After treatment, the asthma control test (ACT) scores in both groups increased significantly, while ACT scores in study group((23.12±3.12) point )was significantly higher than that in control group ((20.45±4.28) point, t=4.51, P<0.05). After treatment, the COPD assessment test (CAT) scores in both groups decreased significantly, while CAT scores in study group ((14.25±3.03) point ) was significantly lower than that in control group ((18.69±3.52) point, t=8.55, P<0.05). After treatment, the forced expiratory volume in 1s (FEV1), FEV1%, FEV1 /Forced vital capacity (FEV1/ FVC) and Inspiratory capacity / total lung capacity (IC/TLC) levels in both groups increased significantly, while FEV1((2.20±0.47)L), FEV1%((68.62±7.89)%), FEV1/ FVC((67.63±7.59)%)and IC/TLC levels(48.84±4.86)%) in study group were significantly higher than those in control group ((1.93±0.49)L, (61.88±7.65)%, (62.88±8.41)%, (43.22±5.15)%)(t value were 3.56, 5.49, 3.75, 7.10, all P<0.05). After treatment, the level of partial pressure of oxygen (PaO 2) in both groups increased significantly, while PaO 2 level in study group((78.12±6.45) mmHg) was significantly higher than that in control group ((72.45±7.52) mmHg)( t=5.12, P<0.05). After treatment, the arterial partial pressure of carbon dioxide (PaCO 2) level in both groups decreased significantly, while PaCO 2 level in study group((46.73±7.13) mmHg) was significantly lower than that in control group((49.81±8.02) mmHg) ( t=2.57, P<0.05). After treatment, the levels of IL-6, hs CRP and TNF-α in the two groups were decreased significantly, while IL-6, hs-CRP and TNF-α levels in study group((15.35±6.72) ng/L, (18.14±7.62) mg/L, (56.84±4.92) ng/L) were significantly lower than those in control group((21.42±5.35) ng/L, (23.35±8.64) mg/L, (69.45±8.51) ng/L) (t value were 6.32, 4.05, 11.47, all P<0.05). After treatment, the levels of CD4 + and CD4 +/CD8 + levels in both groups increased significantly, while CD4 + and CD4 +/CD8 + levels in study group((44.20±6.02)%, (1.82±0.31)) were significantly higher than those in control group((38.52±5.56)%, (1.43±0.29)) ( t=6.20, 8.22, all P<0.05). CD8 + level in both groups decreased significantly, while CD8 + level in study group((23.62±7.89)%) was significantly lower than that in control group((27.42±7.65)%)( t=3.09, P<0.05). Conclusion:Budesonide and formoterol combined with tiotropium bromide in the treatment of ACO has good clinical efficacy, reduce the level of inflammation, relieve the clinical symptoms of COPD and asthma, improve the respiratory function and lung function of patients, and have a good effect on improving the cellular immune function.

4.
Chinese Medical Journal ; (24): 1064-1069, 2021.
Article in English | WPRIM | ID: wpr-878160

ABSTRACT

BACKGROUND@#Thyroid dysfunction is associated with cardiovascular diseases. However, the role of thyroid function in lipid metabolism remains partly unknown. The present study aimed to investigate the causal association between thyroid function and serum lipid metabolism via a genetic analysis termed Mendelian randomization (MR).@*METHODS@#The MR approach uses a genetic variant as the instrumental variable in epidemiological studies to mimic a randomized controlled trial. A two-sample MR was performed to assess the causal association, using summary statistics from the Atrial Fibrillation Genetics Consortium (n = 537,409) and the Global Lipids Genetics Consortium (n = 188,577). The clinical measures of thyroid function include thyrotropin (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels, FT3:FT4 ratio and concentration of thyroid peroxidase antibodies (TPOAb). The serum lipid metabolism traits include total cholesterol (TC) and triglycerides, high-density lipoprotein, and low-density lipoprotein (LDL) levels. The MR estimate and MR inverse variance-weighted method were used to assess the association between thyroid function and serum lipid metabolism.@*RESULTS@#The results demonstrated that increased TSH levels were significantly associated with higher TC (β = 0.052, P = 0.002) and LDL (β = 0.041, P = 0.018) levels. In addition, the FT3:FT4 ratio was significantly associated with TC (β = 0.240, P = 0.033) and LDL (β = 0.025, P = 0.027) levels. However, no significant differences were observed between genetically predicted FT4 and TPOAb and serum lipids.@*CONCLUSION@#Taken together, the results of the present study suggest an association between thyroid function and serum lipid metabolism, highlighting the importance of the pituitary-thyroid-cardiac axis in dyslipidemia susceptibility.


