Analysis of salary characteristics and influencing factors of personnel expenditure in medical institutions in Sichuan province / 中华医院管理杂志

Objective:To analyze the salary characteristics of medical institutions and the influencing factors of personnel expenditure as found in the salary system reform of public hospitals in Sichuan province, for reference in furthering such reform in public hospitals.Methods:The data of personnel expenditure, business operation and medical services came from 96 medical institutions in 21 cities(prefectures)of Sichuan province from 2017 to 2020 by means of institutional survey. The average salary level and salary structure of medical staff were used to describe the salary characteristics, and the total salary was presented by the level of personnel expenditure. The measurement data was represented by M(IQR), the counting data was described by frequency and constituent ratio, and the influencing factors of personnel expenditure were analyzed by generalized linear mixed model. Results:From 2017 to 2020, the personnel expenditure of medical institutions increased by 13.04% annually. In 2020, the per capita salary level of medical staff was 151 900 yuan, while the basic salary and performance salary accounted for 16.20% and 54.60% of personnel expenditure respectively. The analysis results of the generalized linear mixed model showed that the average cost of patients per visit( β=0.596), the level of drugs and sanitary materials consumed per 100 yuan medical income( β=0.286), the number of medical visits( β=0.328), and the years [(2018, 2019, 2020) β=0.025, 0.052, 0.066] were positively correlated to personnel expenditure, while the average length of stay( β=-0.693), the proportion of medical service income( β=-0.392), and the balance rate of income and expenditure( β=-0.062)were negatively correlated to personnel expenditure( P<0.05). The proportion of fiscal subsidy revenue, regional GDP and asset-liability ratio were not the influencing factors of personnel expenditure( P> 0.05). Conclusions:In the reform of the salary system of the province, its salary level of medical institutions has surpassed the current wage ceiling of these institutions. As the salary distribution was mainly made based on the workload, the " baton" role of the salary system reform has begun to pay off. However, the basic guarantee role of compensation has not yet been fully leveraged.Further reform is needed in upgrading refined management, and timely dynamic adjustment of personnel expenditure in combination with the hospital's financial performance and cost analysis, and reasonably optimizing the level of medical staff compensation.

Penetrance estimation of PRRT2 variants in paroxysmal kinesigenic dyskinesia and infantile convulsions / 医学前沿

Proline-rich transmembrane protein 2 (PRRT2) is the leading cause of paroxysmal kinesigenic dyskinesia (PKD), benign familial infantile epilepsy (BFIE), and infantile convulsions with choreoathetosis (ICCA). Reduced penetrance of PRRT2 has been observed in previous studies, whereas the exact penetrance has not been evaluated well. The objective of this study was to estimate the penetrance of PRRT2 and determine its influencing factors. We screened 222 PKD index patients and their available relatives, identified 39 families with pathogenic or likely pathogenic (P/LP) PRRT2 variants via Sanger sequencing, and obtained 184 PKD/BFIE/ICCA families with P/LP PRRT2 variants from the literature. Penetrance was estimated as the proportion of affected variant carriers. PRRT2 penetrance estimate was 77.6% (95% confidence interval (CI) 74.5%-80.7%) in relatives and 74.5% (95% CI 70.2%-78.8%) in obligate carriers. In addition, we first observed that penetrance was higher in truncated than in non-truncated variants (75.8% versus 50.0%, P = 0.01), higher in Asian than in Caucasian carriers (81.5% versus 68.5%, P = 0.004), and exhibited no difference in gender or parental transmission. Our results are meaningful for genetic counseling, implying that approximately three-quarters of PRRT2 variant carriers will develop PRRT2-related disorders, with patients from Asia or carrying truncated variants at a higher risk.

