DRG medical service performance evaluation based on entropy weight TOPSIS and rank sum ratio method / 中华医院管理杂志

Objective:To evaluate medical service performance of the DRG pilot public hospitals in a city was carried out by using the entropy weight TOPSIS and the rank sum ratio method, so as to provid the decision-making basis for the DRG pilot reform and the high-quality development of public hospitals.Methods:The case-mix index(CMI) value, the number of DRG groups, the time consumption index, the cost consumption index, and the low-risk mortality rate were obtained from the first page of medical records of 21 DRG pilot hospitals in a city from January 2019 to December 2020.The entropy weight TOPSIS method and the rank sum ratio method were used to evaluate the medical services performance of 21 DRG pilot hospitals.Results:The CMI value and the number of DRG groups in 21 DRG pilot hospitals increased from 0.81 and 353 in 2019 to 0.86 and 369 in 2020 respectively, and the time consumption index decreased from 0.98 to 0.92. The entropy weight TOPSIS method and the rank sum ratio method had good consistency and correlation with the hospital performance evaluation results from 2019 to 2020 ( P<0.05). The overall ranking of the performance evaluation of pilot hospitals in 2020 was higher than that in 2019, the tertiary hospitals were higher than secondary hospitals, and hospitals were higher than maternal and child health care hospitals. Conclusions:The DRG payment reform had promoted the quality and efficiency of medical services in the city.

TAZ promoting angiogenesis and its mechanism in gastric cancer / 中国肿瘤临床

Objective: To determine the expression of TAZ and its role in angiogenesis in gastric carcinoma. Methods: Immunohistochemical staining was performed to investigate the expression of TAZ and to determine whether a direct relationship exists between TAZ and β-catenin. Transfection with TAZ overexpression plasmid in MKN28 cells was conducted to induce exogenous expression of TAZ and a TAZ knockdown plasmid was transfected into MGC803 cells to reduce TAZ levels. The effects on endothelial cell formation, proliferation, and migration were determined by Matrigel three-dimensional culture, MTT proliferation assay and Transwell migration assay. In addition, the expression of TAZ and β-catenin in transfected gastric cancer cells was detected by Western blot. Results: Immunohistochemistry showed that TAZ protein was expressed in 64 of 150 gastric cancer sample tissues (43%), TAZ was localized in the nucleus, and its expression was associated with tumor grade, TNM stage, metastasis, and microvessel density (MVD) (P<0.05). In addition, the expression frequency of β-catenin in the TAZ positive group was 67.2%, which was significantly higher than that in the TAZ negative group, and the expression of TAZ was positively correlated with β-catenin. After transfection, TAZ overexpression increased the expression of β-catenin and enhanced HUVECs tube formation, proliferation, and migration. In the MGC803 cells transfected with the knockdown plasmid, β-catenin levels were decreased and HUVECs motility was inhibited. Conclusions: TAZ may promote angiogenesis in gastric cancer by promoting β-catenin expression.

IQGAP1 promotes vasculogenic mimicry by increasing stemness in hepatocellular carcinoma / 中国肿瘤临床

Objective:To examine the expression of IQGAP1 in hepatocellular carcinoma and its effect on vasculogenic mimicry(VM). Methods:Immunohistochemical staining was performed to investigate the expression of IQGAP1.CD31/PAS double staining was per-formed to detect VM and analyze the correlation of IQGAP1 and VM.HepG2 cells were transfected with an IQGAP1 overexpression plasmid to induce exogenous expression of IQGAP1,and an IQGAP1 knockdown plasmid was transfected into SMMC7721 cells to re-duce IQGAP1 levels.The expression of cancer stem cell markers CD133,CD44,Sox2,and ALDH1 was analyzed by Western blot and compared with that in the control.Cellular functional experiments were used to determine the role of IQGAP1 in promoting cancer cells' ability of invasiveness and migration, proliferation, and VM formation. Results: Immunohistochemical analysis revealed that IQGAP1 was mainly located in the cell membrane and/or cytoplasm,and the staining intensity was correlated with tumor grade,me-tastasis,and VM(P<0.05).Cells transfected with the overexpression plasmid showed enhanced CD133,CD44,Sox2,and ALDH1 levels due to the increase in IQGAP1 and exhibited increased invasion ability,proliferation,and VM formation.In the SMMC7721 cells trans-fected with the knockdown plasmid,CD133,CD44,Sox2,and ALDH1 levels were decreased and motility was inhibited.Conclusions:IQGAP1 supports malignant behavior in hepatocellular carcinoma and may promote VM by increasing stemness.

