Surgical treatment of hermaphroditism: experience with 25 cases.

This article is a summary of our experience with surgical treatment of 25 patients with hermaphroditism. We treated 25 patients with hermaphroditism since 1985, including 12 with male pseudohermaphroditism, 9 with female pseudohermaphroditism and 4 with true hermaphroditism. Decision on sex reassignment for these patients was made according to their genetic sex, gonad sex, social sex, psychologic sex, and the request of the patients and their relatives. Of the 12 male pseudohermaphrodites, 1 was reassigned with the male sex and penile reconstruction was performed, and the other 11 had a female sex assignment and received undescended testis removal, clitoral reduction, labioplasty of the labia minora and labium majus, and vaginoplasty. Nine female pseudohermaphrodites with female sex assignment underwent clitoral reduction, labioplasty of the labia minora and labium majus, and vaginoplasty. The 4 true hermaphrodites also had female sex assignment, and received such procedures as resection of the ovotestes and undescended testes, clitoral reduction, and labioplasty of the labia minora; resection of the uterus and appendices was also performed in 1 case due to the identification of malignant cells. The reconstructed penis in the patient with male sex assignment had good appearance and allowed normal urination. In patients with female sex assignment, the reconstructed external genitalia had also good appearance and good sensation without obvious contraction. No serious complications occurred in these patients, who were satisfactory with the outcome and reported stable gender identity, and 3 married patients reported normal sexual life. Plastic surgery is still the primary option for correction of hermaphroditism after determination of sex assignment, and satisfactory effect can be achieved by surgical intervention with stable gender identity and minimal complications.

Advances in the study of loneliness among family caregivers of chronically ill patients / 中国实用护理杂志

A review of studies related to the loneliness of family caregivers of chronically ill patients aims to provide a basis for understanding the current situation of loneliness among family caregivers of chronically ill patients, assessing the degree of loneliness among family caregivers, and formulating individualized interventions with a view to reducing the loneliness of family caregivers and promoting their physical and mental health.

Effect of Jiegeng Yuanshen Tang on airway inflammation and mucus secretion in allergic asthmatic mice and its mechanism / 吉林大学学报(医学版)

Objective:To discuss the effect of Jiegeng Yuanshen Tang(JGYST)on airway tissue inflammation and mucus secretion in the mice with allergic asthma,and to clarify the related mechanism.Methods:Forty male C57BL/J mice were randomly divided into control group,JGYST group,ovalbumin(OVA)group,and OVA + JGYST group.The mice in OVA group and OVA +JGYST group were sensitized with 50 μg OVA via intraperitoneal injection twice weekly,followed by 20 μg OVA nasal drops daily for 7 d to induce asthma;the mice in OVA +JGYST group were gavaged with 200 μL JGYST 1 h before each OVA challenge,and the administration lasted for 7 d;the mice in control group were given equivalent dose of PBS via intraperitoneal injection,nasal drops,and gavage;the mice in JGYST group were given the same dose of PBS for intraperitoneal and nasal administration and gavaged with the same dose of JGYST.The pathomorphology of lung tissue of the mice in various groups was observed by HE staining and periodic acid-Schiff(PAS)staining,and the inflammation and PAS scores were calculated;flow cytometry method was used to detect the numbers of eosinophils,neutrophils,helper T lymphocyte 1(Th1)cells,helper T lymphocyte 2(Th2)cells,and dendritic cells(DCs),as well as the percentage of mature DCs and level of reactive oxygen species(ROS)in lung tissue of the mice in various groups;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of interleukin-4(IL-4),interleukin-10(IL-10),and tumor necrosis factor-α(TNF-α)mRNA in lung tissue of the mice in various groups.Results:The HE and PAS staining results showed that the mice in control group had intact airway and alveolar structure,without infiltration of inflammatory cells or mucus secretion;compared with control group,there was a large number of infiltrating inflammatory cells in airway tissue of the mice in OVA group,and the inflammation and PAS scores were increased(P<0.01);compared with OVA group,the infiltration of inflammatory cells in airway tissue of the mice in JGYST group and OVA + JGYST group was decreased,and the inflammation and PAS scores were significantly decreased(P<0.01).The flow cytometry results showed that compared with control group,the numbers of eosinophils,Th2 cells,and DCs in lung tissue of the mice in OVA group were increased(P<0.05 or P<0.01),and the percentage of mature DCs and level of ROS were significantly increased(P<0.01);compared with OVA group,the numbers of eosinophils,Th2 cells,and DCs in lung tissue of the mice in JGYST group and OVA + JGYST group were decreased(P<0.01),and the percentage of mature DCs and level of ROS were significantly decreased(P<0.01).The RT-qPCR results showed that compared with control group,the expression levels of IL-4,IL-10,and TNF-α mRNA in lung tissue of the mice in OVA group were increased(P<0.01);compared with OVA group,the expression levels of IL-4 and TNF-α mRNA in lung tissue of the mice in JGYST group and OVA + JGYST group were decreased(P<0.01),while the expression level of IL-10 mRNA was increased(P<0.01).Conclusion:JGYST can alleviate the airway tissue inflammation and mucus secretion in the mice with allergic asthma,and its mechanism may be related to reducing the number of Th2 cells and DCs,decreasing the ROS level and expression level of proinflammatory cytokine,and increasing the expression level of anti-inflammatory cytokine.

