Research advance in preparation and functional modification of porous polytetrafluoroethylene artificial blood vessels / 中国组织工程研究

BACKGROUND:Medium-and large-diameter polytetrafluoroethylene artificial blood vessels have been widely used in clinical practice.However,most of the products were imported from other countries.Small-diameter porous polytetrafluoroethylene vessels are easy to form thrombosis and intimal hyperplasia,resulting in an extremely low long-term patency rate,which is difficult to fulfill clinical requirements. OBJECTIVE:To review and summarize the research progress of polytetrafluoroethylene in the field of artificial blood vessels,which can provide a reference for the functional modification of small-diameter polytetrafluoroethylene artificial blood vessels and the improvement of their long-term patency rate. METHODS:The relevant articles published from October 2022 to March 2023 in CNKI,Web of Science,Wiley Online Library,SpringerLink,Science Direct and IOP Science databases were searched by the first author.The search terms in Chinese were"porous polytetrafluoroethylene,vascular graft,electrospinning,medical application,functional modification".The search terms in English were"ePTFE,porous polytetrafluoroethylene,vascular graft,electrospinning,medical application,functional modification".All the articles about the preparation and modification of polytetrafluoroethylene artificial blood vessels were retrieved. RESULTS AND CONCLUSION:The preparation and functional modification of porous polytetrafluoroethylene artificial blood vessels were still research hotspots and difficult problems.From the research progress in and outside China in recent years,the preparation of porous polytetrafluoroethylene artificial blood vessels mainly adopted the rapid thermal stretching method,but the preparation of polytetrafluoroethylene artificial blood vessels by electrospinning was a promising new method.By analyzing and summarizing different functional modification methods,it was found that the long-term patency rate of porous polytetrafluoroethylene artificial blood vessels had been improved.However,the functional modification of small-diameter polytetrafluoroethylene artificial blood vessels still needed further exploration and optimization.

Study on the Competition Status and Spatial Correlation of Medical Market in Beijing / 中国医院管理

Objective To analyze the competition status and spatial autocorrelation of Beijing medical market from 2015 to 2019.Methods The Herfindahl-Hirschman Index(HHI)was used to calculate the degree of market competi-tion in 16 districts of Beijing,and the Moran index was used to calculate the spatial autocorrelation of market compe-tition.Results Except for the number of discharged patients,the average HHI of the number of health technicians,the number of beds and the total number of medical visits in 16 medical markets in Beijing from 2015 to 2019 showed a downward trend between 0.2 and 0.4,and the spatial global Moran index of the HHI index was all less than 0,showing a spatial negative correlation with the degree of competition in the medical market.Conclusion The medical market competition in Beijing is strengthened,the competition gap between urban and rural areas is large,and the competition in adjacent markets is mutually exclusive.It is suggested to strengthen the differentiated develop-ment of hospitals,strengthen the balanced layout between regions,and promote the low-competitive market with cross-regional medical association,forming a positive spillover effect.

A Study on High-Quality Development of Public Hospitals Based on Bibliometric / 中国医院管理

Objective To analyze the current status of high-quality development research in public hospitals,sum-marize the connotation and paths,and provide a reference for promoting the high-quality development of public hos-pitals.Methods Using"public hospitals"and"high-quality development"as the title,keywords or themes,1802 articles were retrieved from CNKI and Wanfang databases from January 1,2018,to December 31,2022,for bibliometric analysis.Results The number of articles has increased year by year,published in 235 domestic journals.The authors'institutions are mainly located in the eastern part of China.Among the specific contents,there are the most articles on the"operation management system".In 2021,with the introduction of relevant policies,re-search on the connotation and paths of high-quality development in public hospitals has increased.Conclusion The re-search on high-quality development in public hospitals is growing rapidly,with rich connotations and gradually clear paths,but still faces many difficulties.

Meta-analysis of the prevalence of Giardia duodenalis in sheep and goats in China.

