健康中国战略下公立医院党建工作路径探索与实践

通过分析加强公立医院党建工作在健康中国战略和医药卫生体制改革新形势下的紧迫性与现实意义,运用功能分析理论AGIL模型,构建“找准切入点（A）—找好着力点（G）—抓好关键点（I）—筑牢支撑点（L）”为框架的公立医院党建工作路径,使党建工作融入并引领医院中心工作,使党建成效惠及民心、助力医改及健康中国建设。     

基于德尔菲法的公立医院党建工作评价指标构建

目的 构建公立医院党建工作评价指标,为有效提升公立医院党建工作科学化水平提供评价及考核依据。方法 通过文献研究和理论分析,建立初步的评价指标,运用德尔菲法选择35名专家进行两轮函询,对指标进行修订,确定公立医院党建工作评价指标。结果 两轮函询专家积极系数分别为94.3%、100%,专家权威系数0.837,第二轮专家意见协调程度系数为0.374（P＜0.001）,建立了包括思想建设、组织建设、作风建设、反腐倡廉建设、制度建设及党建工作创新6个一级指标、14个二级指标、35个三级指标的评价体系。结论 所构建的公立医院党建工作评价指标获得专家认可,能够为进一步规范公立医院党建工作、加强党的建设提供依据。     

公立医院法律顾问工作模式探析

目前公立医院面临的法律风险愈加复杂化、多元化，法律风险防范模式落后，急需调整转变。文章提出以构建总法律顾问制度为核心的公立医院法律顾问工作模式转变的路径选择，从而增强公立医院法律风险的可控性和可预防性，为公立医院科学化、规范化和法治化发展提供法律技术支撑。     

辽宁省公立医院医务人员薪酬现状调查分析

目的 了解公立医院医务人员薪酬现状、工作情况以及薪酬满意度情况,为完善公立医院薪酬制度、提高医务人员积极性提供建议。方法 通过调查问卷法、座谈法、描述性分析、方差分析等来综合分析公立医院医务人员薪酬现状。结果 不同经济水平的公立医院医务人员之间的年均工资差距大,77.8%的医务人员对目前薪酬水平不满意。结论 公立医院医务人员的薪酬普遍较低,满意度低;工作压力大,薪酬结构不合理,建议完善卫生机构内部薪酬分配机制。     

以管理成效为导向的医院职能部门绩效考核方法研究

目的 探索适应公立医院绩效评价背景的职能部门绩效考核方法。方法 在文献复习、专题小组讨论和专家访谈的基础上,调研不同类别公立医院进行分析,梳理公立医院职能部门绩效考核的概况、职能部门职责发展变化以及职能部门待解决的问题。结果 发现职能部门任务复杂化,面临系列问题亟待解决,现有的职能部门绩效考核方法有待发展。提出以管理成效为导向的职能部门绩效考核方法;从重点工作、日常行政工作、管理能力进行考核,旨在激励约束职能部门改进管理成效。结论 建立健全以管理成效为导向的职能部门绩效考核方法是促进公立医院执行公立医院绩效评价政策的有益探索。     

公立医院临床医师对临床路径实施工作及效果的评价

目的 了解我国公立医院临床医师对临床路径实施工作及效果的评价。方法 对我国东、中、西3省（直辖市）1638名临床医师进行问卷调查。结果 我国公立医院临床医师对临床路径实施工作和实施效果的总体评价分别为3.16分和3.41分。并且,不同地区、等级公立医院临床医师的评价存在一定差异。结论 我国公立医院临床医师对临床路径实施工作的认可度不高;西部地区和二级医院的临床医师更偏好实施临床路径;临床医师对临床路径实施可提高医疗服务过程质量的认同度相对较高。     

新时期我国民办高校党建工作研究

针对民办高校党建工作的特点和不足,民办高校应进一步加强党建工作的建设,促进民办高校和谐健康的向前发展。与此同时,民办高校党组织一定要正确认识民办高校党建工作与公办高校党建工作的区别,积极贯彻执行党的方针路线,正确引导办学方向,确保其政治核心作用和监督保证作用。     

公立医院改革下护理管理的创新思路

公立医院改革是新医改的核心。加强护理工作是实现医改目标的重要措施之一,是构建和谐医患关系的客观要求。在推进公立医院改革的进程中,从医院层面开展“文化护理管理”、建立护理后勤、创新护理服务等方面的工作,探索公立医院护理管理创新思路。     

初探新疆高职院校党建带团建工作的途径与方法

党建带团建是新疆高校党建工作的重要组成部分,是共青团建设的光荣传统,党建带团建的根本是"建",关键是"带",目标是发展。本文从高校党建带团建工作的"带"和"建"入手,从目前的实践探索提出了深化高校党建带团建工作的途径方法。     

