Search

The uncertainty, immediate hazards, severe consequences and broad impact of medical emergencies are far beyond the scope of ordinary medical treatment, calling for special attention. The importance of constructing hospital emergency management system has been increasingly reflected. The system not only needs the practical solution of hospital management at the present stage, but also the working direction of the hospital management in the future. In this paper, the emergency satisfaction survey was conducted on the patients in two first-class tertiary hospitals in Shanghai. The service satisfaction scores of a hospital with integrated traditional Chinese medicine (TCM) and Western medicine as well as a general hospital were 4. 9 4 ± 0. 3 2 and 4. 9 9 ± 0. 1 4 , respectively. There was a significant difference in the service satisfaction scores between the two hospitals (p < 0. 0 0 0 1). Poor network signal was a vulnerability problem in the dimension of medical auxiliary facilities in both hospitals, accounting for the highest proportion. For the dimension of medical building, the main vulnerability problems were wall cracking and uneven ground, accounting for a high proportion. In the dimension of medical process, the parking inconvenience of a hospital with integrated traditional Chinese and Western medicine was particularly serious, accounting for 81.7%. In the dimension of medical service, the vulnerability of "medical staff overwork" in a general hospital was more prominent, accounting for 39.10%, which was significantly higher than that in a hospital with integrated TCM and Western medicine. In terms of service attitude, the vulnerability of the two hospitals was represented as the poor service attitude of doctors, nurses and managers. In the medical safety dimension of the two hospitals, "lack of assistance in emergencies" and "hospital equipment failures" were the main vulnerability issues. From the perspective of patients, this paper analyzed the current vulnerability problems of the hospital, identified the actual and potential risks of hospital emergency management and put forward suggestions on adjusting the spatial layout, strengthening internal management and comprehensively improving employees' emergency awareness and skills. This will provide a reference for the hospital's emergency management system to make necessary adjustments to meet the practical needs. [ABSTRACT FROM AUTHOR]

Objective Mechanical factors play a critical role in the physiology and pathology of articular cartilage, although the mechanisms of mechanical signal transduction are not fully understood. We undertook this study to test the hypothesis that type VI collagen is necessary for mechanotransduction in articular cartilage by determining the effects of type VI collagen knockout on the activation of the mechano-osmosensitive, calcium-permeable channel TRPV4 (transient receptor potential vanilloid channel 4) as well as on osmotically induced chondrocyte swelling and pericellular matrix (PCM) mechanical properties. Methods Confocal laser scanning microscopy was used to image TRPV4-mediated calcium signaling and osmotically induced cell swelling in intact femora from 2- and 9-month-old wild-type (WT) and type VI collagen-deficient (Col6a1 −/−) mice. Immunofluorescence-guided atomic force microscopy was used to map PCM mechanical properties based on the presence of perlecan. Results Hypo-osmotic stress-induced TRPV4-mediated calcium signaling was increased in Col6a1−/− mice relative to WT controls at 2 months. Col6a1−/− mice exhibited significantly increased osmotically induced cell swelling and decreased PCM moduli relative to WT controls at both ages. Conclusion In contrast to our original hypothesis, type VI collagen was not required for TRPV4-mediated Ca2+ signaling; however, knockout of type VI collagen altered the mechanical properties of the PCM, which in turn increased the extent of cell swelling and osmotically induced TRPV4 signaling in an age-dependent manner. These findings emphasize the role of the PCM as a transducer of mechanical and physicochemical signals, and they suggest that alterations in PCM properties, as may occur with aging or osteoarthritis, can influence mechanotransduction via TRPV4 or other ion channels. [ABSTRACT FROM AUTHOR]