Correlation between transient receptor potential canonical channel with heart and kidney injure of rat model of obstructive sleep apnea hypopnea syndrome / 浙江大学学报·医学版

OBJECTIVE@#To investigate the expression of transient receptor potential canonical channels (TRPCs) in the heart and kidney of rat model of obstructive sleep apnea hypopnea syndrome (OSAHS).@*METHODS@#Eighteen male SD rats were randomly assigned to intermittent hypoxia (IH) group (=9 ) and control group (=9). In IH group, rats were placed in a chamber and exposed to intermittent hypoxia for 8h (10AM-6PM) daily. The expression of TRPC-related mRNA and protein in the heart and kidney tissue were detected by qRT-PCR and Western blotting, respectively.@*RESULTS@#The mRNA expressions of TRPC3/TRPC4/TRPC5 in heart tissues of IH group were increased significantly compared with the control group (all >0.05); while there were no significant differences in the mRNA expressions of TRPC1/TRPC3/TRPC4/TRPC5/TRPC6/TRPC7 in kidney tissue between two groups (all 0.05).@*CONCLUSIONS@#The IH rat model shows that TRPC5 channel is likely to be involved in the OSAHS induced pathophysiological changes in the myocardium and may become a target to prevent OSAHS related cardiac damage.

Characteristic findings of the liver iron overload on MRI and the feasibility of quantitative evaluation by IDEALGIQ / 实用放射学杂志

Objective To explore the classic MRI appearance of secondary hemochromatosis (SHC)related liver iron overload, and the feasibility of quantitative evaluation of liver iron overload by iterative decomposition of water and fat with echo asymmetry and leastGsquares estimationGiron quantification (IDEALGIQ).Methods 20 patients with SHCGrelated liver iron overload (experimental group)and 20 healthy adults (control group)underwent routine liver MRI and IDEALGIQ.The MRI images were comparatively analyzed to assess the hallmark of liver iron overload.In both two groups,the R2 ? values were measured on R2 ? maps,which were generated by IDEALGIQ,then the differences in age,gender and R2 ? value between two groups were comparatively analyzed.In experimental group,the serum ferritin (SF)was detected,and a correlation analysis was tested with R2 ? value.Results For all of the 20 patients, there was signal drop of liver parenchyma on T1 and T2 Gweighted images,signal loss with susceptibility artifact on DWI images,and signal dropped on inGphase images relative to outGofGphase images.Among the 20 patients,18 cases appeared "a dark liver parenchyma"on T2 G weighted images,and the spleen signal in 3 cases was similar to liver parenchyma’s hallmark.The R2 ? values in experimental group and control group were 395.58±255.75 Hz and 41.18±7.86 Hz (t＝－6.12,P＝0.00),respectively.No significant differences between two groups were found in gender and age (χ2＝0.10,P＝0.10 and t＝0.09,P＝0.93).The liver iron overload R2? value was not correlated with SF (r＝0.1 5 3 , P＝0.15).Conclusion On MRI,the typical appearance of liver iron overload is hypointense on T1 and T2Gweighted images,especially"a dark liver parenchyma"on T2 WI,signal drops on inGphase images relative to outGofGphase images,and signal loss with susceptibility artifact on DWI images.R2 ? value of IDEALGIQ can quantitatively evaluate the liver iron overload,without a correlation with SF.

Effects of midazolam pretreatment on inflammatory responses and cell apoptosis during intestinal ischemia-reperfusion in mice / 中华麻醉学杂志

Objective To evaluate the effects of midazolam pretreatment on inflammatory responses and cell apoptosis during intestinal ischemia-reperfusion (I/R) in mice.Methods Thirty healthy male Kunming mice,weighing 18-22 g,were equally and randomly divided into 3 groups using a random number table:sham operation group (S group),I/R group,and midazolam pretreatment group (M group).Intestinal I/R was produced by occlusion of the superior mesenteric artery for 20 min followed by reperfusion.In group M,midazolam 1 mg/kg was injected intraperitoneally,and intestinal I/R was produced 30 min later.At 24 h of reperfusion,the mice were sacrificed,and intestinal tissues were removed for microscopic examination and for determination of the expression of interleukin-6 (IL-6),tumor necrosis factor-alpha (TNF-α) and caspase-3.Intestinal damage was assessed and scored according to Chiu.Results Compared with group S,Chiu's scores were significantly increased,and the expression of IL-6,TNF-α and caspase-3 was significantly up-regulated in I/R and M groups (P＜0.05).Compared with group I/R,Chiu's scores were significantly decreased,and the expression of IL-6,TNF-α and caspase-3 was significantly down-regulated in group M (P＜0.05).Conclusion Midazolam pretreatment can reduce intestinal I/R injury,and the mechanism is related to inhibition of inflammatory responses and cell apoptosis in mice.

