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1.
Food Microbiol ; 93: 103603, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32912578

RESUMO

Staphylococcus aureus is an opportunistic pathogen leading to food poisoning as well as human infections. The present study examined the prevalence and characterization of antimicrobial-resistant S. aureus in sushi from 42 outlets and in pork products from eight outlets in Beijing, China. The total bacterial counts were between 3.0 and 8.9 log CFU/g (mean 5.5 ± 1.5 log CFU/g) in sushi products and 4.8 to 7.4 log CFU/g (mean 5.6 ± 0.8 log CFU/g) in pork products. The mean counts of coliforms were 2.7 and 2.9 log CFU/g in sushi and pork, respectively. Staphylococcus aureus was isolated from seven sushi outlets (13 isolates) and two pork outlets (2 isolates) with average counts below 2 log CFU/g in all cases. A total of 15 S. aureus isolates were further characterized. Six lineages of S. aureus were present, including ST398 (n = 5), ST25 (n = 4), ST15 (n = 2), ST59 (n = 2), ST8 (n = 1) and ST2631 (n = 1). Thirteen isolates contained the scn virulence marker, whereas four and eight isolates contained the virulence marker edinB and enterotoxin genes, respectively. Characterization of antimicrobial resistance profiles documented resistances to ampicillin (n = 15), penicillin (n = 14), ceftazidime (n = 6), erythromycin (n = 4), tetracycline (n = 3), clindamycin (n = 3), and gentamicin (n = 1). Three MRSA isolates were obtained, one from pork (ST398) and two from one sushi outlet (ST59). They were all resistant to at least three classes of antimicrobials and two of them contained the scn gene and enterotoxin genes. Twelve sushi isolates and one of the pork isolates contained the scn gene, indicating that they were of human origin. This emphasizes the potential importance of transmission through foods of antimicrobial-resistant S. aureus including MRSA. We also showed that S. aureus exhibited geographical variation with regards to ST profiles, antimicrobial-resistance and virulence genes when comparing isolates from sushi products sold in Beijing and Copenhagen, Denmark. Whereas food safety is not compromised by the presence of low amounts of S. aureus in sushi, this study shows that with regards to public health such foods may serve as vehicles for transmission of multidrug-resistant S. aureus and MRSA lineages.

2.
Int Braz J Urol ; 47(1): 23-35, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32459454

RESUMO

PURPOSE: To evaluate the efficacy of adjunctive medical expulsive therapy (MET) with tamsulosin for the promotion of stone fragments clearance for repeated extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: This meta-analysis was conducted by systematic search for randomized controlled trial (RCT) studies in PubMed/Medline, Scopus, Cochrane Library, Web of Science databases in January 2020, which compared tamsulosin with either placebo or non-placebo control for repeated ESWL. The primary endpoint was stone-free rate (SFR), the second endpoints were stone clearance time and complications. The quality assessment of included studies was performed by using the Cochrane System and Jadad score. RESULTS: 7 RCTs were included in this meta-analysis. Tamsulosin provided higher SFR (for stones larger than 1cm, OR: 5.56, p=0.0003), except for patients with stones less than 1cm. For patients with renal stones (OR: 2.97, p=0.0005) or upper ureteral stones (OR: 3.10, p=0.004), tamsulosin can also provide a higher SFR. In addition, tamsulosin provided a shorter stone clearance time (WMD: -9.40, p=0.03) and lower pain intensity (WMD=-17.01, p< 0.0001) and incidences of steinstrasse (OR: 0.37, p=0.0002). CONCLUSION: Adjunctive MET with tamsulosin is effective in patients with specific stone size or location that received repeated ESWL. However, no well-designed RCT that used computed tomography for the detection and assessment of residual stone fragments was found. More studies with high quality and the comparison between tamsulosin and secondary ESWL are needed in the future.

