Colorimetric immunoassays based on nanozyme labelling offer promising solution to rapid detect pathogenic bacteria for ensuring food safety. However, sluggish electron transfer kinetics and finite active sites of nanozyme result in unsatisfactory catalytic activity, achieving sensitive detection remains a challenge. Here, we report a Cu2O@CeO2 heterostructure nanozyme with synergistic amplification effect integrating rapid charge transfer kinetics and abundant active sites to enhance the colorimetric immunoassay for sensitive detection of pathogenic bacteria. Highly active CeO2 nanoparticles (NPs) are uniformly and firmly anchored onto stable Cu2O nanocubes to form Cu2O@CeO2 core-shell heterostructure, which effectively alleviates the aggregation of NPs and achieves extremely exposure of catalytic active sites. Density functional theory (DFT) calculations reveal that electron transfer at the heterointerface induces a strong built-in electric field, along with abundant density and high affinity for H2O2, thus enhancing the reaction kinetics and catalytic activity of the nanozyme. Benefiting from these advantages, the Cu2O@CeO2 heterostructure nanozyme exhibits excellent peroxidase-like activity, which could effectively catalyze the substrate 3,3′,5,5′-tetramethylbenzidine (TMB) to generate blue oxidized TMB. More importantly, the colorimetric immunoassay utilizing Cu2O@CeO2 nanozyme as labeling probe achieves sensitive detection of Salmonella with a low limit of detection (LOD) of 26 CFU/mL and presents high specificity and stable applicability in spiked food samples. This work provides scientific insights for developing high-activity heterostructure nanozyme and advancing the exploitation of fast bacteria detection technologies to ensure food safety.

Rapid and reliable detection of foodborne pathogens is essential for ensuring food safety. Here, we report an integrated acoustofluidic biosensing platform for quantitative detection of Salmonella that couples a vibrating bubble-array microchannel with nanozyme-based colorimetric readout. In this design, air bubbles are reproducibly confined between paired cylindrical micropillars and organized as serial trapping units along the microchannel to support continuous-flow operation. Upon low-frequency excitation from a piezoelectric buzzer, oscillating bubbles generate stable streaming vortices that enable size-selective partitioning, preferentially retaining micron-scale bacteria-nanozyme conjugates while allowing nanoscale free Au@Pt nanozymes to pass downstream for subsequent colorimetric readout. Using smartphone-based image analysis, the Salmonella assay achieves a linear response from 8 × 101 to 8 × 105 CFU/mL with a limit of detection of 26 CFU/mL. Reliable performance was further demonstrated in Salmonella-spiked clarified chicken homogenate supernatants with 95.1-101.4% recoveries and RSD ≤ 5.4%. This work demonstrates bubble-enabled acoustofluidic partitioning, providing a simple and wash-reduced platform for foodborne pathogen analysis.

After decades of development, China’s medical consortium construction has achieved initial results. Through the integration and revitalization of medical resources, it has effectively solved the problem of people’s difficulty in visiting a doctor, and has become a major measure of medical reform. Based on the research of the development history, related policies and current problems of medical consortium construction in China, this paper summarizes and analyzes the new ideas of medical consortium construction, including promoting the grid and compact layout, strengthening the matrix management, implementing the "three combinations", promoting the "four separations", strengthening the "three medical linkages", and building an information digital platform so as to constantly improve China’s medical consortium service system, which is the theoretical research of graded diagnosis and treatment and medical consortium system construction in the new era.

