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【Objective】 To study the annual financial expenditure in blood stations with different scales, and to establish the regression equation between blood collection units and total expenditure. 【Methods】 The annual total expenditure, the per capita cost of serving population, as well as the collection units of whole blood and apheresis platelet of 24 blood stations were collected. The financial expenditure required for collecting 10 000U blood was calculated.The statistical analysis was carried out with SPSS statistical software. 【Results】 From 2017 to 2020, the total annual financial expenditure of 24 blood stations showed an upward trend. The total expenditure among blood stations was different. The per capita cost of servicing population in the areas where the 24 blood stations were located had been increasing year by year. The 24 blood stations were divided into two grades according to the blood collection volume as 50 000 U, and the relationship equation between the blood collection volume and the annual total expenditure had been established. After testing, each equation was effective(P<0.05); There was no difference in the financial expenditure required for collecting 10 000U blood among blood stations with different scales. 【Conclusion】 From 2017 to 2020, the blood stations with an annual collection volume more than 50 000 U demonstrated a higher financial expenditure and the per capita cost of serving population than those <50 000 U. The blood collection volume of blood stations is significantly correlated with the annual total expenditure and the per capita cost of serving population.
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Resumen Basado en el concepto de comportamiento de riesgo moral del médico y el modelo teórico de comportamiento planificado, este artículo construye un modelo teórico del comportamiento de riesgo moral del médico y analiza en detalle los principales factores que influyen en el comportamiento de riesgo moral del médico, incluidas las actitudes conductuales, subjetivas normas y control conductual percibido. En combinación con los resultados de la encuesta por cuestionario, este artículo utiliza un modelo de ecuación estructural y un análisis factorial para verificar las hipótesis. Los resultados muestran que en el modelo teórico de la conducta de riesgo moral del médico, las intenciones de riesgo moral de los médicos se ven afectadas por tres variables independientes: actitudes conductuales, normas subjetivas y control conductual percibido. Como variable intermedia, las intenciones de riesgo moral tienen un efecto mediador en el comportamiento de riesgo moral de los médicos. Todos los coeficientes de trayectoria cumplen los requisitos y se verifican todos los supuestos del modelo. El modelo teórico del comportamiento de riesgo moral del médico establecido en este estudio puede explicar eficazmente la ley de ocurrencia del comportamiento de riesgo moral del médico y predecir este comportamiento de acuerdo con la situación real de varios factores influyentes. Esto proporciona una guía teórica eficaz para el siguiente paso para llevar a cabo mejor la investigación relevante sobre el riesgo moral del médico basada en la perspectiva de la gestión, especialmente el establecimiento de estrategias de prevención y control para el comportamiento de riesgo moral del médico.
Abstract Based on the concept of doctor's moral hazard behavior and the theoretical model of planned behavior, this paper constructs a theoretical model of doctor's moral hazard behaviorm and analyzes the main influencing factors of doctor's moral hazard behavior in detail, including behavioral attitudes, subjective norms and perceived behavioral control. Combined with the results of questionnaire survey, this paper uses structural equation model and factor analysis to verify the hypotheses. The results show that in the theoretical model of doctor's moral hazard behavior, doctors' moral risk intentions are affected by three independent variables: behavioral attitudes, subjective norms and perceived behavioral control. As an intermediary variable, moral risk intentions have a mediating effect on doctors' moral hazard behavior. All path coefficients meet the requirements, and all assumptions of the model are verified. The theoretical model of doctor's moral hazard behavior established in this study can effectively explain the occurrence law of doctor's moral hazard behavior and can predict doctor's moral hazard behavior according to the actual situation of various influencing factors. This provides an effective theoretical guidance for the next step to better carry out the relevant research on doctor's moral hazard based on the management perspective, especially the establishment of prevention and control strategies for doctor's moral hazard behavior.
Resumo Baseado no conceito de comportamento moral de risco de médicos e o modelo teórico do comportamento planejado, este artigo constrói um modelo teórico de comportamento de risco moral de médicos e analisa os fatores principais que influenciam o comportamento moral de risco de médicos em detalhes, incluindo atitudes comportamentais, normas subjetivas e controle comportamental percebido. Combinado com os resultados de levantamentos com questionários, esse artigo usa o modelo de equação estrutural e análise fatorial para verificar as hipóteses. Os resultados mostram que no modelo teórico do comportamento de risco moral de médicos, as intenções de risco moral de médicos são afetadas por três variáveis independentes: atitudes comportamentais, normas subjetivas e controle comportamental percebido. Como uma variável intermediária, intenções de risco moral tem um efeito mediador no comportamento de risco moral de médicos. Todos os coeficientes de caminho cumprem os requisitos e todas as suposições do modelo são comprovadas. O modelo teórico do comportamento de risco moral de médicos estabelecidos nesse estudo podem efetivamente explicar a lei de ocorrência do comportamento de risco moral de médicos e pode predizer o comportamento de risco moral de médicos de acordo com a situação real de vários fatores de influência. Isto fornece um guia teórico efetivo para os próximos passos para melhor conduzir pesquisas relevantes sobre risco moral de médicos baseadas na perspectiva de gestão, especialmente o estabelecimento de estratégias de prevenção e controle para o comportamento de risco moral de médicos.
