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Objective:To construct an evaluation indicator system for the efficiency of nursing human resources in integrated medical and elderly care institutions using Data Envelopment Analysis (DEA) and subsequently evaluate its effectiveness.Methods:This cross-sectional survey utilized literature review and investigative methods to initially establish a library of evaluation indicators for nursing human resource efficiency. The Delphi method was employed in two rounds of consultations with 17 experts from various fields, including nursing management, elderly care institution management, integrated medical and elderly care institution management, health economics management, and public health. The reliability of the indicator system was assessed based on factors such as expert enthusiasm, authority, concentration of opinions, and coordination. Adjustments, modifications, and improvements were made to the indicators based on expert opinions to establish the final indicator system. From August to December 2022, the DEA model was applied to evaluate the efficiency of 12 integrated medical and elderly care institutions in Haikou city based on this indicator system.Results:The constructed evaluation indicator system comprised 68 items divided into three levels: 9 primary indicators, 19 secondary indicators, and 40 tertiary indicators. The positive coefficients of the two rounds of expert consultations were 100% and 94.1%, with authority coefficients of 0.88 and 0.92, Kendall harmony coefficients of 0.471 and 0.348, and mean coefficients of variation of 0.16 and 0.12 ( P<0.001). DEA evaluation results for the 12 integrated medical and elderly care institutions showed that 5 were DEA effective institutions with comprehensive efficiency (OE), technical efficiency (TE), and scale efficiency (SE) values all equal to 1.000, while 7 were non-DEA effective institutions, including 4 with SE <1.000 but TE=1.000 and 3 with both SE and TE<1.000. Conclusions:The constructed evaluation indicator system demonstrates high enthusiasm, authority coefficients, and coordination in expert consultations, indicating high acceptability and comprehensive content with distinct levels and strong specialty characteristics. The DEA model′s evaluation results objectively and effectively reflect the efficiency of nursing human resources in integrated medical and elderly care institutions, demonstrating practical utility.
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Objective To explore the change of cellular immune function in renal cancer patients adopting thymopetidum (TP-5) combined with cytokine-induced killer cells (CIK) in peroperative period,and evaluate its curative effect.Methods Forty-one cases of Ⅰ-Ⅲ stage renal cancer patients adopting CIK treatment postoperatively were enrolled in this study for retrospective analysis.According to applicating condition of TP-5,the patients were divided into two groups:16 cases of combination group (TP-5+CIK) and 25 cases of CIK group.The patients in combination group were given TP-5 intramscular injection everyday from preoperative 1 d to postoperative 3 weeks,once a day.Peripheral blood mononuclear cell was collected in the patients of two groups,which was cultivated for 2 weeks and then transfused.Fasting peripheral blood 1 week (before collected peripheral blood mononuclear cell),3 weeks (before CIK retransfusion),4 weeks(after CIK retransfusion for 1 week) and 5 weeks(after CIK retransfusion for 2 weeks) after operation were examined,the peripheral blood T cell subgroups (CD3+,CD4+,CD8+) and nature killer cell (NK cell) levels were detected using flow cytometry.Results At 1 week and 3 weeks (before CIK) after operation,the levels of CD3+,CD4+/CD8+ and NK cell in combination group were significantly higher than those in CIK group:1 week after operation:0.542 ± 0.063 vs.0.491 ± 0.054,0.94 ± 0.09 vs.0.90 ± 0.12,0.247 ± 0.025 vs.0.223 ± 0.033;3weeks after operation:0.641 ±0.058 vs.0.587 ±0.062,1.71 ±0.13 vs.1.02 ±0.07,0.319 ±0.038 vs.0.264 ± 0.047).There were significantly differences (P＜ 0.05).At 4 weeks after operation,the levels of CD3+,CD4+/CD8+ and NK cell in combination group were significantly higher than those in CIK group:0.698 ± 0.041vs.0.649 ± 0.050,2.01 ± 0.11 vs.1.64 ± 0.09,0.331 ± 0.029 vs.0.289 ± 0.034.There were significantly differences (P ＜ 0.05).At 5 weeks after operation,the levels of CD3+,CD4+/CD8+ and NK cell in two grotups were no significant difference (P ＞ 0.05).At 4 and 5 weeks after operation,the levels of CD3+,CD4+/CD8+ and NK cell in two groups were significantly higher than those of 3 weeks after operation (P ＜ 0.05).None of patients occurred acratia,hyperpyrexia,shivering and so on.Conclusions The application of TP-5 treatment in peroperative period can promote the recovery of cellular immune function,which has synergistic effect with CIK.The value of TP-5 is worthy of promotion.
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With the aggravation of enviromental pollution, a quickly, sensitive, inexpensive monitoring means should be developed to protect water resources. Luminescent bacteria as biosensor have the advantages mentioned above. During past two decades, luminescent bacteria toxicity test was used widely in comprehensive toxicity evaluation, screening, monitoring and specific pollutants detection in water, the recent progress in this field was reviewed in this paper.