The Technical Efficiency of Hospitals under a Single Payer System: The Case of Ontario Community Hospitals

Using DEA, we investigated the impact of ownership, size, and location on the relative technical efficiency of community hospitals in Ontario, which has a single payer system. Consistent with Hansmann's theory of non-profit organizations and contrary to US-based research, we find no significant differences in efficiency across ownership types (government, religious or secular non-profit). Nor do we find significant differences in efficiency by size or location. Our findings suggest that model formulation and differences in payer mix across types of hospitals in the US have a strong influence on the measurement of the hospital ownership–efficiency relationship.     

单核苷酸多态性、环境因素与肝细胞肝癌遗传易感性的关系

肝细胞肝癌(HCC)的发生和演进是一个多基因、多因素的复杂过程,是遗传与环境因素相互作用的结果。单核苷酸多态性(SNP)作为第三代遗传标记,充分反映了个体间的遗传差异,决定了个体对疾病的易感性,正成为肝癌遗传易感性研究的重要工具。     

CRH及其受体-1在分娩发动中的作用

目的比较早产及足月分娩剖宫产产妇血清肾上腺皮质激素释放激素（CRH）水平及子宫下段中促肾上腺皮质激素释放激素受体-1（CRH-R1）的表达情况,分析其在分娩发动中的作用。方法按难免早产、足月分娩发动、足月分娩未发动分为3组,术前测定血清中CRH水平,于剖宫产中取子宫下段平滑肌,用免疫组化的方法检测CRH-R1在子宫下段的表达。结果3组间CRH水平差异无统计学意义（P〉0．05）,均为孕期较高水平。难免早产组、足月分娩发动组CRH-R1在子宫下段肌层中呈高表达状,其表达指数明显高于足月分娩未发动组（t值分别为5．000、6．295,均P〈0．05）。难免早产组、足月分娩发动组CRH-R1在子宫下段肌层中的表达差异无统计学意义（P〉0．05）。结论CRH为参与人类分娩启动因子之-。母体血浆CRH水平有望作为早产预测和预后指标,其作用的发挥还有赖于子宫体中CRH-R1的表达。     

Assessment of left ventricular mechanical dyssynchrony by phase analysis of ECG-gated SPECT myocardial perfusion imaging

Cardiac resynchronization therapy (CRT) has shown benefits in patients with severe heart failure. However, at least 30% of patients selected for CRT by use of traditional criteria (New York Heart Association class III or IV, depressed left ventricular [LV] ejection fraction, and prolonged QRS duration) do not respond to CRT. Recent studies with tissue Doppler imaging have shown that the presence of LV dyssynchrony is an important predictor of response to CRT. Phase analysis has been developed to allow assessment of LV dyssynchrony by gated single photon emission computed tomography myocardial perfusion imaging. This technique uses Fourier harmonic functions to approximate regional wall thickness changes over the cardiac cycle and to calculate the regional onset-of-mechanical contraction phase. Once the onset-of-mechanical contraction phases are obtained 3-dimensionally over the left ventricle, a phase distribution map is formed that represents the degree of LV dyssynchrony. This technique has been compared with other methods of measuring LV dyssynchrony and shown promising results in clinical evaluations. In this review the phase analysis methodology is described, and its up-to-date validations are summarized.     

银川市老年人空腹血糖受损与心电图ST段压低的相关性研究

目的：研究宁夏银川市老年人空腹血糖受损与心电图ST段压低的相关性。方法对城市社区958例60岁以上老年人通过调查问卷的方式收集信息和进行临床检查,内容包括询问病史、测量身高、体质量、心电图,实验室检查内容包括空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL－C）、低密度脂蛋白胆固醇（ LDL－C）,对空腹血糖受损与心电图ST段压低的相关性进行分析。结果958例受检人群中,血糖正常788例,其中ST段压低40例,占5％（40／788）;空腹血糖受损者有170例,其中ST段压低者有29例,占17％（29／170）,差异有统计学意义（P＜0?05）。空腹血糖受损组血脂代谢紊乱明显,与血糖正常人群比较 TC、TG、LDL－C明显升高（P＜0?05）,HDL－C低于正常水平（P＜0?05）,肥胖（体质量指数）增高人数于正常血糖组（P＜0?05）。吸烟与空腹血糖受损差异无统计学意义。结论空腹血糖受损组心电图ST压低发生率明显高于正常血糖组,与糖代谢异常和脂代谢异常、冠状动脉粥样硬化有关。     

TAS1R3 and TAS2R38 Polymorphisms Affect Sweet Taste Perception: An Observational Study on Healthy and Obese Subjects