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Humanos , Médicos , Conducta , Control de la Conducta , Riesgo Moral en los Seguros de SaludRESUMEN
Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of bone-modifying agents and inhibits angiogenesis agents. Although the pathogenesis of MRONJ is not entirely clear, multiple factors may be involved in specific microenvironments. The TGF-β1 signalling pathway may have a key role in the development of MRONJ. According to the clinical stage, multiple variables should be considered when selecting the most appropriate treatment. Therefore, the prevention and management of treatment of MRONJ should be conducted in patient-centred multidisciplinary team collaborative networks with oncologists, dentists and dental specialists. This would comprise a closed responsibility treatment loop with all benefits directed to the patient. Thus, in the present review, we aimed to summarise the pathogenesis, risk factors, imaging features, clinical staging, therapeutic methods, prevention and treatment strategies associated with MRONJ, which may provide a reference that can inform preventive strategies and improve the quality of life for patients in the future.
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Humanos , Osteonecrosis de los Maxilares Asociada a Difosfonatos/prevención & control , Conservadores de la Densidad Ósea/efectos adversos , Calidad de Vida , Factores de RiesgoRESUMEN
To explore influence of bisoprolol combined benazepril on ECG and left ventricular diastolic function in hypertensive patients with acute heart failure (AHF).Methods :A total of 124 hypertensive patients with AHF were randomly and equally divided into routine treatment group and combined treatment group (received biso‐prolol combined benazepril based on routine treatment ) ,both groups were treated for two months .Therapeutic effect ,ECG indexes ,left ventricular diastolic function indexes ,levels of heart failure and myocardial injury markers etc .before and after treatment were compared between two groups .Results : After two‐month treatment ,total ef‐fective rate of combined treatment group was significantly higher than that of routine treatment group (96. 77% vs. 82. 26%, P=0.008) ;compared with routine treatment group ,there were significant reductions in QRS wave dura‐tion [ (103. 87 ± 9.70) ms vs.(94.12 ± 8. 93) ms] ,QTc duration [ (432.37 ± 33. 24) msvs .(418.96 ± 29. 64) ms] , plane QRS‐T angle [ (59.75 ± 26. 61)°vs.(48.19 ± 22.30)°] ,mitral annulus late diastolic peak flow velocity (Am) [ (12.84 ± 3.40) cm/svs .(11. 39 ± 3. 11) cm/s] ,plasma levels of N terminal pro brain natriuretic peptide [ (1. 20 ± 0.58) μg/L vs .(0. 75 ± 0.47) μg/L] ,carbohydrate antigen 125 [ (19.10 ± 9.24) U/ml vs.(13.93 ± 7.85) U/ml] ,galectin‐3 [ (4.72 ± 2. 25) μg/L vs .(3.28 ± 1. 65) μg/L] ,cardiac troponin I [ (1.93 ± 0. 97) μg/L vs.(1. 46 ± 0. 85) μg/L] ,and significant rise in mitral early/late diastolic peak flow velocity (E/A) [(1. 18 ± 0.30) vs.(1. 31 ± 0. 28)] and mitral annulus early diastolic peak flow velocity (Em) [ (12.90 ± 3. 76) cm/svs.(14. 49 ± 3.25) cm/s] in combined treatment group , P<0. 05 or <0.01. There was no significant difference in incidence rates of ad‐verse reactions between two groups , P>0.05 all.Conclusion :Bisoprolol combined benazepril possesses significant therapeutic effect on hypertensive patients with AHF ,and its improving effect on ECG indexes and left ventricular diastolic function is significant .