Subject(s)
Lipid Metabolism/genetics , Mendelian Randomization Analysis , Thyroid Function Tests , Thyroid Gland , Thyrotropin , Thyroxine , Triiodothyronine
5.
Article in Chinese | WPRIM | ID: wpr-811547

ABSTRACT

Novel coronavirus pneumonia, which has emerged in Wuhan since the end of 2019, has posed a huge challenge for medical institutions in the city. Rapid completion of a number of cabin hospitals plays a vital role in preventing further spreading of the epidemic, by means of collecting and treating mild patients of the disease. This paper presents the key process of Tongji Hospital in its rapid informatization since it took over a cabin hospital. Based on the network architecture of the Tongji cloud platform, the shared service center is used to share data and integrate services between the cabin hospital and Tongji hospital. This practice can prevent cross-infection and improve service efficiency as well, hence offering a reference for future information infrastructure development of cabin hospitals.

6.
Clinical Medicine of China ; (12): 314-318, 2020.
Article in Chinese | WPRIM | ID: wpr-867534

ABSTRACT

Objective:To investigate the changes of nitric oxide, endothelin-1 (ET-1), homocysteine (Hcy), C-reactive protein (CRP) levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) combined with hypertension and the relationship between the changes and polysomnography monitoring indicators.Methods:A retrospective case-control study was conducted to analyze the clinical data of 115 patients with OSAHS complicated with hypertension, 110 patients with simple OSAHS and 136 healthy persons in Kailuan general hospital and Linxi Hospital of Kailuan general hospital from March 2016 to March 2018. The relationship between sleep related indexes and serological indexes was compared among the three groups.Results:In the control group, simple OSAHS group, OSAHS with hypertension group, the apnea hypopnea index (AHI) was (2.4±0.8), (35.7±12.1), (46.8±13.9) times/h, the lowest oxygen saturation(LSaO 2) was (87.1±6.8) %, (77.8±6.5) %, (66.9±5.1) %, and the mean oxygen saturation(MSpO 2) was (92.7±6.9) %, (80.9±6.7) %, (71.4±6.3) %, and the longest apnea time (LAT) was(4.5±0.7), (48.6±11.3), (58.2±10.4) s. The difference between the three groups was statistically significant ( F values were 637.92, 329.49, 322.96, 1 420.03, respectively, all P<0.05). Nitric oxide in control group, simple OSAHS group and OSAHS combined with hypertension group were (72.8±8.8), (53.7±7.4), (42.6±5.9) μmol/L.Endothelin-1 was(31.1±6.5), (45.4±6.7), (56.6±7.8) ng/L.Hcy was (8.7±1.9), (15.9±6.7), (31.4±6.3) μmol/L.CRP was (1.8±0.6), (18.6±4.3), (25.2±6.4) mg/L.The difference between the three groups was statistically significant ( F valves were 517.46, 419.02, 594.40, 982.14, respectively, all P<0.05). Pearson correlation analysis showed that the levels of endothelin 1, Hcy and CRP in OSAHS patients with hypertension were positively correlated with AHI and LAT (r values were 0.525, 0.704, 0.578, 0.434, 0.464 and 0.449, respectively; all P<0.05), and negatively correlated with LSaO 2 and MSpO 2 (r values were-0.477, -0.458, -0.429, -0.517, -0.534 and -0.617, respectively; all P<0.05). Conclusion:In OSAHS patients with hypertension, nitric oxide decreased, ET-1, Hcy, CRP increased, and polysomnography monitoring indicators were closely related to endothelin-1, Hcy, CRP.