Background: The inter-individual differences in taste perception find a possible rationale in genetic variations. We verified whether the presence of four different single nucleotide polymorphisms (SNPs) in genes encoding for bitter (TAS2R38; 145G > C; 785T > C) and sweet (TAS1R3; −1572C > T; −1266C > T) taste receptors influenced the recognition of the basic tastes. Furthermore, we tested if the allelic distribution of such SNPs varied according to BMI and whether the associations between SNPs and taste recognition were influenced by the presence of overweight/obesity. Methods: DNA of 85 overweight/obese patients and 57 normal weight volunteers was used to investigate the SNPs. For the taste test, filter paper strips were applied. Each of the basic tastes (sweet, sour, salty, bitter) plus pure rapeseed oil, and water were tested. Results: Individuals carrying the AV/AV diplotype of the TAS2R38 gene (A49P G/G and V262 T/T) were less sensitive to sweet taste recognition. These alterations remained significant after adjustment for gender and BMI. Moreover, a significant decrease in overall taste recognition associated with BMI and age was found. There was no significant difference in allelic distribution for the investigated polymorphisms between normal and overweight/obese patients. Conclusions: Our findings suggest that overall taste recognition depends on age and BMI. In the total population, the inter-individual ability to identify the sweet taste at different concentrations was related to the presence of at least one genetic variant for the bitter receptor gene but not to the BMI.     

抗转铁蛋白受体单链抗体原核表达载体的构建和表达

目的 构建抗转铁蛋白受体(TfR)单链抗体原核表达载体，为进一步研究其效应奠定基础。方法 从抗TfR单克隆抗体重链和轻链可变区基因的克隆载体pGEM-T-VH和pGEM-T-VL中扩增重链可变区(VH)和轻链可变区(VL)基因，用重叠延伸PCR的方法，在VH和VL基因间引入连接短肽(Linker)，构建VH-Linker-VL的单链抗体(single chain Fv，scFv)基因。经NcoⅠ和NotⅠ酶切后亚克隆到原核分泌型表达载体pUCl9／119上，转化和筛选后，阳性细菌经IPTG诱导表达。间接免疫荧光法(IFA)及抗体封闭试验鉴定其抗体活性。结果 凝胶电泳可见重叠延伸PCR扩增产物约700bp条带，SDS-PAGE鉴定表达产物的分子量为27kD左右，与scFv的理论值一致，IFA及抗体封闭试验证明表达产物有抗人TfR的活性。结论 本研究成功地构建并表达了抗人TfR scFv，为抗人TfRscFv的应用奠定了基础。     

Shank3基因多态性与汉族儿童孤独症的病例对照研究

目的 探讨Shank3基因的单核苷酸多态性(SNPs)与汉族儿童孤独症的相关性.方法 采用Illumina CNV 370-Duo芯片和Illumina 610芯片对455例孤独症患者(孤独症组)和1 097例无孤独症及相关精神疾病儿童(对照组)的Shank3基因SNPs位点进行基因分型检测,对基因分型数据采用haploview4.1软件进行关联分析.结果 Shank3基因的rs736334、rs8137951位点的等位基因频率和rs9616816-rs736334的G-G、A-A及rs715586-rs8137951的G-A单体型频率在两组间的传递比较,差异有统计学意义(P＜0.05),但经1 000次模拟置换检验后的结果比较,差异无统计学意义(P＞0.05).结论 Shank3基因与汉族儿童孤独症的致病不存在相关性,Shank3基因可能不是汉族儿童孤独症的易感基因.     

Joint analysis of individual participants’ data from 17 studies on the association of the IL6 variant -174G>C with circulating glucose levels,interleukin-6 levels,and body mass index

Background. Several studies have investigated associations between the -174G>C single nucleotide polymorphism (rs1800795) of the IL6 gene and phenotypes related to type 2 diabetes mellitus (T2DM) but presented inconsistent results.

Aims. This joint analysis aimed to clarify whether IL6 -174G>C was associated with glucose and circulating interleukin-6 concentrations as well as body mass index (BMI).

Methods. Individual-level data from all studies of the IL6-T2DM consortium on Caucasian subjects with available BMI were collected. As study-specific estimates did not show heterogeneity (P>0.1), they were combined by using the inverse-variance fixed-effect model.

Results. The main analysis included 9440, 7398, 24,117, or 5659 non-diabetic and manifest T2DM subjects for fasting glucose, 2-hour glucose, BMI, or circulating interleukin-6 levels, respectively. IL6 -174 C-allele carriers had significantly lower fasting glucose (?0.091 mmol/L, P=0.014). There was no evidence for association between IL6 -174G>C and BMI or interleukin-6 levels, except in some subgroups.

Conclusions. Our data suggest that C-allele carriers of the IL6 -174G>C polymorphism have lower fasting glucose levels on average, which substantiates previous findings of decreased T2DM risk of these subjects.