Design of a high speed data acquisition system for biological mass spectrometers / 军事医学

Objective To develop a high-speed data acquisition system with sampling frequency of 2 GHz to meet the requirement of accurate measurement of flight time.Methods The ALTERA STRATIX Ⅲ series FPGA was used as the main control chip, matching with high-performance ADC chip with sampling frequency up to 2 GHz and sampling accuracy up to 12 bit, while extending 512 MB DDR3 SDRAM for data cache and exchanging data with the host computer through Gigabit Ethernet.In addition, a variety of PCB wiring methods were used to effectively ensure the signal integrity.Results The 250 MHz sine signal was input into the data acquisition board with 2 GHz sampling frequency,by analyzing and calculating the sampling data,acquired the following performance index of SNR=44.6639 and ENOB=7.1.Conclusion This high-speed data acquisition system based on ADC technology is a fast and reliable path and method for the measurement and analysis of biological mass spectrometry data.

Determination of multiple optical parameters of red blood cell suspension / 军事医学

Objective To develop a measurement method for determination of optical parameters of a red blood cell ( RBC) suspension based on the measurement of spatial scattered light signals without using an integrating sphere.Methods Multiple independent photoelectric sensors and light intensity modulation were used to obtain the measured values of diffuse reflectance,diffuse transmittance and collimated transmittance.The measured data results were imported into a Monte Carlo simulation based RTE to inversely determine the absorption coefficient, scattering coefficient and anisotropy factor of the measured sample using a new perturbation method.Results The described measurement method was applied to determine the optical parameters of a polystyrene microsphere suspension with a mean diameter of 2.6μm,and the results were essen-tially consistent with the calculated optical parameters by Mie code.Then, the RBC suspension was used for testing optical parameters,and the results were basically consistent with the parameters in the literature.Conclusion The system based on the measurement of spatial scattered light signals without using an integrating sphere will provide a quick and accurate approach for quantitative analysis of free hemoglobins and RBC suspensions.

Effect of NCA on excitation-contraction coupling of cardiac muscle from phospholamban knockout mice / 中国病理生理杂志

AIM:Nitroxyl ( HNO) increases myofilament Ca 2+responsiveness relative to increases in intracel-lular Ca2+in cardiac muscle.In this study, we further investigated this effect of HNO on trabecular muscles from phospho-lamban knockout ( PLB-KO) and wide-type ( WT ) mice using a novel HNO donor , 1-nitrosocyclohexyl acetate ( NCA ) . METHODS:Trabecular muscles were dissected from the right ventricles of the rat hearts and mounted between a force transducer and a motor arm.The muscles were superfused with K-H solution (pH 7.4) at room temperature.Fura-2 was loaded into the trabecular muscles via electrophoresis .The length of the sarcomere was set to 2.2~2.3μm.During stead-y-state activations, the maximal Ca2+-activated force and Ca2+required for 50% activation were measured.RESULTS:The intracellular Ca 2+transients and force of the PLB-KO muscles at baseline were higher than those of the WT muscles and exhibited a negative force-frequency relationship (FFR).NCA (2.5μmol/L) increased systolic force in both PLB-KO group and WT group at any given [Ca2+]o.However, there was more dramatic increase in the force development due to moderate increases in the intracellular Ca 2+transients in the WT muscles when external Ca 2+increased from 1.5 to 4.5 mmol/L under NCA.NCA did not affect the negative FFR in PLB-KO muscle.Steady-state force-Ca2+relations obtained from skinned muscles were not different between the 2 groups, while NCA increased Ca2+responsiveness in skinned mus-cles from both PLB-KO and WT mice.CONCLUSION:HNO increases force development in both PLB-KO and WT mus-cles as a result of increases in myofilament Ca 2+responsiveness .The increased intracellular Ca 2+transients are accompa-nied by greater force development in WT mice , suggesting that HNO improves Ca 2+activation and establishes HNO as a positive inotropic agent with novel mechanisms .

Historical evolution and chinese definition of global health / 中华预防医学杂志

Under the background of globalization, public health issues are becoming more and more complicated. In the international arena, global health has gradually replaced international health and "global public health" as one of the dominant terms in the field of public health. However, until now, there is no unified understanding and definition for the concept of global health domestically and internationally. In this article, various foreign experts 'views and domestic experts' opinions about the concept of global health are collected and solicited, in order to generalize appropriate Chinese definition of global health of China.

