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It is of great significance to construct an information platform for performance appraisal of tertiary public hospitals to realize real-time monitoring and intervention of appraisal indicators, which is conducive to the transmission of responsibility for index optimization to departments and medical groups, and to promote the fine management of hospitals and promote high-quality development.This paper introduced the practice and effect of building a performance appraisal information platform for tertiary public hospitals in four aspects: accurate data filling, timely dynamic monitoring, visual display and safety management since 2022. At the same time, suggestions were put forward for platform optimization from four aspects: data quality control, co-construction and sharing, promotion and application, and system integration, in order to provide reference for other hospitals.
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The expert committee is an important force in promoting the scientific,democratic,and standardized decision-making and management of hospitals.At present,although hospitals can establish a categorized expert committee system in accordance with the requirements of the health administrative department,there is still a gap between the role of the expert committee and the original intention of the system design.It is based on the perspec-tive of evaluation standards and normative document requirements for graded hospitals,summarizes and analyzes the main expert committee category system in hospitals,explores the problems,constraints,and improvement sug-gestions for the role of expert committees,in order to better promote scientific,democratic,and standardized deci-sion-making in hospitals.
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Public welfare orientation is the core requirement of public hospital reform. A profound understanding of the connotation of public welfare in public hospitals is related to the effectiveness of deepening the reform and implementation of public hospitals guided by public welfare. The author reviewed and sorted out the historical evolution process of public hospital reform guided by public welfare, summarized and condensed the core connotation of public hospital public welfare, including " legal obligations, system concepts, people′s positions, and inclusive goals", and introduced the practice of deepening the public welfare reform of public hospitals based on the connotation of Union Hospital affiliated with Tongji Medical College of Huazhong University of Science and Technology based on this connotation, focusing on " party building, medical technology, health emergency response, improvement of services, salary distribution, economic operation, resource expansion and sinking" .
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Greenspace may bring benefits to human health. Evidence on greenness and health has accumulated in western countries, and several reviews have summarized such evidence. Researchers have also conducted some studies on greenspace and human health in Chinese population, but no prior review has pooled or summarized them. To provide more comprehensive evidence on this topic, we searched and summarized studies on greenspace and health that were conducted specifically in Chinese population. We found that a certain number of studies have been conducted in China, and the evidence indicates that greenspace exposure may reduce the odds of cardiovascular diseases, mental health disorders, adverse birth outcomes as well as mortality. However, most of the current reported studies were of cross-sectional design or randomized controlled trails targeting short-term effects, and prospective cohort studies were scarce. Moreover, greenness exposure was mainly assessed using greenness index like normalized difference vegetative index (NDVI), which were static and cannot distinguish construction and species of greenspaces. Future prospective studies with more precise greenness exposure assessment are warranted to evaluate the prior findings.
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The development characteristics of tertiary public hospitals in China presented differently under the macro environment in different periods. Based on the theory of supply and demand chain of medical services, the authors discussed the key factors affecting the high-quality development of tertiary public hospitals under the new situation from the four elements of production, distribution, circulation and consumption, and put forward countermeasures and suggestions as follows: optimizing the supply of medical talents and system construction in the production process; speeding up the layout of high-quality resources and the construction of an integrated medical service system in the distribution process; strengthening imformation construction and the scientific and technological innovation in the circulation process; expanding healthcare/prevention integration and refining supporting policies in the consumption process, so as to provide reference for accelerating the high-quality development of public hospitals in China.
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In recent years, China has issued many laws and regulations on enhancing hospital security order management, and the related system has been gradually improved. However, the management requirements of hospitals are hard to implement. In this way, hospitals have burdened intensive internal pressure to implement the policies, with the dilemma of insufficient external support. Based on the perspective of social co-governance, this study discussed the development of policies related to hospital security order management in China. Also, it summarized the best practices about how to ensure hospitals security order from the aspects of the government, hospitals as well as social organizations. Additionally, it analysed current existing problems, such as the lack of sufficient cooperation of the police-doctor linkage mechanism, the inadequate implementation of technical prevention measures, the delayed mediation and disposal of doctor-patient contradiction, the imperfect of supporting policies and etc.Finally, this paper provided relevant suggestions on long-term mechanism to ensure the security order of hospitals.
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From the perspective of technical evaluation, this article introduces the focus of clinical evaluation of dental implants (systems) in comparison with the comparable devices and discusses the clinical evaluation of such products，combined with the clinical evaluation review of dental implants (systems) products in recent years, in order to provide reference for the registration of these products.
