Anxiety disorder is a common emotional handicap, which seriously affects the normal life of patients and endangers their physical and mental health. The prefrontal cortex is a key brain region which is responsible for anxiety. Action potential and behavioral data of rats in the elevated plus maze (EPM) during anxiety (an innate anxiety paradigm) can be obtained simultaneously by using the in vivo and in conscious animal multi-channel microelectrode array recording technique. Based on maximum likelihood estimation (MLE), the action potential causal network was established, network connectivity strength and global efficiency were calculated, and action potential causal network connectivity pattern of the medial prefrontal cortex was quantitatively characterized. We found that the entries (44.13±6.99) and residence period (439.76±50.43) s of rats in the closed arm of the elevated plus maze were obviously higher than those in the open arm [16.50±3.25, P<0.001; (160.23±48.22) s, P<0.001], respectively. The action potential causal network connectivity strength (0.017 3±0.003 6) and the global efficiency (0.044 2±0.012 8) in the closed arm were both higher than those in the open arm (0.010 4±0.003 2, P<0.01; 0.034 8±0.011 4, P<0.001), respectively. The results suggest that the changes of action potential causal network in the medial prefrontal cortex are related to anxiety state. These data could provide support for the study of the brain network mechanism in prefrontal cortex during anxiety.
Objective To develop a Matlab toolbox to improve the efficiency of musculoskeletal kinematics analysis while ensuring the consistency of musculoskeletal kinematics analysis process and results. Methods Adopted the design concept of “Batch processing tedious operation”, based on the Matlab connection OpenSim interface function ensures the consistency of musculoskeletal kinematics analysis process and results, the functional programming was applied to package the five steps for scale, inverse kinematics analysis, residual reduction algorithm, static optimization analysis, and joint reaction analysis of musculoskeletal kinematics analysis as functional functions, and command programming was applied to analyze musculoskeletal movements in large numbers of patients. A toolbox called LLMKA (Lower Limbs Musculoskeletal Kinematics Analysis) was developed. Taking 120 patients with medial knee osteoarthritis as the research object, a clinical researcher was selected using the LLMKA toolbox and OpenSim to test whether the analysis process and results were consistent between the two methods. The researcher used the LLMKA toolbox again to conduct musculoskeletal kinematics analysis in 120 patients to verify whether the use of this toolbox could improve the efficiency of musculoskeletal kinematics analysis compared with using OpenSim. Results Using the LLMKA toolbox could analyze musculoskeletal kinematics analysis in a large number of patients, and the analysis process and results were consistent with the use of OpenSim. Compared to using OpenSim, musculoskeletal kinematics analysis was completed in 120 patients using the LLMKA toolbox with only 2 operations were needed to enter the patient body mass data, operating steps decreased by 99.19%, total analysis time by 66.84%, and manual participation time by 99.72%, just need 0.079 1 hour (4 minutes and 45 seconds). Conclusion The LLMKA toolbox can complete a large number of musculoskeletal kinematics analysis in patients with one click in a way that is consistent in process and results with using OpenSim, reducing the total time of musculoskeletal kinematics analysis, and liberating clinical researchers from cumbersome steps, making more energy into the clinical significance of musculoskeletal kinematics analysis results.
There are few researches on the modulation effect of transcranial direct current stimulation(tDCS) on complex spatial cognition. Especially, the influence of tDCS on the neural electrophysiological response in spatial cognition is not yet clear. This study selected the classic spatial cognition task paradigm (three-dimensional mental rotation task) as the research object. By comparing the changes in behavior and event-related potentials in different modes of tDCS before, during and after the application of tDCS, this study analyzed the behavioral and neurophysiological effects of tDCS on mental rotation. The comparison between active-tDCS and sham-tDCS showed no statistically significant difference in behavior between different stimulation modes. Still, the changes in the amplitudes of P2 and P3 during the stimulation were statistically significant. Compared with sham-tDCS, the amplitudes of P2 and P3 in active-tDCS mode showed a greater decrease during the stimulation. This study clarifies the influence of tDCS on the event-related potentials of the mental rotation task. It shows that tDCS may improve the brain information processing efficiency during the mental rotation task. Also, this study provides a reference for an in-depth understanding and exploration of the modulation effect of tDCS on complex spatial cognition.
