Advances in research on etiology, diagnosis and treatment of non-obstructive myocardial infarction / 中国医师杂志

Myocardial infarction refers to severe coronary artery stenosis, which leads to continuous and complete occlusion of coronary artery and myocardial necrosis. Coronary artery stenosis (>50%) or occlusion can be seen in 90% of patients undergoing coronary angiography, but 10% of patients have no obvious stenosis, that is, non obstructive myocardial infarction (MINOCA). The incidence rate of MINOCA was about 6%, showing an upward trend year by year, with an average age of 55 years, of which 40% of women. Its etiology is complex, the onset is urgent, and the clinical manifestations are complex and changeable. The incidence of major adverse cardiovascular events (MACE) is very high, and the mortality rate within one year is as high as 3.5%. There is no unified diagnosis and treatment plan at present. In this paper, the etiology, diagnosis and treatment of MINOCA were reviewed.

Research progress in human symbiotic bacteria and their antibacterial molecules / 生物工程学报

With the emergence and globally spread of drug-resistant bacteria, the discovery and development of new antibacterial drugs is imminent. The symbiotic bacteria distributed in different parts of the body can produce a variety of antibacterial molecules to inhibit the colonization and infection of pathogenic bacteria. Human symbiotic bacteria provide a potential treasure house of resource for the research and development of new drugs with broad new molecular structures and action mechanism. With the further development of bioinformatics tools, synthetic biology and omics technology such as genomics, the mining of human symbiotic bacteria antibacterial molecules will be more in-depth and provide an effective way to solve the problem of drug resistance. Here, we review the antimicrobial molecules produced by human symbiotic bacteria and introduce several methods to explore the resources of natural antibacterial drugs. With the development of modern biotechnology, the antimicrobial molecules of human symbiotic bacteria will be more comprehensively and systematically explored and applied.

Diversity and antimicrobial susceptibility of cultivable commensal bacteria from 18 to 22 year-old healthy people's nose and skin / 中华检验医学杂志

Objective To investigate the diversity and antimicrobial susceptibility of cultivable commesal bacteria from 18 to 22 year-old healthy people′s nose and skin. Methods From June to August 2017,18 to 22 year-old healthy people (n=210) were swabbed on skin and nose and cultured with blood plates at Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Species determination was performed using matrix assisted laser desorption Lonization-time of flight-mass spectrometry(MALDI-TOF-MS);Susceptibility testing was performed on the major species by the disc diffusion method; Genomic characteristics of methicillin resistant Staphylococcus epidermidis(MRSE) were determined by pulsed field gel electrophoresis (PFGE) method;SCCmec typing was tested by polymerase chain reaction(PCR);Statistical analysis was performed using SPSS software and association statistics were tested using Chi-Square tests. Results In total, 25 genera were identified of cultivable bacteria from 210 healthy people′s nose (1497 isolates) and skin (941 isolates).Staphylococcus isolates from nose and skin accounted for 82.03% and 80.23% respectively.Eleven species were identified of all Staphylococcus isolates and coagulase-negative Staphylococci(CoNS)from nose and skin accounted for 90.72% and 99.21% respectively.Furthermore, a variety of other species and differences between men and women were observed. Susceptibility testing was done on 631 Staphylococcus isolates, which were sensitive to most antibiotics but show high prevalence of resistance towards penicillin (76.55%), erythromycin (41.20%), clindamycin (10.77%) and trimethoprim/sulfamethoxazole(10.14%). Methicillin Resistant Staphylococcus (MRS) (45 isolates) showed higher prevalence of resistance towards penicillin (χ2=12.17,P<0.001), erythromycin (χ2=10.80,P=0.001), levofloxacin (χ2=20.24, P<0.001) and trimethoprim/sulfamethoxazole (χ2=58.57,P<0.001) compared to methicillin sensitive Staphylococcus (MSS)(586 isolates). Moreover, multidrug resistance (MDR) was observed in 42.16% of 631 isolates and MRS showed a significantly higher proportion than MSS(100.00% vs 37.71%,χ2=66.49,P<0.001).PFGE generated 23 groups out of 33 MRSE isolates. SCCmec genotyping of MRSE showed the most prevalent type was SCCmecⅣ (66.67%). Conclusions Obvious genus and species diversity and genetic diversity were observed on cultivable bacteria from 18 to 22 year-old healthy people′s nose and skin,and CoNS was in the majority. Staphylococcus isolates from healthy people′s nose and skin were sensitive to most antibiotics,but show high prevalence of resistance towards penicillin, erythromycin, clindamycin and trimethoprim/sulfamethoxazole. In addition, MDR was serious especially in MRS. Commensal bacteria may act as reservoir for resistance genes facilitating bacteria infection.

Building a management system for operating room hidden costs / 中华医院管理杂志

The paper proposed a concept to build a management system for operating room hidden costs in an effort to better hospital management and alleviate patients' economic burden.The authors analyzed the root of such costs from the levels of operating room's design and construction,as well as management and operations,proposing a framework of such hidden costs.Based on diversified cost characteristics,they come up with a number of estimating methods,and control methods against different hidden costs by using management theories systematically.