7.
Article in Chinese | WPRIM | ID: wpr-872271

ABSTRACT

COVID-19 has posed a huge challenge for medical institutions in the city. Rapid completion and operation of a number of cabin hospitals has played a vital role in preventing further spreading of the epidemic, by means of collecting and treating mild patients of the disease. This paper presented the key process of Tongji Hospital in its rapid informationization since it took over a cabin hospital. Based on the network architecture of the Tongji cloud platform, the shared service center is used to share data and integrate services between the cabin hospital and Tongji Hospital. This practice can prevent cross-infection and improve service efficiency as well, hence offering a reference for future information infrastructure development of cabin hospitals.

8.
Article in Chinese | WPRIM | ID: wpr-868729

ABSTRACT

Objective:To determine the role of type Ⅱ alveolar epithelial stem cells (AEC Ⅱ) in radiation-induced pulmonary injury and investigate the potential mechanism by observing the dynamic changes in the expression levels of anti-prosurfactant protein C (proSP-C) proSP-C (AEC Ⅱ biomarker), homeobox only protein X (HOPX, type I alveolar epithelial cell biomarker) or vimentin (a mesenchymal marker) and transforming growth factor β 1(TGF-β 1), a profibrotic cytokine. Methods:Eight-week old C57BL/6j female mice were exposed to X-ray thoracic irradiation. Mouse lungs were collected at 8 different time points of 24 h, 1 week, 1 to 6 months after irradiation. The histopathological changes of the lungs at different time points were observed with H& E staining to determine the time of formation of pulmonary fibrosis. In addition, the co-expression of proSP-C with HOPX or vimentin in AEC Ⅱ was confirmed by immunofluorescence staining to track AEC Ⅱ phenotypes at different injury phases following thoracic irradiation. The expression levels of those proteins and TGF-β 1 were quantitatively detected by Western blot. Results:After thoracic exposure to a single dose of 20 Gy X-ray for 3 months, the fibrotic lesions in the lungs could be noted. The co-expression of proSP-C with vimentin or HOPX could be observed in AEC Ⅱ. Western blot demonstrated that the expression levels of TGF-β 1 and those proteins were also changed along with the lung injury. Conclusion:AEC Ⅱ can be differentiated into mesenchymal-like cells after X-ray irradiation due to the up-regulated expression of TGF-β 1, which is a potential cause of radiation-induced pulmonary fibrosis.

9.
Article in English | WPRIM | ID: wpr-773398

ABSTRACT

OBJECTIVE@#Identification of new risk factors is needed to improve prediction of adverse outcomes in patients with three-vessel disease (TVD). The present study aimed to evaluate the prognostic values of serum chloride and sodium levels in patients with TVD.@*METHODS@#We used data from a prospective cohort of consecutive patients with angiographically confirmed TVD. The primary endpoint was all-cause death. Cox proportional hazard regression was used to analyze the relationship of serum chloride and sodium levels with long-term outcomes of TVD patients.@*RESULTS@#A total of 8,318 participants with available serum chloride and sodium data were included in this analysis. At baseline, patients in the low tertiles group of serum chloride level (⪕ 102.0 mmol/L) or serum sodium level (⪕ 139.0 mmol/L) had more severe disease conditions. During a median follow-up of 7.5-year, both low serum chloride level and low serum sodium level were found to be associated with an increased risk for mortality in univariate analysis. However, when both parameters were incorporated into a multivariate model, only low serum sodium level remained to be an independent predictor of all-cause death (hazard ratio: 1.16, 95% confidence interval: 1.01-1.34, P = 0.041). Modest but significant improvement of discrimination was observed after incorporating serum sodium level into the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery score.@*CONCLUSION@#Serum sodium level is more strongly associated with long-term outcomes of TVD patients compared with serum chloride level. Low serum sodium level is an independent risk factor for mortality, but only provides modest prognostic information beyond an established risk model.