Determination of Bromate in Drinking Water by Eluent Generator Ion Chromatography / 现代检验医学杂志

Objective To establish the method for determination of bromate in drinking water by eluent generator suppressed conductivity ion chromatography.Methods Used application of American Dionex ICS-2100 ion chromatograph and EGC-III eluent automatic generator for ion chromatography gradient elution method to do determination of bromate in drinking water [IonPac AS19 (4×250 mm)].Eluent generator produced KOH online,gradient elution,Flow rate:1.0 ml/min.Results The method was linear in the range of Y =-0.000 609 7+0.000 873 1X,r =0.999 9,high precision (CV% < 1.5).The samples average of recovery was 99.5%~100.8%.The lowest detection limit was 0.50 μg/L.Conclusion Ion chromatog-raphy gradient elution method for the determination of bromate in drinking water was simple,rapid,and sensitive.It can be suitable for determination of bromate in drinking water.

Pretreatment with Xuebijing injection alleviates systemic inflammatory response induced by severe heat-stroke via ameliorating intestinal injury in rats / 中华危重病急救医学

ObjectiveTo observe the effect of Xuebijing injection pretreatment on systemic inflammatory response induced by severe heat-stroke, and to investigate the mechanism of alleviation of intestinal injury in rats. Methods Thirty-six healthy adult male Wistar rats with grade SPF were randomly assigned into three groups with randomized number method, namely sham group, severe heat-stroke model group, and Xuebijing pretreatment group (XBJ group), with 12 rats in each group. The animals were placed in a pre-warm chamber [temperature (40±2)℃, humidity (65±5)%] in order to induce typical heat-stroke. The duration of heat-stress was 60 minutes, while the animals in sham group were exposed to ambient temperature of 25℃. Arterial blood samples were collected at the beginning and the end of heat-stress, the concentrations of tumor necrosis factor-α(TNF-α), interleukins (IL-1β, IL-6), and lipopolysaccharide (LPS) in peripheral blood were determined by enzyme linked immunosorbent assay (ELISA). The intestinal tissues were harvested after heat-stress, and the pathological changes in intestine tissues were observed after hematoxylin-eosin (HE) staining and under optical microscope. The pathological injury scores were calculated. Immunohistochemistry was performed to determine inducible nitric oxide synthase (iNOS) expression in intestinal tissue. Apoptosis was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. Western Blot was used to measure the tight junction protein occludin expression.Results The concentrations of TNF-α, IL-1β, IL-6 and LPS in blood of the rats after heat-stress in model group were significantly higher than those of sham group [TNF-α (μg/L): 443.00±110.10 vs. 98.36±44.61, IL-1β (μg/L): 436.37±163.64 vs. 64.24±16.15, IL-6 (μg/L): 342.70±92.42 vs. 54.40±13.22, LPS (μg/L): 0.68±0.22 vs. 0.09±0.02, allP< 0.01], but the levels of these parameters in XBJ group were significantly lower than those of model group [TNF-α (μg/L):340.45±68.57 vs. 443.00±110.10, IL-1β (μg/L): 191.33±82.78 vs. 436.37±163.64, IL-6 (μg/L): 192.21±37.89 vs. 342.70±92.42, LPS (μg/L): 0.43±0.17 vs. 0.68±0.22, allP< 0.01]. Infiltration of inflammatory cells, necrosis and hemorrhage in intestinal mucosa were found in the intestine of heat-stroke animals in model group. The pathological lesions in XBJ group were milder than those of model group, with a decreased pathological injury score compared with model group (2.10±1.15 vs. 3.20±0.67,P< 0.01). The expression of iNOS and apoptosis of cells in intestinal tissue in model group were increased compared with that of sham group, but they were significantly less marked in XBJ group compared with model group [iNOS (adjustedA value): 0.32±0.15 vs. 0.74±0.17, apoptotic index: 0.23±0.08 vs. 0.56±0.07, bothP< 0.01]. The order of expression for occludin protein from high to low was sham group, XBJ group and model group (A value was 0.96±0.25, 0.62±0.20, 0.33±0.11, respectively). Furthermore, there was significant difference in the expression of occludin protein between model group and both XBJ group and sham group (bothP<0.01).Conclusions Xuebijing injection alleviates inflammation and endotoxemia produced by severe heat-stroke in rats. The mechanism may be related to amelioration of oxidative injury, apoptosis, and dysfunction of tight junction protein occludin expression.