Optimizing operating department facility capacity with the queuing theory / 中华医院管理杂志

Objective Reengineering of existing facility capacity of the hospital operating department to tap the potential of the capacity, and development of scientific and quantitative basis for hospital decision-making. Methods Existing data of the hospital's operating department was called into play for a fit test of probability distribution, followed by an analysis of such capacity in the queuing theory, ending with a redesign based on the present service demand.Results The operating department in question was found with a low utilization, and with surplus capacity. When the utilization lies between 70% and 80% (7 operating rooms), the queuing system indexes are optimal.Conclusion It is rational and feasible to analyze and optimize operating department facility capacity in the queuing theory. This is conductive to increasing operating room utilization and enhancing hospital competitiveness.

Current hospital cost management and studies / 中华医院管理杂志

An analysis of the development and present status of overseas hospital cost management pinpoints the setbacks found in China's hospital cost management, and brings forth the proposal to learn from advanced ideas and methods in overseas hospital industrial engineering and cost management. The goals are to build a nationwide total cost control system, explore new fields in cost management and introduce strategic cost management, in an effort to realize scientific cost management in China.

Effect of double filtration plasmapheresis in refractory rheumatoid arthritis / 中国综合临床

Objective To evaluate the efficacy of double filtration plasmapheresis (DFPP) in the treatment of patients with refractory rheumatoid arthritis (RA). Methods Eighty-two patients were randomly aesigned,42 to the DFPP group and 40 to the no-DFPP group. All patients previously experienced an incomplete response to 2-3 dis-ease-modifying antirheumatic drugs (DMARDs) and 1-2 nonsteroidal anti-inflammatory drugs (NSAIDs) or predni-sene. All patients received sulphasalazine (SASP,0.75 g three times daily) plus methotrexate (MTX, 10 mg orally once weekly). DFPP was performed once a week for 2-3 sessions. A total of 121 plasmapheresis procedures were per-formed in 42 patients. Control patients did not receive sham DFPP. The efficacy measures recorded one day after the final treatment and latest month in follow up for 12～24 months included the American College of Rheumatology 20% ,50% ,and 70% improvement criteria (ACR20, ACR50, and ACR70), the Health Assessment Questionnaire estimate of disability (HAQ); and the disease activity index. Results Patients in the DFPP group had ACR 20, ACR 50 and ACR 70 improvements of 100% ,92.9% and 81.0%,as compared with the patients in no-DFPP group 17.5% ,0,and 0 (P<0.001). Significant change from baseline was observed in HAQ scores in the DFPP group but not in the no-DFPP group (P<0.001). The changes from baseline in the disease activity scores were significantlygreater than in the no-DFPP group (P<0.001). Conclusion DFPP therapy significantly alters the signs and symp-toms of refractory RA. There are significant increases in physical function and improvement in quality of life.

The effects of comprehensive rehabilitation program on severe brain-injured young patients / 中华物理医学与康复杂志

Objective To observe the effects of comprehensive rehabilitation program on severe traumatic brain injury young patients when the time from injury to admission was delayed. Methods Eleven severe traumatic brain injury young patients received comprehensive rehabilitation program, including the neurodevelopmental techniques. They were evaluated with Functional Independence Measure (FIM) and Berg Balance Scale. One Way ANOVA was used to assess the functional status of patients during the course of treatment. Results After 6 to 12 months' treatment, the motor, cognitive and total scores of FIM and the Berg scores of all patients increased significantly ( P

Study and Application of Information System for Hospital Material Flow Management / 医疗卫生装备

Objective To develop an information system for hospital material flow management.Methods The system,taking financial accounting and hard assets controlling as the primary purpose and making the flow rebuild as the masterstroke,mainly consisted of seven functions as follows: management of medical material and non-hygiene material,management of antisepsis providing department,management of hard assets,management of drug,management of storehouse materials economical using and support in peacetime and war time,management of biohazard waste and management of the budget of finical IC card department.Results The system formed the information chain of the whole hospital material flow process and effectively controlled the hospital medical costs and operational costs.Furthermore,the system firstly developed the storehouse material economical using and support management system both in peacetime and war time in our country.Conclusion The information system for hospital material flow management can resolve the problem of financial and material management divorce and promote the hospital holistic management level.

Application of Management Information System for Medical High-value Consumables in Operation Room / 医疗卫生装备

Objective To make the management responsibility clear for guarding against the lacking of legal basis in patient lawsuits.Methods An implantable coding database for medical consumables was set.Barcode on packaging bag was scanned in 'information system'.'secondary management database for high-value consumables' was set in operation room.According to a warehouse-out list,the warehouse was checked monthly.Results The flow of all consumables was controlled.Conclusion Operational links are reduced and work efficiency is improved.Besides,the transparency of charges is increased.[Chinese Medical Equipment Journal,2008,29(2):64-65]