Subject(s)
Aged , China , Epidemiology , Chlorides , Blood , Coronary Artery Disease , Blood , Diagnosis , Mortality , Female , Humans , Male , Middle Aged , Prognosis , Prospective Studies , Sodium , Blood
10.
Chinese Journal of Cardiology ; (12): 447-451, 2019.
Article in Chinese | WPRIM | ID: wpr-810665

ABSTRACT

Objective@#To determine the impact of low T3 syndrome on adverse cardiovascular events in adult patients with acute viral myocarditis.@*Methods@#The study population consisted of 134 consecutive patients admitted between January 2002 and March 2018 with diagnoses of acute viral myocarditis (onset of symptoms<1 month,patients were divided into low serum free triiodothyronine (FT3, n=20) group and normal FT3 (n=114) group. General information, clinical presentation,electrocardiography at admission,laboratory tests,echocardiography features were analyzed. Low T3 syndrome was defined as a state with decreased FT3 and total triiodothyronine (TT3), normal or decreased free thyroxine (FT4) and total thyroxine (TT4) as well as normal thyroid stimulating hormone (TSH). Composite adverse cardiovascular events included death, persistent ventricular tachycardia (VT) or ventricular fibrillation (VF) and cardiac arrest. Risk factors related with composite adverse cardiovascular events in adult patients with acute viral myocarditis were analyzed by logistic regression analysis.@*Results@#Systolic blood pressure was significantly lower (P<0.01),while heart rate (P=0.004) and the prevalence of VT/VF were significantly higher (P=0.017) in low T3 group than in the normal T3 group. Level of white blood cell,C response protein,fasting glucose (all P<0.01) as well as creatinine (P=0.035) were significantly higher, while level of FT3 and left ventricular ejection fraction (LVEF) were significantly lower (both P<0.01) in low T3 group than in normal T3 group. Multivariate logistic regression analysis revealed that LVEF at admission less than 40% (OR=6.615,95%CI 1.186-36.907, P=0.031) and FT3 level less than 1.79 ng/L (OR=9.131, 95%CI 1.577-52.857, P=0.014) were independent risk factors of increased composite adverse cardiovascular events in patients with acute viral myocarditis.@*Conclusion@#Low FT3 increases the risk of adverse cardiovascular events in adult patients with acute viral myocarditis.

11.
Chinese Journal of Immunology ; (12): 431-435, 2018.
Article in Chinese | WPRIM | ID: wpr-702748

ABSTRACT

Objective:To investigate the value of autoantibodies and serum levels of IgG4 and CA19-9 in the diagnosis of IgG4 associated cholangitis (IgG4-SC).Methods:Detect the serum IgG4 and CA19-9 of 41 clinical cases of IgG4-SC patients,162 clinical cases of non IgG4-SC patients and 40 healthy human serum samples by immunoassay and direct chemiluminescence methods, also detect the antinuclear antibodies (ANA),anti neutrophil antibody (ANCA),anti smooth muscle antibody (SMA) and anti mitochondrial antibody (AMA) of the above serum samples by indirect immunofluorescence and analyze the detection results.Results:①The positive rates of ANA,ANCA,SMA and AMA in patients with IgG4-SC were 41.46%,7.32%,0 and 2.44%.Among them,the positive rate of ANA was significantly different from that of the normal control group(P<0.01),and the positive rate of SMA and AMA was significantly different from that of non IgG4-SC group(P<0.01),and so as the positive rate of ANCA do with that of PSC group.②The number of serum IgG4 and CA19-9 increased samples were significantly compared with the normal control group (P<0.01);the area under the ROC curve (AUC) was 0.979 and 0.646,respectively,and P<0.05.Conclusion:The high level of serum IgG4 and CA19-9 and autoantibody detection are of great accuracy and important clinical value in the differential diagnosis of IgG4-SC.

