Objective To investigate the effect of myoblast transplantation on duchenne muscular dystrophy (DMD) and to explore the method and feasibil ity of applying gene therapy to DMD. Methods Myoblast of C57/BL10 mice were cultured using multiple-step enzyme digestion method and differential velocity adherent technique. The morphology of the cells was observed with inverted phase contrast microscope. The cells at passage 4 were labeled with 5-BrdU. Twenty-four DMDmodel mice (mdx mice: aged 4-6 weeks, male, 13.8-24.6 g) were randomly divided into two groups (n=12 per group): group A, 1 × 106/mL labeled myoblast were injected via ven caudal is twice at an interval of 2 weeks; group B: 1 mL DMEM/F12 was injected in the same manner serving as a control group. The mice were killed 4 weeks after operation and the motor abil ity of the mice was detected by one-time exhaustive swimming before their death. HE staining and immunohistochemistry staining observation for 5-BrdU, desmin, and dystrophin (Dys) were preformed, and the imaging analysis was conducted. Results The primary myoblast could be sub-cultured 5-7 days after culture, providing stable passage and sufficient cells. The time of onetime exhaustive swimming was (60.72 ± 5.76) minutes in group A and (47.77 ± 5.40) minutes in group B, there was significant significance between two groups (P lt; 0.01). At 4 weeks after injection, HE staining showed that in group A, there were round and transparent-stained myocytes and the percentage of centrally nucleated fibers (CNF) was 67%; while in group B, there were uneven muscle fiber with such pathological changes as hypertrophia, atrophia, degeneration, and necrosis, and the percentage of CNF was above 80%. Immunohistochemistry staining revealed that the expression of 5-BrdU, desmin, and Dys was positive in group A; while in group B, those expressions were l ittle or negative. Image analysis result displayed that integral absorbency (IA) value of desmin was 489.70 ± 451.83 in group A and 71.15 ± 61.14 in group B (P lt; 0.05) and the ratio of positive area to thetotal vision area was 0.314 3 ± 0.197 3 in group A and 0.102 8 ± 0.062 8 in group B (P lt; 0.05); the Dys IA value was 5 424.64 ± 2 658.01 in group A and 902.12 ± 593.51 in group B (P gt; 0.05) and the ratio of positive area to the total vision area was 0.323 7 ± 0.117 7 in group A and 0.035 2 ± 0.032 9 in group B (P lt; 0.05). Conclusion Myoblast transplantation has certain therapeutic effect on DMD of mice.
ObjectiveTo explore the application of pre-examination and triage service for outpatients in large general hospitals to improve the quality of service and increase the satisfaction of the patients. MethodsBy using convenience sampling, the outpatients from four third-class A level hospitals were investigated with self-designed questionnaire between July and August, 2013. The patients were differentiated according to the frequency of visiting doctors; the first and subsequent visit being the variables, the rank-sum test was used to investigate the demand and satisficing of the pre-examination and triage service in the two kinds of outpatients in large general hospitals. ResultsThe satisficing of the pre-examination and triage service was high; the demand of the service was high in the first-visit patients with high satisficing. The difference in out-patient consultation between the two kinds of patients were significant. ConclusionPre-examination and triage service has a great guiding effect on outpatients in large general hospitals, and its availability is related to the type of the patients, awareness rate of the service and satisfaction to nurses.
According to the characteristics of the diversified employment system of general hospitals, we have independently developed a set of personnel information platforms suitable for our hospital's operating model and work-flow which achieved establishing a novel big data management model for big personnel. After a year of trial operation, the big data management of personnel has completely covered the target management and requirements of the hospital, covering basic quality, public services, teaching work, medical work, scientific research, and other dimensions of information, which helped the hospital constructed a systematically networked and full-coveraged, personnel information system with strong early warning functions and incentives, enabling the reasonable utilization rate of human capital and continuous improvement of the quality of talent training.
Objective To explore the influencing factors of the usage behavior of the scientific research management system and provide references for hospitals in constructing scientific research management systems. Methods Data were collected through questionnaires in April 2024. Based on the unified theory of acceptance and use of technology (UTAUT), the information system success model, and the self-efficacy theory, a research model on the influencing factors of the usage behavior of the scientific research management system among medical staff was constructed from the dual perspectives of users and information systems. The structural equation model was utilized to explore the influencing factors of the usage behavior of the scientific research management system. Results A total of 527 questionnaires were collected. Among them, there were 157 males and 370 females. The overall Cronbach α coefficient of the questionnaire was 0.916, and the KMO value was 0.896. For Bartlett’s test of sphericity (P<0.001). The composite reliability of each latent variable was greater than 0.7, and the average variance extracted was greater than 0.5. Therefore, this questionnaire had good reliability and validity. The research showed that information quality, performance expectancy, effort expectancy, and system quality all had significant positive impacts on the usage intention of users of the scientific research management system (P<0.05). Meanwhile, facilitating conditions and usage intention both had significant positive impacts on the usage behavior of users (P<0.05). Conclusions The construction of the scientific research management system should be guided by management needs, comprehensively sort out the general scientific research work needs of medical staff. Through the apply information-based means, various forms of training, and strengthening policy guidance, the aim is to improve the intelligence level of system operations, enhance the convenience of user self-service, and promote the effective construction of the ecosystem of the scientific research management system.
