浙江省县级公立医院改革试点医院收支状况分析

目的 分析浙江省县级公立医院综合改革的施行对县级公立医院收支状况的影响。 方法 收集浙江省2011年12月启动改革的5个县（市）22家医院2011-2013年上半年的收入和支出数据,对定量资料采用描述性统计分析。结果 县级公立医院综合改革实施后,医院收入结构变化明显,一方面政府财政[1]补助额度逐年提高,财政补助占医院总收入的比例上升;另一方面,药品收入占医疗收入的比例逐年下降,药品收支结余对医院的补偿能力逐步减弱。结论 浙江省县级公立医院在改革实施后,依托合理的医疗服务调价手段和政府财政的有力支持,县级公立医院改革平稳推进。
     

整合受体调控基因表达信息构建细胞通信网络

目的 构建细胞通信网络有助于揭示细胞间协同工作机制、生物学过程和疾病发病机理。目前基于配体-受体相互作用构建细胞通信网络的方法大多只考虑配体和受体的表达信息，忽略了受体对其调控基因的信号传递影响，导致构建的细胞通信网络可靠性较低。鉴于此，本文提出IRRG算法，旨在构建更为准确的细胞通信网络，并挖掘具有生物学意义的细胞通信模式。方法 本文提出了一种整合受体调控基因表达信息构建细胞通信网络的方法（命名为IRRG）。该方法通过随机游走方式计算受体对下游基因的影响得分，进而与配体-受体共表达量结合构建细胞通信网络。结果 使用IRRG构建了小鼠滤泡间表皮（IFE）细胞通信网络并分析了配体-受体对的生物学意义，验证了IRRG计算受体影响得分的稳定性和细胞通信网络构建的可靠性。此外，使用IRRG构建了透明细胞肾细胞癌（ccRCC）的细胞通信网络，挖掘并分析其肿瘤微环境细胞通信模式。结论 IRRG可以构建富有生物学意义并且可靠的细胞通信网络，帮助人们从细胞通信的角度更深入地了解多种生物过程。IRRG算法代码可从GitHub获取：https://github.com/NWPU-903PR/IRRG。     

苦绳（Dregea sinensis）中多氧化孕烷糖苷与免疫蛋白相互作用的研究

目的 基于化学结构特点研究植物苦绳（Dregea sinensis）中多氧孕烷糖苷的生物活性,以及化合物分子与靶蛋白分子间的作用机理。方法 本研究采用分子对接和表面等离子体共振方法,对191个多氧化孕烷糖苷类成分（>800 u）进行了免疫活性及其与免疫蛋白的动力学评价。结果 通过分子对接方法筛选出7个配体分子（6、18、23、30、78、79和80）和3个免疫相关蛋白（IL-2Rα、TLR4和TNF-α）。研究表明,化合物30和78在SPR实验中与靶蛋白IL-2Rα和TLR4具有显著的结合趋势,与IL-2Rα的结合常数K_D分别为2.41×10^-6和2.14×10^-6 mol/L,与TLR4则分别为1.96×10^-5和5.60×10^-6 mol/L。分子动力学研究进一步表征SPR阳性分子6、18、30、78和80与靶蛋白之间的相互作用基团。结论 研究揭示多氧化孕烷糖苷类成分可以通过形成氢键和Pi-Pi相互作用与靶蛋白结合。研究内容对快速评价多氧化孕烷糖苷类成分的活性具有重要意义,为揭示低丰度药效物质的潜在作用机制进行了有益探索。     

职场正念对公立医院护士心理韧性的影响研究

目的 探讨职场正念对护士心理韧性的影响及可能的机制。方法 通过一个横断面式的网络问卷调查收集资料,阶层线性回归法验证变量间的作用关系。结果 护士的职场正念均值水平为（4.74±0.63）,护士心理韧性均值水平为（3.44±0.89）;职场正念对护士心理韧性（β= 0.255,P＜0.01）具有正向预测作用。结论 职场正念可以有效提升护士的心理韧性水平,有助于护士抵御不良事件和负向情绪的侵袭,帮助她们快速从消极情绪中恢复。     