12.
Chinese Medical Journal ; (24): 1-9, 2018.
Article in English | WPRIM | ID: wpr-324693

ABSTRACT

<p><b>BACKGROUND</b>Patients with premature triple-vessel disease (PTVD) have a higher risk of recurrent coronary events and repeat revascularization; however, the long-term outcome of coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and medical therapy (MT) alone for PTVD patients is controversial. The aim of this study is to evaluate the long-term outcome of PTVD patients among these three treatment strategies, to find out the most appropriate treatment methods for these patients.</p><p><b>METHODS</b>One thousand seven hundred and ninety-two patients with PTVD (age: men ≤50 years and women ≤60 years) were enrolled between 2004 and 2011. The primary end point was all-cause death. The secondary end points were cardiac death, myocardial infarction, stroke, or repeat revascularization.</p><p><b>RESULTS</b>PCI, CABG, and MT alone were performed in 933 (52.1%), 459 (25.6%), and 400 (22.3%) patients. Both PCI and CABG were associated with lower all-cause death (4.6% vs. 4.1% vs. 15.5%, respectively, P < 0.01) and cardiac death (2.8% vs. 2.0% vs. 9.8%, respectively, P < 0.01) versus MT alone. The rate of repeat revascularization in the CABG group was significantly lower than those in the PCI and MT groups. After adjusting for baseline factors, PCI and CABG were still associated with similar lower risk of all-cause death and cardiac death versus MT alone (all-cause death: hazard ratio [HR]: 0.35, 95% confidence interval [CI]: 0.23-0.53, P < 0.01 and HR: 0.35, 95% CI: 0.18-0.70, P = 0.003, respectively, and cardiac death: HR: 0.32, 95% CI: 0.19-0.54, P < 0.01 and HR: 0.36, 95% CI: 0.14-0.93, P = 0.03, respectively).</p><p><b>CONCLUSIONS</b>PCI and CABG provided equal long-term benefits for all-cause death and cardiac death for PTVD patients. Patients undergoing MT alone had the worst long-term clinical outcomes.</p><p><b>TRIAL REGISTRATION</b>ClinicalTrials.gov; Identifier: NCT02634086. https://www.clinicaltrials.gov/ct2/show/record/NCT02634086?term=NCT02634086&rank=1.</p>

13.
Chinese Journal of Cardiology ; (12): 1049-1057, 2017.
Article in Chinese | WPRIM | ID: wpr-809652

ABSTRACT

Objective@#To compare the effectiveness of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) or medical therapy (MT) alone for real-world stable coronary artery disease (SCAD) patients with three-vessel disease (TVD) in mainland China.@*Methods@#A total of 8 943 consecutive cases with TVD hospitalized in our center from April 2004 to February 2011 were screened for this study. In this cohort, 3 435 cases diagnosed as SCAD were analyzed. PCI, CABG, MT alone were performed in 1 313 (38.2%), 1 259 (36.7%) and 863 (25.1%) patients, respectively. Propensity score matching (PSM) analysis using nearest neighbor matching with a 1∶1 ratio was applied, and 758 pairs of CABG and PCI groups, 552 pairs of PCI and MT groups, 639 pairs of CABG and MT groups were selected, respectively. 1- and 2-year clinical outcomes were evaluated among PCI, CABG and MT group. Kaplan-Meier curves and multivariable Cox regression method were used for survival analysis.@*Results@#Significant differences were found at baseline between PCI, CABG and MT group, including age, gender, body mass index, family history of coronary artery disease, hyperlipidemia, diabetes mellitus, previous myocardial infarction, stroke, previous revascularization, peripheral vascular disease, SNYTAX score, left ventricular ejection fraction, hemoglobin, serum creatinine, high-sensitivity C-reactive protein, triglyceride and medication (all P<0.05) . All-cause death rates of 1- and 2-year follow-up of PCI, CABG and MT group were 0.6% (8/1 313), 1.1% (14/1 259), 3.4% (29/863) (P<0.001) and 1.1%(14/1 313), 1.5%(19/1 259), 7.3%(63/863) (P<0.001), respectively. Multivariate Cox regression analysis showed that 1-year MACCE rate (HR=0.51, 95%CI 0.33-0.77, P=0.001) was significantly reduced, due to the significant decrease of myocardial infarction (MI) rate (HR=0.09, 95%CI 0.01-0.76, P=0.027) and repeat revascularization rate (HR=0.21, 95%CI 0.10-0.41, P<0.001) in CABG group compared to PCI group, while all-cause death (HR=1.21, 95%CI 0.48-3.00, P=0.69) and stroke rate (HR=2.31, 95%CI 0.82-6.47, P=0.112) were similar between 2 groups. 2-year outcome showed CABG was associated with higher stroke rate (HR=2.20, 95%CI 1.06-4.55, P=0.034) and lower MI (HR=0.19, 95%CI 0.06-0.59, P=0.004) and repeat revascularization rate (HR=0.22, 95%CI 0.13-0.37, P<0.001), and lower MACCE rate (HR=0.49, 95%CI 0.36-0.68, P<0.001). Compared to MT group, 2-year all-cause death (HR=0.22, 95%CI 0.12-0.42, P<0.001) and MACCE rate (HR=0.63, 95%CI 0.47-0.83, P=0.001) were lower in PCI group, while 2-year all-cause death (HR=0.21, 95%CI 0.13-0.37, P<0.001), MACCE (HR=0.31, 95%CI 0.23-0.42, P<0.001), MI (HR=0.19, 95%CI 0.06-0.60, P=0.004) and repeat revascularization rate (HR=0.24, 95%CI 0.13-0.41, P<0.001) were lower in CABG group. Results of multivariate Cox regression analysis after PSM were consistent with above results.@*Conclusion@#For SCAD patients with TVD, CABG shows better effectiveness by reducing MI and revascularization risk as compared to PCI, even though stroke risk is somehow higher in CABG patients. Patients received MT alone are associated with worse outcomes than those undergoing revascularization strategies.