Screening of pathogenic bacteria is an essential measure for ensuring food safety. A fast, sensitive and automatic platform for Salmonella determination was presented employing continuous-flow magnetic isolation, enzymatic impedance amplification and smartphone data analysis. First, magnetic nanoparticles coupling with polyclonal antibody, polystyrene spheres coupling with monoclonal antibody and glucose oxidase, and bacterial sample were simultaneously immitted into reaction chamber, and actively mixed for formation of MNP-Salmonella-PS complexes in the microfluidic chip. After the MNP-Salmonella-PS complexes were continuous-flow caught in separation channel using the enhanced magnetic field and successively washed for removing redundant immune PSs and remanent ions, glucose with high impedance was then pumped and catalyzed into hydrogen peroxide and gluconic acid. Finally, impedance change of catalysate was dynamically measured with the on-chip PCB electrode and analyzed by the self-developed smartphone to quantify target bacteria. The microfluidic platform was able to quantitatively detect Salmonella from 1.3 x 102 to 1.3 x 106 CFU/mL in 1.5 h with a detection limit of 53 CFU/mL. The recovery of Salmonella in spiked chicken meats ranged from 88.2% to 112.0%, verifying its good practical applicability. This platform is featured with fast detection, high sensitivity and simple operation, and promising for in-field Salmonella screening.

Blood tests are considered as standard clinical procedures to screen for markers of diseases and health conditions. However, the complex cellular background (>99.9% RBCs) and biomolecular composition often pose significant technical challenges for accurate blood analysis. An emerging approach for point-of-care blood diagnostics is utilizing "label-free" microfluidic technologies that rely on intrinsic cell properties for blood fractionation and disease detection without any antibody binding. A growing body of clinical evidence has also reported that cellular dysfunction and their biophysical phenotypes are complementary to standard hematoanalyzer analysis (complete blood count) and can provide a more comprehensive health profiling. In this review, we will summarize recent advances in microfluidic label-free separation of different blood cell components including circulating tumor cells, leukocytes, platelets and nanoscale extracellular vesicles. Label-free single cell analysis of intrinsic cell morphology, spectrochemical properties, dielectric parameters and biophysical characteristics as novel blood-based biomarkers will also be presented. Next, we will highlight research efforts that combine label-free microfluidics with machine learning approaches to enhance detection sensitivity and specificity in clinical studies, as well as innovative microfluidic solutions which are capable of fully integrated and label-free blood cell sorting and analysis. Lastly, we will envisage the current challenges and future outlook of label-free microfluidics platforms for high throughput multi-dimensional blood cell analysis to identify non-traditional circulating biomarkers for clinical diagnostics.

随着经济社会的飞速发展以及医疗服务水平的不断提高,中国特色的价值医疗理念也在健康中国建设进程中蓬勃发展.本文以北京大学第三医院价值医疗的服务模式与实践路径的构建为例,总结分析了高质量发展新时期公立医院价值医疗建设的内涵、理念与重要意义,从以人为本的"一站式服务"模式探索、DRG支付调控赋能、药品耗材精益管理、智慧医疗信息化建设、成本预算管控的业财融合范式构建、绩效激励机制的不断完善以及医联体服务体系建设等多个方面入手,探索价值导向医疗体系建设的新思路、新举措,为医疗服务模式创新和相关政策制定提供经验借鉴,也为新时期深化医药卫生体制改革、推动公立医院高质量发展助力.

随着医改的不断深入,公立医院集团化发展模式作为分级诊疗和医联体政策落地的重要载体之一,成为健康中国战略"十四五"规划的必然布局.该文回顾了国内公立医院集团化发展的历史背景和政策演变,分析了新时期医院集团化创新经验与特色模式,并基于目前存在的现实问题,探讨了公立医院集团化新模式建设的有效实施路径,推进治理机制和人事制度改革,提升基层医院服务能力和认可度,明确集团内部利益分配机制,注重人才梯队建设,加强集团同质化管理和文化建设,增强凝聚力,回归公益,推动医院的高质量发展.

Pathogen screening is an important measure for ensuring food safety. A colorimetric biosensor was presented for Salmonella determination employing staggered magnetic bead chains for continuous-flow bacteria isolation, MnO2 nanozymes for effective signal amplification, and smartphone for accurate catalysate analysis. First, im-mune magnetic beads were distributed under the staggered magnetic field to form higher magnetic bead chains to occupy more cross-section of separation channel. Then, target bacteria were injected and captured onto magnetic bead chains, followed by labeling with the immune MnO2 nanozymes to form bead-bacteria-nanozyme complexes. Finally, H2O2-TMB substrate was catalyzed by MnO2 nanozymes on these complexes, and color change was monitored and analyzed through smartphone to quantify target bacteria. The sensor enabled Sal-monella detection as few as 60 CFU/mL in 2 h.