Surveillance of Antimicrobial Resistance and Pathogen of Clinical Isolates in Hebei Province in 2 0 1 2 / 现代检验医学杂志

Objective To investigate antimicrobial resistance and pathogen in hebei antibacterial resistance investigation net in 2012.Methods Antimicrobial susceptibility test was detected by Kirby-Bauer method or broth dilution test.Results were analyzed according to CLSI 2010 breakpoints.WHONET 5.5 software was used to analyze the data.Results A total of 10 504 clinical isolates were collected in 2012,of which gram negative bacilli and gram positive cocci accounted for 76.2%, 23.8%,respectively.The most common pathogen in gram-negative rod was E.coli,K.pneumoniae,P.aeruginosa, A.baumanii and E.cloacae respectively.The most common pathogen in gram-positive cocci was S.aureus,E.facium,E-.faecalis,S.pneumoniae and S.epidermidis.ESBL rate of E.coli and K.pneumoniae was 66.5 and 46.7%.The resistant rate of E.coli,K.pneumoniae,E.cloacae to imipenem was 0.1%,0.5%,8.9% and to meropenem was 0.1%,0.6%,4.2%, respectively.P.aeruginosa was resistant to imipenem and meropenem were 38.9% and 32.3%.A.baumanii was resistant to imipenem and meropenem were 5 6.5% and 5 9.7%.Methicillin-resistant strains accounted for an average of 5 7.5% in S.aureus and 87.3% in coagulase negative staphylococcus.Staphylococcus was still susceptible to minocycline and chloram-phenicol.No staphylococcal strains were found resistant to vancomycin,linezolid.But a few coagulase negative staphylococcal strains were resistant to teicoplanin.Conclusion Surveillance of antimicrobial agents played an important role in controlling hospital infection.

The analysis of risk factors for the recurrence of senior patients with cerebral infarction / 重庆医学

Objective To explore the risk factors for the recurrence of senior patients with cerebral infarction ,and provide refer-ences for its prevention .Methods The 102 elder patients(age>65y) with cerebral infarction were regarded as recurrent group ,and 218 elder cerebral infarction patients without recurrence were considered as primary group .The sex ,age ,body mass index(BMI) , heavy smoking ,drunkenness ,TIA ,location of primary cerebral infarction ,using anti-platelet drugs ,diabetes ,hypertension ,coronary heart disease ,hyperlipidemia ,carotid atherosclerotic plaque ,fibrillation atrial ,chronic obstructive pulmonary diseases (COPD) ,in-creased serum levels of homocysteine(Hcy) ,and high level of C reaction protein(CRP) were analyzed by single and multi factors a-nalysis .Results The single analysis showed the factors including hypertension ,TIA ,carotid atherosclerotic plaque ,heavy smoking , hyperlipidemia ,diabetes ,coronary heart disease ,increased serum levels of homocysteine (Hcy) ,and high level of C reaction protein (CRP) were risk factors for the recurrence of senior patients with cerebral infarction ,but using anti-platelet drugs was the protec-tive factor .Multi-factors analysis showed the factors including coronary heart disease ,hyperlipidemia ,TIA ,diabetes ,carotid athero-sclerotic plaque ,hypertension ,heavy smoking were isolated risk factors but using anti-platelet drugs was the protective factor .Con-clusion There are multitude factors for the recurrence of senior patients with cerebral infarction .We must pain more attention to the factors and decrease their recurrence .