Giardia duodenum (G. duodenalis) can cause giardiasis and infect a variety of hosts. So far, there have been no detailed data regarding the positive rate of G. duodenalis in sheep and goats in China. Here, a systematic literature review was carried out to investigate the epidemiology of G. duodenalis in sheep and goats in China. To perform the meta-analysis, the databases CNKI, VIP, WanFang, PubMed, Web of science and ScienceDirect were employed for screening studies related to the prevalence of G. duodenalis in sheep and goats in China. The total prevalence of G. duodenalis in sheep and goats was estimated to be 7.00% (95% CI: 4.00-10.00). In the age subgroup, the prevalence of G. duodenalis in sheep and goats of >12 months (11.29%; 95% CI: 8.08-14.97) was higher than that in sheep and goats of ≤12 months (7.57%; 95% CI: 3.95-12.24). An analysis based on seasons showed that the prevalence of G. duodenalis in sheep and goats was higher in summer (11.90%; 95% CI: 0.50-35.05) than that in other seasons. The prevalence of G. duodenalis in sheep and goats after 2016 was 8.57% (95% CI: 5.34-11.79), which was higher than others. The highest prevalence of G. duodenalis in sheep and goats was 13.06% (95% CI: 6.26-19.86) recorded in Southwestern China. The prevalence of Giardia infection in sheep (7.28%; 95% CI: 2.30-14.73) was higher than that in goats (5.43%; 95% CI: 2.73-8.98). The NOAA's National Center for Environmental Information (https://gis.ncdc.noaa.gov/maps/ncei/cdo/monthly) was used to extract relevant geoclimatic data (latitude, longitude, elevation, temperature, precipitation, humidity, and climate). By analyzing the data of each subgroup, it was shown that region, genetype, and climate were potential risk factors for giardiasis prevalence in sheep and goats. Based on the analysis of common factors and geographical factors, it is recommended to strengthen effective management measures (e.g. ventilation and disinfection in warm and humid areas) and formulate relevant policies according to local conditions. Breeders should strengthen the detection of G. duodenalis in sheep and goats, customize corresponding control measures according to the diet and living habits of sheep and goats, and strengthen the protection of sheep and lamb calves, so as to reduce the incidence rate and reduce the economic loss of China's animal husbandry.

Research progress in hepaticalveolar echinococcosis leading to cirrhosis / 中国人兽共患病学报

Alveolar echinococcosis is a zoonotic parasitic disease caused by an infection with Echinococcosis multilocularis.The liver is the primary organ of alveolar echinococcosis.Alveolar echinococcosis is usually characterized by invasive growth and consequently iscalled"parasitic cancer."Resection of radical lesions is a preferred and effective treatment for hepatic alveolar echinococcosis.End-stage hepatic alveolar echinococcosis often occurs with parasiticcirrhosis,such as secondary biliary cirrhosis,congestive liver cirrhosis or Budd-Chiari syndrome.Few studies have examined hepatic multilocular echinococcosis leading to cirrhosis.This article reviews the aspects of hepatic alveolar echinococcosis involving the invasion of important blood vessels and bile ducts,thereby leading to secondary biliary cirrhosis and congestive liver cirrhosis caused by hepatic alveolar echinococcosis.

Study on the evaluation of organizational capability and maturity of primary medical institutions in Beijing / 中国卫生政策研究

Objective:To evaluate the current situation of organizational capacity and maturity of primary medical institutions(PMIs)in Beijing,and to provide a reference for improving organizational capacity and promoting sustainable development of PMIs.Methods:This study designs a self-assessment questionnaire based on the organizational capability index system established in the previous stage,and selects all PMIs in D district(urban)and S district(suburban)of Beijing as the research objects.Ten middle managers who are familiar with the operation of their organizations are selected from each organization as questionnaire respondents.A total of 295 valid questionnaires are collected and the organizational capability score and maturity of each PMIs are evaluated on the basis of verifying the reliability and validity of the questionnaires.Results:The score of organizational capability of the 33 PMIs included in this study is 4.10±0.40,and it indicates that the organizational capability of D district is higher than that of S district in all dimensions.In general,core capability in the first level indicators is the highest and development capability is the lowest.In the second level indicators,the score of prevention and control of infectious diseases capacity is the highest and the score of resource management capability is the lowest.Most of the PMIs are in the phase of basic stability and steady development.Conclusions:There are differences in the organizational capacity among PMIs in Beijing,and PMIs in developed areas are more likely to have higher organizational capacity.The PMIs in Beijing have moved out of the initial stage of development,but they should still focus on improving their resource management capability and learning capability.In addition,the PMIs should also pay attention to the cultivation of development capacity.

