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With the deepening of China′s medical reform, in order to further improve the utilization efficiency of medical resources, public hospitals have actively explored the establishment of different forms of hospital groups, made many useful attempts in the group operation mode, and accumulated a lot of experience. Taking the group construction practice of Peking University Third Hospital as an example, the authors probed into effective implementation paths for group construction of public hospitals from the aspects of management mode, governance structure, resource sharing, homogeneous management among others. By creating a management model of compact hospital districts, compact community health service centers, and semi compact trusteeship branches, the group had constantly refined the development path of discipline construction, and promoted the comprehensive integration and development of medicine, education, research. On such basis, the group had paved a solid and effective path in the aspects of expanding the influence of the hospital, and promoting the implementation of hierarchical medical service, for references in high-quality development of public hospitals.
RESUMO
Academic Papers published with hospital-based data between 2004～2013 on top 5％ impact factor journals in all JCR 184 subject categories were reviewed in the study.All of them were differentiated to 3 groups according to the ways of collaboration between authors.The distribution of these papers institutions and subjects were studied and questionnaire survey to hospitals was also used.It's found that the multidisciplinary collaborating work is a key factor to publish high impact papers which showed the central tendency in subjects and institutions levels,active management measures on interdisciplinary development will contribute the outcome of high impact papers.
RESUMO
Ninty-eight patients of type 2 diabetes mellitus with mild cognitive impairment were collected according to the Montreal Cognitive Assessment( MoCA )and mismatch negativity( MMN ).Forty-eight patients were assigned to conventional treatment with nimodipine (20 mg/d).The MoCA and MMN were evaluated and compared with the remaining 50 patients who served as a control group.There was no significant difference between two patient groups in MoCA( P＞0.05 ) ;the latency and amplitude of MMN were significantly improved in the treated group( P＜0.05 ) ; the amplitude of MMN was reduced in control group ( P＜0.05 ),but the latency of MMN showed no significant change( P＞0.05 ).
RESUMO
Objective To explore the methods for early detection of cognitive impairment in type 2 diabetic patients. Methods With the results from the mini-mental state examination (MMSE) ,48 patients of type 2 diabetes mellitus with cognitive impairment (group B) and 52 without cognitive impairment (group A) were enrolled. And 40 healthy subjects served as control. The clinical, laboratory, and imaging data of these subjects were compared. Results No differences in the prevalence of carotid atherosclerosis, serum HbA_1C, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesteroi, body mass index, and waist-to-hip ratio were found between groups A and B. Atrophy of temporal lobe and hippocampus was more marked in group A than that in group B by MRI. The demyelinating changes were found both in group B (35%)and A (12%). Among 3 groups, group B had the longest latency of mismatch negativity (MMN) and P300 and the lowest amplitude of MMN ; the order was followed by group A and control group (all P<0.05). Logistic regression analysis showed that the findings in MRI, P300, MMN were negatively correlated with cognitive impairment in type 2 diabetes mellitus. Conclusion MRI, MMN, and P300 are helpful in detecting cognitive impairment in type 2 diabetic patients. MMN seems to be more sensitive in early detection of the impairment.