党委领导下的院长负责制是实现党对公立医院领导的关键制度.进一步完善公立医院党的领导体制,对于促进公立医院党的建设和卫生事业发展具有重大意义.回顾了新中国成立以来我国公立医院领导体制的演变过程,以北京大学第三医院探索实践为例,探讨了公立医院领导体制转换的有效实施路径,从章程制定、党委议事制度完善、人事干部管理、与职工的双向沟通渠道、支部职能转变、意识形态思想引导等多方面入手,推动医院的良性发展.

In this study, a power-free biosensor was presented to detect Salmonella typhimurium on a microfluidic chip using a slide multivalve for channel selection and a disposable syringe for fluidic transfer. First, bacterial sample with immunomagnetic nanoparticles (IMNPs) and glucose oxidase (GOx) modified immune polystyrene nanoparticles (IPNPs), washing buffer, glucose, and peroxide test strip (PTS) were preloaded in their respective chambers at the periphery of chip. After the slide multivalve was selected to connect sample chamber with common separation chamber, which was connected with a syringe, the mixture of Salmonella, IMNPs and IPNPs was back and forth moved through 3D Tesla-structure micromixer using the syringe, resulting in the formation of IMNP-Salmonella-IPNP complexes, which were captured in the separation chamber using a magnet. Then, two washing chambers were selectively connected respectively to remove sample background and excessive IPNPs, and glucose chamber was connected, allowing the GOx to catalyze glucose to produce hydrogen peroxide in the separation chamber. Finally, PTS chamber was connected and the catalysate was transferred from the separation chamber to the PTS chamber, leading to the color change of PTS, followed by using smartphone App to collect and analyze the image of PTS for bacterial determination. The simple biosensor enabled simple detection of Salmonella as few as 130 CFU/mL within 60 min and is promising for practical applications in the resource-limited regions due to its low cost, simple operation, and small size.

近年来,在全面加强党的领导新形势下,中共中央国务院和各部委先后就加强高校教师党支部建设和培育教师党支部书记"双带头人"等工作颁布了多项实施政策,赋予了教师党支部"双带头人"新的时代内涵.本研究以北京大学附属医院为例,结合国家及高校附属医院"双带头人"培育工程相关政策,深入分析研判当前制度体系和建设模式,探究实际情况中存在的困难问题,并针对性地提出"双带头人"的优化培育路径,进一步发挥基层党支部书记在组织管理中的"头雁效应",促进新时期高校基层党建和业务的双促进、双融合,助力新时期高校附属医院党建工作高质量发展和学校双一流建设.

With the deepening of China′s medical reform, in order to further improve the utilization efficiency of medical resources, public hospitals have actively explored the establishment of different forms of hospital groups, made many useful attempts in the group operation mode, and accumulated a lot of experience. Taking the group construction practice of Peking University Third Hospital as an example, the authors probed into effective implementation paths for group construction of public hospitals from the aspects of management mode, governance structure, resource sharing, homogeneous management among others. By creating a management model of compact hospital districts, compact community health service centers, and semi compact trusteeship branches, the group had constantly refined the development path of discipline construction, and promoted the comprehensive integration and development of medicine, education, research. On such basis, the group had paved a solid and effective path in the aspects of expanding the influence of the hospital, and promoting the implementation of hierarchical medical service, for references in high-quality development of public hospitals.

党委领导下的院长负责制是实现公立医院党的全面领导的关键制度.在全面从严治党的新常态下,进一步完善公立医院党的领导体制,充分发挥党委的政治核心作用,对于促进公立医院党的建设和医药卫生事业发展具有十分重要的意义.本文回顾了新中国成立以来我国公立医院治理机制的演变过程,基于目前存在的现实问题,探讨了公立医院领导体制转换的有效实施路径,发挥医院党委把方向、管大局、作决策、促改革、保落实的领导作用,推动医院的良性发展.