3.
Zool Res ; : 1-29, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33045777

RESUMO

The emerging virus SARS-CoV-2 has caused a global pandemic, and understanding its pathogenesis and host antiviral immunity is critical for the development of vaccines and antivirals. Mice are frequently used to generate animal models of infectious diseases due to their convenience and ability to undergo genetic manipulation. However, normal adult mice are not susceptible to SARS-CoV-2. Here, we developed a viral receptor (human angiotensin-converting enzyme 2, hACE2) pulmonary transfection mouse model to rapidly establish SARS-CoV-2 infection in the mouse lung. Based on the model, the virus successfully infected the mouse lung after 2 days of transfection. Viral RNA/protein, innate immune cell infiltration, inflammatory cytokine expression, and pathological changes in the infected lung were observed after infection. Further studies indicated that neutrophils were the first and most abundant leukocytes that infiltrated the infected lung soon after viral infection. In addition, using infected CXCL5-knockout mice, the chemokine CXCL5 was found to be responsible for neutrophil recruitment. CXCL5 knockout decreased lung inflammation without diminishing viral clearance, suggesting a potential target for controlling pneumonia.

4.
Genome Biol ; 21(1): 265, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066802

RESUMO

The recent advances in sequencing technologies enable the assembly of individual genomes to the quality of the reference genome. How to integrate multiple genomes from the same species and make the integrated representation accessible to biologists remains an open challenge. Here, we propose a graph-based data model and associated formats to represent multiple genomes while preserving the coordinate of the linear reference genome. We implement our ideas in the minigraph toolkit and demonstrate that we can efficiently construct a pangenome graph and compactly encode tens of thousands of structural variants missing from the current reference genome.

5.
Artigo em Inglês | MEDLINE | ID: mdl-33085622

RESUMO

The problem of effectively exploiting the information multiple data sources has become a relevant but challenging research topic in remote sensing. In this article, we propose a new approach to exploit the complementarity of two data sources: hyperspectral images (HSIs) and light detection and ranging (LiDAR) data. Specifically, we develop a new dual-channel spatial, spectral and multiscale attention convolutional long short-term memory neural network (called dual-channel A³CLNN) for feature extraction and classification of multisource remote sensing data. Spatial, spectral, and multiscale attention mechanisms are first designed for HSI and LiDAR data in order to learn spectral- and spatial-enhanced feature representations and to represent multiscale information for different classes. In the designed fusion network, a novel composite attention learning mechanism (combined with a three-level fusion strategy) is used to fully integrate the features in these two data sources. Finally, inspired by the idea of transfer learning, a novel stepwise training strategy is designed to yield a final classification result. Our experimental results, conducted on several multisource remote sensing data sets, demonstrate that the newly proposed dual-channel A³CLNN exhibits better feature representation ability (leading to more competitive classification performance) than other state-of-the-art methods.

6.
Transplant Proc ; 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-33004221

RESUMO

Iliac atherosclerosis is common in renal transplant recipients. In severe cases, it affects intraoperative renal arterial anastomosis and increases the risk of postanastomosis complications. At present, safe and efficient vascular replacement methods are relatively limited. In the 2 renal transplant cases at our center, described here, the donors' iliac arteries were unavailable. We therefore attempted to replace the recipients' diseased external iliac artery with the donors' inferior vena cava and then performed an end-to-side grafting with the attachment in arterial reconstruction. One patient received a single kidney transplantation, while the other received a dual kidney transplantation. Antiplatelet/anticoagulation drug application was avoided, and both patients were observed for more than 6 months. Stable renal graft function was achieved without any vascular complications. During this study, all procedures were in compliance with the Helsinki Congress and the Declaration of Istanbul. For end-stage renal disease patients with severe iliac atherosclerosis who are waiting for kidney transplantation, a donor's vena cava graft could potentially be a promising replacement option to restore external iliac artery patency and reconstruct renal blood flow, without the necessity of harvesting a recipient's autologous vessels or looking for costly artificial ones.