Exploration and practice of constructing medical-rehabilitation integration working mode in rehabilita-tion hospital under new circumstances / 现代医院

Driven by multiple factors such as policy incentives,enhanced economic capacity of residents,aging popula-tion,and medical system reform,China's rehabilitation industry has been in a rapid development stage where opportunities and challenges coexist.Various rehabilitation hospitals urgently need new development thinking on how to seize the new opportunities for the development of rehabilitation medicine,give full play to the benefits of high-quality rehabilitation medical resources,and deal with the development of rehabilitation institutions under the new situation.Taking the tertiary rehabilitation hospital where the authors work as an example,this paper deeply analyzes the practical difficulties and challenges faced by the development of reha-bilitation hospital under the new circumstance,further explores the construction of a new working mode based on people-oriented and medical-rehabilitation integration.It also briefly summarizes the beneficial experiences and practices in the reform of rehabili-tation service models,and elaborates on the periodic achievement,so as to provide a meaningful reference for the majority of re-habilitation hospitals to plan and practice high-quality development and reform.

Transcriptomic analysis of the molecular mechanism of Tiaopi Chengqi decoction improving gastric digestive function in mice with food accumulation / 中国临床药理学与治疗学

AIM:To explore the molecular mechanism of Tiaopi Chengqi decoction (TpCqD) improving hyperthermia and high-protein food-induced hyperphagia mice based on transcriptomics. METHODS:C57 mice were randomly divided into a control group, model group, low-dose TpCqD group, high-dose TpCqD group, and domperidone group. The general condition of the experimental mice was observed and the average food intake was counted, and the rate of gastric emptying and intestinal propulsion was determined for each group of mice. H&E staining was used to observe pathological changes in gastric tissue. PAS staining was used to observe glycogen changes in gastric tissue. Pepsin activity was determined by colorimetry. pH value of gastric contents was measured by acid-base titration. Transcriptome sequencing was used to analyze the differential genes in gastric tissue, a volcano map and a cluster heat map were made for the differential genes, and KEGG was used to analyze the signal pathway enrichment of the differential genes. RT-qPCR verified the differential genes obtained by screening. RESULTS:After treatment with TpCqD, the body weight and average food intake of mice with food accumulation increased (P<0.05), and the intestinal propulsion rate and gastric emptying speed of mice with food accumulation accelerated (P<0.05). TpCqD could protect gastric tissue structure and glycogen degradation, increase pepsin activity (P<0.05), and reduce gastric content pH (P<0.05). Transcriptome results showed that TpCqD could regulate the expression of Acox2 and cilp2, regulate fat digestion and absorption, protein digestion and absorption, and pancreatic secretion signals. RT-qPCR showed that compare with model group, TpCqD up-regulated Acox2 (P<0.05) and down-regulated the mRNA level of cilp2 (P<0.05). CONCLUSION:TpCqD ameliorated digestive dysfunction in mice with high-calorie and high-protein diets leading to food accumulation involving the regulation of the fat and sugar metabolism genes Acox2 and cilp2, and pancreatic secretory signaling.