Early screening of Salmonella is of utmost importance to minimize the incidence of related foodborne diseases. Here, we reported an immunosensor to fast detect Salmonella using Fe-MIL-88NH(2) metal-organic framework (Fe-MOF) nanocubes to load platinum nanoparticles (PtNPs) for signal amplification and smartphone thermal imaging to monitor the temperature change. The Fe-MOF nanocubes decorated with PtNPs (Fe-MOF/PtNPs) were prepared as peroxidase mimics to catalyze hydrogen peroxide (H2O2) to produce O-2. The immune magnetic nanoparticles (MNPs), the target bacteria, and the immune Fe-MOF/PtNPs were first mixed by the three-dimensional (3D) chaotic micromixer and conjugated in the microfluidic chip to form MNP-bacteria-Fe-MOF/PtNPs sandwich complexes. After magnetic separation and washing, H2O2 was injected and decomposed by Fe-MOF/PtNPs on the sandwich complexes to generate O-2 in a sealed chamber. The increase in the pressure pushed the preloaded water to react with calcium oxide powder, resulting in the generation of heat, which was measured using the smartphone-based thermal sensor to determine the bacteria. The microfluidic immunosensor could detect Salmonella as low as 93 CFU/mL within 1 h.

Background County hospitals as the backbone of the China’s healthcare system are providing services for over 70% of the total population. However, the hospital management practice (HMP) and its links with quality of care, efficiency and finance in these hospitals are unknown. Methods We did two cross-sectional surveys of HMP in 2013 and 2015 among 101 county hospitals across rural China. Three managing roles (hospital director, director of medical affairs office and director of cardiology) and a cardiologist were invited to the surveys. A novel HMP rating scale, with 100 as full score, was used to measure the HMP in 17 indicators under four dimensions (target, operation, performance, and talent management) for each hospital. We analyzed the association of HMP score with variables on quality of care, efficiency and finance using linear mixed models with and without adjustment for potential confounders. Findings A total of 95 hospitals participated in at least one survey and were included in the analysis. The overall mean HMP score varied dramatically across the hospitals and 84% of them scored less than 60. The dimension mean HMP score was 38.6 (target), 56.4 (operation), 53.2 (performance) and 55.7 (talent), respectively. The pattern of indicator mean HMP score, however, was almost identical between hospitals with high and low overall HMP score, showing the same ‘strength’ (staff satisfaction, staff performance appraisal, ‘hard wares’, patient-centered services, etc.) and ‘weakness’ (target balance, target setting, continuous quality improvement, penalties on staff with dissatisfied performance, etc.). The associations of overall mean HMP score with quality of care and efficiency variables and cost per hospitalization was not statistically significant. The statistical significance in the association with hospital annual total income disappeared after adjusting for region, teaching status, number of competitors, number of staff and number of beds in use. Conclusion The HMP in Chinese county hospitals scores low in general and was not significantly associated with hospital care quality, efficiency and finance. The current healthcare reform in China should address the micro level issues in hospital management practices.

In-field screening of foodborne pathogens plays an important role in ensuring food safety. Thus, a microfluidic biosensor was developed for rapid and sensitive detection of Salmonella using manganese dioxide nanoflowers (MnO2 NFs) for amplifying the biological signal, a microfluidic chip with a convergence-divergence spiral micromixer for performing automatic operations, and a smartphone app with a saturation calculation algorithm for processing the image. First, immune magnetic nanoparticles (MNPs), the sample, and immune MnO2 NFs were fully mixed and sufficiently incubated in the spiral micromixer to form MNP-bacteria-MnO2 sandwich complexes, which were magnetically captured in a separation chamber in the microfluidic chip. Then, a 3,3',5,5'-tetramethylbenzidine (TMB) substrate was injected and catalyzed by a MnO2 NF nanomimetic enzyme on the complexes, resulting in the production of yellow catalysate. Finally, the catalysate was transferred into a detection chamber and its image was measured and processed using the smartphone app to determine the number of bacteria. This biosensor was able to detect Salmonella from 4.4 × 101 to 4.4 × 106 CFU/mL in 45 min with a detection limit of 44 CFU/mL, and has the potential to provide a promising platform for on-site detection of foodborne bacteria.