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Dental ImplantsABSTRACT
Lipid metabolism disorders contribute to hyperlipidemia and hepatic steatosis. It is ideal to develop drugs simultaneous improving both hyperlipidemia and hepatic steatosis. Nitazoxanide is an FDA-approved oral antiprotozoal drug with excellent pharmacokinetic and safety profile. We found that nitazoxanide and its metabolite tizoxanide induced mild mitochondrial uncoupling and subsequently activated AMPK in HepG2 cells. Gavage administration of nitazoxanide inhibited high-fat diet (HFD)-induced increases of liver weight, blood and liver lipids, and ameliorated HFD-induced renal lipid accumulation in hamsters. Nitazoxanide significantly improved HFD-induced histopathologic changes of hamster livers. In the hamsters with pre-existing hyperlipidemia and hepatic steatosis, nitazoxanide also showed therapeutic effect. Gavage administration of nitazoxanide improved HFD-induced hepatic steatosis in C57BL/6J mice and western diet (WD)-induced hepatic steatosis in Apoe -/- mice. The present study suggests that repurposing nitazoxanide as a drug for hyperlipidemia and hepatic steatosis treatment is promising.
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In the case of public emergency, cross regional and institutional deployment of health technicians as a contingency measure is imperative in alleviating the shortage of medical resources and improving the medical capacity in the location of emergency. The authors rounded up common modes of such deployment, namely independent deployment of a complete organization, deployment by job division for individual responsibility, deployment of individuals joining in a cooperative action, and that of expert guidance. In practice, the emergency deployment of health technicians was faced with serial challenges, such as their mobility, interoperability, professionalism, economy and persistence. To improve the performance of emergency deployment, it is necessary to strengthen the routine emergency skill reserve and simulation drill, to formulate " wartime" joint diagnosis and treatment decision-making rules, to build high-level health emergency teams, to establish and improve a complete, flexible and orderly deployment mechanism of such human resources, and to improve the honor award and reward system for health emergency personnel.
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Objective:This study by using the method of network pharmacology to screen the active constituent and related targets of Epimedii Folium aims to explore the mechanisms of the reinforcing effect of Epimedii Folium on kidney in the treatment of PCOS. Methods:By retrieving data from TCMSP datebase, screened out the active constituent of Epimedii Folium and the information of the targets corresponding to each active constituent; by using the gene database of NCBI, translated the information of the targets into gene names; by retrieving data from GeneCards datebase, extracted the genes related to PCOS; related targets of Epimedii Folium in the treatment of PCOS were obtained by Venn tool; by using Cytoscape 3.7.2 software, constructed a network diagram of Epimedii Folium-active constituents-targets-PCOS; by using STRING database, constructed the protein interaction network; then carried out GO enrichment analysis of related targets by Geneontology database and carried out pathway enrichment analysis of related targets by KEGG database. Results:There were 23 active constituents of Epimedii Folium and 132 related targets treating PCOS. The Epimedii Folium could play the reinforcing effect on kidney mainly by regulating the biological processes like steroid hormone receptor activity, as well as KEGG pathways such as Estrogen signaling pathway, GnRH signaling pathway, GnRH secretion, HIF-1 signaling pathway and VEGF signaling pathway in treating PCOS. Conclusion:From the perspective of network pharmacology, this study preliminarily analyzed the related targets and pathways of reinforcing effect on kidney of Epimedii folium in the treatment of PCOS, providing reference for further experiments and application inclinics.
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Talent evaluation is the premise of development management and the use of human resources. The establishment of the talent classification and evaluation mechanism of university affiliated hospitals plays an important role in setting up the correct employment orientation, stimulating the career development of talents and promoting the high-quality development of public hospitals. The authors took the perspective of university affiliated hospitals, summed up the construction process of talent evaluation system in China, analyzed the existing problems in evaluation indicators, evaluation methods and operation mechanism of talent evaluation system, and came out with suggestions that the national level should strengthen the top-level design and collaborative management of talent evaluation, the hospital level should refine the evaluation indicators, improve the evaluation methods and establish the concept of developmental evaluation, at meanwhile, schools should improve the talent management mechanism and strengthen the function of audit and supervision.
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Objectives:To investigate the current research status and focus of multi-campus construction and management in public hospitals, and to provide research reference and policy recommendations.Methods:The CNKI and Wanfang databases were searched from the establishment of the databases to October 31, 2020. Literatures of multi-campus construction and management in public hospitals were screened following inclusion and exclusion criteria. Bibliometric analysis was used to analyze the characteristics of the included literatures.Results:A total of 99 articles were included. In 2019, there were 18 articles, which was the most over the years. The number of published literatures has increased significantly since 2014. The most common origin cities of publications were Shanghai, Wuhan and Beijing. Literature research focused on integration, homogeneity, economic operation, cultural construction and development strategy.Conclusions:The development of multi-campus in public hospitals has attracted more and more attention, but it has not yet involved in the research of setting access, functional positioning, construction mode, peacetime and wartime transformation, and it is predicted that it will become a research hotspot in the future.