Progress of Research on Immune Mechanism of Fungi in Inflammatory Bowel Disease / 胃肠病学

Inflammatory bowel disease(IBD)is a multifactorial,nonspecific and refractory chronic intestinal inflammatory disease that significantly affects the health and quality of life of patients.These include ulcerative colitis(UC)and Crohn's disease(CD),which continues to increase globally.In recent years,more and more studies have shown that the imbalance of gut microbiota is closely related to the pathogenesis and development of IBD,especially the abnormal proliferation of gut fungi may be an important factor in exacerbating the inflammatory response.Currently,treatment methods such as fecal microbiota transplantation and probiotics have been widely used in the treatment of IBD.This article summarizes the gut fungal dysbiosis and immune regulation mechanisms of IBD,as well as the current treatments,aiming to provide references for the research progress of fungi in IBD.

The effects of clinical rehabilitation pathway management on intubation time, dysfunction and medical cost for stroke survivors after tracheotomy / 中华物理医学与康复杂志

Objective:To document any effect of clinical rehabilitation pathway management on intubation time, dysfunction and medical expenditure associated with tracheotomy after a stroke.Methods:A total of 154 stroke survivors undergoing tracheotomy were randomly divided into an observation group and a control group, each of 77. Both groups were given routine rehabilitation, while the observation group was additionally provided with clinical rehabilitation pathway management during the rehabilitation intervention. Kaplan-Meier analysis was performed before the experiment and after 2, 4 and 6 weeks of treatment. Clinical pulmonary infection scores (CPISs), scores on the Chelsea Physical Function Assessment Scale (CPAx) and hospitalization cost were compared between the two groups.Results:The median extubation time of the observation group (2d) was significantly shorter than that of the control group (10d). After 2, 4 and 6 weeks of treatment, the average CPIS scores of the observation group were in each case significantly lower than those before treatment and the control group′s averages at the same time points, even though after 4 and 6 weeks of treatment the control group′s average CPIS scores had improved significantly. After 2, 4 and 6 weeks of treatment, the average CPAx scores of the observation group were significantly higher than those before treatment and better than the control group′s averages, even though the control group too had improved significantly compared with before the treatment. Hospitalization days, total hospitalization cost, antibiotic cost and laboratory examination cost of the observation group were, on average, significantly lower than those of the control group.Conclusion:Rehabilitation path management can shorten the period of intubation, prevent pulmonary infections, relieve dysfunction, and reduce medical expenses for stroke survivors after a tracheotomy. It is worthy of clinical promotion.

Mechanism of Nuclear Factor Erythroid 2-related Factor 2 Against Intestinal Fibrosis in Inflammatory Bowel Disease / 胃肠病学

Inflammatory bowel disease (IBD) is characterized by recurrent non ⁃ specific intestinal inflammatory responses. Intestinal fibrosis is an important cause of IBD complicated with intestinal obstruction. Nuclear factor erythroid 2⁃ related factor 2 (Nrf2) is a transcription factor that has anti ⁃ oxidative stress response in cells. In IBD, Nrf2 and its downstream regulated antioxidant enzymes achieve protective effects against intestinal fibrosis by inhibiting the activation of nuclear factor ⁃ κB, regulating T helper cell 17/regulatory T cell balance of intestinal immunity, and inhibiting transforming growth factor⁃β1/Smads signaling pathway. In this review, the structure of Nrf2, the specific mechanism of Nrf2's effect on intestinal fibrosis in IBD, and the recent studies on the treatment of IBD through Nrf2 pathway were reviewed in an attempt to provide a new direction for the prevention and treatment of IBD.

Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures (version 2023) / 中华创伤杂志

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Simultaneous determination of ten constituents in Xiao’er-Jinqiao granules by UPLC / 国际中医中药杂志

Objective:To establish a method for simultaneously determinating the content of 10 constituents including chlorogenic acid, puerarin, forsythoside A, liquiritin, matrine, saikosaponin A, saikosaponin D, forsythin, ammonium glycyrrhizate, indirubin in Xiao’er-Jinqiao granules by UPLC. Methods:ACQUITY UPLCTMC18 chromatographic column (100 mm × 2.1 mm, 1.7 μm) was used. The mobile phase was acetonitrile-0.05% phosphoric acid solution with gradient elution at the flow rate of 0.2 ml/min. The detection wavelength was 250 nm. The column temperature was 30 ℃. The injection volume was 2 μl.Results:The linear ranges of chlorogenic acid, puerarin, forsythoside A, liquiritin, matrine, saikosaponin A, saikosaponin D, forsythin, ammonium glycyrrhizate, indirubin were 0.789 5-15.793 4 μg ( r=0.999 6), 0.571 8-11.445 6 μg ( r=0.999 4), 0.110 7-2.214 7 μg ( r=0.999 3), 0.047 5-0.950 5 μg ( r=0.999 2), 0.269 8-5.395 8 μg ( r=0.999 7), 0.085 1-1.703 9 μg ( r= 0.999 5), 0.105 7-2.113 0 μg ( r=0.999 4), 0.065 6-1.312 1 μg ( r=0.999 3), 0.080 5-1.611 2 μg ( r=0.999 5), 0.057 7-1.153 3 μg ( r=0.999 4). The limits of quantitation were 8.322, 9.023, 9.857, 4.583, 6.872, 7.844, 8.643, 5.895, 7.568, 5.251 μg/ml. The average recovery rates were 99.11%, 98.87%, 97.83%, 98.10%, 98.17%, 98.30%, 98.10%, 98.14%, 97.99% and 98.02%, and RSDs were all below 2.0%, respectively. RSDs of precision, reproducibility and stability tests were lower than 2.0%. Conclusions:The established method of multi-component content determination is fast, accurate and reproducible. It can be used for the quality control of Xiao’er-Jinqiao granules.

Study on influencing factors of length of stay for type 2 diabetes mellitus with urinary tract infection / 中国实用护理杂志

Objective:To investigate the related factors of length of stay in type 2 diabetes mellitus (T2DM) with urinary tract infection, and provide reference for clinical nursing.Methods:A retrospective analysis was used to collect patients ′ general demographic data, disease history, HbA1c, and other laboratory indicators, and etc. A total of 228 hospitalized patients with confirmed T2DM with urinary tract infection in Shanxi People ′s Hospital from January 2019 to September 2020 were selected as the study subjects. The patients were divided into observation group ( n=79) and control group ( n = 149) according to their length of stay. The electronic medical history and related laboratory examination indexes of the two groups during hospitalization in the Department of Endocrinology were analyzed retrospectively. The general demographic data, disease history, glycosylated hemoglobin and other laboratory indexes of the two groups were statistically analyzed. Results:The results of single factor analysis on the influence of length of stay showed that there were statistically significant differences in age, gender, medicare payment method, Charlson Complication Index (CCI), treatment, glycosylated hemoglobin, procalcitonin (PCT) ( χ2 values were from 5.107 to 20.134, t value was 3.946, Z value was -2.914, P<0.05). Logistic regression analysis showed that female ( OR=0.405, 95% CI 0.172-0.951), age≥70 years old( OR=0.528, 95% CI 0.263-0.922), insulin treatment ( OR=0.479, 95% CI 0.269-0.854), CCI≥3 points ( OR=2.555, 95% CI 1.346-4.851), payment method of new rural cooperative medical insurance ( OR=0.273, 95% CI 0.120-0.620), resident medical insurance ( OR=0.184, 95% CI 0.083-0.405), others ( OR=0.367, 95% CI 0.157-0.862), PCT( OR= 0.252, 95% CI 0.290-0.877), and HbA1c ( OR= 0.81, 95% CI 0.705-0.930) were the influencing factors for the length of stay in patients of T2DM with urinary tract infection. Conclusion:Patients have a longer hospital stay in women, age ≥70 years old, and insulin treatment, CCI≥3 points, HbA1c and PCT. Compared with the employee medical insurance, patients have a shorter hospital stay with new rural cooperative medical insurance, resident medical insurance and other payment methods. Therefore, clinical testing ability should be further improved to effectively reduce the pain and economic burden of patients.