ObjectiveTo measure the operational efficiency and explore the phenomenon of the economy of scale in secondary public general hospitals of China for improving the health service efficiency.MethodsFrom February to August 2019, the data set of two input indicators (the number of employees and actual open beds) and two output indicators (the numbers of outpatients and discharges) in 511 secondary general hospitals of Shandong, Anhui, Shanxi, Hubei and Hainan provinces in 2018 were collected for data envelopment analysis. The analysis processes were three folds: First, the technical efficiency, pure technical efficiency, scale efficiency and scale compensation status of the sample hospitals were calculated respectively. Second, the comparative analysis of efficiency value and scale compensation status was carried out in 5 groups according to the bed scale. Finally, the input and output projection analysis was carried out on the ineffective decision making units.ResultsThe medians of technical efficiencies, pure technical efficiencies, and scale efficiencies of the 511 secondary general hospitals were 0.472, 0.531, and 0.909, respectively. In the 511 hospitals, 493 hospitals (96.5%) were in ineffective state, of which 321 hospitals (62.8%) were in the state of decreasing return to scale. The staff redundancy of the group with beds >100 and ≤300 was 23.86%, and its service quantity could be increased by 39.37%.ConclusionsThe overall operating efficiencies are inefficiency in secondary general hospitals of China and the optimal scale of actual open beds is between 300 and 500 beds from the perspective of scale efficiency.
Objective To compare the clinical efficacy and safety of thrombolysis with anticoagulation therapy for patients with acute sub-massive pulmonary thromboembolism. Methods The clinical data of 84 patients with acute sub-massive pulmonary thromboembolism were analyzed retrospectively, mainly focusing on the in-hospital efficacy and safety of thrombolysis and/ or anticoagulation. The efficacy was evaluated based on 6 grades: cured, markedly improved, improved, not changed, deteriorated and died. Results Among the 84 patients,49 patients received thrombolysis and sequential anticoagulation therapy( thrombolysis group) , 35 patients received anticoagulation therapy alone( anticoagulation group) . As compared with the anticoagulation group, the thrombolysis group had higher effective rate( defined as patients who were cured, markedly improved or improved, 81. 6% versus 54. 3%, P = 0. 007) , lower critical event occurrence ( defined as clinical condition deteriorated or died, 2. 0% versus 14. 3% , P = 0. 032) . There was no significant difference in bleeding rates between the two groups ( thrombolysis group 20. 4% versus anticoagulation group 14. 3% , P gt; 0. 05) . No major bleeding or intracranial hemorrhage occurred in any of the patients. Conclusions Thrombolysis therapy may be more effective than anticoagulation therapy alone in patients with acute sub-massive pulmonary thromboembolism, and thus warrants further prospective randomized control study in large population.
In the present study, packaging system composed of pAAV-CMV-GFP, pAAV-RC and pHelper were transfected into human embryonic kidney 293 cells (HEK293 cells) mediated by polyethyleneimine (PEI) to explore an optimal transfection condition. Different total plasmid DNA dosages (1, 2, 3, 4, 5, 6μg) and different PEI/Plasmid ratios (1:1, 3:1, 5:1, 7:1) were tested with detection of green fluorescence protein (GFP) with ImagePro Plus6.0 Software. Then transfection efficiency of the optimized transfection system was further observed for different time periods(12, 24, 36, 48, 60, 72 h). The results showed that total plasmid dosage of 4μg/well with PEI/plasmid ratio of 3:1~5:1 was an efficient transfection condition. Transfection efficiency-time curve was an S-shaped curve. Transfection efficiency reached a plateau at 60 h after transfection. The optimized conditions for PEI-mediated transfection at the optimal time result in enhanced transfection efficiency of triple plasmid into HEK293 cells.
