Study of bed resource allocation model based on DRG and performance orientation / 中华医院管理杂志

Objective:To build a hospital bed resource allocation model, for the reference of public hospitals in optimizing their bed resource allocation.Methods:Based on ReLU activation function, a hospital bed resource allocation model was constructed by combining DRG and public hospital performance appraisal requirements, including discharge person times, average length of stay, hospital bed utilization rate, proportion of surgery, proportion of fourth level surgery, case mix index, average bed day income and other indicators. When the existing number of hospital beds available was greater than the number of hospital beds allocated for the first time, a secondary allocation should be made. A tertiary general hospital was taken as an example for a model analysis.Results:As found in the model analysis, among the 2 729 beds of the hospital in the first allocation, 110 beds were left available for secondary allocation. The results of bed allocation of 40 inpatient departments in the hospital were as follows: 15 departments need more beds, 3 departments need more beds and shorter length of stay, 2 departments need no change, 1 department needs shorter length of stay, 4 departments need less beds, and 15 departments need less beds and shorter length of stay.Conclusions:The bed resource allocation model enriches the connotation of indicators, reflects the specialty characteristics. These indicators can be flexibly adjusted in combination with hospital development planning and budget management, hence conducive to refined management of hospital bed resources in public hospitals.

Effect of Terpinen-4-ol on the proliferation of lung adenocarcinoma A-549 cells in vitro and in vivo / 局解手术学杂志

Objective To investigate the effect of Terpinen-4-ol on the proliferation of lung adenocarcinoma A-549 cells and its related mechanism. Methods A-549 cells were treated with different concentrations of Terpinen-4-ol. The inhibitory effect of Terpinen-4-ol on A-549 cells was tested by MTT method. Cell grow ability was determined by CCK-8 colorimetry. The ultrastructure of A549 cells were observed by transmission electron microscopy before and after Terpinen-4-ol treatment. The changes of cell cycle, apoptosis, and the level of intracel-lular calcium were inspected by flow cytometry. Inoculated the lung adenocarcinoma A-549 cells on the nude mice to form transplantation tumor. The experimental nude mice with transplantation tumors were divided into three groups:negative control group,high dose positive con-trol group and low dose positive control group. The mice were given continuously intraperitoneal injection for 10 days, and then the transplan-tation tumors were taken and the size and weight of them were detected. Results After Terpinen-4-ol treatment for 24 h,MTT assay showed that the IC50 value of A549 cells was 0. 067% v/v. The growth curves of positive control groups were significantly smooth than the negative control group. The formation of autophagosome increased after treatment with Terpinen-4-ol. The results of flow cytometry showed that the cell cycle was arrested in S phase,Terpinen-4-ol could induce apoptosis of A549 cell, The intracellular calcium concentrations in positive control groups were significantly higher than the negative control group(P<0. 05). Low dose group and high dose group restrained the growth of the transplantation tumor obviously, and the tumor inhibitory rate were 53. 33% and 77. 76% respectively. Conclusion Terpinen-4-ol has inhibitory effect on the proliferation of A-549 cells in vitro and in vivo.

Effects of nuclear factor kappa B(NF-κB)inhibition on heat shock protein 70(HSP 70)expression in a rodent model of hemorrhagic shock / 中华急诊医学杂志

Objective To study the effects of the inhibition of nuclear factor kappa-B ( NF-κB) , on the hepatic heat shock protein 70 (HSP70) expression as well as on the changes of hepatic function and ultrastructure in a rodent model of hemonhageic shock. Method Hemorrhagic shock was produced by inducing bilateral femoral fractures in male Wistar rats. Intraperitoneal injection of pyrrolidine dithiocarbamate(PDTC)was used to inhibit NF-κB activation 1 hour before induction of shock. A total of 66 adult male Wistar rats were randomly divided into 3 groups: control group (Control, n = 6), trauma shock (TS, n = 30), and NF-κB inhibition followed by trauma shock (NF-κB inhibition, n =30). Measurements of hepatic NF-KB and HSP70, hepatic function bio-markers, TNF-α and IL-6 were obtained 0.5, 2, 4, 6, 8 hours after trauma. Histopathological changes in liver tissues were also noted. Hepatic expression of NF-κB was determined by using electrophoretic mobility shift assay, while HSP70 was assayed by western blot and analyzed with computer imaging. Results In rats with trauma shock, both hepatic NF-κB activity and HSP70 expression increased significantly compared to the control group, reaching peaks at 6 hour post injury. Serum alanine transferase (ALT) and total bilirubin (TB) also rose significantly,reaching peaks at 8 hours post trauma. Light microscopy revealed hepatic congestion with infiltration of inflammatory cells into hepatic sinusoid in the TS group at 8 hours. Inhibiting the activity of NF-κB one hour before trauma significantly decreased expression of HSP70 at 6 hours post trauma [16.9±4.4 (NF-κB inhibition) vs. 23.0±1.7 (TS), P ＜ 0.05]. In addition,levels TNF-α and IL-6 in the liver tissue also decreased, and hepatic congestion as well as hepatic cell degeneration were ameliorated, showing minimal inflammatory infiltrates in the hepatic sinusoids. NF-κB inhibition also significantly lowered the levels of ALT and TB at 4 hours post trauma [ALT, 540.8 ±66.2 nmol/L (NF-KB inhibition) vs. 640.6±80.2 nmol/L (TS), P ＜ 0.05; TB,2.3±0.3 mol/L (NF-κB inhibition) vs. 4.7 ±1.1 mol/L (TS), P ＜ 0.05]. Conclusions NF-κB and HSP70 are involved in the pathogenesis of hepatic injury during hemorrhagic shock, and the degree of NF-κB activity and HSP70 expression may be consistent with the extent of hepatocellular damage. Inhibition of NF-κB helps ameliorate liver injury due to trauma shock.