14.
Article in Chinese | WPRIM | ID: wpr-667175

ABSTRACT

This paper briefly introduced the evaluation systems widely used in hospital informationization,namely that of the EMRAM of HIMSS of the United States,that of the electronic medical record function and application level grading,and that of hospital information interoperability standardization maturity used in China. A comparative study was made on those evaluation systems in terms of their evaluation objective,evaluation content,grading solution,evaluation method and evaluation process etc. It is held that the three evaluation systems are essentially an evaluation of the overall level of hospital informationization, yet each has different emphases and differences, and its rational application can guide and promote hospital informationization.

15.
Article in Chinese | WPRIM | ID: wpr-666687

ABSTRACT

The binding mechanism between pterostilbene ( PTE) and human serum albumin ( HSA) was investigated by fluorescence spectrometry and surface enhanced Raman spectroscopy (SERS) under simulated physiological conditions. The experiment result showed that the effect between PTE and HSA was a static fluorescence quenching with F?rsterˊ s non-radioactive energy transformation, and PTE could bind HSA strongly with a 1: 1 molar ratio. The binding distances between PTE and HSA was 1. 495 nm, and the binding constants (KA) between PTE and HSA were 1. 12 × 104 (298 K), 4. 07 × 104 (304 K) and 2. 45 × 105 L/ mol (310 K). SERS revealed that PTE combined with HAS by methoxy group. Thermodynamic data indicated that the interaction between PTE and HSA was mainly hydrophobic interaction. Marker competition experiments pointed out that the primary binding site for PTE was located at site Ⅲ in HSA. Three-dimensional, synchronous fluorescence spectrum and SERS showed that the conformation of HSA changed apparently with the addition of PTE, resulting in the tryptophan residue of HSA exposing to a less hydrophobic micro-environment. However, the conformation of PTE did not change apparently with the addition of HSA.

16.
Article in Chinese | WPRIM | ID: wpr-350165

ABSTRACT

Urinary tract infection (UTI) in traditional Chinese medicine (TCM) belongs to the category of stranguria. This article describes the unsatisfactory situations in clinical practice such as antibiotics abuse, increasing of drug-resistant bacteria, high recurrence rate, etc. According to evidence-based medicine, literatures as evidence are collected for summarizing and analyzing and the result shows the advantages of TCM of relieving symptoms, reducing the dosage of antibiotics, less side effects, lower recurrence rate, etc. In the field of fundamental research, literatures associated with UTI are also summarized and analysed from several perspectives, such as causes, pathogenesis, syndrome differentiation, pharmacological effects of Chinese herbal medicine, working mechanism of non-drug therapy, etc and the result presents that integrated treatment of TCM in UTI has significant advangtages and its own characteristic.