Objective To establish a cooperative decision-making model of county-level public hospitals, so as to freely select the best partner in different decision-making units and promote the optimal allocation of medical resources. Methods The input and output data of 10 adjacent county-level public hospitals in Henan province from 2017 to 2019 was selected. Based on the traditional data envelopment analysis (DEA) model, a generalized fuzzy DEA cooperative decision-making model with better applicability to fuzzy indicators and optional decision-making units was constructed. By inputting index information such as total number of employees, number of beds, annual outpatient and emergency volume, number of discharged patients, total income and hospital grade evaluation, the cooperation efficiency intervals of different hospitals were calculated to scientifically select the best partner in different decision-making units.Results After substituting the data of 10 county-level public hospitals in H1-H10 into the model, taking H2 hospital as an example to make cooperative decision, among the four hospitals in H1, H2, H7 and H10 of the same scale, under optimistic circumstances, the best partner of H2 hospital was H7 hospital, and the cooperation efficiency value was 1.97; in a pessimistic situation, the best partner of H2 hospital was H10 hospital, and the cooperation efficiency value was 0.98. The model had good applicability in the cooperative decision-making of county-level public hospitals. Conclusion The generalized fuzzy DEA model can better evaluate the cooperative decision-making analysis between county-level public hospitals.
Objective To evaluate the pathways for improving the operational efficiency of medical teams, thereby providing micro-level empirical evidence for the refined management and high-quality development of public hospitals. MethodsBased on panel data from nine surgical teams in the Department of Thoracic Surgery at Sichuan Cancer Hospital from 2021 to 2024, this study employed the data envelopment analysis (DEA) with the BCC model to assess static efficiency, including technical efficiency (TE), scale efficiency (SE), and overall efficiency (OE). The Malmquist index was used to analyze the dynamic total factor productivity (TFP) and its decomposition into efficiency change (EC) and technology change (TC). Input indicators were the number of physicians and the number of open beds. Output indicators included the proportion of surgical patients, the proportion of grade Ⅳ surgeries, and the average length of stay (reciprocally transformed for positive orientation). Results The mean OE of all medical teams showed a continuous upward trend, while the mean SE exhibited a “V-shaped” pattern, initially decreasing and then increasing. The most significant growth was observed in mean TE, which was the primary driver of the OE improvement. All medical teams achieved positive TFP growth, with TC values greater than 1.000 across all teams, indicating that technological innovation was the core engine of efficiency enhancement. However, EC showed a divergent trend among the teams. Conclusion Public hospital performance appraisal policies effectively guide technological upgrading of medical teams through indicators such as “proportion of discharged patients undergoing surgery” and “proportion of grade Ⅳ surgeries”. However, issues of hospital resource mismatch and SE differentiation persist. It is necessary to establish specialized operation groups for dynamic resource monitoring and construct a “technological upgrading, scale adaptation, and management innovation” triangular balanced system to achieve a sustainable mechanism for maximizing healthcare resource input-output.
Microfluidic chips can be used to realize continuous cryoprotectants (CPA) loading/unloading for oocytes, reducing osmotic damage and chemical toxicity of CPA. In this study, five different Y-shape microfluidic chips were fabricated to realize the continuous CPA loading/unloading. The effects of flow rate, entrance angle, aspect ratio and turning radius of microchannels on the mixing efficiency of microfluidic chips were analyzed quantitatively. The experimental results showed that with the decrease of flow rates, the increase of aspect ratios and the decrease of turning raradius of microchannel, the mixing length decreased and the mixing velocity was promoted, while the entrance angle had little effect on the mixing efficiency. However, the operating conditions and structural parameters of the chips in practical application should be determined based on an overall consideration of CPA loading/unloading time and machining accuracy. These results would provide a reference to the application of microfluidic chip in CPA mixing.