Current situation and influencing factors of physicians′ innovative behavior in Beijing municipal hospitals / 中华医院管理杂志

Objective:To understand the current situation of physicians′ innovative behavior and its influencing factors in Beijing municipal hospitals, for reference in improving their innovation ability and encouraging high-quality development of public hospitals.Methods:A stratified sampling was conducted with 22 practicing (assistant) physicians in Beijing municipal hospitals as subjects. From October to November 2022, a questionnaire survey was conducted to understand the innovative behavior, innovative self-efficacy and innovative atmosphere of such practicing (assistant) physicians. SPSS 25.0 was used for descriptive analysis of the data, while t-test, variance analysis and linear regression were used for univariate analysis. Furthermore, multiple linear regression was adopted to explore the influencing factors of innovative behavior of such practicing(assistant) physicians. Results:A total of 2 178 questionnaires were distributed in this study, and 1 906 valid ones were recovered, with effective recovery of 87.51%. Scores of innovative behavior, innovative self-efficacy and innovative atmosphere of 1 906 practicing (assistant) physicians scored (4.00±0.70) points, (3.85±0.74) points and (3.98±0.66) points respectively. The results of univariate analysis showed scores of statistical significance regarding the innovative behavior of practicing (assistant) physicians with different marital status, educational background, professional title, position, department type, innovative self-efficacy level and innovative atmosphere level. Multiple linear regression results showed that position, innovation self-efficacy score, innovation atmosphere score and subordinates′ incentive mechanism, as well as teamwork and resource security had statistical significance on innovation behavior score.Conclusions:The practicing (assistant) physicians in Beijing municipal hospitals are highly enthusiastic for innovation, but their innovative behavior is expected to be upgraded. In this regard, public hospitals should improve their innovation incentive mechanism, strengthen resource assurance, encourage cooperation and exchange, and create a desirable atmosphere for innovation. Furthermore, greater supply of continuing education resources is expected, supporting these physicians in their further study, advanced education, and promotion of professional titles.

Analysis of the incentive level and its influencing factors of family doctors in Beijing / 中华医院管理杂志

Objective:To analysis the incentive level of family doctors in primary medical and health institutions in Beijing, and to explore its influencing factors, so as to provide references for promoting family doctors′ contract service.Methods:From October to December 2021, 40 family doctors were randomly selected from 135 urban community health service centers in 8 districts of Beijing, and a survey was conducted on basic demographic information, institutional organizational capacity evaluation, and family doctor incentive level evaluation (including four dimensions of work value, organizational environment, personal development, and reward compensation), and the influencing factors of family doctor incentive level was analyzed. Chi-square test and Pearson correlation analysis were used for univariate analysis, and multiple linear regression analysis was used for multivariate analysis.Results:A total of 4 568 family doctors were included, and the score of family doctors′ incentive level was 3.75±0.81, among which the work value score was the highest(3.89±0.77), followed by the organizational environment score(3.69±0.92) and personal development score(3.75±0.90), and the lowest score was reward(3.75±0.90). Age, education, professional title, working years and average total working hours per week negatively affected the incentive level( P<0.05), while the average monthly income, the frequency of attending training and further study, and the organizational ability of the organization positively affected the incentive level( P<0.05). Conclusions:The overall incentive level of family doctors in primary medical and health institutions in Beijing needed improvement, and there were many factors that affect the incentive level of family doctors. It was recommended to appropriately increase the salary and benefits of family doctors, reasonably arrange the workload of family doctors, strengthen the training mechanism of family doctors, and strengthen the organizational capacity building of primary medical and health institutions.

The interplays among meteorology, source, and chemistry in high particulate matter pollution episodes in urban Shanghai, China.

