Cost accounting of hospital pharmaceutical service based on job analysis / 中华医院管理杂志

With the full implementation of the separation policy of medicine in China, the circulation of drugs in hospitals no longer produces direct economic value, but turns into the operating cost in the process of providing medical services. The research on the cost calculation of hospital pharmaceutical service can not only help the hospital to strengthen the internal cost management, but also provide the basis for the government policy compensation. This paper constructed a model of pharmaceutical service cost calculation based on job analysis, and produced basic pharmaceutical and advanced pharmaceutical service cost based on the data of a sample hospital.

Analysis of 2019 version tertiary hospital performance evaluation indexes and the impact on hospital management / 中华医院管理杂志

The authors compared and analyzed the guidelines and the index system of public hospitals as stated in such papers as " State Council′s Opinions on Performance Evaluation of Tertiary Hospitals" (No.4 Document of State Council, 2019)and " Guidance on Strengthening the Performance Evaluation of Public Hospitals" (No.94 Document of Guo Wei Ren, 2015). Based on their studies, this paper summarized the commonness and law of development of the two editions of the indexes. They proceeded on such basis to collect data from over 3 600 medical institutions of tertiary hospitals in Beijing and the rest of China before and after the drug-clinic-separation reform in Beijing, National tertiary public hospitals and analyzed key indexes to learn the guidelines and impacts of the 2019 edition on hospital management. The performance indexes of the 2019 edition highlight the public welfare of public hospitals, strengthen the functional orientation of tertiary public hospitals, and point out the direction for further healthcare reform. These papers have a far-reaching impact on hospital strategy and management mode, guiding public hospitals to change their concepts and take on dual responsibilities of public welfare and self-development.

Analysis of 2019 version tertiary hospital performance evaluation indexes and the impact on hospital management / 中华医院管理杂志

The authors compared and analyzed the guidelines and the index system of public hospitals as stated in such papers as " State Council′s Opinions on Performance Evaluation of Tertiary Hospitals" ( No.4 Document of State Council, 2019 ) and " Guidance on Strengthening the Performance Evaluation of Public Hospitals" (No.94 Document of Guo Wei Ren, 2015). Based on their studies, this paper summarized the commonness and law of development of the two editions of the indexes. They proceeded on such basis to collect data from over 3 600 medical institutions of tertiary hospitals in Beijing and the rest of China before and after the drug-clinic-separation reform in Beijing, National tertiary public hospitals and analyzed key indexes to learn the guidelines and impacts of the 2019 edition on hospital management. The performance indexes of the 2019 edition highlight the public welfare of public hospitals, strengthen the functional orientation of tertiary public hospitals, and point out the direction for further healthcare reform. These papers have a far-reaching impact on hospital strategy and management mode, guiding public hospitals to change their concepts and take on dual responsibilities of public welfare and self-development.

Research of impacts on medical visit behaviors of patients due to the two reforms of the clinic-pharmacy-separation at a hospital in Beijing / 中华医院管理杂志

Objective To study the impacts and the difference made by the pilot reform and comprehensive reform of clinic-pharmacy-separation on the medical visit behaviors of outpatients in Beijing.Methods Invoice information of outpatients′ fee payment during the December 2012 reform and April 2017 reform at the hospital was collected.Information of these patients at the same time as controls was collected to analyze patients′ fee categories, so as to study the effect on the behavior of these patients.Results The outpatient visits decreased by 5.29% as a result of the pilot reform.The ratio of medical insurance patients rose by 6.86%, and that of such patients seeking only prescriptions rose by 4.30%;number of outpatient visits decreased by 2.03% after the comprehensive reform, while the ratio of medical insurance outpatients dropped by 2.61%, and those seeking prescription only dropped by 2.54%.Conclusions The comprehensive reform of clinic-pharmacy-separation has influenced the outpatient′s medical visit behavior, evidencing a positive outcome of the healthcare reform.

Rosiglitazone down-regulates lipopolysaccharide-induced expression of CD40 and intercellular adhesion molecule 1 in rat peritoneal mesothelial cells through a NF-κB dependent mechanism / 中华肾脏病杂志