实习前护理专科生的焦虑状况及影响因素分析

目的 了解 护理专科生实习前心理健康状况,探讨其实习前焦虑程度的影响因素。方法 收集2013级某中专院校护理专业10个班和某高等职业院校护理专业5个班的调查问卷,最终整理所得有效样本为578份。应用SPSS19软件进行统计分析。结 果 护生实习前心理健康问题除人际敏感和抑郁之外,均高于全国青年常模（P ＜0.05）;护生的焦虑水平与护生的人格特点、年龄有关;回归分析得出护生的学历、生源地、独生子女等对焦虑程度有明显影响,差异有统计学意义（P ＜0.05）。结论 掌握影响护生产生焦虑程度的因素,为护生护理教育提供依据。     

浙江省县级综合医院卫生人力资源配置公平性研究

目的 分析2013年浙江省县级综合医院卫生人力资源配置及按人口分布的公平性,为合理配置卫生人力资源提供依据。方法 采用自填问卷的方式,调查浙江省11个地级市137家县级综合医院,同时用Lorenz曲线和基尼系数从人口分布来判断其公平性。 结果 编制外人员所占比例较大,尤其护理人员无编制情况严重;医护比、护理人员数占卫生技术人员总数的比例、每千人口卫生人员,均与标准差距较大;各地级市之间差距较大;卫生技术人员、执业医师、护理人员数按人口分布公平性较高。结论 应科学核定编制数,优化人员配置结构,合理开展区域卫生规划。     

卫生行政机构应急队伍建设影响因素框架模型构建

?????? 目的 通过框架模型的构建系统梳理、整合,明晰影响并制约黑龙江省卫生行政机构应急队伍建设的核心能力与关键要素。 方法 随机整群抽样,采用现场问卷调查和深入访谈相结合的方法。结果 应急管理专职人员比例较少且兼职人员数量不足、应急专职机构设置欠佳、应急专项经费投入不足和应急队伍各项管理技术能力薄弱等是卫生行政机构应急队伍建设的重要制约因素。结论 基于卫生应急队伍建设影响因素的框架模型构建与分析,黑龙江省卫生行政机构应急队伍迫切需要从应急管理基础维、保障维和技术维着手,有针对性地加强应急能力建设。     

武汉市医院效率动态变化的Malmquist指数分析

目的 了解武汉市医院2006—2008年3年间运行效率变化的情况,找出引起其效率变化的原因,有针对性地采取措施,以提高医院的整体效率。方法 通过Malmquist指数法分析了武汉市23家医院3年间的全要素生产率、技术效率、技术变化等方面的变化趋势。结果 23家医院全要素生产率普遍下降主要是由于技术退步所致,医院的纯技术效率和规模效率趋于稳定,发挥的促进作用较小。结论 医院不但需要提高管理水平、引进先进的管理模式、控制合适的规模以保证技术效率的提高;更应引进人才,加强技术培训与进修,鼓励医务人员在诊疗技术、诊疗过程上有所创新,以此来提高医疗技术水平,进而提升医院的运行效率。

     

县级公立医院薪酬水平感知及满意度影响因素分析

目的 探讨县级公立医院薪酬水平感知和满意度的影响因素。方法 采用调查问卷对县级公立医院员工进行现场调查,利用SPSS 19.0软件对数据进行Logistic回归分析。结果 Logistic回归分析发现,员工薪酬水平感知受到个体的工作年限、岗位类别、职称、是否在编、每周工作时间和医院的级别6个因素的影响。薪酬水平满意度受到个体的工作年限、科室类别、每周工作时间和医院级别4个因素的影响。结论 县级公立医院员工薪酬水平感知和满意度偏低。完善员工的职称晋升机制,完善薪酬设计,建立向临床一线超负荷工作者倾斜、体现岗位价值的薪酬政策,实现同工同酬是提高员工薪酬水平感知和满意度的可行选择。     

AbRSA: A robust tool for antibody numbering

The remarkable progress in cancer immunotherapy in recent years has led to the heat of great development for therapeutic antibodies. Antibody numbering, which standardizes a residue index at each position of an antibody variable domain, is an important step in immunoinformatic analysis. It provides an equivalent index for the comparison of sequences or structures, which is particularly valuable for antibody modeling and engineering. However, due to the extremely high diversity of antibody sequences, antibody‐numbering tools cannot work in all cases. This article introduces a new antibody‐numbering tool named AbRSA, which integrates heuristic knowledge of region‐specific features into sequence mapping to enhance the robustness. The benchmarks demonstrate that, AbRSA exhibits robust performance in numbering sequences with diverse lengths and patterns compared with the state‐of‐the‐art tools. AbRSA offers a user‐friendly interface for antibody numbering, complementarity‐determining region delimitation, and 3D structure rendering. It is freely available at http://cao.labshare.cn/AbRSA .     

