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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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Objective:To evaluate the homogenization effect of standardized residency training base of internal medicine and to provide reference for further improving the standardized residency training system.Methods:Taking all "unit residents" who took part in the standardized residency training test of Beijing resident physicians in 2015 and 2016 as the research objects, the self-assessment questionnaire survey of resident competency was carried out to analyze the training effect on competency. SPSS 21.0 was used to statistically analyze the collected data.Results:There are differences in self-assessment scores among the four system bases. From high to low, the overall self-assessment score are PUMCH, CCMU, the military, PUHSC. Among the eight abilities, the abilities of teaching and scientific research were the lowest.Conclusion:The training effect of Beijing internal medicine training base has not achieved homogenization. In order to improve the comprehensive ability of residents, it is suggested to strengthen the weak links in the standardized residency training from three aspects: teachers, training process and increasing support.
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OBJECTIVE@#To analyze the clinical efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for paroxysmal nocturnal hemoglobinuria (PNH), and preliminarily explore the role of an improved post-transplantation cyclophosphamide (PTCy) based conditioning regimen in PNH patients receiving transplantation.@*METHODS@#Clinical related data of PNH sufferers receiving allo-HSCT in Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were collected, and hematopoietic reconstitution, chimerism, PNH cloning, graft-versus-host disease (GVHD), infection, and survival were analyzed.@*RESULTS@#Totally five PNH patients receiving allo-HSCT were enrolled, including 1 case with classic PNH, 3 cases with aplastic anemia-PNH syndrome, 1 case with myelodysplastic syndrome, three of them (case 1-3) received the improved PTCy based conditioning regimen before HSCT. All sufferers engrafted successfully within 28 days, the median time of neutrophil and platelet engraftment was 11 days and 12 days, respectively, no patient occurred acute or chronic GVHD, after a median follow-up of 16 months, all recipients survived and completely eliminated PNH cloning.@*CONCLUSION@#Allo-HSCT can completely clear PNH cloning and restore hematopoietic function with controllable complications, and the improved PTCy based conditioning regimen is proved to be effective in PNH transplantation.
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Humains , Anémie aplasique/thérapie , Maladie du greffon contre l'hôte , Transplantation de cellules souches hématopoïétiques , Hémoglobinurie paroxystique/thérapie , Conditionnement pour greffeRésumé
Objective:To explore the application and effect of team-based learning (TBL) combined with flipped classroom in the teaching of physiology.Methods:A total of 70 medical students were selected and randomly divided into two groups, experimental group ( n=34) and control group ( n=36). Both groups studied digestion physiology by different method. In the experimental group, the students were taught by TBL combined with flipped classroom. The control group was given traditional teaching. The students studied and discussed problems in a team, and shared the answers in the flipped classroom. The effects of teaching were evaluated by the final test scores and the self-made questionnaire. SPSS 17.0 was used for t test on data comparison between the two groups. Results:The test scores of digestion physiology in the experimental group were (5.47±1.02) points, which were significantly higher than those of the control group (4.42±1.63) points, with significant differences ( P=0.020). A total of 34 questionnaires were issued and 34 valid questionnaires were collected, with an effective rate of 100%. The questionnaire results showed that TBL combined with flipped classroom was accepted and approved by about 82% of students in the experimental group who agreed that the teaching model helps enhance students' initiative and interest in learning, develop their sense of cooperation and comprehensive application ability. Conclusion:TBL combined with flipped classroom is feasible and effective in the physiological teaching, and it can be popularized in medical courses.
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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.
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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.
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Extracellular vesicles (EVs) refer to bilayer membrane transport vesicles secreted by cells. EVs can take macromolecules from cells and transfer them to receptor cells. Among these macromolecular substances, the most studied are microRNAs (miRNAs). miRNA is non-coding RNA involved in the regulation of gene expression. It has been confirmed that there are different non-coding RNAs in mammalian follicular fluid EVs. EVs carrying miRNA can act as an alternative mechanism for autocrine and paracrine, affecting follicular development. This paper systematically introduced the kinds, characteristics and methods of isolation and identification of EVs, focusing on the effects of EVs and miRNAs on follicular development, including early follicular development, oocyte maturation, follicular dominance and effects on granulosa cell function. At the same time, the authors prospected the future research of EVs and microRNAs in follicular fluid, and provided ideas and directions for the research and application of EVs and miRNA functions in follicular fluid.