7.
Curr Med Imaging ; 16(8): 1029-1033, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33081663

RESUMO

BACKGROUND: Initial staging of rectal cancer is done by high-resolution magnetic resonance imaging (MRI), however, pelvic computed tomography (CT) is also frequently used. The aim of this study was to evaluate the added clinical benefit of pelvic CT or whether it can alter the initial staging or not. METHODS: The study was composed of 187 patients with rectal cancer. Firstly, imaging except pelvic CT was evaluated. Secondly, the pelvic CT was evaluated and the staging was adjusted according to the new findings. Subsequently, the two staging results were compared to investigate the added clinical benefit of pelvic CT. RESULTS: Compared with the imaging data except pelvic CT, new findings revealed by the pelvic CT included metastases of the pelvic bone (n = 1) and pelvic peritoneum (n = 3). However, the new findings did not change the primary staging. Of the three patients with pelvic peritoneal metastasis, two were already determined with peritoneal involvement and ascites by abdominal CT, and the third patient was observed with liver and distant lymph node metastasis. Thus, none of their initial stagings needed to be changed. CONCLUSION: The addition of pelvic CT to the pre-treatment imaging strategy cannot provide added clinical benefit for the primary evaluation of rectal cancer.

8.
Cell Mol Biol (Noisy-le-grand) ; 66(5): 208-213, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-33040838

RESUMO

The purpose of this study was to investigate the potential of cell-free DNA (cfDNA) as a prognostic factor for non-small cell lung cancer (NSCLC).   Patients with NSCLC (n = 154) treated with gefitinib were recruited over a 5-year period for this study, and served as the observation group (79 males and 75 females, mean age = 53.74 ± 10.86 years). The control group (normal healthy individuals) consisted of 30 males and 22 females, aged 44 - 64 years (mean age = 54.12 ± 9.83 years). The follow-up lasted 5 years, or until the patient relapsed and died. The plasma level of cfDNA was determined in patients 1 day before treatment, 3 days after treatment, and on the 28th day of treatment.Based on the cfDNA expression level, NSCLC patients were subdivided into high-expression and low-expression groups, and differences in survival were compared. Univariate and multivariate analyses were performed on factors affecting patients survival using COX. Total effectiveness was significantly higher in observation group (49.35%) than in control group (13.95 %) (p<0.05). The extent of disease control wasalso significantly higher in the observation group (93.51 %) than in control group (p<0.05). Plasma cfDNA level of NSCLCpatients was significantly higher than that of control group before treatment, but was significantly and time-dependently reduced after gefitinib treatment (p<0.05). Cell-free DNA (cfDNA) level increased with severity of disease (p<0.05). Patients in cfDNA low-expression group had significantly higher chances of survival than those in the high-expression group (p<0.05). The results of Cox multivariate analysis showed that pathological severity and cfDNA concentration were independent factors affecting prognosis of NSCLC (p<0.05). Plasma cfDNA is a potential prognostic index in patients with NSCLC.

9.
Artigo em Inglês | MEDLINE | ID: mdl-33035679

RESUMO

Myocardin (MYOCD) plays an important role in cardiovascular disease. However, its underlying impact on atherosclerosis remains to be elucidated. ATP binding cassette transporter A1 (ABCA1), a key membrane-associated lipid transporter which maintains intracellular lipid homeostasis, has a protective function in atherosclerosis progress. The purpose of this study was to investigate whether and how the effect of MYOCD on atherosclerosis is associated with ABCA1 in vascular smooth muscle cells (VSMCs). We found both MYOCD and ABCA1 expression were dramatically decreased in atherosclerotic patient aortas compared to control. MYOCD knockdown inhibited ABCA1 expression in human aortic vascular smooth muscle cells (HAVSMCs), leading to reduced cholesterol efflux and increased intracellular cholesterol contents. MYOCD overexpression exerted the opposite effect. Mechanistically, MYOCD regulates ABCA1 expression in an SRF-dependent manner. Consistently, apolipoprotein E-deficient mice treated with MYOCD shRNA developed more plaques in the aortic sinus, which is associated with reduced ABCA1 expression, increased cholesterol retention in the aorta, and decreased high-density lipoprotein cholesterol levels in the plasma. Our data suggest that MYOCD deficiency exacerbates atherosclerosis by downregulating ABCA1 dependent cholesterol efflux from VSMCs, thereby providing a novel strategy for the therapeutic treatment of atherosclerotic cardiovascular disease.