基层医疗机构人才队伍建设的探讨

??????? 在医改中硬件是基础,软件是根本,基层医疗机构人才队伍建设问题至关重要,本文就如何吸引毕业生下沉到基层、如何提升基层现存医疗队伍的技术水平提出建议,并为如何实现2020年培养30万名全科医生的总体目标,提出利用社会融资方法培养农村全科医生的构想。     

Non-Redundant Unique Interface Structures as Templates for Modeling Protein Interactions

Improvements in experimental techniques increasingly provide structural data relating to protein-protein interactions. Classification of structural details of protein-protein interactions can provide valuable insights for modeling and abstracting design principles. Here, we aim to cluster protein-protein interactions by their interface structures, and to exploit these clusters to obtain and study shared and distinct protein binding sites. We find that there are 22604 unique interface structures in the PDB. These unique interfaces, which provide a rich resource of structural data of protein-protein interactions, can be used for template-based docking. We test the specificity of these non-redundant unique interface structures by finding protein pairs which have multiple binding sites. We suggest that residues with more than 40% relative accessible surface area should be considered as surface residues in template-based docking studies. This comprehensive study of protein interface structures can serve as a resource for the community. The dataset can be accessed at http://prism.ccbb.ku.edu.tr/piface.     

Whole genome transcriptome polymorphisms in Arabidopsis thaliana

ArrayPlex is a software package that centrally provides a large number of flexible toolsets useful for functional genomics, including microarray data storage, quality assessments, data visualization, gene annotation retrieval, statistical tests, genomic sequence retrieval and motif analysis. It uses a client-server architecture based on open source components, provides graphical, command-line, and programmatic access to all needed resources, and is extensible by virtue of a documented application programming interface. ArrayPlex is available at http://sourceforge.net/projects/arrayplex/.     

Protein-Protein Docking with F2Dock 2.0 and GB-Rerank

Motivation

Computational simulation of protein-protein docking can expedite the process of molecular modeling and drug discovery. This paper reports on our new F² Dock protocol which improves the state of the art in initial stage rigid body exhaustive docking search, scoring and ranking by introducing improvements in the shape-complementarity and electrostatics affinity functions, a new knowledge-based interface propensity term with FFT formulation, a set of novel knowledge-based filters and finally a solvation energy (GBSA) based reranking technique. Our algorithms are based on highly efficient data structures including the dynamic packing grids and octrees which significantly speed up the computations and also provide guaranteed bounds on approximation error.

Results

The improved affinity functions show superior performance compared to their traditional counterparts in finding correct docking poses at higher ranks. We found that the new filters and the GBSA based reranking individually and in combination significantly improve the accuracy of docking predictions with only minor increase in computation time. We compared F² Dock 2.0 with ZDock 3.0.2 and found improvements over it, specifically among 176 complexes in ZLab Benchmark 4.0, F² Dock 2.0 finds a near-native solution as the top prediction for 22 complexes; where ZDock 3.0.2 does so for 13 complexes. F² Dock 2.0 finds a near-native solution within the top 1000 predictions for 106 complexes as opposed to 104 complexes for ZDock 3.0.2. However, there are 17 and 15 complexes where F² Dock 2.0 finds a solution but ZDock 3.0.2 does not and vice versa; which indicates that the two docking protocols can also complement each other.

Availability

The docking protocol has been implemented as a server with a graphical client (TexMol) which allows the user to manage multiple docking jobs, and visualize the docked poses and interfaces. Both the server and client are available for download. Server: http://www.cs.utexas.edu/~bajaj/cvc/software/f2dock.shtml. Client: http://www.cs.utexas.edu/~bajaj/cvc/software/f2dockclient.shtml.     