17.
Article in Chinese | WPRIM | ID: wpr-496195

ABSTRACT

Objective To investigate the efficacy of biphasic insulin aspart 50(BIAsp50)twice daily(bid) versusbiphasichumaninsulin50(BHI50)(bid)plusmetforminonbloodglucosecontrolfollowingastandardmealtest in Chinese patients with type 2 diabetes mellitus(T2DM). Methods A randomized, open-label, 2-sequence, crossover trial for two 4-week treatment periods was conducted in 14 Chines institutes. Eligible subjects inadequately controlled with BHI50(bid)plus metformin were randomized to two sequences in a 1 : 1 ratio(A:BIAsp50-BHI50, B:BHI50-BIAsp50 ) . Standard meal tests were performed at baseline and the ends of two periods within 4 weeks. Primary endpoint was 2h postprandial plasma glucose ( PPG) increment following standard meal test, with insulin dose standardized at 0. 3 IU/kg. Results A total of 161 subjects were randomized into two sequences(81 to sequence A, and 80 to sequence B) and finally analysed. After 4 weeks of treatment, mean 2h PPG increment with BIAsp50 was lower than that with BHI50 [ treatment difference of BIAsp50 vs BHI50: -1. 12 mmol/L ( 95% CI-1. 66,-0. 58), P<0. 01], suggesting superiority of BIAsp50 over BHI50. Incremental area under the curve for PPG(0-2 h)with BIAsp50 was lower than that with BHI50 [treatment difference:-38. 8 mmol·L-1·min-1(95%CI-77. 3,-0. 26), P=0. 049], as was the mean 2h PPG [treatment difference:-0. 58 mmol/L(95% CI -1. 13,-0. 03), P=0. 040]. The FPG value with BIAsp50 was higher than that with BHI50 [treatment difference:0. 52 mmol/L(95%CI 0. 18, 0. 86), P=0. 003]. The rate of nocturnal hypoglycemia with BIAsp50 was lower than that with BHI50(1. 13 vs 2. 86 events per subject year, P<0. 01). Conclusion In patients with T2DM inadequately controlled with BHI50 plus metformin, BIAsp50 was proven to be well-tolerated with improved postprandial glucose control compared with BHI50.

18.
Article in Chinese | WPRIM | ID: wpr-672272

ABSTRACT

This paper presents some ideas and practices to realize the homogeneity quality management process within the Beijing Children Hospital Group,the largest specialized medical group in the country.This research aims at providing references and thoughts on homogeneity quality management for trans-regional medical unions in the country.

19.
Article in Chinese | WPRIM | ID: wpr-602533

ABSTRACT

In 2012,Beijing Children’s Hospital established the Beijing Children’s Hospital Group to explore the new model of public hospital reform.This study covered the target setting,management framework,network system,and sharing mechanism of the group,and discussed the merits and setbacks of such a practice,for insights of public hospital reform.

20.
Journal of Clinical Hepatology ; (12): 1675-1677, 2015.
Article in Chinese | WPRIM | ID: wpr-778203

ABSTRACT

ObjectiveTo investigate the identification and treatment of variation of extrahepatic bile duct in laparoscopic cholecystectomy (LC), and to reduce the occurrence of bile duct injury. MethodsThis study included 60 patients who received LC in the People′s Hospital of Caidian District in Wuhan and had structural variation of extrahepatic bile duct found during the operation from January 2012 to January 2014. The clinical data were retrospectively analyzed, and the intraoperative and postoperative conditions were summarized. ResultsDuring operation, cystic duct variation was found in 32 cases, abnormal position of the point where the cystic duct joins the extrahepatic bile duct in 20 cases, the cystic duct and the common hepatic duct having the common wall before joining the common bile duct in 2 cases, aberrant bile duct in the gallbladder bed in 2 cases, and accessory hepatic duct in 4 cases. Fifty-one patients (85%) successfully underwent LC; 9 patients (15%) were converted to open surgery. All patients finished surgery successfully. There were 2 cases of postoperative complications; one patient developed residual stones in the bile duct, and bile leakage occurred in the other patient at one week after LC, who recovered after reoperation. All patients were cured and discharged, without severe complications such as intraperitoneal hemorrhage, infection, and intestinal injury. ConclusionIdentifying the structural variation of extrahepatic bile duct, dissecting the Calot′s triangle meticulously, and determining the type of variation of extrahepatic bile duct play important roles in LC and significantly reduce the incidence of bile duct injury.

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