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Objective:By using balloon occlusive hepatic angiography in cirrhotic portal hypertension to evaluate contrast doses on the detection rate of intrahepatic venous-lateral branch shunt (HVVC), and the effect on hepatic venous pressure gradient (HVPG) and portal vein pressure gradient (PPG).Methods:From Jan 2018 to Jun 2021, 131 patients received transjugular intrahepatic portosystemic shunt (TIPS) at Beijing Shijitan Hospital.Results:A positive correlation between PVP and weged hepatic venous pressure (WHVP) ( r=0.241, P=0.001) was found when only by right hepatic vein approach. Ten ml of iodine contrast medium when compared to 5ml doses found more cases of intrahepatic venous-venous lateral branch shunt. The mean PPG of patients with HVVC was significantly higher than the mean of HVPG( P<0.05).The right hepatic vein was the only reliable vein by which WHVP was measured. Conclusions:Right hepatic vein manometry,adequate ballon occlusion and using 10ml of iodine contrast help get reliable WHVP and found HVVC; HVVC can affect the consistency of HVPG and PPG.

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Objective:Case mix index indicates the capacity of disease diagnosis and treatment, as well as the quality of health cares in related disciplines. Science and technology evaluation metrics represent the level of innovation and sustainable development of science and technology. Quality of health care and sustainable development are considered as two key evaluation indicators in the performance evaluation of national tertiary public hospitals. This study aimed to explore the effect of case mix index on the science and technology evaluation metrics.Methods:According to a cross-sectional design, the relationship between case mix index and science and technology evaluation metrics was analyzed in a tertiary public general hospital between 2017 and 2019.Results:In three years′ period time, the departments in top 100 disciplines of science and technology evaluation metrics had the case mix index 17% which was higher than other departments in non-top 100 disciplines ( P<0.05). In the multivariate analysis, higher case mix index increased a 2.29-fold higher probability to be in top 100 disciplines. They are under the receiver operative character curve between case mix index and top 100 disciplines in evaluation of departments was 0.716 ( P=0.001). Conclusions:Case mix index indicated the level of science and technology evaluation metrics and the clinical departments should improve the case mix index, service quality of health care and the motivation of sustainable development.

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To study the prevalence of burnout and job satisfaction in Chinese pediatrics residents.Prospective participants were invited via a WeChat group to participate from October 1, 2018 to January 31, 2019. The Maslach Burnout Inventory-Human Services Survey was used to measure physician burnout, and the Minnesota Satisfaction Questionnaire was used to measure job satisfaction.A total of 380 residents (81.1% response rate) from 35 pediatric residency programs completed the cross-sectional web-based survey. Of the responders, 233 (61.3%) exhibited high levels of career burnout. Residents 24 to 29 years of age were less likely to report burnout than residents ≥30 years of age (50.9% vs74.7%; P < .05). In addition, residents with an annual income less than 80,000 RMB seem to have higher burnout levels (66.2%). Residents who reported that they felt sleep deprived had significantly higher rates of burnout than those who did not (P < .01). Logistic regression showed that age ≥30 years (odds ratio [OR] 3.74 [1.57-7.66], P < .01) and sleep deprivation (OR 4.11 [2.19-7.35], P < .01) were the 2 independent risk factors associated with burnout.Burnout is highly prevalent among Chinese pediatrics residents who also reported poor job satisfaction.

Asunto(s)

Agotamiento Profesional/epidemiología , Internado y Residencia/estadística & datos numéricos , Satisfacción en el Trabajo , Pediatría/educación , Adulto , Factores de Edad , Estudios Transversales , Femenino , Humanos , Internet , Modelos Logísticos , Masculino , Sueño