High particulate matter (PM) pollution episodes still occur occasionally in urban China, despite of improvements in recent years. Investigating the influencing factors of high-PM episodes is beneficial in the formulation of effective control measures. We herein present the effects of weather condition, emission source, and chemical conversion on the occurrence of high-PM episodes in urban Shanghai using multiple online measurements. Three high-PM episodes, i.e., locally-accumulated, regionally-transported, and dust-affected ones, as well as a clean period were selected. Stagnant air with temperature inversion was found in both locally-accumulated and regionally-transported high-PM episodes, but differences in PM evolution were observed. In the more complicated dust-affected episode, the weather condition interacted with the emission/transport sources and chemical conversion, resulting in consecutive stages with different PM characteristics. Specifically, there were (1) stronger local accumulation in the pre-dust period, (2) dust-laden air with aged organic aerosol (OA) upon dust arrival, (3) pollutants being swept into the ocean, and (4) back to the city with aged OA. Our results suggest that (a) local emissions could be rapidly oxidized in some episodes but not all, (b) aged OA from long-range transport (aged in space) had a similar degree of oxygenation compared to the prolonged local oxidation (aged in time), and (c) OA aged over land and over the ocean were similar in chemical characteristics. The findings help better understand the causes and evolution of high-PM episodes, which are manifested by the interplays among meteorology, source, and chemistry, providing a scientific basis for control measures.

Iterative Synthesis of 2-Deoxyoligosaccharides Enabled by Stereoselective Visible-Light-Promoted Glycosylation.

The photoinitiated intramolecular hydroetherification of alkenols has been used to form C-O bonds, but the intermolecular hydroetherification of alkenes with alcohols remains an unsolved challenge. We herein report the visible-light-promoted 2-deoxyglycosylation of alcohols with glycals. The glycosylation reaction was completed within 2 min in a high quantum yield (ϕ=28.6). This method was suitable for a wide array of substrates and displayed good reaction yields and excellent stereoselectivity. The value of this protocol was further demonstrated by the iterative synthesis of 2-deoxyglycans with α-2-deoxyglycosidic linkages up to a 20-mer in length and digoxin with ß-2-deoxyglycosidic linkages. Mechanistic studies indicated that this reaction involved a glycosyl radical cation intermediate and a photoinitiated chain process.

Study on the influencing factors of turnover intention of pre-hospital emergency nurses in Beijing / 中华医院管理杂志

Objective:To explore the influencing factors of turnover intention of pre-hospital emergency nurses in Beijing, and provide references for reducing the turnover rate of pre-hospital emergency nurses and stabilizing the pre-hospital emergency nursing team.Methods:Pre-hospital emergency nurses from 2 emergency centers in Beijing were selected as the survey objects, and a self-designed questionnaire was used to conduct an online survey in September 2019. The questionnaire covered such aspects as the main demographic characteristics, workload, doctor-patient relationship, professional identity, job burnout and turnover intention. Descriptive analysis was conducted for the data, while rank-sum test and Kappa consistency test were used for univariate analysis, and ordered logistic regression analysis was used for multivariate analysis.Results:A total of 340 valid questionnaires were received, among which 41.5% (141) of the nurses said that they occasionally considered quitting, 11.7% (40) said they often considered quitting, while the scoring of professional identity was (33.29±6.00), and that of job burnout was (63.70±14.90). Univariate analysis showed that age, work units, self-rated health status, professional identity, job burnout, seniority, workload, doctor-patient relationship, and pressure of title promotion were significant ( P<0.05). The results of multivariate analysis showed that job burnout, average number of car trips per shift, and self-rated health status were positively correlated with turnover intention, while professional identity was negatively correlated with turnover intention ( P<0.05). Conclusions:The turnover intention of pre-hospital emergency nurses in Beijing was found at a high level. The authorities are recommended to rationalize the scheduling system and increase the staffing of pre-hospital emergency nurses; establish the diversion policy, title promotion system and post risk special allowance for such nurses; and train medical aid workers to undertake the transfer and lifting of patients, so as to reduce the turnover intention of these nurses.

Mechanism of Cordycepin Inhibiting Proliferation and Promoting Apoptosis of Hepatoma Cells by Regulating Gli1 / 中国实验方剂学杂志