基于公益性的我国公立医院运行机制分析

公立医院的改革试点及其医疗服务水平的提高,是当下我国医药卫生体制改革的重点之一,对于解决群众“看好病”的问题有着深远意义。从我国公立医院发展与运作的现状出发,剖析公立医院公益性淡化的各种因由;针对公立医院运行中存在的突出问题,提出基于公益性的公立医院运行机制分析框架;结合我国医药卫生事业改革工作的主要内容,以我国公立医院公益性为主旨,浅析医疗资源配置、医疗合理定价以及药品事业管理改革等相关重要问题。     

外泌体在白血病中的重要调控作用

目前,白血病复发是患者死亡的主要原因之一。肿瘤细胞和微环境的相互作用,以及隐匿在骨髓中的肿瘤干细胞,促进了白血病的复发和向淋巴组织的转移,因此白血病的治疗、转移和复发问题受到广泛关注。外泌体是由绝大多数细胞分泌的双层脂质膜囊泡,可以调控细胞间的交流和信息传递。在白血病细胞、基质细胞和内皮细胞之间的相互联系中都涉及到外泌体,白血病细胞来源的外泌体存在于白血病患者的血浆中,能把其携带的白血病相关抗原及微小RNA呈递给靶细胞,促进白血病肿瘤细胞的增殖,有助于肿瘤细胞实现免疫逃避,保护白血病细胞抵抗化疗药物导致的细胞毒性作用,促进血管生成及肿瘤细胞的迁移。因此,外泌体与白血病的转移、治疗及预后密切相关,可以用来检测和监测白血病的进展。本文综述了外泌体的来源、形成与分泌机制,以及外泌体在白血病发生前、发展中、预后和免疫治疗中所扮演的重要角色。     

Natural 15N abundance in soils and plants in relation to N cycling in a rangeland in Inner Mongolia

Aims Natural 15 N abundance provides integrated information about nitrogen (N) input, transformation and output, indirectly reflecting N cycling traits within terrestrial ecosystems. However, relationships between natural 15 N abundance and N cycling processes are poorly understood in China. Here, our primary objectives were to (i) examine the effects of grazing at varying levels of intensity on δ 15 N of soils and plants in a semi-arid grassland; (ii) detect the relationships between δ 15 N of soils and four major N cycling processes (i.e. mineralization, nitrification, denitrification and ammonia volatilization); and (iii) determine whether δ 15 N of soils can be used as an indicator of N cycling in this semi-arid grassland.Methods The field experiment was conducted within the long-term (17-year) grazing enclosures in a semi-arid grassland in Inner Mongolia. Five grazing intensities (0.00, 1.33, 2.67, 4.00 and 5.33 sheep ha^-1) were designed. δ 15 N values of topsoils (0–10 cm), surface soils (0–2 cm) and plants were measured in 2006. Differences in δ 15 N of soils and plants between the five grazing intensities were examined. Rates of four soil N cycling processes were measured periodically during the 2005 and 2006 growing seasons. The δ 15 N values of topsoils were linked to the four N cycling processes to investigate their relationships.Important findings The δ 15 N values of topsoils (5.20–5.96‰) were substantially higher than the δ 15 N values of plants (2.51–2.93‰) and surface soils (1.44–2.92‰) regardless of grazing intensities. The 15 N-depleted N losses during microbial decomposition of organic matter in concert with the downward movement of residual substrate over time are the possible causes of higher δ 15 N values in topsoils than in surface soils. In addition, the δ 15 N values of topsoils were positively correlated with the δ 15 N values of both plants and surface soils. Grazing, especially the high-intensity grazing (5.33 sheep ha^-1), resulted in a significant decrease in δ 15 N of surface soils. However, no statistically significant variations in δ 15 N of topsoils and plants were found in response to grazing. The δ 15 N values of topsoils exhibited significant dependence on the cumulative rates of NH 3 volatilization, net nitrification and denitrification in 2005 but not in 2006.     