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Objective:To observe the inhibitory effect of metformin on the inflammatory response of Kupffer cells (KCs) of liver in the diabetic mice, and to explore its improvement on the phagocytic function of KCs, and to elucidate the protective mechanism of metformin on the KCs in the diabetic mice.Methods:The C57BLKS/J db/db mice were divided into diabetes group and diabetes+metformin group, and the C57BLKS/J db/m mice were divided into non-diabetes group and non-diabetes+metformin group, 8mice in each group.The KCs were cultured in vitro and the changes of ultrastrustures of KCs were observed by transmission electron microscope.The levels of interleukin 6 (IL-6) , tumor necrosis factorα (TNF-α) andγ-interferon (INF-γ) in the KCs were detected by ELISA.The expression levels of intercellular adhesion molecule 1 (ICAM-1) protein in the KCs was detected by Western blotting method.Transwell chamber assay was used to detect the neutrophil chemotaxis ability of the KCs, and the phagocytic ability of KCs was observed under inverted microscope.Results:The number of mitochondria and rough endoplasmic reticulum (RER) in the KCs of the diabetic mice was reduced, the RER expanded, the mitochondria swelled, and the lipid droplets were increased.Compared with non-diabetes group, the levels of IL-6, TNF-α, INF-γand the expression level of ICAM-1in the KCs of the mice in diabetes group were significantly increased (P＜0.05) ;the neutrophil chemotaxis ability of the KCs was enhanced (P＜0.05) , and the phagocytic ability was decreased (P＜0.05) .Compared with diabetes group, the levels of IL-6, TNF-α, INF-γand the expression level of ICAM-1in the KCs in diabetes+metformin group were significantly decreased (P＜0.05) ;the neutrophil chemotaxis ability was decreased (P＜0.05) , and the phagocytic ability was enhanced (P＜0.05) .Conclusion:Metformin can inhibit the inflammatory response of KCs in the diabetic mice and improve its phagocytic function and protect the KCs.

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Objective To discuss the relationship between discipline ranking and personnel rationality,and explore the problems of personnel development among all the disciplines and put forward further countermeasures.Methods A 3A general hospital in Beijing was targeted,and departments in it were divided into,in descending order of hospital regulations,key disciplines,developing-key disciplines,characteristic disciplines and general disciplines.To analyze the rationality of personnel,four dimensions as educational background structure,professional title structure,age structure and academic proficiency of department leader were adopted.Results The hospital had 52 departments in total,which were divided into key disciplines (7),developing-key disciplines (10),characteristic disciplines (6) and general disciplines (29).With the decline of the discipline level,the problem of the talent team was gradually increasing.The major problem of personnel among all the disciplines was that the proportion of senior staff was too high,so did the key disciplines and developing key disciplines.Age structure irrationalized was another major problem for developing-key disciplines.As for characteristic disciplines,the problems in personnel were even diversified,which included not only the irrational age structure and senior professional proportion,but also the fact that director of one third of these departments showed low academic proficiency.In general disciplines,all above four types of problems exited.Conclusions The rationality of the talent team is closely related to the level of the discipline.Problems in personnel varied among different disciplines,and countermeasures should be provided targeted at existing problems.

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Objective@#To analyze the relationship between clinicopathologic characteristics of pseudomyxoma peritonei (PMP) and its prognosis.@*Methods@#Fifty-two cases of PMP collected from 2012 to 2017 at Beijing Shijitan Hospital, Capital Medical University were reviewed using the diagnostic criteria of WHO 2010. The histopathologic features, including original location, neural invasion and calcification were observed; and the relationship with prognosis was analyzed. Immunohistochemical staining for CK7, CK20 and CDX2 was performed on all cases. ER, PR, and p16 were additionally performed on those without clear origin.@*Results@#Patients′ mean age was 52.0 years, and included 29 males and 23 females. Thirty-two cases were derived from appendix; among them, 23 were low grade and 29 were high grade. Signet ring-cells, neural invasion and calcification were detected in 15, 12 and 9 cases respectively. Neural invasion was associated with adverse prognosis (P=0.025) and signet ring cell morphology (P<0.01). Prognosis was not related to gender, age, original location or grade.@*Conclusion@#Neural invasion is not uncommon in PMP and predicts a bad prognosis.

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The expression of estrogen receptor (ER) in thymus of female BALB/c mice at different ages was investigated. The results showed that the expression of ER in thymus was increased from 1 to 8 weeks after birth. ER positive cells were thymic epithelial cells and thymocytes. ER existed not only in the cytoplasm, but also in the nucleus.