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Quality supervision is the important guarantee of hospital quality and patient safety, and also the core content of the fourth cycle grade hospital evaluation in Zhejiang province. Based on the evaluation standards, Hangzhou Women′s Hospital used information technology to optimize the hospital′s quality supervision and feedback system, and set up a traceable and closed-loop quality and safety supervision system. The system realized five function points: storage and extraction of supervision problems, online recording of supervision results, real-time feedback of supervision results, online feedback of rectification opinions of supervised departments, and tracking and evaluation of functional departments. After the operation of the system, the quality supervision process of the hospital realized information operation, and could be tracked online at all time points, which improved the efficiency of hospital quality management, better ensured the implementation of medical system and patient safety, and promoted the continuous improvement of medical quality indicators.
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Objective To investigate the changes of microRNA-223 (miR-223) in patients with complication of sepsis after mini-invasive surgery of upper urinary tract stones, and to approach the value of miR-223 in the early diagnosis of sepsis. Methods Patients with upper urinary tract stones underwent micro-invasive treatment in the Department of Urology Surgery of the Affiliated Hospital of Hangzhou Normal University from January 2014 to January 2017 were enrolled. There were 60 patients with sepsis within 24 hours after surgery were assigned in the sepsis group, and 60 patients without sepsis were included in the non-sepsis group. The clinical data of miR-223, CD4+CD25+regulatory T cells (CD4+CD25+ Treg), procalcitonin (PCT) interleukin-10 (IL-10), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP) in the blood, etc were collected within 24 hours after surgery. The differences in above indexes were compared between the two groups. The receiver operating characteristic curve (ROC curve) was drawn to evaluate the diagnostic values of blood mir-223, PCT and CRP in the patients, predicting whether septic complication after urinary calculi surgery would occur. Correlation analyses were used to analyze the correlations between mir-223 and CD4+CD25+ Treg, IL-10 and TNF-α. Results The miR-223 expression level and the contents of CD4+CD25+ Treg, IL-10, TNF-α, PCT and CRP in sepsis group were obviously higher than those in non-sepsis group [2ΔΔCt (×10-4):2.81±1.04 vs. 2.13±0.91, CD4+CD25+ Treg(×10-2): 17.61±4.48 vs. 8.37±2.71, IL-10 (ng/L): 58.42±16.38 vs. 34.68±12.45, TNF-α (pg/L): 249.41±30.69 vs. 167.54±25.98, PCT (ng/L): 4.45±1.89 vs. 0.31±0.08, CRP (μg/L):10.29±3.63 vs. 4.13±1.57, all P < 0.05); in sepsis group, the miR-223 expression and the level of CD4+CD25+ Treg (r = 0.367, P = 0.004) and IL-10 (r = 0.516, P = 0.006) were also significantly positively correlated, but miR-223 and TNF-α were not markedly correlated (r = 0.237, P > 0.05). The area under ROC curve (AUC), sensitivity, specificity and 95% confidence interval (95%CI) of miR-223 predicting sepsis occurrence after urinary operation were higher than those of CRP, PCT (AUC: 0.923 vs. 0.547, 0.769, the sensitivity: 81.73% vs. 71.23%, 66.59%, specificity: 86.00%vs. 42.00%, 83.00%, 95%CI: 0.862-0.979 vs. 0.351-0.679, 0.682-0.927). Conclusions The expression levels of plasma miR-223 in patients with sepsis after mini-invasive treatment for upper urinary tract lithotrity can reflect their immune reaction status, and can be one of the early diagnostic markers of whether the sepsis complication may occur after the surgery.