ObjectiveTo investigate the molecular mechanism of cordycepin inhibiting proliferation and promoting apoptosis of human hepatoma cells （HCCs）. MethodGlioma-associated oncogene homolog 1 （Gli1） gene was silenced by small interfering RNA （siRNA） and transfected into SMMC-7721 cells， and then cell proliferation was detected by cell counting kit-8 （CCK-8） assay and cell cloning assay. SMMC-7721 cells were treated with different concentration of cordycepin， and the cell proliferation and apoptosis were examined. The expression of Gli1 and the downstream related genes was determined by Real-time polymerase chain reaction（PCR） and Western blot. ResultThe mRNA and protein expression of Gli1 in SMMC-7721 cells was higher than that in normal liver cells （P<0.01）. The proliferation rate of SMMC-7721 with silenced Gli1 decreased at 72 and 96 h （P<0.05， P<0.01）， and the colony-forming capacity lowered （P<0.01） compared with those in the blank group. Compared with the control， 80 μmol·L-1 and 120 μmol·L-1 cordycepin significantly inhibited the proliferation of SMMC-7721 cells at 72 and 96 h （P<0.05， P<0.01）， and promoted the apoptosis of them （P<0.01）. Moreover， 80 and 120 μmol·L-1 cordycepin restrained the mRNA and protein expression of Gli1 in SMMC7721 cells （P<0.05， P<0.01）. At 120 μmol·L-1， cordycepin led to the decrease in the mRNA and protein levels of B-cell lymphoma-2 （Bcl-2） and c-Myc （P<0.05， P<0.01）， and the increase in the mRNA and protein expression of cysteine-aspartic acid protease-3 （Caspase-3） （P<0.05）. ConclusionGli1 is highly expressed in HCCs， and cordycepin can suppress the proliferation and enhance the apoptosis of HCCs by regulating Gli1 and the downstream apoptosis-related factors.

Temporal Patterns of Bacterial and Viral Communities during Algae Blooms of a Reservoir in Macau.

Compositions of microbial communities associated with blooms of algae in a storage reservoir in Macau, China were investigated between 2013 and 2016. Algae were enumerated by visible light microscopy. Profiles of organisms in water were examined by 16S rRNA sequences and viral metagenomics, based on next generation sequencing. Results of 16S rRNA sequencing indicated that majority of the identified organisms were bacteria closely related to Proteobacteria, Cyanobacteria, Verrucomicrobia, Bacteroidetes, and Actinobacteria. Metagenomics sequences demonstrated that the dominant virus was Phycodnavirus, accounting for 70% of the total population. Patterns of relative numbers of bacteria in the microbial community and their temporal changes were determined through alpha diversity indices, principal coordinates analysis (PCoA), relative abundance, and visualized by Venn diagrams. Ways in which the bacterial and viral communities are influenced by various water-related variables were elucidated based on redundancy analysis (RDA). Relationships of the relative numbers of bacteria with trophic status in a reservoir used for drinking water in Macau, provided insight into associations of Phycodnavirus and Proteobacteria with changes in blooms of algae.

Enhanced Nitrite Production from the Aqueous Photolysis of Nitrate in the Presence of Vanillic Acid and Implications for the Roles of Light-Absorbing Organics.

A prominent source of hydroxyl radicals (•OH), nitrous acid (HONO) plays a key role in tropospheric chemistry. Apart from direct emission, HONO (or its conjugate base nitrite, NO2-) can be formed secondarily in the atmosphere. Yet, how secondary HONO forms requires elucidation, especially for heterogeneous processes involving numerous organic compounds in atmospheric aerosols. We investigated nitrite production from aqueous photolysis of nitrate for a range of conditions (pH, organic compound, nitrate concentration, and cation). Upon adding small oxygenates such as ethanol, n-butanol, or formate as •OH scavengers, the average intrinsic quantum yield of nitrite [Φ(NO2-)] was 0.75 ± 0.15%. With near-UV-light-absorbing vanillic acid (VA), however, the effective Φ(NO2-) was strongly pH-dependent, reaching 8.0 ± 2.1% at a pH of 8 and 1.5 ± 0.39% at a more atmospherically relevant pH of 5. Our results suggest that brown carbon (BrC) may greatly enhance the nitrite production from the aqueous nitrate photolysis through photosensitizing reactions, where the triplet excited state of BrC may generate solvated electrons, which reduce nitrate to NO2 for further conversion to nitrite. This photosensitization process by BrC chromophores during nitrate photolysis under mildly acidic conditions may partly explain the missing HONO in urban environments.

Metagenomic Analysis of Fecal Archaea, Bacteria, Eukaryota, and Virus in Przewalski's Horses Following Anthelmintic Treatment.