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Collectively migrating tumor cells have been recently implicated in enhanced metastasis of epithelial malignancies. In oral squamous cell carcinoma (OSCC), v integrin is a crucial mediator of multicellular clustering and collective movement ; however, its contribution to metastatic spread remains to be addressed. According to the emerging therapeutic concept, dissociation of tumor clusters into single cells could significantly suppress metastasis-seeding ability of carcinomas. This study aimed to investigate the anti-OSCC potential of novel endostatin-derived polypeptide PEP06 as a cluster-dissociating therapeutic agent . Firstly, we found marked enrichment of v integrin in collectively invading multicellular clusters in human OSCCs. Our study revealed that metastatic progression of OSCC was associated with augmented immunostaining of v integrin in cancerous lesions. Following PEP06 treatment, cell clustering on fibronectin, migration, multicellular aggregation, anchorage-independent survival and colony formation of OSCC were significantly inhibited. Moreover, PEP06 suppressed v integrin/FAK/Src signaling in OSCC cells. PEP06-induced loss of active Src and E-cadherin from cell-cell contacts contributed to diminished collective migration of OSCC . Overall, these results suggest that PEP06 polypeptide 30 inhibiting v integrin/FAK/Src signaling and disrupting E-cadherin-based intercellular junctions possesses anti-metastatic potential in OSCC by acting as a cluster-dissociating therapeutic agent.
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Objectives To identify ABO blood type from a child having discrepant results in forward and reverse ABO blood grouping by serological identification and genetic testing.Methods After routine serological detection with ABO blood group,the ABO gene and ABO blood group-A subgroup genotype were tested by PCR-SSP method.Results The Serological results showed that the specimen was positive type A (anti-A:1 +w),the reverse type is O type (Ac:2 +,Bc:4 +);PCRSSP A-subtype typing showed that the genotype of the child was Ax14/O2.Conclusion Difficult blood type identification sometimes need to combine serology and molecular biology methods to confirm.In this case,the phenotype of the child was Ax,and the genotype was Ax14/O2.
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AIM:To observe the effects and mechanisms of hydroxyethylstarch (HES) 130/0.4 on no-reflow phenomenon after myocardial ischemia-reperfusion in rats.METHODS: SD rats were randomly divided into 4 groups:sham operation group , ischemia-reperfusion ( IR, treated with normal saline ) group, normal saline ischemia-reperfusion (NS-IR, treated with NS) group and HES ischemia-reperfusion (HES-IR, treated with HES) group.Myocardial infarct size and no-reflow range were determined by staining methods , and the activities of myocardial enzymes ( CK-MB, cTnI and MPO) were measured .Meanwhile , cardiac microvascular endothelial cells of the rat were cultured and divided into 4 groups:control group, hypoxia/reoxygenation (H/R) group, NS-H/R group and HES-H/R group.Acute ischemia reper-fusion models were simulated , and the concentration of calcium ions was measured .The relative cell activity was evaluated by CCK-8 assay, and the apoptotic rate was detected by flow cytometry .RESULTS:In HES-IR group, the myocardial in-farct size, the no-reflow zone, CK-MB, cTnI and MPO activity were all significantly lower than those in IR group ( P<0.05).In microvascular endothelial cells , the concentration of calcium ions and the apoptotic rate in HES-H/R group were significantly decreased, while the relative cell activity increased compared with H/R group (P<0.05).CONCLUSION:HES reduces no-reflow in acute myocardial ischemia-reperfusion .The mechanism may be involved in the inhibition of both the infiltration of neutrophils and the calcium overload of endothelial cells .
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Objective To investigate the clinical curative effect of Danhong injection and Tongxinluo capsule in treating patients with cerebral Infarction. Methods Eighty cerebral infarction patients of Neurology Department in Kailuan General Hospital Affiliated to Hebei United University were selected and randomly divided into control and treatment groups. Patients in the control group were received the based therapy,and patients in treatment group were received Danhong injection and Tongxinluo capsule besides the based therapy. The levels of homocysteine(Hcy),blood lipid,blood viscosity were measured at before treatment,the 14th day,1 month and 3 months after the treatment. All data were analyzed by SPSS13. 0. Results (1)The levels of Hcy,total cholesterol( TC),triglyceride( TG)and blood viscosity( high shear viscosity,low shear viscosity and hematocrit)in treatment group were significantly different from the control group at the 14th day after treatment(P < 0. 05).(2)The levels of TC,TG,HDL-C,LDL-C and blood viscosity in patients of the treatment group at 1 month and 3 months after treatment were different from those of the control group( P< 0. 05). Meanwhile,the levels of TC,TG,HDL-C,LDL-C and blood viscosity in patients of the treatment group at the 14th day after treament were significant different from those of 3 month after treatment(P < 0. 05).(3) The levels of TG,HDL-C,LDL-C and hematocrit in patients of the control group at 3 months after treatment were significantly different from those at pre-treatment(P < 0. 05). The CHOL and TG levels of the control group were different from those at pre-treatment at the 14th day after treatment( P < 0. 05).(4)There were significant differences between two groups at the 14th day,1 month and 3months after treatment in terms of therapy effect(Z= 5. 21,5. 54,3. 86;P = 0. 031,0. 024,0. 048). Conclusion The therapy of Danhong injection combined with Tongxinluo capsule can reduce the levels of Hcy,blood lipid,blood viscosity,and then improve the prognosis of patients with cerebral infarction.