Objective To investigate the effect and mechanism by which PPARγ ligand, rosiglitasone, regulates the expression of CD40 and intercellular adhesion molecule 1 (ICAM-1) in the rat peritoneal mesothelial cells (RPMCs) induced by lipopolysaccharide (LPS). Methods RPMCs were harvested from Sprague-Dawley rat peritoneal cavity and maintained under defined in vitro conditions. The cells were randomly divided into groups as follows: medium, LPS (5 mg/L), LPS (5 mg/L)+BAY11-7085(5 μmol/L, NF-κB inhibitor), rosiglitazone (10 μmol/L or 20 μmol/L, peroxisome proliferator-activated receptor γ activator), LPS (5 mg/L)+rosiglitazone (10 μmol/L)+GW9662 (3 μmol/L, peroxisome proliferator-aetivatcd receptor γ antagonist), and LPS (5 mg/L)+vehicle (DMSO 0.2 ml/L). The expressions of CD40 and ICAM-1 RNA in RPMCs were examined by RT-PCR after 3 hour treatment, and the protein expressions of CD40, ICAM-1, p-NF-κB p65 and p-IκBα were examined by Western blot or immunofluorescence after 24 hour treatment. Results Following treatment with LPS, both the expressions of CD40 and ICAM-1 protein in RPMCs were up-regulated significantly (P<0.05), and the phosphoralation of p65 was increased greatly (1.10±0.17 vs 0.55±0.06, P<0.05). BAY11-7085 (5 μmol/L) significantly decreased the protein expression of p-p65 (0.22±0.11 vs 1.10±0.17, P<0.01), CD40 (0.34±0.02 vs 0.50±0.06, P<0.05) and ICAM-1 (0.35±0.16 vs 0.74±0.03, P<0.05). Pretreated with rosiglitazone for 3 h then added with LPS for 1 h, the levels of p-p65, CD40 and ICAM-1 in RPMCs were significantly decreased compared with those of LPS group (0.77±0.08 vs 0.90±0.10, P<O.01; 0.79±0.16 vs 0.99±0.06, P<0.05; 0.83±0.20 vs 1.22±0.13, P<0.05). However, for the group pretreated with rosiglitazone(10 μmol/L) and GW9662(3 μmol/L) for 3 h then added with LPS, the levels of p-p65 in RPMCs did not change significantly compared with those of rosiglitazone-pretreated group. The expressions of CD40 and ICAM-1 in RPMCs were significantly increased compared with those of rosiglitazone-pretreated group (0.95±0.19 vs 0.79±0.16, and 1.04±0.24 vs 0.83±0.20, P<0.05). Conclusion Rosiglitazone can decrease LPS-induced expression of CD40 and ICAM-1 in RPMCs by inhibition of NF-κB activation, which suggests that rosiglitazone may mediate its antiinflammatory effect through a NF-κB dependent mechanism.

Up-regulation of CD40 and ICAM-1 expression treated with lipopolysaccharide through the activation of NF-κB in rat peritoneal mesothelial cells / 中华微生物学和免疫学杂志

Objective To investigate the expression of CD40 and intercellular adhesion molecule-1 (ICAM-1) treated with lipopolysaccharide (LPS) in rat peritoneal mesothelial cells(RPMC) and the role of NF-κB signal transduction pathway. Methods RPMCs were harvested from Sprague-Dawley rat peritoneal cavity and maintained under defined in vitro conditions. The cells were exposed respectively to different concentrations of LPS for 12 h or treated with LPS (5 μg/ml) for different time points. To observe the effect of LPS on the expression of CD40 and ICAM-1, the RPMCs were treated with LPS (5 μg/ml) for different time points. To observe the effect of LPS on the expression of NF-κB and p-NF-κB protein, the RPMCs were treated by LPS or pretreated with BAY11-7085 (5 μmol/L or 1 μmol/L ) for 3 h, then treated with LPS for another 3 h, respectively. Expression of CD40 and ICAM-1 mRNA was examined by RT-PCR. Expression of NF-κB and p-NF-κB protein was detected by Western blot. Results Compared with medium control group, stimulation of RPMCs with 1 μg/ml and 5 μg/ml of LPS resulted in a significant increase in the expression of CD40 and ICAM-1 mRNA(P<0.05). 10 μg/ml of LPS had strongest effect on CD40 and ICAM-1 expression compared with that of 1 μg/ml and 5 μg/ml of LPS. Treatment with 5 μg/ml of LPS resulted in time-dependent increase in the gene level of CD40 and ICAM-1, with the peak at 3 h. However, after that time point, the gene level of them was gradually attenuated. Following treatment with LPS (5 μg/ml), the level of p-NF-κB began to increase at 15 min, gradually reached the peak at 1 h, and then decreased. But the level of p-NF-κB at 2 h was still significantly higher than that of medium control. 5 μmol/L of BAY11-7085 decreased significantly the up-regulation of CD40 and ICAM-1 induced by LPS. Conclusion LPS enhanced the expression of CD40 and ICAM-1 on RPMCs in a concentration-dependent and a time-dependent manner. LPS induced expression of CD40 and ICAM-1 depend on the NF-κB signal transduction pathway.