10.
Blood ; 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32902645

RESUMO

Immune checkpoint therapy has resulted in remarkable improvements in the outcome for certain cancers. To broaden the clinical impact of checkpoint targeting, we devised a strategy that couples targeting of the cytokine-inducible SH2-containing (CIS) protein, a key negative regulator of interleukin (IL)-15 signaling, with fourth generation 'armored' chimeric antigen receptor (CAR-IL-15) engineering of cord blood (CB) derived natural killer (NK) cells. This combined strategy boosted NK cell effector function through enhancing the Akt/mTORC1 axis and c-MYC signaling, resulting in increased aerobic glycolysis. When tested in a lymphoma mouse model, this combined approach improved NK cell anti-tumor activity more than either alteration alone, eradicating lymphoma xenografts without signs of any measurable toxicity. We conclude that targeting a cytokine checkpoint further enhances the antitumor activity of IL-15 secreting armored CAR-NK cells by promoting their metabolic fitness and anti-tumor activity. This combined approach represents a promising milestone in the development of the next generation of NK cells for cancer immunotherapy.

11.
Chem Biodivers ; 2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32940397

RESUMO

A systematically chemical investigation of Citrus changshan-huyou Y.B.Chang resulted in the isolation and structure determination of twelve known natural products, including limonoid, nootkatone, scoparone, ß-sitosterol, 3,3',4',5,6,7,8,-heptamethoxyflavone, nobiletin, tangeretin, naringin, hesperidin, neohesperidin, 3,5-dihydroxyphenyl ß-D-glucoside, ß-sitosterol-D-glucoside. The structure modification of the most abundant compound limonin further led to eight limonoid derivatives, including epi-limonol, epi-limonyl acetate, and six new compounds epi-limonol A, limonol A, limonol B, epi-limonol B, epi-limonol C, epi-limonol D, which enlarged the chemical diversity of limonin related limonoids. The structures of the new limonoid derivatives were identified by extensive spectroscopic analysis. In bioassay, all the isolates, the semi-synthetic derivatives and the previously isolated limonoids in our natural product library were subjected for anti-inflammatory activities evaluation, and several limonoids exhibited the inhibition of TNF-α release.

12.
Sci Rep ; 10(1): 15404, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32958806

RESUMO

The large catalytic subunit of acetohydroxyacid synthase (AHAS, EC 2.2.1.6) of Thermotoga maritima (TmcAHAS) was prepared in this study. It possesses high specific activity and excellent stability. The protein and a whole cell catalyst overexpressing the protein were applied to the preparation of α-hydroxyketones including acetoin (AC), 3-hydroxy-2-pentanone (HP), and (R)-phenylacetylcarbinol (R-PAC). The results show that AC and HP could be produced in high yields (84% and 62%, respectively), while R-PAC could be synthesized in a high yield (about 78%) with an R/S ratio of 9:1. Therefore, TmcAHAS and the whole cell catalyst overexpressing the protein could be practically useful bio-catalysts in the preparation of α-hydroxyketones including AC, HP, and R-PAC. To the best of our knowledge, this is the first time that bacterial AHAS was used as a catalyst to prepare HP with a good yield, and also the first time that TmcAHAS was employed to synthesize AC and R-PAC.

13.
Bioinformatics ; 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32966548

RESUMO

SUMMARY: We present bedtk, a new toolkit for manipulating genomic intervals in the BED format. It supports sorting, merging, intersection, subtraction and the calculation of the breadth of coverage. Bedtk employs implicit interval tree, a data structure for fast interval overlap queries. It is several to tens of times faster than existing tools and tends to use less memory. AVAILABILITY: https://github.com/lh3/bedtk. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