Optogenetic Perturbation of Neural Activity with Laser Illumination in Semi-intact Drosophila Larvae in Motion

Drosophila larval locomotion is a splendid model system in developmental and physiological neuroscience, by virtue of the genetic accessibility of the underlying neuronal components in the circuits^1-6. Application of optogenetics^7,8 in the larval neural circuit allows us to manipulate neuronal activity in spatially and temporally patterned ways^9-13. Typically, specimens are broadly illuminated with a mercury lamp or LED, so specificity of the target neurons is controlled by binary gene expression systems such as the Gal4-UAS system^14,15. In this work, to improve the spatial resolution to "sub-genetic resolution", we locally illuminated a subset of neurons in the ventral nerve cord using lasers implemented in a conventional confocal microscope. While monitoring the motion of the body wall of the semi-intact larvae, we interactively activated or inhibited neural activity with channelrhodopsin^16,17 or halorhodopsin^18-20, respectively. By spatially and temporally restricted illumination of the neural tissue, we can manipulate the activity of specific neurons in the circuit at a specific phase of behavior. This method is useful for studying the relationship between the activities of a local neural assembly in the ventral nerve cord and the spatiotemporal pattern of motor output.     

培菌白蚁菌圃微生物降解木质纤维素的研究进展

白蚁及其共生微生物协同降解植物细胞壁的机理一直被世界各国科学家所关注。培菌白蚁作为高等白蚁,相比低等食木白蚁具有更多样化的食性,其利用外共生系统“菌圃”,对多种植物材料进行处理。本文综述了菌圃微生物降解木质纤维素的研究进展,以期为深入研究菌圃中木质纤维素降解过程及其机制,并挖掘利用菌圃降解木质纤维素的能力及仿生模拟菌圃开发新的生物质利用系统提供参考。培 菌白蚁在其巢内利用由植物材料修建的多孔海绵状结构——“菌圃”来培养共生真菌鸡枞菌Termitomyces spp.,形成了独特的木质纤维素食物降解和消化策略,使木质纤维素在培菌白蚁及其共生微生物协同作用下被逐步降解。幼年工蚁取食菌圃上的共生真菌菌丝组成的小白球和老年工蚁觅得食物并排出粪便堆积到菌圃上成为上层菌圃。这一过程中,被幼年工蚁取食的共生真菌释放木质素降解酶对包裹在植物多糖外部的木质素屏障进行解聚。菌圃微生物(包括共生真菌)对解聚的木质素基团进一步降解,将多糖长链或主链剪切成短链,使菌圃基质自下而上被逐步降解。最后下层的老熟菌圃被老年工蚁取食,其中肠的内源酶系及后肠微生物将这些短链进一步剪切和利用。因此,蚁巢菌圃及其微生物是培菌白蚁高效转化利用木质纤维素的基础。化学层面的研究表明,菌圃能够实现对植物次生物质解毒和植 物纤维化学结构解构。对共生真菌相关酶系的研究显示可能其在菌圃的植物纤维化学结构和植物次生物质的降解中发挥了作用,但不同属共生真菌间其效率和具体功能不尽相同。而菌圃中的细菌是否发挥了作用和哪些细菌类群发挥了作用等仍有待进一步的研究。相比于低等食木白蚁利用其后肠共生微生物降解木质纤维素,培菌白蚁利用菌圃降解木质纤维素具有非厌氧和能处理多种类型食物两大优势,仿生模拟菌圃降解木质纤维素的机制对林地表面枯枝落叶的资源化利用具有重要意义。     

Phospholipase Dδ is Involved in Wounding Induced Phosphatidic Acid Formation in Arabidopsis

Phosphalipase D (PLD) hydrolyzes phospholipids into phosphatidic acid (PA). PLDα1 and δ are the two most abundant members of the 12 member PLD family in Arabidopsis. PLDα1 has been demonstrated having role in the wounding induced PA signalling. However, whether and how PLDδ is involved in wounding induced PA formation remained unclear. In the present study, the membrane lipids response to wounding was profiled in Wassilewskija (WS) and PLDδ knockout mutant (PLDδ KO) of Arabidopsis. The levels of most lipids, including monogalactosyldiacylglycerol, digalactosyldiacylglycerol, phosphatidylcholine and phosphatidylglycerol had decreased rapidly within 30min after wounding in the two Arabidopsis genotypes. In contrast, the level of PA increased sharply and significantly 30min after wounding. It continued to increase until peaking at 1h post wounding in WS and 3h post wounding in PLDδ KO, and then decreased. The PA levels were similar in the two genotypes in untreated leaves and in leaves 6h after wounding. However, these levels were lower in PLDδ KO than in WS from 30min to 3h post wounding. The significant difference of PA level between the two genotypes occurred 30min after wounding, when it was about 20% lower in PLDδ KO than in WS. These results show that PLDδ is involved in wounding induced PA formation in Arabidopsis, but its absence induces PA response later and with less intensity than PLDα1.     