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Animaux , Femelle , Vésicules extracellulaires , Métabolisme , Liquide folliculaire , Chimie , Cellules de la granulosa , microARN , Pharmacologie , OvogenèseRésumé
Objective:To analyze the research status and development trend of pediatrician competence in China and abroad, for reference in promoting the pediatrician competence research in the country.Methods:Literature review on pediatric resident′s competency was made using CNKI, WanFang and PubMed databases, ranging from their establishment up to December 25, 2019. A descriptive statistical analysis was made on the literatures′ publication year, publication area, research object and application area among others, using Excel 2019 and EndnoteX8.Results:A total of 199 Chinese documents and 262 English documents were finally retrieved. From 2009, the number of publications increased year by year, of which the Pediatrics has topped the rest, followed by Academic Medicine and Chinese Journal of Medical Education Research. The publishing institutions were mostly universities and affiliated hospitals, among which the Children′s Hospital of Chongqing Medical University topped the rest. The keyword of the highest frequency was education and the researches focus on the competency application and modelling. Conclusions:The pediatric healthcare system is paying greater attention on competence researches, but China has not yet established an appropriate pediatric resident competency model fitting local conditions. Meanwhile, the researches are plagued by such setbacks as excessive concentration of resources, simple methods and lack of empirical studies. It is recommended to broaden the explorations in this regard so as to identify pediatric resident competency development models fitting China′s conditions.
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Objective@#To explore the clinical characteristics and prognosis of the new coronavirus 2019-nCoV patients combined with cardiovascular disease (CVD).@*Methods@#A retrospective analysis was performed on 112 COVID-19 patients with CVD admitted to the western district of Union Hospital in Wuhan, from January 20, 2020 to February 15, 2020. They were divided into critical group (ICU, n=16) and general group (n=96) according to the severity of the disease and patients were followed up to the clinical endpoint. The observation indicators included total blood count, C-reactive protein (CRP), arterial blood gas analysis, myocardial injury markers, coagulation function, liver and kidney function, electrolyte, procalcitonin (PCT), B-type natriuretic peptide (BNP), blood lipid, pulmonary CT and pathogen detection.@*Results@#Compared with the general group, the lymphocyte count (0.74×109 (0.34×109, 0.94×109)/L vs. 0.99×109 (0.71×109, 1.29×109)/L, P=0.03) was extremely lower in the critical group, CRP (106.98 (81.57, 135.76) mg/L vs. 34.34 (9.55,76.54) mg/L, P<0.001) and PCT (0.20 (0.15,0.48) μg/L vs. 0.11 (0.06,0.20)μg/L, P<0.001) were significantly higher in the critical group. The BMI of the critical group was significantly higher than that of the general group (25.5 (23.0, 27.5) kg/m2 vs. 22.0 (20.0, 24.0) kg/m2, P=0.003). Patients were further divided into non-survivor group (17, 15.18%) group and survivor group (95, 84.82%). Among the non-survivors, there were 88.24% (15/17) patients with BMI> 25 kg/m2, which was significantly higher than that of survivors (18.95% (18/95), P<0.001). Compared with the survived patients, oxygenation index (130 (102, 415) vs. 434 (410, 444), P<0.001) was significantly lower and lactic acid (1.70 (1.30, 3.00) mmol/L vs. 1.20 (1.10, 1.60) mmol/L, P<0.001) was significantly higher in the non-survivors. There was no significant difference in the proportion of ACEI/ARB medication between the critical group and the general group or between non-survivors and survivors (all P>0.05).@*Conclusion@#COVID-19 patients combined with CVD are associated with a higher risk of mortality. Critical patients are characterized with lower lymphocyte counts. Higher BMI are more often seen in critical patients and non-survivor. ACEI/ARB use does not affect the morbidity and mortality of COVID-19 combined with CVD. Aggravating causes of death include fulminant inflammation, lactic acid accumulation and thrombotic events.
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Objective: To explore the clinical characteristics and prognosis of the new coronavirus 2019-nCoV patients combined with cardiovascular disease （CVD). Methods: A retrospective analysis was performed on 112 COVID-19 patients with CVD admitted to the western district of Union Hospital in Wuhan, from January 20, 2020 to February 15, 2020. They were divided into critical group (ICU, n=16) and general group (n=96) according to the severity of the disease and patients were followed up to the clinical endpoint. The observation indicators included total blood count, C-reactive protein (CRP), arterial blood gas analysis, myocardial injury markers, coagulation function, liver and kidney function, electrolyte, procalcitonin (PCT), B-type natriuretic peptide (BNP), blood lipid, pulmonary CT and pathogen detection. Results: Compared with the general group, the lymphocyte count (0.74 (0.34, 0.94)×109/L vs. 0.99 (0.71, 1.29)×109/L, P=0.03) was extremely lower in the critical group, CRP (106.98 (81.57, 135.76) mg/L vs. 34.34 (9.55,76.54) mg/L, P<0.001) and PCT (0.20 (0.15,0.48) μg/L vs. 0.11 (0.06,0.20) μg/L, P<0.001) were significantly higher in the critical group. The BMI of the critical group was significantly higher than that of the general group (25.5 (23.0, 27.5) kg/m2 vs. 22.0 (20.0, 24.0) kg/m2，P=0.003). Patients were further divided into non-survivor group (17, 15.18%) group and survivor group (95, 84.82%). Among the non-survivors, there were 88.24% (15/17) patients with BMI> 25.0 kg/m2, which was significantly higher than that of survivors (18.95% (18/95), P<0.001). Compared with the survived patients, oxygenation index (130 (102, 415) vs. 434 (410, 444), P<0.001) was significantly lower and lactic acid (1.70 (1.30, 3.00) mmol/L vs. 1.20 (1.10, 1.60) mmol/L, P<0.001) was significantly higher in the non-survivors. There was no significant difference in the proportion of ACEI/ARB medication between the critical group and the general group or between non-survivors and survivors （all P>0.05). Conclusion: COVID-19 patients combined with CVD are associated with a higher risk of mortality. Critical patients are characterized with lower lymphocyte counts. Higher BMI are more often seen in critical patients and non-survivor. ACEI/ARB use does not affect the morbidity and mortality of COVID-19 combined with CVD. Aggravating causes of death include fulminant inflammation, lactic acid accumulation and thrombotic events.
