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Background: Isolated soft tissue injuries of the posterior capsulolabral complex can be addressed arthroscopically, with various anchor systems available for repair. Purpose: To evaluate clinical and patient-reported outcomes after arthroscopic capsulolabral repair in patients with posterior shoulder instability (PSI) and to compare differences in outcomes between patients treated with a suture-first technique (PushLock anchor) and an anchor-first technique (FiberTak all-suture anchor). Study Design: Cohort study; Level of evidence, 3. Methods: Included were 32 patients with dynamic structural PSI (type B2 according to the ABC classification) treated with an arthroscopic posterior capsulolabral repair. After a mean follow-up time of 4.8 ± 3.4 years (range, 2-11) patients were evaluated clinically, and standardized outcome scores were obtained for the Subjective Shoulder Value (SSV), the Western Ontario Shoulder Instability Index (WOSI), Rowe, Kerlan-Jobe Orthopaedic Clinic (KJOC), patient satisfaction (0-5 [best]), and pain on a visual analog scale (VAS; 0-10 [worst]). Results: The overall satisfaction level with the outcome of the surgery was 4.6 ± 0.5 (range, 4-5). No patient suffered from instability events. The mean VAS level for pain was 0.4 ± 0.9 (range, 0-4) at rest and 1.9 ± 2.0 (range, 0-6) during motion. The mean SSV was 80 ± 17 (range, 30-100), the mean postoperative WOSI score 75% ± 19% (range, 18-98), the mean Rowe score 78 ± 20 (range, 10-100), and the mean KJOC score was 81 ± 18 (range, 40-100) for the entire cohort. There was no significant difference between the techniques with regard to range of motion, strength, or clinical outcome scores. Conclusion: Arthroscopic posterior capsulolabral repair was a satisfactory method to treat structural PSI type B2 with regard to stability, pain relief, and functional restoration. The majority of patients had good outcomes. No differences in outcomes were observed between the anchor-first and suture-first techniques.

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ATP-binding cassette (ABC) transporters belong to one of the largest membrane protein superfamilies, which function in translocating substrates across biological membranes using energy from ATP hydrolysis. Currently, the classification of ABC transporters in Clostridioides difficile is not complete. Therefore, the sequence-function relationship of all ABC proteins encoded within the C. difficile genome was analyzed. Identification of protein domains associated with the ABC system in the C. difficile 630 reference genome revealed 226 domains: 97 nucleotide-binding domains (NBDs), 98 transmembrane domains (TMDs), 30 substrate-binding domains (SBDs), and one domain with features of an adaptor protein. Gene organization and transcriptional unit analyses indicated the presence of 78 ABC systems comprising 28 importers and 50 exporters. Based on NBD sequence similarity, ABC transporters were classified into 12 sub-families according to their substrates. Interestingly, all ABC exporters, accounting for 64% of the total ABC systems, are involved in antibiotic resistance. Based on analysis of ABC proteins from 49 C. difficile strains, the majority of core NBDs are predicted to be involved in multidrug resistance systems, consistent with the ability of this organism to survive exposure to an array of antibiotics. Our findings herein provide another step toward a better understanding of the function and evolutionary relationships of ABC proteins in this pathogen.

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BACKGROUND: Very few studies have explored the changes of serum pepsinogen after bariatric surgery and no research has evaluated the feasibility of ABC classification to predict gastric cancer risk after bariatric surgery. METHODS: We enrolled 94 obese subjects that received bariatric surgery, including 41 sleeve gastrectomy (SG) and 53 Roux-en-Y gastric bypass (RYGB). The serum pepsinogen I (PGI), pepsinogen II (PGII), PGI/II ratio and seropositivity of Helicobacter pylori ( H. pylori ) were measured before and one year after surgery. Patients were classified according to ABC classification and post-operative change was evaluated. RESULTS: Preoperatively, four (4.2%) patients were classified into high risk group (classification C and D) for gastric cancer. Significant reduction of PGI, PGII and decrease of PGI/II ratio were noted after bariatric surgery. H. pylori seropositive patients had a greater postoperative change of PGI (-38.6µg/L vs -22.1µg/L, p=0.003) and PGII (-8.0µg/L vs -2.5µg/L, p <0.001) but a less postoperative change of PGI/II ratio (-0.6 vs -2.1, p =0.04) than H. pylori seronegative patients. One year after surgery, the portion of high risk group of ABC classification for gastric cancer increased markedly from 4.2% to 23.7%. CONCLUSION: Both of SG and RYGB resulted in significant reduction of serum PGI and PGII after bariatric surgery, and significantly influenced the ABC classification. The application of ABC classification for gastric cancer screening was limited after bariatric surgery.