Getting to Compliance in Forced Exercise in Rodents: A Critical Standard to Evaluate Exercise Impact in Aging-related Disorders and Disease

There is a major increase in the awareness of the positive impact of exercise on improving several disease states with neurobiological basis; these include improving cognitive function and physical performance. As a result, there is an increase in the number of animal studies employing exercise. It is argued that one intrinsic value of forced exercise is that the investigator has control over the factors that can influence the impact of exercise on behavioral outcomes, notably exercise frequency, duration, and intensity of the exercise regimen. However, compliance in forced exercise regimens may be an issue, particularly if potential confounds of employing foot-shock are to be avoided. It is also important to consider that since most cognitive and locomotor impairments strike in the aged individual, determining impact of exercise on these impairments should consider using aged rodents with a highest possible level of compliance to ensure minimal need for test subjects. Here, the pertinent steps and considerations necessary to achieve nearly 100% compliance to treadmill exercise in an aged rodent model will be presented and discussed. Notwithstanding the particular exercise regimen being employed by the investigator, our protocol should be of use to investigators that are particularly interested in the potential impact of forced exercise on aging-related impairments, including aging-related Parkinsonism and Parkinson’s disease.     

Automated High-throughput Behavioral Analyses in Zebrafish Larvae

We have created a novel high-throughput imaging system for the analysis of behavior in 7-day-old zebrafish larvae in multi-lane plates. This system measures spontaneous behaviors and the response to an aversive stimulus, which is shown to the larvae via a PowerPoint presentation. The recorded images are analyzed with an ImageJ macro, which automatically splits the color channels, subtracts the background, and applies a threshold to identify individual larvae placement in the lanes. We can then import the coordinates into an Excel sheet to quantify swim speed, preference for edge or side of the lane, resting behavior, thigmotaxis, distance between larvae, and avoidance behavior. Subtle changes in behavior are easily detected using our system, making it useful for behavioral analyses after exposure to environmental toxicants or pharmaceuticals.     

Conditional cold avoidance drives between-population variation in germination behaviour in Calluna vulgaris

Background and Aims

Across their range, widely distributed species are exposed to a variety of climatic and other environmental conditions, and accordingly may display variation in life history strategies. For seed germination in cold climates, two contrasting responses to variation in winter temperature have been documented: first, an increased ability to germinate at low temperatures (cold tolerance) as winter temperatures decrease, and secondly a reduced ability to germinate at low temperatures (cold avoidance) that concentrates germination towards the warmer parts of the season.

Methods

Germination responses were tested for Calluna vulgaris, the dominant species of European heathlands, from ten populations collected along broad-scale bioclimatic gradients (latitude, altitude) in Norway, covering a substantial fraction of the species'' climatic range. Incubation treatments varied from 10 to 25 °C, and germination performance across populations was analysed in relation to temperature conditions at the seed collection locations.

Key Results

Seeds from all populations germinated rapidly and to high final percentages under the warmer incubation temperatures. Under low incubation temperatures, cold-climate populations had significantly lower germination rates and percentages than warm-climate populations. While germination rates and percentages also increased with seed mass, seed mass did not vary along the climatic gradients, and therefore did not explain the variation in germination responses.

Conclusions

Variation in germination responses among Calluna populations was consistent with increased temperature requirements for germination towards colder climates, indicating a cold-avoidance germination strategy conditional on the temperature at the seeds'' origin. Along a gradient of increasing temperatures this suggests a shift in selection pressures on germination from climatic adversity (i.e. low temperatures and potential frost risk in early or late season) to competitive performance and better exploitation of the entire growing season.     

Lignin characteristics in soil profiles in different plant communities in a subtropical mixed forest

Aims Lignin is generally considered as an important indicator of soil organic carbon (SOC) storage and dynamics. To evaluate the effects of plant communities and soil depth on soil lignin is critical to better understand forest carbon cycling.Methods We compared lignin content and chemical signature in three soil depths of four major plant communities in a subtropical forest, which located in the north part of Wuling Mountains, China. Lignin was measured using CuO oxidation method.Important findings Both lignin content and its biochemical signature in plant litter varied among communities. However, these differences were mostly no longer exist in the upper soil layers. Lignin chemistry in soils inherited some of the biochemical signature of lignin in litter, but in a diminished magnitude. These results suggest that different plant communities had similar decomposition process with varying rates, caused diminished differences in lignin content and its biochemical signature. Lignin content decreased with soil depth, but the biochemical signature of lignin was not significantly different among soil layers for all communities, which suggests that vertical movement of lignin within the soil profile is very likely a key process causing this similar biochemical signature. These results emphasized the important roles of lignin inputs and soil eluviation in shaping lignin characteristics and distribution in forest soils, which pinpoint the urgent need to consider hydrological processes in studying forest soil carbon cycling.