加强公立医院党员档案管理、实现管理规范化是新时期公立医院进一步加强党的建设、提升党员发展质量、指导和规范基层支部党建工作的重要内容.文章基于北京大学第三医院党员档案管理实践,分析公立医院党员档案管理存在的问题并提出改进建议,认为可通过加强工作顶层设计、健全档案管理机制、提高档案管理人员业务能力、推进部门间协作等方式,实现党员档案规范化管理.

2019年末到2020年初,一场突如其来的新型冠状病毒肺炎疫情肆虐全国.全国各界紧急动员,精准施策,打响了一场没有硝烟的疫情防控阻击战.本文以北京大学第三医院党委和医院援鄂抗疫国家医疗队临时党总支在抗击新冠肺炎战役中的总体部署和具体经验做法为例,深入分析党组织在疫情整体防控和应对中发挥的统筹协调、凝聚力量、宣传引导、服务保障等巨大效用,为充分发挥基层党支部的战斗堡垒作用、早日打赢疫情防控阻击战打下坚实的基础,为抗疫救援工作提供了有益的实践借鉴.

An acid-responsive microfluidic biosensor using curcumin (CUR) as signal reporter and ZnO-capped mesoporous silica nanoparticles (MSNs) for signal amplification was developed for sensitive and rapid detection of Salmonella in colorimetric and fluorescent modal. The MSNs were first incubated with CUR to obtain MSN@CUR nanoparticles (MC NPs). The MC NPs were then capped with ZnO nanoparticles to form MSN@CUR@ZnO nanoparticles (MCZ NPs) to prevent CUR from premature release, followed by modification with polyclonal antibodies (pAbs) against Salmonella Typhimurium (S. Typhimurium) to obtain immune MSN@CUR@ZnO@pAbs nanoparticles (MCZP NPs). The immune magnetic nanoparticles (MNPs), the S. Typhimurium cells and the MCZP NPs were conjugated in the microfluidic chip with a Koch fractal mixing channel to form MNP-bacteria-MCZP complexes. Finally, the acetic acid (HAc) was first time introduced to release CUR from the complexes, and both the color and fluorescence changes were measured to determine the concentration of Salmonella. This proposed biosensor was able to quantitatively detect S. Typhimurium ranging from 10(2) to 10(7) CFU/mL in 1.5 h and the lower detection limits were calculated to be 63 CFU/mL for colorimetric measurement and 40 CFU/mL for fluorescent measurement, respectively. The mean recovery was about 104 % for Salmonella in the spiked chicken samples.

Salmonella screening is a key to ensure food safety in poultry supply chains. Currently available Salmonella detection methods including culture, polymerase chain reaction and enzyme-linked immuno-sorbent assay could not achieve rapid, sensitive, and in-field detection. In this study, different strategies for separation and detection of Salmonella were proposed, compared, and improved based on our previous studies on immunomagnetic separation and impedance biosensor. First, the coaxial capillary for immunomagnetic separation of target bacteria was improved with less contamination, and 3 strategies based on the improved capillary and immunomagnetic nanoparticles were compared to separate the target bacteria from sample and form the magnetic bacteria. The experimental results showed that the strategy of capture in tube and separation in capillary was the most suitable with separation efficiency of approximately 88%. Then, the immune gold nanoparticles coated with urease were used to label the magnetic bacteria, resulting in the formation of enzymatic bacteria, which were injected into the capillary. After the urea was catalyzed by the urease on the enzymatic bacteria in the capillary, different electrodes were compared to measure the impedance of the catalysate and the screen-printed electrode with higher sensitivity and better stability was the most suitable. This impedance biosensor-based bacterial detection strategy was able to detect Salmonella as low as 102 CFU/mL in 2 h without complex operations. Compared to the gold standard culture method for practical screening of Salmonella in poultry supply chains, this proposed strategy had an accuracy of approximately 90% for 75 real poultry samples.