目的 探討內鏡反轉黏膜切除術治療超低位直腸大型側向發育型腫瘤的價值。 方法 回顧性分析四川大學華西醫院消化內鏡中心2010年1月-2011年12月間38例內鏡反轉黏膜切除術治療超低位直腸大型側向發育型腫瘤病變殘留、治療效果。 結果 38例患者,男18例,女20例,年齡8~80歲;病變下緣距肛門齒狀線1~4.0 cm24例,侵及齒狀線14例。病變大小(按病變最大徑分類):1.5~3.0 cm 12例,3.1~4.0 cm 8例,4.1~5.0 cm4例,5.1~7.0 cm 10例,10 cm 4例。病變直徑在5.0 cm以下的24例患者,經首次手術治療腫瘤完整切除,術后2例灶性癌變,追加外科手術;其余22例2個月復查,病變無殘留,6個月復查,2例復發,經再次手術病變完整切除。隨訪1年,全部未見復發,治愈率為100%,無殘留。病變直徑5.1~7.0 cm的10例患者,經首次手術治療腫瘤分次切除,2個月復查,6例病變完整切除無殘留,6個月復查,其中2例復發,經再次內鏡下手術切完病變,隨訪1年,無復發;另4例有殘留,經再次內鏡下手術切完病變,6個月復查無復發,隨訪1年,4例均未見復發。病變直徑10 cm 的4例患者,經多次手術后復查均有病變殘留,無法完全切除,患者拒絕外科手術。5.1 cm以上病變治愈率71.43%,殘留率高達57.14%。本組術后出血16例,感染1例,直腸狹窄1例,肛門墜脹3例,無穿孔發生。 結論 內鏡反轉黏膜切除術治療超低位直腸大型側向發育型腫瘤有效,對5.0 cm以下病變能一次完整切除,5.1 cm以上病變殘留率高,需再次內鏡下手術,10 cm以上病變切除不完全。應慎重選擇病例,術后密切隨訪。
摘要:醫院有效事前監測、管控醫療不良事件,是保障患者安全、提高醫療質量的管理措施之一。超大型醫院對醫療不良事件管理的實戰中,建立、實施醫療安全隱患事件關鍵監測指標、醫療安全隱患事件篩查程序指標,積極開展醫療不良事件后臺監管工作,切斷醫療安全隱患事件向醫療風險事件演變、醫療風險事件向醫療糾紛事件演變的環節,保障患者安全。Abstract: Effective supervision in advance to the medical adverse event, is one of measures which hospital adopt to guarantee patient safety and enhance medical quality. The actual combat of supervision to the medical adverse event in super sized hospital, set up and put in practice on the key target of supervising the medical adverse event and the key target of ridding procedure, remain in the background and work actively on supervision on the medical adverse event, shut off the road from the medical safety issue to the medical risk issue and the road from the medical risk issue to the medical dissension in order to guarantee the patient safety.
Objective To investigate and analyze the 3-year physical examination results of the employees of a large financial enterprise in Chengdu, explore the key factors of health management and provide scientific basis for implementing reasonable health management. Methods The physical examination results of the employees of a large financial enterprise in Chengdu from 2012 to 2014 were analyzed, and the common abnormal results in the physical examination were summarized. Results The proportion of the employees whose physical examination results were completely normal in 2012, 2013, and 2014 was 4.97%, 2.01%, and 1.48%, respectively, showing a decreasing trend. Overweight, fatty liver and elevated triglycerides were always the top three of the abnormal examination results; the detection rates of which in the male staff were much higher than those in the female staff (P<0.05). In the female staff, the detection rate of overweight was always in the first place; the detection rate of columnar ectopy was always in the top three; the detection rate of liver cyst was in third place in 2013; and the detection rate of Nabothian cyst was in the second place in 2014. Conclusion The health management program of employees of this large financial enterprise is poor, thus health management should be paid enough attention to improve the employees’ physical quality.