The purpose of hierarchical medical system is to lead in terms of improving efficiency, differentiating healthcare services and promoting labor division by changing the healthcare seeking behavior. The purpose of this...The purpose of hierarchical medical system is to lead in terms of improving efficiency, differentiating healthcare services and promoting labor division by changing the healthcare seeking behavior. The purpose of this research aims to discuss the public awareness of hierarchical medical system in Taiwan for the reference of health policy makers. We obtained our research data using a questionnaire survey;the total number of qualified patients was 1340. This research finds that more subjects agreed to the hierarchical medical system and medical referral system, but many people still disagreed with changes to their healthcare seeking choices due to policy promotion. Subtle changes, therefore, are observed that imply a crisis in terms of the trust in healthcare. The healthcare seeking behavior will not change if there is a difference between the medical awareness of patients and policy implementation, and the government needs to be concerned with this result when making policies.展开更多
Acute respiratory distress syndrome(ARDS)is a syndrome characterized by significant lung edema,impaired permeability of lung microvascular endothelial cells with the mal-expression of aquaporins(AQPs).In this study,a ...Acute respiratory distress syndrome(ARDS)is a syndrome characterized by significant lung edema,impaired permeability of lung microvascular endothelial cells with the mal-expression of aquaporins(AQPs).In this study,a two-hit porcine model of ARDS induced by smoking and methicillinresistant Staphylococcus aureus(MRSA)was developed,we investigate the AQPs expression and the influence of Ulinastatin(UTI)to them.Forty-nine healthy male domestic pigs aged 8–10 weeks and weighing 30±2 kg were used for the study.Anesthesia was maintained through continuous intravenous infusion of pentobarbital[8 mg/(kg∙h)].A 5-Fr PiCCO catheter(Pulsiocath PV2015L20;Pulsion Medical Systems,Munich,Germany)and a central venous catheter was inserted for hemodynamic monitoring,including mean arterial pressure(MAP),cardiac index(CI),systemic vascular resistance index(SVRI)and extravascular lung water index(ELWI).展开更多
COVID-19 patients can recover with a median SARS-CoV-2 clearance of 20 days post initial symptoms(PIS).However,we observed some COVID-19 patients with existing SARS-CoV-2 for more than 50 days PIS.This study aimed to ...COVID-19 patients can recover with a median SARS-CoV-2 clearance of 20 days post initial symptoms(PIS).However,we observed some COVID-19 patients with existing SARS-CoV-2 for more than 50 days PIS.This study aimed to investigate the cause of viral clearance delay and the infectivity in these patients.Demographic data and clinical characteristics of 22 long-term COVID-19 patients were collected.The median age of the studied cohort was59.83±12.94 years.All patients were clinically cured after long-term SARS-CoV-2 infection ranging from 53 to112 days PIS.Peripheral lymphocytes counts were normal.The ratios of interferon gamma(IFN-c)-secreting cells to total CD4^(+)and CD8^(+)cells were normal as 24.68%±9.60%and 66.41%±14.87%respectively.However,the number of IFNc-secreting NK cells diminished(58.03%±11.78%).All patients presented detectable IgG,which positively correlated with mild neutralizing activity(Mean value neutralisation antibodies titers=157.2,P=0.05).No SARS-CoV-2 virus was isolated in Vero E6 cells inoculated with nasopharyngeal swab samples from all patients 50 days PIS,and the cytopathic effect was lacking.But one sample was positive for SARS-CoV-2 nucleic acid test in cell supernatants after two passages.Genome sequencing revealed that only three synonymous variants were identified in spike protein coding regions.In conclusion,decreased IFN-c production by NK cells and low neutralizing antibodies might favor SARS-CoV-2 long-term existence.Further,low viral load and weak viral pathogenicity were observed in COVID-19 patients with long-term SARSCoV-2 infection.展开更多
文摘The purpose of hierarchical medical system is to lead in terms of improving efficiency, differentiating healthcare services and promoting labor division by changing the healthcare seeking behavior. The purpose of this research aims to discuss the public awareness of hierarchical medical system in Taiwan for the reference of health policy makers. We obtained our research data using a questionnaire survey;the total number of qualified patients was 1340. This research finds that more subjects agreed to the hierarchical medical system and medical referral system, but many people still disagreed with changes to their healthcare seeking choices due to policy promotion. Subtle changes, therefore, are observed that imply a crisis in terms of the trust in healthcare. The healthcare seeking behavior will not change if there is a difference between the medical awareness of patients and policy implementation, and the government needs to be concerned with this result when making policies.
文摘Acute respiratory distress syndrome(ARDS)is a syndrome characterized by significant lung edema,impaired permeability of lung microvascular endothelial cells with the mal-expression of aquaporins(AQPs).In this study,a two-hit porcine model of ARDS induced by smoking and methicillinresistant Staphylococcus aureus(MRSA)was developed,we investigate the AQPs expression and the influence of Ulinastatin(UTI)to them.Forty-nine healthy male domestic pigs aged 8–10 weeks and weighing 30±2 kg were used for the study.Anesthesia was maintained through continuous intravenous infusion of pentobarbital[8 mg/(kg∙h)].A 5-Fr PiCCO catheter(Pulsiocath PV2015L20;Pulsion Medical Systems,Munich,Germany)and a central venous catheter was inserted for hemodynamic monitoring,including mean arterial pressure(MAP),cardiac index(CI),systemic vascular resistance index(SVRI)and extravascular lung water index(ELWI).
基金support by National Natural Science Foundation of China under Grant(81800095)Key Scientific and Technological Project of Hubei province(2020FCA004)。
文摘COVID-19 patients can recover with a median SARS-CoV-2 clearance of 20 days post initial symptoms(PIS).However,we observed some COVID-19 patients with existing SARS-CoV-2 for more than 50 days PIS.This study aimed to investigate the cause of viral clearance delay and the infectivity in these patients.Demographic data and clinical characteristics of 22 long-term COVID-19 patients were collected.The median age of the studied cohort was59.83±12.94 years.All patients were clinically cured after long-term SARS-CoV-2 infection ranging from 53 to112 days PIS.Peripheral lymphocytes counts were normal.The ratios of interferon gamma(IFN-c)-secreting cells to total CD4^(+)and CD8^(+)cells were normal as 24.68%±9.60%and 66.41%±14.87%respectively.However,the number of IFNc-secreting NK cells diminished(58.03%±11.78%).All patients presented detectable IgG,which positively correlated with mild neutralizing activity(Mean value neutralisation antibodies titers=157.2,P=0.05).No SARS-CoV-2 virus was isolated in Vero E6 cells inoculated with nasopharyngeal swab samples from all patients 50 days PIS,and the cytopathic effect was lacking.But one sample was positive for SARS-CoV-2 nucleic acid test in cell supernatants after two passages.Genome sequencing revealed that only three synonymous variants were identified in spike protein coding regions.In conclusion,decreased IFN-c production by NK cells and low neutralizing antibodies might favor SARS-CoV-2 long-term existence.Further,low viral load and weak viral pathogenicity were observed in COVID-19 patients with long-term SARSCoV-2 infection.