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Objective To investigate the changes of microRNA-223 (miR-223) in patients with complication of sepsis after mini-invasive surgery of upper urinary tract stones, and to approach the value of miR-223 in the early diagnosis of sepsis. Methods Patients with upper urinary tract stones underwent micro-invasive treatment in the Department of Urology Surgery of the Affiliated Hospital of Hangzhou Normal University from January 2014 to January 2017 were enrolled. There were 60 patients with sepsis within 24 hours after surgery were assigned in the sepsis group, and 60 patients without sepsis were included in the non-sepsis group. The clinical data of miR-223, CD4+CD25+regulatory T cells (CD4+CD25+ Treg), procalcitonin (PCT) interleukin-10 (IL-10), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP) in the blood, etc were collected within 24 hours after surgery. The differences in above indexes were compared between the two groups. The receiver operating characteristic curve (ROC curve) was drawn to evaluate the diagnostic values of blood mir-223, PCT and CRP in the patients, predicting whether septic complication after urinary calculi surgery would occur. Correlation analyses were used to analyze the correlations between mir-223 and CD4+CD25+ Treg, IL-10 and TNF-α. Results The miR-223 expression level and the contents of CD4+CD25+ Treg, IL-10, TNF-α, PCT and CRP in sepsis group were obviously higher than those in non-sepsis group [2ΔΔCt (×10-4):2.81±1.04 vs. 2.13±0.91, CD4+CD25+ Treg(×10-2): 17.61±4.48 vs. 8.37±2.71, IL-10 (ng/L): 58.42±16.38 vs. 34.68±12.45, TNF-α (pg/L): 249.41±30.69 vs. 167.54±25.98, PCT (ng/L): 4.45±1.89 vs. 0.31±0.08, CRP (μg/L):10.29±3.63 vs. 4.13±1.57, all P < 0.05); in sepsis group, the miR-223 expression and the level of CD4+CD25+ Treg (r = 0.367, P = 0.004) and IL-10 (r = 0.516, P = 0.006) were also significantly positively correlated, but miR-223 and TNF-α were not markedly correlated (r = 0.237, P > 0.05). The area under ROC curve (AUC), sensitivity, specificity and 95% confidence interval (95%CI) of miR-223 predicting sepsis occurrence after urinary operation were higher than those of CRP, PCT (AUC: 0.923 vs. 0.547, 0.769, the sensitivity: 81.73% vs. 71.23%, 66.59%, specificity: 86.00%vs. 42.00%, 83.00%, 95%CI: 0.862-0.979 vs. 0.351-0.679, 0.682-0.927). Conclusions The expression levels of plasma miR-223 in patients with sepsis after mini-invasive treatment for upper urinary tract lithotrity can reflect their immune reaction status, and can be one of the early diagnostic markers of whether the sepsis complication may occur after the surgery.
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Objective:To explore therapeutic effect of ticagrelor on patients with acute ST elevation myocardial in‐farction (STEMI) and its influence on short‐term prognosis .Methods :A total of 180 STEMI patients undergoing e‐mergency percutaneous coronary intervention (PCI) were selected ,randomly divided into clopidogrel group (n=90) and ticagrelor group (n=90) .Clinical therapeutic effect was compared between two groups ;platelet function ,inci‐dence of major adverse cardiovascular events (MACE) ,adverse reactions and bleeding events were observed in two groups .Results:Total effective rate of ticagrelor group was significantly higher than that of clopidogrel group (93.4% vs .87.8% ,P=0.036);compared with clopidogrel group on 24h and 7d after operation ,there were signif‐icant reductions in platelet aggregation rate [24h :(62.1 ± 5.2)% vs . (56.5 ± 5.4)% ,7d:(47.3 ± 6.1)% vs . (38.7 ± 5.2)% ] and P2Y12 reaction unit [24h:(218.1 ± 12.3) U vs . (201.3 ± 11.1) U ,7d:(173.4 ± 11.8) U vs . (152.6 ± 12.6) U] in ticagrelor , P0. 05 all .Conclusion:Compared with clopi‐dogrel ,ticagrelor can better reduce platelet aggregation rate and improve clinical therapeutic effect without increas‐ing incidence of adverse reactions and bleeding events .
