The advanced management is the foundation of the long-term development of hospital. How to break the barriers between institutions, explore and set up formal management system and operating mechanism is a headache faced by many public hospitals. By bringing in Project Management (PM) theory to establish up the management reform will be a smart way. This study reported the examples of the PMs of West China Hospital of Sichuan University, summarized the management experiences, revealed the great value of PM, and provided references for the managers of hospitals.
ObjectiveTo investigate the effect of Notch signaling pathway important target Hey1 expression on the differentiation and proliferation of C3H10T1/2 cells induced by bone morphogenetic protein 9 (BMP-9). MethodsHey1 lentivirus and Hey1 short hairpin RNA lentivirus were constructed and used to infect C3H10T1/2 cells to change the expression level of Hey1 in C3H10T1/2 cells. C3H10T1/2 cells infected with LV-Blank (empty plasmid) as control. The Hey1 expression levels of different groups were detected by fluorescence microscope, real-time fluorescence quantitative PCR, and Western blot. The C3H10T1/2 cells with different Hey1 expression level were induced by BMP-9 conditioned medium (BMP-9+C3H10T1/2 group, BMP-9+C3H10T1/2-Hey1 group, and BMP-9+C3H10T1/2-shHey1 group); the cells of control groups (C3H10T1/2 group and C3H10T1/2-Blank group) were cultured with normal medium. The mRNA and protein expression levels of osteogenesis related transcription factors (Runx2, osteopontin, and osteocalcin) were detected at 48 hours by real-time fluorescence quantitative PCR and Western blot assay. The cells proliferation and cycles were detected by MTT assay at 4, 5, 6, and 7 days and flow cytometry at 4, 5, and 10 days. The alkaline phosphatase (ALP) activity was analyzed by ELISA and observed by ALP staining at 4 and 7 days. ResultsC3H10T1/2 cell lines with different Hey1 expression levels were successfully established. In osteogenesis compared with BMP-9+C3H10T1/2 group, overexpression of Hey1 enhanced the mRNA and protein expressions of transcription factors (Runx2, osteopontin, and osteocalcin), and the expression of osteogenic differentiation marker (ALP) (P < 0.05); however, inhibition of Hey1 expression significantly decreased the above indexes (P < 0.05). In cell proliferation activity compared with BMP-9+C3H10T1/2 group, overexpression of Hey1 increased absorbance (A) value in MTT assay and pecentage of G2+S cells in cytometry assay, but inhibition of Hey1 expression significantly decreased the indexes (P < 0.05). ConclusionExpression of Hey1 is the important link in the osteogenic differentiation process of C3H10T1/2 cells induced by BMP-9, and plays an important role in the regulation of early cell proliferation.
ObjectiveTo evaluate the outcomes of the Health Professionals Training Project in West China in the West China Hospital of Sichuan University, launched by the National Health and Family Planning Commission of the People's Republic of China, so as to provide advices and experience for primary health institute physician training work. MethodsA questionnaire investigation was conducted among 130 trainees who took part in the second and third training programs from September 2011 to March 2013. Based on the feedback, this study analyzed their motivation of participation, performance of acquired skills in local region and practicability of such skills, and compared their mastery of such skills before and after training. ResultsWith high-degree satisfaction, the trainees learnt skills well and could perform and promote applicable techniques in local regions. ConclusionPolicies encouraging the Health Professionals Training Project should be made in primary-level hospitals; on the other hand, the traning health institutes should screen applicable techniques, strengthen management and services, and promote health professionals training from comprehensive perspective in all aspects.
This paper analyzed the four aspects of the medical consortium both in China and abroad, including evaluation of object, theoretical basis and model, content and method, and provided reference for construction and development of medical consortium evaluation in China.
Objective To discuss the improved method and effectiveness of posterior pedicle-screw fixation combined with restoring and grafting through the injured vertebrae for treating thoracolumbar burst fracture. Methods Between March 2008 and September 2010, 21 patients with thoracolumbar burst fracture were treated by posterior pedicle-screw fixationcombined with restoring and grafting through the injured vertebrae. Of 21 cases, 15 were male and 6 were female with an age range of 20-61 years (mean, 38.4 years). Affected segments included T12 in 5 cases, L1 in 7 cases, L2 in 5 cases, and T12-L1 in 4 cases. According to Frankel classification for neurological function, 2 cases were rated as grade A, 4 cases as grade B, 6 cases as grade C, 5 cases as grade D, and 4 cases as grade E; based on Denis classification, all 21 cases were burst fractures, including 7 cases of type A, 11 cases of type B, and 3 cases of type C. The X-ray film was taken to measure the relative height of fractured vertebrae and Cobb’s angle, and the function of the spinal cord was evaluated at preoperation, postoperation, and last followup. Results All the incisions healed primarily. The 21 patients were followed up 12-30 months (mean, 26 months). No loosening or breakage of screws and rods occurred. X-ray films showed good bone heal ing with the heal ing time from 12 to 23 months (mean, 16 months). The Cobb’s angles at 1 week and 1 year postoperatively were (3.4 ± 2.4)° and (5.2 ± 3.2)° respectively, showing significant differences when compared with preoperative angle (22.1 ± 1.2)° (P lt; 0.05), while no significant difference between 1 week and 1 year after operation (P gt; 0.05). The anterior height of injured vertebrae recovered from (14.6 ± 2.1) mm (40.2% ± 1.5% of the normal) at preoperation to (36.0 ± 2.0) mm (95.3% ± 1.3% of the normal) at 1 week, and to (35.0 ± 2.4) mm (94.4% ± 2.5% of the normal) at 1 year; significant differences were found between preoperation and postoperation (P lt; 0.05), while no significant difference between 1 week and 1 year after operation (P gt; 0.05). At 1 year after operation, the Frankel neurological function grade was improved in varying degrees, showing significant difference when compared with preoperative grade (χ2=11.140, P=0.025). Conclusion Improved method of posterior pedicle-screw fixation combined with restoring and grafting through the injured vertebrae in treatment of thoracolumbar burst fracture can reconstructthe anterior and middle column stabil ity and prevent loss of Cobb’s angle and height of vertebrae.
Under the vigorous promotion of national policies, by the end of 2018, the construction of the national medical consortium has been fully launched, and all public tertiary hospitals have actively participated in the construction of medical consortium. The practice of lead-type close medical consortium in West China Hospital of Sichuan University is an innovative exploration in the context of the new national medical reform. Combining the social responsibilities, location characteristics, functional orientation of West China Hospital of Sichuan University, and the remarkable results of the lead-type close medical consortium, this article elaborats three distinctive features of the lead-type close medical consortium, namely the cooperation between the government and the hospitals as the cornerstone, the hierarchical collaboration as the core, and the medical care and great health as the guiding principle, to provide a reference for the construction of a high-quality and efficient medical and health service system in China.
This article introduces the exploration and practice of the “West China Hospital of Sichuan University-Zhenxiong model”, discusses the model of medical precision poverty alleviation work in the new era. Through in office and online service, the counterpart assistance measures will be deeply integrated with the reality of Zhenxiong, to effectively radiate the high-quality medical resources of West China Hospital of Sichuan University to Zhenxiong, and gradually promote the county to form a cross-regional medical alliance of “West China Hospital of Sichuan University + Zhenxiong medical community”, so as to practice the national medical reform policy. It is hoped that through the practice of this model, non-Communist parties can learn from the experience of participating in poverty alleviation.