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Outbreak of the novel coronavirus pneumonia (NC) across the country has seriously threatened people's lives and health, endangering smooth operation of the national economy and social stability. An all-out campaign to save the NCP patients and reduce their mortality is not only one of the key tasks to fight against the epidemic, but also a major responsibility and mission of public hospitals. In view of the field practice of Wuhan Union Hospital in the epicenter, the authorsDescribed the challenges faced by such hospitals in the prevention and control, summarized its experiences and proposed improvement measures, for reference of other public hospitals and relevant authorities.
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Since the outbreak of COVID-19 in Wuhan, cabin hospitals have played an important role in preventing the spread of the epidemic and admitting all the patients and suspected ones. As one of the first three cabin hospitals in Wuhan, Jianghan cabin hospital under care of Wuhan Union Hospital has efficiently fulfilled its purpose of admitting patients of mild symptoms. Measures taken by the cabin hospital include clearing its positioning, optimizing its layout, establishing organization structure, setting up the rules and regulations, and strengthening the prevention and control of hospital infection. This article briefly summed up the operation and management practices of the cabin hospital, and analyzed its management difficulties, hence putting forwards suggestions on medical emergency management system of China, for references of hospitals and authorities in charge.
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Since the outbreak of COVID-19 in Wuhan, cabin hospitals have played an important role in preventing the spread of the epidemic and admitting all the patients and suspected ones. As one of the first three cabin hospitals in Wuhan, Jianghan cabin hospital under care of Wuhan Union Hospital has efficiently fulfilled its purpose of admitting patients of mild symptoms. Measures taken by the cabin hospital include defining its positioning, optimizing its layout, establishing organization structure, setting up the rules and regulations, and strengthening the prevention and control of hospital infection. This article briefly summed up the operation and management practices of the cabin hospital, and analyzed its management difficulties, hence putting forward suggestions on medical emergency management system of China, for references of hospitals and authorities in charge.
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Outbreak of COVID-19 across the country has seriously threatened people′s lives and health, endangering smooth operation of the national economy and social stability. An all-out campaign to save these patients and reduce their mortality is not only one of the key tasks to fight against the epidemic, but also a major responsibility and mission of public hospitals. In view of the field practice of Wuhan Union Hospital in the epicenter, the authors described the challenges faced by such hospitals in the prevention and control, summarized its experiences and proposed improvement measures, for reference of other public hospitals and relevant authorities.
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Objective@#To analyze the effect of variables on both " effective operative time" and " operative turnaround rate" .@*Methods@#Based on the time node data of operation rooms (OR) of a hospital in 2017, SPSS 19.0 statistical software was used to analyze the " effective operative time" and " operative turnover rate" under different condition variables. The methods include mean value, standard deviation and independent sample t test.@*Results@#The mean values of " effective operative time" varied with months (with the highest month of 9.18±2.49 h/d, and the lowest month of 7.93±2.60 h/d), and with workdays as well (the highest on Monday: 8.72±2.57 h/d, and the lowest on Friday: 7.77±2.67 h/d). Meanwhile it also varied with ORs (the highest of 9.92±2.50, and the lowest of 4.84±1.98). In surgeries which started before 8: 30 am, the effective operative time of OR was significantly higher than others. On Mondays, the effective operative time of ORs was the highest, but the operative turnover rate was poor (as low as 13.20%). There was significant difference in the operative turnover rate between specialized ORs and those not for general purpose.@*Conclusions@#In order to optimize the comprehensive utilization of operation rooms, it is necessary to coordinate the operations, reduce the proportion of non-planned operations on " Mondays" , raise the turnover rate, and strengthen the coordination between working posts.