Design and implementation of auto-control system for high-throughput and multi-channel DNA synthesis / 军事医学

Objective To establish an auto-control system for high-throughput and multi-channel DNA synthesis which can simultaneously and quickly synthesize up to 96 different oligonucleotides in a 96-well microtiter format.Methods The PLC and its extended modules is used as the main-control unit, which executes the DNA automatic synthesis process according to the synthesis sequences and steps set by the user,and the manual injecting reagent etc.And the configuration software and VC6.0 were used for programming the man-machine interface sofeware to set synthesis parameters, position calibration,flux calibration data etc, and communicated with PLC.Results The synthesis application of about 150 000 DNA chains has proved that the synthesis cycle time for 96 couplings was 4 min,the average coupling efficiency was 99%across the entire 96-well plate,the monomer reagent usage was reduced by 50 percent,and the synthesis configuration was more flexible.Conclusion A reliable and simple auto-control system is provided for parallel synthesis of 96-channel oligonucleotide chains,which can meet the demands of high-throughput and multi-channel DNA synthesis.

Effect of human umbilical cord WJ-MHCs on TNF-α and NT-proBNP in the rats with heart failure of acute myocardial infarction / 重庆医学

Objective To observe the influence of human umbilical cord wharton′s jelly‐mesenchymal stem cells(WJ‐MHCs) on the tumor necrosis factorα (TNF‐α) and N‐terminal pro‐brain natriuretic peptide(NT‐proBNP) in rats with heart failure of a‐cute myocardial infarction .Methods Totally 80 male rat models of heart failure of acute myocardial infarction were made by isopre‐naline(ISO) 200 mg/kg injected subcutaneously twice at an interval of 24 hours .After one week ,24 survival rats were randomly di‐vided into WJ‐M HCs transplantation group and normal control group .Sham group was made of 12 health rats ,and then each of the three groups was subdivided into pre‐transplantation group and post‐transplantation group 4 weeks later .WJ‐MHCs transplantation group was transplanted with WJ‐MHCs with DAPI labeled after ISO injected one week .Sham group and normal group were un‐treated and normally bred .The left ventricular ejection fraction(LVEF) measured by before transplantation and post‐transplantation 4 weeks later .The injected cells and the expression of TNF‐αwas measured .Results Compared to pre‐transplantation group ,WJ‐M HCs transplantation group increased the LVEF(P<0 .05);compared to pre‐transplantation and normal control ,WJ‐M HCs trans‐plantation group reduced the TNF‐αand NT‐proBNP in the serum(P<0 .05)and the expression of TNF‐α from the heart tissue (P<0 .05);compared to normal transplantation ,WJ‐M HCs transplantation group reduced the mortality from 33 .3% to 16 .7% ;immunofluorescence demonstrated that transplanted cells were still found alive in the heart after transplantation 4 weeks later .Con‐clusion Transplantation of WJ‐MHCS down‐regulates TNF‐α and NT‐proBNP in the serum in the serum and the expression of TNF‐αfrom the heart tissue and up‐regulates the LVEF in rats with heart failure of acute myocardial infarction .

The preliminary establishment and application of a new method for evaluating K-ras mutations based fluid chip / 中华检验医学杂志

Objective A new method for detecting K-ras mutations based liquid chip was used to evaluate K-ras mutations associated with non-small cell lung cancer (NSCLC) patients,to direct the personalized treatment and prognosis evaluation.Methods Take the diagnosis technology research methods,the sensitivity and repeatability of the liquid chip K-ras gene mutation detection method were assessed.A total of 100 NSCLC patients from Nov 2011 to Feb 2012 in Shanghai Chest hospital were included in this study,the fresh tumor tissues were collected for DNA extraction.The 2nd exon 12 and 13 codons,containing 8 K-ras mutations occuring in high frequency were amplified by polymerase chain reaction (PCR),followed by ligation of the PCR products to a series of special probes using ligase detection reaction (LDR),then the PCR-LDR products were analyzed by liquid chip platform.Direct sequencing was applied to compare with the detection results.Results The sensitivity of liquid chip technology detection was 10％-20％,higher than the traditional sequencing method by 1％.Average CV value was 4％-15％ and showed good repeatability.5 K-ras mutations in 100 patients (5％) were detected using multiplex PCR-LDR combined fluid chip methods,including 3 Glyl2Val and 2 Gly12Asp mutations in exon 2.The 5 K-ras mutations were verified accurately by direct sequencing.Conclusions The novel detection method of K-ras mutations based PCRLDR and fluid chip shows high throughput,high sensitivity,good repeatability and the results are reliable and accurate.This method can be used to accurately identified K-ras mutations for NSCLC patients prior to their targeted therapy with TKIs.