Intestinal microbiota is involved in immune response and metabolism of the host. The frequent use of anthelmintic compounds for parasite expulsion causes disturbance to the equine intestinal microbiota. However, most studies were on the effects of such treatment on the intestinal bacterial microbes; none is on the entire microbial community including archaea and eukaryotic and viral community in equine animals. This study is the first to explore the differences of the microbial community composition and structure in Przewalski's horses prior to and following anthelmintic treatment, and to determine the corresponding changes of their functional attributes based on metagenomic sequencing. Results showed that in archaea, the methanogen of Euryarchaeota was the dominant phylum. Under this phylum, anthelmintic treatment increased the Methanobrevibacter genus and decreased the Methanocorpusculum genus and two other dominant archaea species, Methanocorpusculum labreanum and Methanocorpusculum bavaricum. In bacteria, Firmicutes and Bacteroidetes were the dominant phyla. Anthelmintic treatment increased the genera of Clostridium and Eubacterium and decreased those of Bacteroides and Prevotella and dominant bacteria species. These altered genera were associated with immunity and digestion. In eukaryota, anthelmintic treatment also changed the genera related to digestion and substantially decreased the relative abundances of identified species. In virus, anthelmintic treatment increased the genus of unclassified_d__Viruses and decreased those of unclassified_f__Siphoviridae and unclassified_f__Myoviridae. Most of the identified viral species were classified into phage, which were more sensitive to anthelmintic treatment than other viruses. Furthermore, anthelmintic treatment was found to increase the number of pathogens related to some clinical diseases in horses. The COG and KEGG function analysis showed that the intestinal microbiota of Przewalski's horse mainly participated in the carbohydrate and amino acid metabolism. The anthelmintic treatment did not change their overall function; however, it displaced the population of the functional microbes involved in each function or pathway. These results provide a complete view on the changes caused by anthelmintic treatment in the intestinal microbiota of the Przewalski's horses.

Secondary Metabolite Production Potential of Mangrove-Derived Streptomyces olivaceus.

Mangroves are intertidal extreme environments with rich microbial communities. Actinobacteria are well known for producing antibiotics. The search for biosynthetic potential of Actinobacteria from mangrove environments could provide more possibilities for useful secondary metabolites. In this study, whole genome sequencing and MS/MS analysis were used to explore the secondary metabolite production potential of one actinobacterial strain of Streptomyces olivaceus sp., isolated from a mangrove in Macau, China. The results showed that a total of 105 gene clusters were found in the genome of S. olivaceus sp., and 53 known secondary metabolites, including bioactive compounds, peptides, and other products, were predicted by genome mining. There were 28 secondary metabolites classified as antibiotics, which were not previously known from S. olivaceus. ISP medium 2 was then used to ferment the S. olivaceus sp. to determine which predicted secondary metabolite could be truly produced. The chemical analysis revealed that ectoine, melanin, and the antibiotic of validamycin A could be observed in the fermentation broth. This was the first observation that these three compounds can be produced by a strain of S. olivaceus. Therefore, it can be concluded that Actinobacteria isolated from the mangrove environment have unknown potential to produce bioactive secondary metabolites.

Effects of Gasterophilus pecorum infestation on the intestinal microbiota of the rewilded Przewalski's horses in China.

Horse botflies have been a threat to the Przewalski's horses in the Kalamaili Nature Reserve in Xinjiang of China since their reintroduction to the original range. As larvae of these parasites could infest the intestine of a horse for months, they could interact with and alter the structure and composition of its intestinal microbiota, affecting adversely its health. Nonetheless, there are no such studies on the rewilded Przewalski's horses yet. For the first time, this study characterizes the composition of the intestinal microbiota of 7 rewilded Przewalski's horses infected severely by Gasterophilus pecorum following and prior to their anthelmintic treatment. Bioinformatics analyses of the sequence data obtained by amplicon high throughput sequencing of bacterial 16S rRNA genes showed that G. pecorum infestation significantly increased the richness of the intestinal microbial community but not its diversity. Firmicutes and Bacteroidetes were found the dominant phyla as in other animals, and the parasitic infestation decreased the F/B ratio largely by over 50%. Large reduction in relative abundances of the two genera Streptococcus and Lactobacillus observed with G. pecorum infestation suggested possible changes in colic and digestion related conditions of the infected horses. Variations on the relative abundance of the genus groups known to be pathogenic or symbiotic showed that adverse impact of the G. pecorum infestation could be associated with reduction of the symbiotic genera Lactobacillus and Bifidobacterium that are probiotics and able to promote immunity against parasitic infection.