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Objective:Exploring the " bottle neck" factors in the scientific research management of recipient hospitals, making good use of counterpart support resources to help identifying appropriate, tailored strategies of scientific research management that might improve the research capacity of recipient hospitals.Methods:Data were collected according to questionnaire survey and on-site interview, ABC classification method were used to perform statistical analysis, and " bottleneck" factors that constraint the scientific research work of the recipient hospital were summarized.Results:" Insufficient scientific research skills and lacking of talents" and " lacking of scientific research environment and recognition" are the two most prominent factors that negatively affect the scientific research capacity building of the recipient hospitals, followed closely by " the out-dated scientific research policies and lacking support from the hospital leadership" , insufficient of research platform or resources including research funding, as well as other factors. Based on such findings, this article took the First People's Hospital of Kashgar (Guangdong counterpart support) as an example, and tried to discuss some corresponding measures on how to make good use of counterpart support resources.Conclusions:The ABC classification method were used to identify the main " bottleneck" factors, and a series of effective measures that help to making good use of counterpart support resources were explored. As a result, the efficiency of the scientific research management of the recipient hospitals, which in terms of management methods, management concepts and management models, were improved.

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AIMS: Evaluating the accuracy of the modified Endoscopic ABC (Endo ABC) classification with an electronic endoscopy with narrow band imaging without magnification in diagnosing Helicobacter pylori (H. pylori)-infected gastritis. METHODS: A total of 576 patients were enrolled and they underwent modified Endo ABC. They were stratified into 5 groups (A to E) based on the grades of endoscopic findings. H. pylori-infected gastritis status was determined in the following ways: current H. pylori gastritis was defined as active gastritis and/or chronic atrophic gastritis (CAG) seen on endoscopy and positive H. pylori test, naïve H. pylori gastritis was defined as regular arrangement of collecting venules in the angle of the lesser curvature without CAG and negative H. pylori test, and previous H. pylori gastritis was defined as negative H. pylori tests regardless of the presence of CAG. RESULTS: Endo A has 97% accuracy and 100% positive predictive value in diagnosing naïve H. pylori gastritis. Endo E has 97% accuracy and 100% positive predictive value in diagnosing previous H. pylori gastritis. The accuracy of Endo B and Endo C in diagnosing current H. pylori gastritis was 89 and 82% respectively. Endo D has 87% accuracy in diagnosing previous H. pylori gastritis. CONCLUSION: This study showed that the modified Endo ABC classification enables to accurately determine the H. pylori-infected gastritis status.

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BACKGROUND: ABC classification has been used to assess the risk for gastric cancer. The current problem of ABC classification is that Group A contains individuals with current and past H. pylori infection. The aims of this study were to assesse the proportion of current and past infection in Group A and to establish a criteria for the identification of subjects with past infection from Group A subjects with negative results of urea breath test (UBT) and/or stool antigen test. METHODS: 201 subjects classified into Group A received UBT and/or stool antigen test, and also subsequent upper gastrointestinal endoscopy. The subjects were classified by the status of H. pylori infection defined by endoscopic findings. Levels of pepsinogen (PG) I, PG II and PG I/II ratio were compared between the groups, and receiver operating characteristic curves were constructed to extract the corresponding cutoff values. RESULTS: 22 subjects were tested positive by UBT and/or stool antigen test. Endoscopic images of 157 out of 179 subjects were studied. 15 of the subjects were regarded to have past H. pylori infection. The optimal cut-off value of PG I and PG I/II ratio for the determination of past H. pylori infection were ≤ 31.2 ng/mL and ≤ 4.6, respectively. CONCLUSIONS: Approximately 20% of Group A subjects have current or past H. pylori infection. Addition of UBT and/or stool antigen test can identify current but not past infection. Serum PG levels would be useful to identify subjects with past H. pylori infection.

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OBJECTIVE:To shorten the turnover days of hospital drug inventory,reduce the cost of drug inventory and improve the level of hospital drug inventory management.METHODS:The data of 65 kinds of antitumor drugs and its adjuvant drugs during Jan.1st,2016-Dec.31st,2016 were collected from hospital information system (HIS) of our hospital,such as price,inventory to classify by using ABC classification method.According to demanded quantity of class A drugs in the secondary drug storage,the amount purchased of upper and lower limitation of class A drugs could be calculated.The data of class C drugs were analyzed one by one to determine the "temporary use" drug directory.The turnover days of class A drugs and the inventory cost of class C drugs were counted before and after classification management.RESULTS:There were 10 class A drugs,accounting for 15.38％ of total types and 78.27％ of total consumption sum;the turnover days of pharmacy inventory decreased from (43.96 ± 19.04) d to (13.64 ± 8.02) d by adopting the principle of purchasing in small quantity by several times.There were 10 "temporary use" drugs of class C drugs,accounting for 26.32％ of total types,270 thousand yuan inventory cost saved each year.CONCLUSIONS:Hierarchical management of hospital drug inventory by ABC classification can effectively optimize the inventory types and amount,and provide definite evidence for "temporary use" drugs so as to shorten turnover days of pharmacy inventory and recue the cost of pharmacy inventory.