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Objective To evaluate the necessity of construction of hospital information system integration platform for county Hospital as the urban and rural medical hub in the context of the development of modern medical information.Methods By referring to the development of the domestic and international integration platform,and comprehensively considered the development status of the county hospital,and analyzed based on the perspective of sustainable development.Results The hospital information integration platform was formed to meet the needs of the county hospital,and it platform was used to open up the internal and external medical information resources,realize the integration of business resources and process optimization..Conclusion The county hospital building information system integration platform is the inevitable trend of the current construction of information technology,and its comple-ted construction can enhance province -city-county tertiary care facility data communication,reduce the coupling within the hospital business systems,and make the county hospital more flexible in the future construction and devel-opment.
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Objective To study the level and clinical value of differential display code 3 (DD3) in peripheral blood of patients with prostate cancer.Methods 27 patients with prostate cancer from April 2014 to April 2015 in Affiliated Hospital of Hangzhou Normal University were researched.26 patients with non prostate diseases were selected as control group.DD3 mRNA levels were detected in peripheral blood of all patients.DD3 absorbance value of three groups of patients,the relationship between the relative content of DD3 mRNA and the clinical characteristics of prostate cancer,DD3 mRNA in urine and peripheral blood of patients with prostate cancer and benign prostatic hyperplasia were observed.Results In the patients with benign hyperplasia of prostate and non prostate diseases,a total of 4 patients did not appear to be DD3 specific bands.In prostate cancer patients,all patients were found to have DD3 specific bands.The relative content of patients with non prostate diseases was (0.18 ± 0.05) copies/mL.The relative content of benign prostatic hyperplasia patients was (0.30 ± 0.09) copies/mL.The relative content of prostate cancer patients was (0.78 ± 0.23) copies/mL.The positive expression rates of DD3 mRNA in peripheral blood and urine of patients with prostate cancer were 85.18％ (23/27),51.85％ (14/27),respectively,which were significantly higher than those in patients with benign prostatic hyperplasia[21.42％ (6/28),7.14％ (2/27)] (x2 =22.416,13.319,all P ＜ 0.05).Conclusion The specific expression of DD3 mRNA in peripheral blood of patients with prostate cancer can be used as an effective basis for judging the patients' condition,and it has certain value for the treatment and prognosis of patients with prostate cancer.
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Objective To investigate the change of ischemia modified albumin (IMA) in polycystic ovary syndrome (PCOS) women,and to examine the relationship between IMA and metabolic disorder.Methods 31 PCOS women (PCOS group) and 28 age-and BMI-matched healthy women (control group) were recruited.Serum IMA levels and related biochemical indexes were compared between the two groups,and the correlation between IMA and each index was analyzed.Results Serum IMA level in PCOS group was significantly higher than that in the control group (P＜0.05).Correlation analysis showed that serum IMA levels were positively correlated with testosterone levels (r=0.57,P=0.03).Conclusion Serum IMA levels in PCOS patients are significantly elevated and closely related to testosterone,suggesting that oxidative stress may be involved in the pathogenesis and development of hyperandrogenemia.
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Based on the current county hospital information construction in the problem of integration,pro-posed a scheme based on a unified architecture application integration platform.The original business system interface standardization of the construction of hospital information systems analysis and integration platform architecture and integration framework,the framework can be achieved through integrated hospital between heterogeneous systems.A unified standardized interfaces can achieve a good cross -system data integration.The construction of county hospitals information system integration platform,data sharing and interaction is conducive to solve the problem of data islands facing the county hospital,hospital to enhance business development capabilities and scale.