Emission Inventories and Particulate Matter Air Quality Modeling over the Pearl River Delta Region.

The Pearl River Delta (PRD) region is located on the southeast coast of mainland China and it is an important economic hub. The high levels of particulate matter (PM) in the atmosphere, however, and poor visibility have become a complex environmental problem for the region. Air quality modeling systems are useful to understand the temporal and spatial distribution of air pollution, making use of atmospheric emission data as inputs. Over the years, several atmospheric emission inventories have been developed for the Asia region. The main purpose of this work is to evaluate the performance of the air quality modeling system for simulating PM concentrations over the PRD using three atmospheric emission inventories (i.e., EDGAR, REAS and MIX) during a winter and a summer period. In general, there is a tendency to underestimate PM levels, but results based on the EDGAR emission inventory show slightly better accuracy. However, improvements in the spatial and temporal disaggregation of emissions are still needed to properly represent PRD air quality. This study's comparison of the three emission inventories' data, as well as their PM simulating outcomes, generates recommendations for future improvements to atmospheric emission inventories and our understanding of air pollution problems in the PRD region.

Research on the organizational capability and maturity status of private hospitals in China / 中华医院管理杂志

Objective:To evaluate the current organizational capacity and maturity of private hospitals in China, in references improving their organizational capacity and promoting their sustainable development.Methods:The purposive sampling method was used from May to November 2019, and private hospitals of continuous operation for 5 years or above were selected for a questionnaire survey. Self-evaluation was made on the organization capacity of these hospitals in such 12 aspects as positioning, normalization, decision making, execution, supervision, marketing, coerciveness, risk exposure, innovation, learning capacity and leadership. Based on existing models, five levels of maturity models from low to high were established, namely that of business in difficulty, that of basic stable operation, that of stable development, that of expanding business, and that of independent branding.Factor analysis was used for structural efficiency analysis, the questionnaires were subject to a descriptive analysis, and a maturity scoring was obtained based on self-evaluation of organizational capacity.Results:A total of 45 non-public hospitals were investigated in this study, and 450 valid questionnaires were recovered. The factor analysis classified the organizational capacity into basic capacity, core capacity and development capacity. The organizational capability of the hospitals scored in average 4.14 points; the development capacity scoring(3.87 points) was lower than basic capacity(4.16 points) and core capacity(4.06 points). 80% of the private hospitals were in the basic stable stage or stable development stage.Conclusions:Private hospitals feature in general lower maturity, good basic capacity and core capacity, while they tend to have weak development capacity, not to mention innovation and construction of learning organizations.

Analysis on the equity of pediatrician resource allocation in Beijing / 中华医院管理杂志

Objective:To analyze the equity of pediatrician resource allocation in Beijing from 2010 to 2019, and to provide a reference for optimizing their allocation.Methods:The data of pediatrician resources in Beijing in 2010, 2014, and 2019 were collected. The resource agglomeration degree, Gini coefficient and Theil index method were used to analyze the fairness of resource allocation of pediatricians in functional areas in Beijing.Results:In 2010, 2014, and 2019, the Gini coefficients of Beijing′s overall pediatrician resources by the dimension of the number of children were 0.386, 0.276 and 0.286, respectively, an allocation relatively reasonable. But the Gini coefficients by that of geographic areas were 0.681, 0.578 and 0.537 respectively, still unreasonable. The resource allocation of pediatricians in the four regions was fair, but the aggregation degree of pediatricians in the central area of Beijing were 70.327, 59.243, and 53.220 in the three years, far higher than that in the urban functional development area, urban development new area and ecological conservation development area of the city.Conclusions:Beijing should rationally plan and allocate pediatrician resources, in order to minimize unequal resources allocation induced by regional differences. Such means as advancing the hierarchical diagnosis and treatment system and strengthening the construction of medical alliances are expected to gradually alleviate the conflicts between the growing demand for pediatrician resources and their unreasonable allocation.