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Objective: To analyze the situation of inventory and consumption of non-implantable medical device of urinary surgery of teaching hospital so as to provide theoretical basis for improving logistics management of non-implantable medical device and effectively implementing decision of cost control.Methods: The inventory and usage situation of non-implantable medical devices of urinary surgery of teaching hospital during 2011 year and 2016 year were collected,and the Pareto rule was applied.And then these non-implantable medical devices of urinary surgery were divided into three categories(A,B and C)according to consumption sum of annual mean.Results: As the calculation results of consumption sum of annual mean,the non-implantable medical devices included 8 kinds of medical devices that were infusion device(49.808％),20mL syringe(10.912％),electrode(7.663％),medical gloves(5.634％),5mL syringe(2.293％),2mL syringe(2.209％),3M adhesive plaster(1.474％)and expander(1.435％),respectively.And the ratios of medical devices of A,B and C in the total amount of consumption of annual mean were 81.43％,9.88％and 8.69％,respectively.And their ratio in non-implantable medical device were 8.64％,9.75％and 81.48％,respectively.Conclusion: Logistics management involves many links,and if the ratio of one kind of medical device in the total amount of mean consumption is 80％while the ratio of type of goods is under 20％,we should strengthen the management for it.

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Posterior glenohumeral instability (PGHI) is a commonly under- and misdiagnosed pathology owing to its variety of clinical presentations. In order to facilitate diagnosis and treatment, the simple yet comprehensive ABC classification for PGHI is based on the underlying pathomechanical principles and current standard of treatment. Three main groups of PGHI are distinguished based on the type of instability: A (first time), B (dynamic), C (static). Two subtypes further differentiate these groups in terms of their specific pathomechanism and provide a guideline in the choice of appropriate treatment: A (1, subluxation; 2, dislocation), B (1, functional; 2, structural), C (1, constitutional; 2, acquired). While conservative treatment is warranted in most patients with type 1 PGHI (A1, B1, C1), surgical treatment should be considered on an individual basis in patients with type 2 PGHI (A2, B2, C2), while keeping in mind that the different groups and subtypes can overlap, co-exist, or even progress from one to another over time. Of course the necessity for surgical treatment depends on the extent of the structural defects, on the severity of symptoms, on the chronicity, as well as on patient-specific functional demand, age, and health status. Nonetheless, the ABC classification helps to correctly diagnose the type of PGHI and provides a guideline for the generally recommended type of treatment.

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Objective:To control the maintenance cost of medical equipment and improve the efficiency and service level for maintenance, and to research the management about classification maintenance for medical equipment based on analytic hierarchy process (AHP).Methods: 69 clinical department and 14 engineers were involved in the questionnaire survey and the evaluated factors were obtained from their questionnaires. The (AHP) was used to determine what is the factor weight of maintenance for the medical equipment, and then calculate the maintenance scores of the equipment. Finally, the weight scores were applied to ABC classification method and the equipments will be divided into three types (A\B\C) as this method, and they will be managed by different mode.Results: Depended on the sixth order analysis data from 6 factors of evaluation (price, frequency, stability, running time, standby factor and difficulty of maintenance) that were compared between any two factors by using AHP, through comprehensive scores ratio to got A\B\C classification and work out relative implement countermeasure of maintenance. The new classification management mode has achieved planning and preventive maintenance for key equipment, regular maintenance for major equipment, and maintenance after event for general equipment. After the method was applied, the fault rate of second half of 2016 year was decrease 30% compared with same time of 2015 year. The total cost of maintenance of 2016 year decreased 10% compared with that of 2015 year. And the satisfaction of clinical department for department of equipment was enhanced.Conclusion: The AHP is applied to classified manage medical equipment and maintain them as weight of factor. This method has resolved many problems on maintenance of equipment, such as confused primary and secondary, and formalism and so on. According to the factor weight of maintenance to manage medical equipment at classification mode, hospital can catch key point of maintenance of equipment, and the maintenance cost can be efficiently controlled, and the work efficiency and clinical service level of equipment department can be improved and enhanced.

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PURPOSE: To investigate the correlation between ABC risk assessment and radiological findings of gastric mucosa and to propose an improved method for gastric cancer screening. MATERIALS AND METHODS: We evaluated 318 participants with Helicobacter pylori (Hp) antibody titers, serum pepsinogen (PG) and upper GI radiography and then classified them into three groups: A, double-negative; B, Hp-positive, PG-negative; C, PG-positive. Group A was subclassified as: A-1, Hp antibody titer <3.0 U/ml; A-2, Hp antibody titer ≥3.0 U/ml. Results for group A and non-A (B or C) participants and radiological findings of gastric mucosa (fold and area gastricae) were analyzed retrospectively. RESULTS: Radiological findings differed significantly between the 207 A-1 and 98 non-A group. Odds ratios were 17.72 for fold distribution, 10.63 for fold thickness, 6.10 for fold characteristics, and 10.62 for area gastricae. Presence of ≥2 risk factors offered 90.3 % sensitivity, 94.7 % specificity, and 93.3 % accuracy. Nine (69.2 %) of the 13 A-2 group participants and 11 (5.3 %) A-1 group participants had a risk for gastric cancer according to radiological findings. CONCLUSION: A good correlation exists between ABC classifications and radiological findings for gastric cancer risk, but some discrepant cases exist. We recommend both methods as screening for gastric cancer.

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