Objective To explore the present situation of the efficiency about public tertiary general hospitals in Shandong province, measure and compare the efficiency and the state of returns to scale of hospitals under different bed scales. Methods Based on the input and output data of 137 public tertiary general hospitals in Shandong province in 2017, two input indicators (the number of employees and the number of actual beds) and two output indicators (the total number of outpatients and emergent patients, and the number of discharges) were selected. The technical efficiency, pure technical efficiency and scale efficiency of sample hospitals were calculated by using data envelopment analysis, and a comparative analysis was carried out under different bed scales. Results Of the 137 public tertiary general hospitals, the mean of technical efficiency value was 0.666, the medians of pure technical efficiency value and scale efficiency value in 2017 were 0.817 and 0.919, respectively. In the 137 sample hospitals, there were 132 hospitals (96.4%) in ineffective status; there were 90 hospitals (65.7%) exhibiting increasing returns to scale, 11 hospitals (8.0%) exhibiting constant returns to scale, and 36 hospitals (26.3%) exhibiting decreasing returns to scale. There were significant differences in hospital efficiency and returns to scale under different bed sizes (P<0.001), and the scale efficiency was the highest when the bed size was 1001-2000. Conclusions The overall operating efficiency of the public tertiary general hospitals in the province was not high yet. Most hospitals were in ineffective status and most of them were in the state of increasing returns to scale. The optimal scale of actual beds is between 1001 and 2000 beds from the perspective of scale efficiency.
Objective To investigate the cellular compatibil ity of polyvinyl alcohol (PVA)/wild antheraea pernyisilk fibroin (WSF), and to explore the feasibil ity for tendon tissue engineering scaffold in vitro. Methods The solutions of WSF (11%), PVA (11%), and PVA/WSF (11%) were prepared with 98% formic acid (mass fraction) at a mass ratio of 9 : 1. The electrospinning membranes of WSF, PVA, and PVA/WSF were prepared by electrostatic spinning apparatus. The morphologies of scaffolds were evaluated using scanning electronic microscope (SEM). The tendon cells were isolated from tail tendon of 3-dayold Sprague Dawley rats in vitro. The experiment was performed using the 3rd generation cells. The tendon cells (1 × 106/mL) were cocultured with PVA and PVA/WSF electrospinning film, respectively, and MTT test was used to assess the cell adhesion rate 4, 12 hours after coculture. The tendon cells were cultured in PVA and PVA/WSF extraction medium of different concentration (1, 1/2, and 1/4), respectively; and the absorbance (A) values were detected at 1, 3, 5, and 7 days to evaluate the cytotoxicity. The composite of tendon cells and the PVA or PVA/WSF scaffold were observed by HE staining at 7 days and characterized by SEM at 1,3, 5, and 7 days. Results The solution of WSF could not be used to electrospin; and the solution of PVA and PVA/WSF could be electrospun. After coculture of tendon and PVA or PVA/WSF electrospinning membranes, the cell adhesion rates were 26.9% ±0.4% and 87.0% ± 1.0%, respectively for 4 hours, showing significant difference (t=100.400, P=0.000); the cell adhesion rates were 35.2% ± 0.6% and 110.0% ± 1.7%, respectively for 12 hours, showing significant difference (t=42.500, P=0.000). The cytotoxicity of PVA/WSF was less significantly than that of PVA (P lt; 0.05) and significant difference was observed between 1/2 PVA and 1/4PVA (P lt; 0.05). HE staining and SEM images showed that the tendon cells could adhere to PVA and PVA/WSF scaffolds, but that the cells grew better in PVA/WSF scaffold than in PVA scaffold in vitro. Conclusion PVA/WSF electrospinning membrane scaffold has good cell compatibility, and it is expected to be an ideal scaffold of tendon tissue engineering.
The application scenarios and conditions of the burden of disease were sorted out, and the survey databases related to disease surveillance at home and abroad and the GBD research of IHME were introduced. Through the collection of literature, five cases of the burden of disease application of health big data were summarized, and their construction modes were described in detail based on different types of databases. We pointed out the problems and challenges faced by the application of health data, and put forward some ideas and prospects for future research on the application of the burden of disease of health big data.