14.
Transplantation ; 2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32890130

RESUMO

BACKGROUND: Donor-derived cell-free DNA (dd-cfDNA) is a potential noninvasive molecular marker of graft rejection after kidney transplant, whose diagnostic accuracy remains controversial. METHODS: We performed a systematic review and meta-analysis to evaluate the diagnostic accuracy of dd-cfDNA. Relevant literature was searched from online databases, and the data on the diagnostic accuracy of discriminating main rejection episodes (MRE) and antibody-mediated rejection (AMR) were merged, respectively. RESULTS: Nine studies were included in the meta-analysis, of which 6 were focused on the diagnostic accuracy of dd-cfDNA for MRE, whose pooled sensitivity, specificity, area under the receiver operating characteristics curve (AUC), diagnostic odds ratio(DOR), overall positive likelihood ratio (PLR), and negative likelihood ratio (NLR) with 95% confidence intervals were 0.70(0.57-0.81), 0.78(0.70-0.84), 0.81(0.77-0.84), 8.18(5.11-13.09), 3.15(2.47-4.02), 0.39(0.27-0.55), respectively. 5 tests were focused on discriminating AMR, whose pooled indicators were 0.84(0.75-0.90), 0.80(0.74-0.84), 0.89(0.86-0.91), 20.48(10.76-38.99), 4.13(3.21-5.33), 0.20(0.12-0.33), respectively. CONCLUSIONS: Donor-derived cell-free DNA can be a helpful marker for the diagnosis of antibody-mediated rejection among those recipients suspected of renal dysfunction. Its diagnostic accuracy on the main rejection episodes remains uncertain, which requires further prospective, large-scale, multicenter, and common population research.

15.
Environ Technol ; : 1-12, 2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32876536

RESUMO

Cr(VI)-imprinting thiosemicarbazide-functionalized sodium alginate (IIPTSC@SA) microspheres were fabricated to achieve the good selective adsorption for Cr(VI) removal from aqueous solution containing multiple ions. The selective adsorption and reusability of IIPTSC@SA microsphere were intensively investigated. The results showed that the grafting conditions of thiosemicarbazide were optimized at 0.2 g of TSC at 60 °C for 5 h and the ion-imprinting conditions at 100 mL of 2 wt % glutaraldehyde at 60 °C for 6 h. IIPTSC@SA microspheres exhibited the maximum adsorption capacity of 252.5 mg/g and good selectivity to remove Cr(VI) from multi-ion coexisting water. The adsorption process complied with a monolayer adsorption by virtue of chemical interactions together with endothermic spontaneously. After eight adsorption-desorption, the adsorption capacity and selectivity of IIPTSC@SA microspheres remained relatively stable.

16.
Mar Pollut Bull ; 160: 111650, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32920257

RESUMO

Microplastic accumulation in estuarine environments is considered the dominant input of land-based plastics into the oceans. In this study, the level of microplastic contamination was evaluated in 26 species of wild fish from the Pearl River Estuary, South China. Results showed that microplastics abundance ranged from 0.17 items individual-1 (Boleophthalmus pectinirostris & Acanthogobius flavimanus) to 1.33 items individual-1 (Plectorhynchus cinctus) among different species. The distribution of microplastic abundance in the gills and gastrointestinal tracts was not significantly different. Microplastics in gills are strongly related to the filtration area of gills in 15 fish species. Fibers were the dominant shapes accounting for 93.45% of the total shapes. The majority of microplastics were <3 mm in size. The most common polymer composition was polyethylene terephthalate (38.2%) and the most common color was black (30.36%). The findings of this study provide baseline data for microplastic contamination in wild fish from an urban estuary.

17.
Adv Mater ; 32(43): e2004901, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32924219

RESUMO

The COVID-19 pandemic has taken a significant toll on people worldwide, and there are currently no specific antivirus drugs or vaccines. Herein it is a therapeutic based on catalase, an antioxidant enzyme that can effectively breakdown hydrogen peroxide and minimize the downstream reactive oxygen species, which are excessively produced resulting from the infection and inflammatory process, is reported. Catalase assists to regulate production of cytokines, protect oxidative injury, and repress replication of SARS-CoV-2, as demonstrated in human leukocytes and alveolar epithelial cells, and rhesus macaques, without noticeable toxicity. Such a therapeutic can be readily manufactured at low cost as a potential treatment for COVID-19.