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Objective To investigate the effects of ch1D1, an anti-CD86 chimeric antibody, on autoreactive B lymphocytes isolated from patients with systemic lupus erythematosus ( SLE) . Methods Flow cytometry analysis was performed to measure the expression of CD86 on the surface of B cells isolated from patients with SLE and to analyze the effects of ch1D1 on the activation of CD4+T cells. The method of magnetic bead sorting was used to separate B cells, NK cells and CD4+T cells from PBMC collected from healthy subjects and patients with SLE for subsequent experiments. Antibody-dependent cell-mediated cyto-toxicity (ADCC) and complement-dependent cytotoxicity (CDC) that were mediated by ch1D1 were meas-ured with LDH release assay. Effects of ch1D1 on the secretion of auto-antibodies and the proliferation of CD 4+ T were detected by ELISA and 3 H -thymidine ( 3 H-TdR) incorporation assay, respectively. Results The levels of CD80 (68. 08±14. 28 vs 46. 10±12. 14, n=24, P<0. 000 1) and CD86 (44. 72±14. 90 vs 13. 99±10. 74, n=24, P<0. 000 1) expressed on the surface of B cells isolated from patients with SLE were significantly higher than those from the healthy subjects, suggesting the abnormal activation of B cells. Com-pared with the negative control group and the murine monoclonal antibody 1D1, ch1D1 was more effective in mediating the ADCC and CDC responses (P=0. 017 2, P=0. 038 8). Activated T cells significantly en-hanced the secretion of auto-antibodies by B cells isolated from patients with SLE. Compared with the nega-tive control group, the enhanced secretion of auto-antibodies was significantly inhibited by treatment with ch1D1 (P=0. 001 9). Moreover, ch1D1 significantly inhibited the proliferation and activation of CD4+T cells induced in patients with SLE (P=0. 002 4, P=0. 049 5). Conclusion ch1D1, the anti-CD86 chim-eric antibody, could effectively mediate the ADCC and CDC responses against autoreactive B cells isolated from patients with SLE, inhibit the secretion of auto-antibodies and suppress the proliferation and activation of auto-reactive CD4+T cells. It might be a potential immunotherapy agent for the treatment of SLE.
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Objective To observe the expression changes of peripheral endothelial progenitor cells (EPCs) and Ang-1/Tie2 in patients with pulmonary arterial hypertension (PAH).Methods From Jun 2011 to Dec 2012,45 patients with PAH charged in Affiliated Hospital of Hangzhou Normal University were divided into 3 groups according to mean pulmonary arterial blood pressure (15 per group):mild(Group L),moderate(Group M),and severe(Group S),with another 15 normal people as control group(Group C).The EPCs were isolated from peripheral blood of every patient,number counting using fluorescence activated cell sorter (FACS),function test using cell culture in vitro.Expression of Ang-1 and Tie2 in the peripheral EPCs were measured by RT-PCR or Western-blot.Non normal data was analyzed by non parametric statistical test.Results The statistical discrepancy existed among Group L,M,S and the control in the number of EPCs [32.0 (27.0,37.0),26.0 (19.0,31.0),24.0 (22.0,26.0) vs 40.0 (37.0,51.0),P ＜ 0.05].The ability of migration [32.1 (26.5,37.5),26.8 (22.4,35.4),21.0 (17.8,34.0) vs 39.0 (33.3,42.4),P＜0.05] and adhesion of the EPCs [57.1(50.9,61.8),51.8(45.2,58.7),46.0 (37.2,55.1) vs 64.1 (56.2,75.0),P ＜ 0.05] among study groups and control group was different in statistic,the same with the proliferation activity of EPCs in different groups [0.6 (0.5,0.7),0.5 (0.4,0.6),0.4(0.3,0.5) vs 0.7(0.6,0.8),P ＜0.05].The mRNA expression of Ang-1 and Tie2 in Group M & S were significantly reduced compared with control [4.33 (2.49,4.62) and 2.89 (2.39,3.44) vs 5.31(3.78,6.22),P＜0.05],Tie2 mRNA[1.32(1.23,1.34)and 1.23(1.08,1.42)vs 1.49(1.25,1.66),P ＜ 0.05],and the protein expression of the phosphorylated Tie 2 in Group M &S were decreased [0.16 (0.15,0.24) and 0.12 (0.08,0.18) vs 0.22 (0.19,0.28),P ＜ 0.05].No significant difference of Ang-1 and Tie2 expression was observed between Group L and control [5.42 (4.72,5.95),1.54 (1.43,1.66) and0.23(0.19,0.33),P=0.674,0.867 and 0.674].Conelusion With the severity of PAH,the number and function of circulating EPCs decreased,as consistent with Ang-1 and Tie2 expression changes,suggesting that function decrease of EPCs in patients with PAH may be associated with the decrease of Ang-1/Tie2 expression.