Survival analysis of lupus nephritis with neuropsychiatric systemic lupus erythematosus / 中华肾脏病杂志

Objective To investigate the survival rate and the influencing factors in lupus nephritis (LN) patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Methods Clinical characteristics and biochemical markers of 78 patients including 59 variances were analyzed. Patients were followed up from the onset of NPSLE to death. Patient survival rate was estimated by Kaplan-Meier method. Cox regression model was used to analyze influencing factors. Results Sixteen (20.5%) of 78 patients died of SLE or its complications. Infection was the main cause of death (31.3%). One-, 3-, 5- and 10-year survival rates were 83.2%, 81.7%, 76.7% and 76.7%, respectively. Hypertension (RR =6.965,95% CI:1.578-30.746, P= 0.010), pulmonary infection (RR=8.171,95% CI:1.954-34.177, P=0.004)and acute renal failure (RR=6.978,95%CI:2.063-23.609, P=0.002) were risk factors of mortality, while cyclophosphamide (CTX) impulse therapy (RR =0.130,95 % CI:0.031-0.541, P=0.005) and resolution of NPSLE (RR= 0.169, 95%CI:0.042-0.679,P=O.012)were protective factors. Conclusions Infection is the main cause of death in patients of LN complicated with NPSLE. Survival rate of LN patients with NPSLE in this study is lower than those of LN and NPSLE alone reported by other authors. Hypertension, pulmonary infection and acute renal failure are risk factors of mortality, while CTX impulse therapy and resolution of NPSLE reduce the mortality and improve the prognosis.

Diagnostic significance of lupus band test in systemic lupus erythematosus / 中华风湿病学杂志

0 05).Of patients with lupus renal lesions 86% had a positive LBT (+LBT),which was significantly higher than that of patients without renal lesions(37%) ( P

Hyaluronan preserves the membrane transport properties in chronic peritoneal dialysis animal model of rats / 中国病理生理杂志

AIM: We have shown that intraperitoneal (IP) addition of hyaluronan could increase peritoneal fluid removal by decreasing peritoneal fluid absorption rate. In this study, we investigated the impact of chronic use of hyaluronan on peritoneal membrane transport characteristics. METHODS: Twenty male SD rats received daily IP injection of 25 mL 4.25% glucose dialysis solution without (HP, n=8) or with 0.025% hyaluronan (HA, n=6) for one week, another six rats did not receive any peritoneal injection. Twenty-four hours after the last injection, a 4h dwell study using 25 mL 4.25% glucose dialysis solution with IP volume marker and frequent dialysate and blood samplings were performed in each rat. RESULTS:IPV was significantly higher in the HA group as compared to the HP group (ANOVA repeated measurement, P

Hyaluronan synthase-2-specific antisense oligonucleotides inhibit the formation of extracellular coat in human peritoneal mesothclial cells / 中华肾脏病杂志

Objective To define which hyaluronan synthase (HAS), of three hyaluronan synthesizing enzymes HAS-1, HAS-2, and HAS-3, is primarily responsible for hyaluronan synthesis and extracellular matrix/extracellular coat formation in human peritoneal mesothelial cells (HPMCs) . Methods As a prerequisite study, the expression of each HAS mRNA in cultured HPMCs was measured by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). Only the expression of HAS-2 and HAS-3 mRNA could be detected. The level of HAS-2 mRNA expression was about 10 fold higher than that of HAS-3. HAS-2 specific antisense oligonucleotide was then transfected into cultured HPMCs by lipofectamine. After 0, 8, 24, and 48 hours, the expression of HAS-2 mRNA was detected by RT-PCR and the extracellular coat was measured by particle exclusion test. Results 8 hours and 24 hours after transfection, the expression of HAS-2 mRNA in HPMCs decreased by 58% and 89% respectively; 48 hours after transfection, the expression of HAS-2 mRNA in HPMCs partially restored to 25% of the normal level. Correspondingly, 24 hours after transfection, the extracellular matrix/extracellular coat in HPMCs almost completely disappeared. However, as control, sense and reverse oligonucleotides showed no effect. Conclusion HAS-2 plays a leading role in HPMCs hyaluronan synthesis and the formation of extracellualr matrix/extracellular coat.

Effect of osmotic agents on hyaluronan synthesis in human peritoneal mesothelial cells / 中国病理生理杂志

AIM: To understand the effect of osmotic agents on hyaluronan synthesis in human peritoneal mesothelial cells(HPMCs). METHODS: Cultured HPMCs were stimulated with 90 mmol/L glucose(HG), 30 mmol/L glucose(LG), 5% polyglucose(PG) and 90 mmol/L mannitol. Extracellular cell coats were examined using particle exclusion assay, the expressions of hyaluronan synthase 2 and 3(HAS-2 and HAS-3) mRNA in HPMCs were measured by reverse transcription-polymerase chain reaction(RT-PCR). The concentration of hyaluronan in cultured medium was measured by hyaluronan radio-immunoassay kits. RESULTS: HAS-2 mRNA expressions in the four experimental experimental groups were significantly higher than that of the control group. However, only HG enhanced HAS-3 mRNA expression. The sizes of the extracelluar coat in the four experimental groups were not significantly different from that of the control. In addition, hyaluronan concentrations were significantly higher in the four experimental groups as compared with the control group. The hyaluronan concentration in HG group was much higher than that of the LG, PG and mannitol groups. CONCLUSIONS: Although polyglucose increased HAS-2 mRNA expression, it tended to have no effect on HAS-3 mRNA in HPMCs. This result implies that polyglucose might be more biocompatible to peritoneum in peritoneal dialysis as compared with hypertonic glucose.