18.
Arch Gerontol Geriatr ; 92: 104227, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32979552

RESUMO

OBJECTIVES: Little is known about the magnitude of catastrophic health expenditure (CHE) attributable to critical disease, especially in the middle-aged and elderly population. This research aimed to exploring the key aspects of how the health insurance fails to protect the middle-aged and elderly against CHE in the past five years. And propose corresponding measures to improve. METHODS: Data were obtained from the 2011 to 2015 China Health and Retirement Longitudinal Study. The method was adapted from WHO to calculate the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME), and use Generalized Linear Mixed Models (GLMMs) to comprehensively analyze the risk factors that cause middle-aged and elderly people to fall into CHE. RESULTS: The incidence of CHE of China's middle-aged and elderly population has been rose in the five years from 2011 (10.5 %) to 2013 (17.5 %) to 2015 (19.7 %). The CHE of richest families was almost 6 times from 2011 to 2015. Urban Employee Medical Insurance Scheme, the incidence of CHE was up 10 percentage from 2011 to 2015. According to the GLMMs, families have inpatient cares as the most important factor to CHE. The incidence of CHE increased by 2.25 times compared with those who did not use inpatient services. CONCLUSIONS: The health system needs to control the irrational growth of health expenses and reduce residents' overuse of health services. Government should take supplementary measures to comprehensively strengthen the advantages of health insurance. Raise residents' awareness of health care, enhance citizens' physical fitness, and avoid unnecessary waste of health resources.

19.
Signal Transduct Target Ther ; 5(1): 194, 2020 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-32934199

RESUMO

Modulation of alloimmune responses is critical to improving transplant outcome and promoting long-term graft survival. To determine mechanisms by which a nonhematopoietic erythropoietin (EPO) derivative, carbamylated EPO (CEPO), regulates innate and adaptive immune cells and affects renal allograft survival, we utilized a rat model of fully MHC-mismatched kidney transplantation. CEPO administration markedly extended the survival time of kidney allografts compared with the transplant alone control group. This therapeutic effect was inhibited when the recipients were given LY294002, a selective inhibitor of the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway or anti-EPO receptor (EPOR) antibody, in addition to CEPO. In vitro, CEPO inhibited the differentiation and function of dendritic cells and modulated their production of pro-inflammatory and anti-inflammatory cytokines, along with activating the PI3K/AKT signaling pathway and increasing EPOR mRNA and protein expression by these innate immune cells. Moreover, after CD4+ T cells were exposed to CEPO the Th1/Th2 ratio decreased and the regulatory T cell (Treg)/Th17 ratio increased. These effects were abolished by LY294002 or anti-EPOR antibody, suggesting that CEPO regulates immune responses and promotes kidney allograft survival by activating the PI3K/AKT signaling pathway in an EPOR-dependent manner. The immunomodulatory and specific signaling pathway effects of CEPO identified in this study suggest a potential therapeutic approach to promoting kidney transplant survival.

20.
BMJ Open ; 10(9): e034681, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973050

RESUMO

OBJECTIVES: The study analysed medical malpractice claims to assess patient safety in hospitals. The information derived from malpractice claims reflects potential risks and could help lead to reducing medical errors and improving patient safety. DESIGN, SETTING: We analysed 4380 medical malpractice claims from 351 grade-A tertiary hospitals in China for 2008-2017. We examined the characteristics of medical errors and patient safety, including the types of medical errors, proportionate liabilities and payments for medical malpractice in different clinical specialties. MAIN OUTCOME MEASURES: We assessed claim characteristics, payment amounts and liability. RESULTS: Our data analysis demonstrated that 72.5% of the claims involved medical errors, with average payments of US$31 430. The hospital's errors in medical malpractice resulted in 41.4% average liability in patient injury payments. Most medical malpractice cases occurred in Shanghai (817 claims, 18.7%) and Beijing (468 claims, 10.7%). The highest risks for medical error and malpractice claims were related to orthopaedics (11.3% of all claims, 72.8% with medical errors) and obstetrics and gynaecology (10.0% of all claims, 76.0% with medical errors). The highest rates related to proportionate liabilities were observed in otolaryngology (51.9%) and endocrinology (47.7%). Respiratory medicine had the highest proportion of claims in death rates (77.3%). Medical technology errors accounted for 91.8% of the claims and medical ethics errors for 5.8%. The highest average payment was found in cardiovascular surgery (US$41 733) and the lowest in stomatology (US$8822). CONCLUSIONS: A previous study found that grade-A tertiary hospitals in China have similar medical error rates to general Chinese hospitals. 36Different specialties had different risk characteristics regarding medical errors, payments and proportionate liabilities. Orthopaedics had the highest number of malpractices claims and higher proportionate liability but lower death rates.

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