Effects of ursolic acid on proliferation of transplanted glioma in nude mice and its mechanisms / 第三军医大学学报

Objective To investigate the effects of ursolic acid on the expression of extracellular signal regulated kinase(ERK1),C-Jun,C-Myc,Cyclin D1 in transplanted tumor of malignant glioblastoma cell line C6 in nude mice and the related mechanisms.Methods C6 glioblastoma cells were subcutaneously injected into nude mice to establish the subcutaneous model of glioblastoma in nude mice,and then the mouse models were divided into 3 groups: blank control group,ursolic acid group(50 mg?kg-1?d-1,intra-abdominal injection,20 d),PD98059 group(2 mg?kg-1?d-1,intra-abdominal injection,7 d).Survival of nude mice,growth and histopathological changes of the tumors were observed.The expressions of ERK1,C-Jun,C-Myc,and Cyclin D1 in the tumor tissues and the expression of ERK1 mRNA in the tumor tissues were detected by immunohistochemical technique(IHC) and in suit hybridization(ISH),respectively.Results Slow growth of the implanted tumor was found in ursolic acid group and PD98059 group.The mean volume and weight of tumors in the two groups were significantly smaller than those in the blank control group(P

Clinicopathological study of extraskeletal myxoid chondrosarcoma / 重庆医科大学学报

Objective:To investigate the clinicopathological characteristics of extraskeletal myxoid chondrosarcoma(EMC).Methods:Nine cases of extraskeletal myxoid chondrosarcoma were studied.Immunohistochemical analysis was performed in all cases and ultrastructural studies were done in 2 extraskeletal myxoid chondrosarcomas.Follow-up information was available for seven patients.Results:There were 7 males and 2 females whose ages ranged from 31 to 69 years(median 52.78 years).Local pain or tenderness and the presence of a palpable mass were the main complaints of the patients.The tumors were located mainly in the lower extremities(66.7%).Most tumors were deep-seated.They usually had a distinct multinodular configuration delineated by fibrous connective tissue.The tumor cells were arranged in delicate intersecting strands,rings,and garlands for the most part.The myxoid matrix was abundant in most cases.Immunohistochemical analysis was performed in all cases and ultrastructural studies were done in 2 extraskeletal myxoid chondrosarcomas.EMC expressed vimentin(100%,9/9),neuron-specific enolase(77.8%,7/9),S-100 protein(66.7%,6/9),synaptop hysin and chromogranin A(22.2%,2/9),None of the tumors expressed EMA and desmin.Ultrastructurally,EMC was characterized by distinct cords of cells immersed in a glycosaminoglycan rich matrix.The cells were rich in mitochondria,had well-developed Golgi apparatus and there were numerous smooth vesicles.In many cells,there were also prominent glycogen deposits and lipid droplets.Some tumor cells had intracisternal microtubules.In one of 2 extraskeletal myxoid chondrosarcomas there were 140～180 nm diameter membrane-bound dense-core secretory granules in cell bodies.Conclusion:Extraskeletal myxoid chondrosarcoma is a rare soft tissue sarcoma characterized by distinctive morphological and cytogenetical features.It was believed to represent a variant of soft-tissue chondrosarcoma owing to its histological resemblance to chondroblastic tissue in the early stages of cartilage development or chondroid tumors such as skeletal chondrosarcoma.However,the chondroid nature has been a subject of controversy,and its line of differentiation remains to be determined.A substantial proportion of EMC show immunophenotypic and/or ultrastructural evidence of neuroendocrine differentiation.EMC has high potential of local recurrence and metastasis,and a high disease-associated death rate.

Classification of tumors and cultivation of pathologists / 中华医学教育探索杂志

The latest WHO classification of tumors is the most important standard for clinicpathologic diagnosis of pathologists in medical practice.We should study,grasp,and apply it to medical practice for need of patients and ourselves.

Detection of alpha-thalassemia gene by coelocentesis in early prenatal diagnosis / 中华围产医学杂志

Objective To investigate the safety and accuracy of diagnosing alpha-thalassemia with extraembryonic coelomic cells. Methods Coelocentesis was performed before artificial abortion to collect extraembryonic coelmic fluid in 40 women with singleton pregnancy during 6-10 gestational weeks. The villi was gathered after suction. PCR technique was used to amplify alpha-thalassemia gene in both extraembryonic coelomic cells and villi and concordant rate of two different kinds of samples were compared. Results The genotypes of alpha-thalassemia were successfully amplified in 37 cases of coelomic cells and all were concordant with the results of villi. Conclusion Extraembryonic coelomic cells can be used in early prenatal diagnosis of alpha-thalassemia by PCR technique and is practicable.

Significance of expression of Flt-4 in different histopa thological grades of astrocytoma / 中国病理生理杂志

AIM: To study the significance of expressio n of fms-like tyrosine kinase 4 (Flt-4) in different histopathological grades of a strocytoma. METHODS: The surgical specimens from 50 brain astrocytoma patien ts were stained immunohistochemically for examining Flt-4 and vascular endotheli al growth factor (VEGF) expression. Intratumoral microvessel density (IMVD) was calculated by labeling the endothelial cells of the blood vessels within the tum or. RESULTS: Flt-4, VEGF expression were closely correlated with his topathological grades of astrocytoma. Flt-4 and VEGF expression were found in 52 % (26/50), 60% (30/50) of tumors. A significant correlation was found between Fl t-4 and VEGF expression (P