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Objective: To explore the effect of BMI and waist circumference on diabetes of adults. Methods: After excluding participants with heart disease, stroke, cancer and diabetes at baseline study, 53 916 people aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang city of Zhejiang province were recruited. Cox regression model was used to estimate the hazards ratios (HR) for the associations of baseline BMI and waist circumference with incident diabetes. Results: Among 391 512 person-years of the follow-up program between 2004 and 2013 (median 7.26 years), a total of 944 men and 1 643 women were diagnosed as having diabetes. Compared to those with normal weight, after adjusting for known or potential factors, HR of both overweight and obesity in men for incident diabetes appeared as 2.72 (95%CI: 2.47-2.99) and 6.27 (95%CI: 5.33-7.36), respectively. The corresponding figures in women were 2.19 (95%CI: 2.04-2.36) and 3.78 (95%CI: 3.36-4.26). Compared to those with normal waist circumference, after adjusting for known or potential factors, HR of Ⅰgrade andⅡgrade in men for diabetes were 2.56 (95%CI: 2.22-2.95) and 4.66 (95%CI: 4.14-5.24), respectively. The corresponding figures in women were 1.99 (95%CI: 1.80-2.21) and 3.16 (95%CI: 2.90-3.44), respectively. Conclusions: Overweight, obesity and central obesity were all associated with the increased incident of diabetes. Strategies on diabetes prevention should include not only losing weight, but reducing waist circumference as well.
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Adult , Aged , Female , Humans , Male , Middle Aged , Body Mass Index , China/epidemiology , Diabetes Mellitus/ethnology , Incidence , Obesity/epidemiology , Obesity, Abdominal/epidemiology , Overweight/epidemiology , Proportional Hazards Models , Prospective Studies , Risk Factors , Waist CircumferenceABSTRACT
Objective To explore the effect of BMI and waist circumference on diabetes of adults.Methods After excluding participants with heart disease,stroke,cancer and diabetes at baseline study,53 916 people aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang city of Zhejiang province were recruited.Cox regression model was used to estimate the hazards ratios (HR) for the associations of baseline BMI and waist circumference with incident diabetes.Results Among 391 512 person-years of the follow-up program between 2004 and 2013 (median 7.26 years),a total of 944 men and 1 643 women were diagnosed as having diabetes.Compared to those with normal weight,after adjusting for known or potential factors,HR of both overweight and obesity in men for incident diabetes appeared as 2.72 (95％CI:2.47-2.99) and 6.27 (95％CI:5.33-7.36),respectively.The corresponding figures in women were 2.19 (95％CI:2.04-2.36)and 3.78 (95％CI:3.36-4.26).Compared to those with normal waist circumference,after adjusting for known or potential factors,HR of Ⅰ grade and Ⅱ grade in men for diabetes were 2.56 (95％ CI:2.22-2.95) and 4.66 (95％CI:4.14-5.24),respectively.The corresponding figures in women were 1.99 (95％CI:1.80-2.21) and 3.16 (95％CI:2.90-3.44),respectively.Conclusions Overweight,obesity and central obesity were all associated with the increased incident of diabetes.Strategies on diabetes prevention should include not only losing weight,but reducing waist circumference as well.
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Aim Toresearchthemolecularmecha-nisms of adriamycin-induced cardiomyocyte apoptosis based on β-adrenoceptor signaling pathway during de-velopmentofheartfailure.Methods SeventymaleSD rats were assigned randomly into two groups:the con-trol group(CON,n=30)and the ADR-induced cardio-toxicity group (ADR,n =40 ).ADR was administered intraperitoneally in five equal injections (each contai-ning 3 mg·kg-1 )over a period of two weeks,with a total cumulative dose of 15 mg · kg-1 body weight. Age-matched rats injected with saline were used as controls.The general condition of all rats was observed, and transthoracic echocardiography was performed im-mediately following the final ADR injection,and then every other week.Serum and myocardial tissue were harvested at W2,W4 and W6 separately.The serum contents of brain natriuretic peptide(BNP)and cardiac troponin-T(cTn-T)were analyzed by euzymelinked im-munosorbent assay (ELISA ).The pathological change and apoptosis were determined by HE,Masson and ter-minal deoxyribonucleotide transferase-mediated dUTP nick end labeling (TUNEL).The protein expressions ofβ1-AR,β2-AR,PKA and CaMK Ⅱ were detectedbyWesternblot.Results FollowingthefinalADRin-jection,cardiac systolic function and SV declined, which was accompanied by marked atrophy of the heart,low levels of cardiomyocyte fibrosis and apopto-sis,significantly increased serum BNP and cTn-T and decreased β1-AR,PKA and CaMK Ⅱ protein expres-sion.However,cardiac systolic function was improved with the extension of time but remained depressed as compared to CON group.The serum BNP and cTn-T concentration kept on rising.The gradual aggravation apoptosis and concomitant fibrosis in the ADR group heart were observed following ADR withdrawal.β1-AR protein expression was continuously down-regulated,β2-AR protein expression unchanged.Expression of PKA and CaMKⅡ proteins in hearts from ADR-injec-ted rats gradually increased.Conclusion β-AR/PKA/CaMKⅡ signaling pathway mediates cardiomyo-cyte apoptosis during the progress of ADR-induced car-diac dysfunction and pathological remodeling and apop-tosis.