Effectiveness of swallowing training in patients with dysphagia after acute stroke / 中华全科医师杂志

Sixty patients with dysphagia following the acute stroke were enrolled and divided into training group and control group with 30 cases in each group.Both groups received the routine medication,but patients in training group had additional swallowing rehabilitation training.After 4 weeks,the recovery rate of swallowing function in training group was higher than that in control group [ 93 ％ (28/30) vs.63 ％(19/30),P ＜ 0.05 ] ; the incidence rate of aspiration pneumonia in training group was lower than that in control group[ 3.3％ ( 1/30 ) vs.26.7％ ( 8/30 ),P ＜ 0.05 ].The results showed that swallowing training applied to acute stroke patients with dysphasia may promote the recovery of swallowing function,reduce the complications and improve their quality of life.

Preliminary study on the aerobes distribution of nasal cavity from the healthy children and adults / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study whether there are differences in the bacteria distribution from the nasal cavity of the healthy children, teenagers and adults@*METHOD@#The cotton swab specimens were taken from the nasal cavity of the healthy children, teenagers and adults for aerobic culture training.@*RESULT@#Corynebacterium, coagulase-negative staphylococci, Staphylococcus aureus, Gram-negative Neisseria, alpha-hemolytic streptococcus and gram-negative bacillus with, six species of bacteria in total, were cultivated from the nasal cavity of 40 healthy children. The positive rate of bacterial culture was 80.0%; Corynebacterium, coagulase-negative staphylococci and Staphylococcus aureus were cultivated from the nasal cavity of 40 healthy teenagers and 56 healthy adults with the positive rate of bacterial culture was 90.0% from the healthy teenagers group and was 92.9% from the healthy adults group.@*CONCLUSION@#There were obvious difference between the nasal cavity of the healthy children and adults with no obvious difference between the bacteria distribution from the nasal cavity of healthy teenagers and adults.

Comparison of emergency percutaneous coronary intervention and intravenous thrombolysis combined with emergency percutaneous coronary intervent for acute myocardial infarction / 中国基层医药

Objective To evaluate the efficacy and safety of intravenous thrombolysiswith urokinase combined with emergency interventional therapy acute myocardial infarction(AMI).Methods 128 patients with AMI were randomized to thrombolysis plus PCI group and primary PCI group,the patency rate of infarct related artery(IRA) before intervention,the procedural success rate,the incidence of bleeding complications and acute ischemic events during hospitalization and the left ventricular ejection function(LVEF) measured by echocardiography before discharge were compared.Results The IRA patency rate in the thombolysis plus PCI group(65.7%) was significantly higher than that in the primary PCI group(24.3%)(P

Pathogenic Bacteria Disrtibution and Drug Resistance of Urinary System Infection / 中华医院感染学杂志

OBJECTIVE To understand pathogen distribution and drug resistance of urinary system infection in Langfang,then help the clinic to use drug rationally.METHODS Totally 846 bacteria were isolated from the urine and given in vitro drug sensiticity test with Kirby-Bauer method to detect special resistant strains such as MRS,VRE,HLAR and the ESBLs-producing bacteria.RESULTS The first 5 were Escherichia coli(60.2%),cogulase negative Staphylococcus (CNS,16.7%),Klebsiella pneumoniae(3.2%),Enterococcus(2.6%),and Proteus(2.1%).ESBLs-producing bacteria were 23.5%,MRS were 83.7%,HLAR were 59.1%,VRE were not detected.E.coli was sensitive to cefepime,piperacillin/tazobactam,ceftazidime,amikacin(71.0-99.0%).CNS was sensitive to vancomycin,piperacillin/tazobactam,nitrofurantoin,and ofloxacin(70.0-100.0%).Vancomycin-resistant CNS was not detected.CONCLUSIONS E.coli is the most encountered pathogen causing urinary system infection in Langfang,Then are CNS.Antibiotics we were used such as gentamicin,ciprofloxacin,et,al already produced higher resistance,so clinic should consider the drug sensitivity agent and special resistant strain and choice antibiotics rationally,to make the resistant streains decreasing in number.