Central arterial augmentation index in Uygur health adults from Hetian,Xinjiang Detection by Sphygmocor pulse wave analysis system / 中国组织工程研究

BACKGROUND:Arterial stiffness is an independent risk factor for cardiovascular disease.Augmentation index(Alx)is an important marker which reflects the systemic arterial stiffness.OBJECTIVE:To investigate Alx and the affecting factors in Xinjiang Uygur health adults.METHODS:A total of 559 healthy adults(251 males and 308 females)with a mean age of(44.95±11.87)years were selected from Hetian,Xinjiang Uygur Autonomous Region.The following indexes of all subjects were measured,including questionnaire,physical examination,blood biochemistry and C-reactive protein(CRP).Central systolic blood pressure(cSBP)and central Alx were measured by Sphygmocor.Pearson correlation and partial correlation analysis were used for two-group analysis of correlation,and multiple regression analysis was used to analyze influential factors for Alx.RESULTS AND CONCULUSION:Alx was greater in female than in male and was positively related to age in both sexes(male:r=0.548,female:r =0.405,P < 0.05),as well as adjusted other influential factors(male:r=0.182,female:r =0.234,P < 0.05).Multiple regression analysis showed that cSBP,systolic blood pressure(SBP),sex,age and CRP were main factors which affected Alx in Uygur healthy adults,cSBP,SBP,age,body mass and CRP were main factors which affected Alx in the male,while cSBP,SBP,age,height and CRP were main factors which affected Alx in the female.Results revealed that Alx was greater in female than in male which was positively related to age in both sexes.Age,cSBP,SBP and CRP were main factors that affected Alx in Xinjiang Uygur healthy adults.

Development of B→O blood conversion device control system / 中国组织工程研究

B→O blood conversion has very important meanings in the blood transfusion during the period of peace and war.In the leader of Professor Zhang Yangpei,from Academy of Military Medical Sciences,B→O blood conversion has been achieved by using gene engineering.They obtained the great breakthrough in the domain of blood type conversion.In order to realize standardization and automatization,it is necessary to develop a device applying to B→O blood conversion.This device automatically accomplishes the process of B→O blood conversion,shortens the time of B→O blood conversion to quarter than the time by manual operation,and ensures the standardization and obturation.In the condition of one-off pipeline,this device meets the clinical demands for blood,and lays a foundation for clinical expansion of B→O blood conversion.This paper presented the control system of B→O blood conversion device,including design of software and hardware.This device provides a safe and efficient tool for B→O blood conversion.

Development of control system for B→O blood conversion device / 医疗卫生装备

In order to realize standardization and automatization,it necessary to develop a device for B→O blood conversion.This paper emphasizes on the control system of B→O blood conversion device,including software and hardware design,which provides a safe and rapid method for B→O blood conversion.

Development of the electronic control system for LGJ-80 freeze dryer / 医疗卫生装备

This paper introduces some information of the electronic control system for LGJ-80 freeze dryer, including its system structure, hardware system and software system. The automatic control during overall course, automatic adjustment for degree of vacuum and antijamming are realized in this paper.

Application of Fussy-PID Control in Freeze-Drier / 医疗卫生装备

Objective To improve the freeze-dryer shelf temperature control effect.Methods The fuzzy-PID control algorithm that's adjusting the PID parameters in real-time in the control process,was adopted to control the shelf temperature,expecting to adapt the changing of process parameters of shelf.Results In the process of freeze-drying temperature control shelves,the shelf temperature static performance and dynamic performance were improved,and the effect of shelf temperature control was archived satisfyingly.Conclusion In the freeze-drying process,the process parameters of shelf are changed along with the drying time and the working environment.The conventional PID control is difficult to obtain satisfactory results.The fuzzy-PID controller,which can adjust PID parameters on real-time in the controlling process,be used in the shelf temperature control,and the result is satisfied.