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OBJECTIVE To evaluate the direct economic losses caused by nosocomial infection(NI) in patients with cerebral infarction.METHODS All patients(79 with NI as case group,300 without NI as control group) in pairs were investigated through case-control study retrospectively.RESULTS The average of expenses on medical service in NI group was higher when compared to that of control,the increased medical charge was 3 873.56 yuan and the increased hospitalized charge was 6 254.92 yuan.The average bed-staytime of NI group exceeded that of control by 11 days,there was a significant difference between two groups(P
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AIM To investigate protective effects and mechanism of tanshinones on ischemia-like injury models. METHODS Six ischemia models including hypoxia, hypoglucose, oxidant injury, caffeine injury, nitric oxide neurotoxicity and excitatory amino acid injury were used to assay the anti-ischemic roles of tanshinones in cultured primary cortex neurons. The changes of injuried cortex neurons were observed by the way of morphological examination, and live neurons of crystal violet staining were measured according to absorbent index. RESULTS It was found that tanshinones possessed obvious protective effects on primary neurons in injury models by the way of morphological examination. Crystal violet staining also indicated that tanshinones increased number of live neurons in injury models significantly. The protective effects of tanshinones on models of oxidant injury, caffeine injury and NMDA injury were superior to other injury models. CONCLUSIONS 83.0 μmol*L-1 tanshinones protected rat cortex cells from all injury models effectively in vitro.
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Aim To investigate protective effects and mechanism of TPG on ischemia_like injury models. Methods Six ischemia models including hypoxia, hypoglucose, oxidant injury, calcium overload, nitric oxide neurotoxicity and excitatory amino acid injury were used to assay the anti_ischemic roles of TPG in cultured primary cortex neurons. Results It was found that TPG possessed obvious protective effects on primary neurons in injury models by the way of morphological examination. Crystal violet staining also indicated that TPG increased number of life neurons in injury models significantly. Couclusions 50~200 ?g?ml-1 TPG protected rat cortex cells from all injury models effectively in vitro.
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Objective: To investigate the protective effect and mechanism of total peaony glycoside (TPG) on calium overloading injury of nerve cells in rat models. Methods: The nerve cells of cerebral cortex of primary rats were subject to tissue culture,and the calcuim-overloading injury models were induced by caffeine,KCl and NMDA respectively. Results:TPG possessed obvious protective effects on the nerve cells in rat models, increased the number of survival nerve cells and reduced the content of LDH released nerve cells.Conclusion: TPG can protect rat nerve cells with calium-overloading injuriy.
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Objective: To investigate the effects and mechanism of transhinone on calcium overloaded injuried models.Methods: Three injured models induced by caffeine, KCI, and NMDA, respectively, were used to assay the action of tanshinone in cultured primary cortex neurone of baby rats. Results: It was found that tanshinone possessed obvious protective effects on primary neurone in injured models by the way of morphological examination. Crystal violet staining and lactic dehydrogenase (LDH) measurement in supernate also indicated that tanshinone increased number of live neurone and reduced the extent of cell injury significantly.Conclusion: Tanshinone protected rat cortex cells from three kinds of calcium overloadied injured effectively in vitro.
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AIM To investigate protective effects and mechanism of tanshinones on ischemia-like injury models. METHODS Six ischemia models including hypoxia, hypoglucose, oxidant injury, caffeine injury, nitric oxide neurotoxicity and excitatory amino acid injury were used to assay the anti-ischemic roles of tanshinones in cultured primary cortex neurons. The changes of injuried cortex neurons were observed by the way of morphological examination, and live neurons of crystal violet staining were measured according to absorbent index. RESULTS it was found that tanshinones possessed obvious protective effects on primary neurons in injury models by the way of morphological e~nation. Crystal violet staining also indicated that tanshinones increased number of live neurons in injury models significantly. The protective effects of tanshinones on models of oxidant injury, caffeine injury and NMDA injury were superior to other injury models. CONCLUSIONS 83.0 ?mol? L- 1 tanshinones protected rat cortex cells fm all injury models effectively in vitro.