AraPPISite: a database of fine-grained protein–protein interaction site annotations for Arabidopsis thaliana

Knowledge about protein interaction sites provides detailed information of protein–protein interactions (PPIs). To date, nearly 20,000 of PPIs from Arabidopsis thaliana have been identified. Nevertheless, the interaction site information has been largely missed by previously published PPI databases. Here, AraPPISite, a database that presents fine-grained interaction details for A. thaliana PPIs is established. First, the experimentally determined 3D structures of 27 A. thaliana PPIs are collected from the Protein Data Bank database and the predicted 3D structures of 3023 A. thaliana PPIs are modeled by using two well-established template-based docking methods. For each experimental/predicted complex structure, AraPPISite not only provides an interactive user interface for browsing interaction sites, but also lists detailed evolutionary and physicochemical properties of these sites. Second, AraPPISite assigns domain–domain interactions or domain–motif interactions to 4286 PPIs whose 3D structures cannot be modeled. In this case, users can easily query protein interaction regions at the sequence level. AraPPISite is a free and user-friendly database, which does not require user registration or any configuration on local machines. We anticipate AraPPISite can serve as a helpful database resource for the users with less experience in structural biology or protein bioinformatics to probe the details of PPIs, and thus accelerate the studies of plant genetics and functional genomics. AraPPISite is available at http://systbio.cau.edu.cn/arappisite/index.html.     

ArrayPlex: distributed,interactive and programmatic access to genome sequence,annotation, ontology,and analytical toolsets

ArrayPlex is a software package that centrally provides a large number of flexible toolsets useful for functional genomics, including microarray data storage, quality assessments, data visualization, gene annotation retrieval, statistical tests, genomic sequence retrieval and motif analysis. It uses a client-server architecture based on open source components, provides graphical, command-line, and programmatic access to all needed resources, and is extensible by virtue of a documented application programming interface. ArrayPlex is available at http://sourceforge.net/projects/arrayplex/.     

TangleSolve: topological analysis of site-specific recombination

TangleSolve is a program for analysing site-specific recombination using the tangle model. The program offers an easy-to-use graphical user interface and a visualization tool. Biologists working in topological enzymology can use this program to compute and visualize site-specific recombination mechanisms that accommodate their experimental data. TangleSolve can also prove useful as a teaching aid for mathematical biology and computational molecular biology courses. AVAILABILITY: http://bio.math.berkeley.edu/TangleSolve/     

Comprehensive analysis of NMR data using advanced line shape fitting

NMR spectroscopy is uniquely suited for atomic resolution studies of biomolecules such as proteins, nucleic acids and metabolites, since detailed information on structure and dynamics are encoded in positions and line shapes of peaks in NMR spectra. Unfortunately, accurate determination of these parameters is often complicated and time consuming, in part due to the need for different software at the various analysis steps and for validating the results. Here, we present an integrated, cross-platform and open-source software that is significantly more versatile than the typical line shape fitting application. The software is a completely redesigned version of PINT (https://pint-nmr.github.io/PINT/). It features a graphical user interface and includes functionality for peak picking, editing of peak lists and line shape fitting. In addition, the obtained peak intensities can be used directly to extract, for instance, relaxation rates, heteronuclear NOE values and exchange parameters. In contrast to most available software the entire process from spectral visualization to preparation of publication-ready figures is done solely using PINT and often within minutes, thereby, increasing productivity for users of all experience levels. Unique to the software are also the outstanding tools for evaluating the quality of the fitting results and extensive, but easy-to-use, customization of the fitting protocol and graphical output. In this communication, we describe the features of the new version of PINT and benchmark its performance.     

QTLNetwork: mapping and visualizing genetic architecture of complex traits in experimental populations

SUMMARY: QTLNetwork is a software package for mapping and visualizing the genetic architecture underlying complex traits for experimental populations derived from a cross between two inbred lines. It can simultaneously map quantitative trait loci (QTL) with individual effects, epistasis and QTL-environment interaction. Currently, it is able to handle data from F(2), backcross, recombinant inbred lines and double-haploid populations, as well as populations from specific mating designs (immortalized F(2) and BC(n)F(n) populations). The Windows version of QTLNetwork was developed with a graphical user interface. Alternatively, the command-line versions have the facility to be run in other prevalent operating systems, such as Linux, Unix and MacOS. AVAILABILITY: http://ibi.zju.edu.cn/software/qtlnetwork.