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Humains , Betacoronavirus , COVID-19 , Maladies cardiovasculaires/thérapie , Infections à coronavirus/complications , Pandémies , Pneumopathie virale/complications , Pronostic , Études rétrospectives , SARS-CoV-2 , Résultat thérapeutiqueRésumé
OBJECTIVE To establish three-dimensional (3D) spherical tissue-like models for HepaRG cells and HepG2 cells and compare Ihe difference in morphology, functional protein expressions and drug hepatotoxicity tests to provide data for the selection of drug hepatotoxicity detection models in vitro. METHODS Two in vitro 3D hepatocyte spheroid models were constructed on HepaRG and HepG2 cells in logarithmic growth phase. The two types of cells were separately seeded in ultra-low attachment surface 96-well plates at a cell density of 100 cells per well, and cultured in a conventional manner without adding any inducer. The morphology of the spheroids on the 3∗ day (D3), D7, D14, D21 after seeding was observed under the microscope, and the average diameters of spheroids were caculated. Differential expressions of cytochrome P450 enzymes and albumin at mRNA and protein levels in the two models were studied with quantitative real-time PCR, immunofluorescence staining and Western blotting. Seven drugs (thiamine, fialuridine, acetaminophen, benzbromarone, cyclophosphamide, isoniazid and nefazodone) were selected for hepatotoxicity detection. After a single dose and repeated dose experiments, the cell inhibitory rate was measured and inhibitory concentration 50 (IC∗) was calculated. RESULTS The average diameters of the two models increased with time. The average diameters of HepaRG cell spheroids on D7, D14 and D21 after seeding were 317.5, 334.3 and 397.8 pm, respectively, which were smaller than those of HepG2 spheroids (P40, 0.87, >20 , 35.74 and 2.57 mmol • L"\ respectively. Under the single administration and partial drug repeated administration, the inhibitory effect on the suivival of 2 spheroid cells did not reach half of the inhibiory level. CONCLUSION HepaRG spheroids are superior to HepG2 spheroids in morphology control and functional protein expressions. They are more sensitive in drug hepatotoxicity detection in vitro. HepaRG spheroids are a better 3D spherical tissue-like model in vitro.
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Objective:This article analyzes the cognition and satisfaction evaluation of patients in medical alli-ance. Under the medical alliance mode,the present study tries to explore the choice of medical treatment of patients, the first diagnosis of primary health care institutions and its influencing factors, in order to provide reference for the construction of medical alliance. Methods:With the help of stratified sampling method,eighteen (18) medical alli-ances were selected from 16 districts and counties in Beijing. The survey questionnaire was designed to be used as the tool for data collection. A total of 1 280 patients in medical alliance participated in this study. The Chi-square Test and binary logistic regression model were used for statistical analysis. Results:59.12% of patients understand the medical association and related policies. 39.12% of the patients are satisfied with the medical association,51.44% of patients are willing to take first diagnosis at primary health care institutions. The distribution of medical resources in various districts is uneven. The type of hospital visited,the degree of understanding of medical alliance,the expe-rience of medical alliance and the satisfaction toward medical alliance will have an impact on the willingness about basic initial diagnosis,and the influence make a significant statistical sense. Conclusions:The Medical alliance con-struction in Beijing has achieved a certain effect,as first visit at primary health care institutions will be the initial for-mation. But the unbalanced distribution of medical resources in various districts,the service capacity of primary care institutions which does not meet the needs of patients,the insufficient sensitization of relevant policy and the current health insurance policy are seen as limiting factors to the development of medical alliance.