Problems and suggestions in the process of hospital scientific research funds management informatization / 中华医学科研管理杂志

Objective:Combined with the development and application of the hospital's current scientific research fund management information system, this paper explores how to further improve the informatization of scientific research fund management.Methods:Through the analysis of the service condition of four information systems, this paper identifies and illustrates problems existed in the process of informatization of scientific research funds.Results:There are some problems in the information system of scientific research funds, such as the failure to realize the " full life cycle" informatization of scientific research funds management, the uneven quality of information system, and lack of top-level design of management team. Route-cause analysis is conducted.Conclusions:It is suggested that the top-level design of information management at the national level, the reform of internal control system in hospitals, the cultivation of inter-disciplinary talent, and the increase of publicity should be taken to improve the informatization management of scientific research funds and improve the efficiency of funds utilization.

HCV infection in 219 heroin addicts with pulmonary tuberculosis in Xi’an / 西安交通大学学报(医学版)

【Objective】 To explore the incidence rate and characteristics of hepatitis-C virus (HCV) infection in heroin addicts with pulmonary tuberculosis (TB) in Xi’an so as to provide a basis for pulmonary TB and HCV prevention and control measures. 【Methods】 We carried out behavior investigation and serological detection of 219 heroin addicts with pulmonary TB infection in Xi’an Eighth Hospital. We analyzed HCV infection risk factors by Chi-square test and multi-factor Logistic regression method. 【Results】 The prevalence of HCV infection in heroin addicts with pulmonary TB was 71.2% and 92.9% in injected drug users (IDUs). The HCV infection rate was higher than the infection rate of HBV (10.9%) and HIV (5.9%) in heroin addicts with pulmonary TB. The major infection risk factors were intravenous injection (OR=18.632, 95% CI: 8.146-41.284) and longer duration of drug use (OR=1.428, 95% CI: 1.086-1.876). 【Conclusion】 The study found high HCV infection rate in heroin addicts with pulmonary TB and that the independent risk factors are the drug injection and duration of drug use. In order to prevent further spread of HCV in heroin addicts with pulmonary TB, we should establish and perfect the management system of HCV infection.

Implementation and Evaluation of Subject Diagnosis and Treatment Module Based on Drug Clinical Trial Mana- gement System / 中国药房

OBJECTIVE：To provide reference for the c onstruction of subject diagnosis and treatment scheme in drug clinical trials. METHODS ：The subject diagnosis and treatment module was developed and implemented in our hospital on the basis of CTMS，and its effects were evaluated. RESULTS ：A subject diagnosis and treatment module was established in CTMS of our hospital. Within one year from the launch of the module in the middle of October ，2019，the overall number of subjects in the group showed an increasing trend ，and the overall mean dropout rate of subjects was 0.16％. The data interface of CTMS system ， hospital information system （HIS），laboratory information management system ，medical imaging information system had been established，so as to realize the synchronization of subject information （displaying subject identification in HIS system ）and the interaction of diagnosis and treatment information and billing data （patients and subjects were charged separately ）. Since the launch of the module ，the amount of data generated by the interface had been increasing ，and the number of departments producing the subject diagnosis and treatment business had been increasing month by month. Compared with subject diagnosis and treatment project based on HIS system ，the number of subject diagnosis and treatment business based on CTMS system was increased significantly（P＜0.05）. CONCLUSIONS ：The subject diagnosis and treatment module based on CTMS improves the efficiency of subject diagnosis and treatment project implementation and financial settlement ，and realizes the efficient implementation of drug clinical trial projects in large general hospitals.

Establishment and practice of the innovative science and technology evaluation and service system of Fuwai Hospital / 中华医学科研管理杂志

Objective:By demonstrating the performance, experience and practical value of the original " science and technology evaluation" of Fuwai Hospital, it is expected to build the brand of " Fuwai innovative service for science and technology evaluation" and provide a wider social service.Methods:The four-in-one " science and technology evaluation and service system" , which is composed of " standardized local data-base" , " Fuwai Spider Net Map and Spider Track Map evaluation method" , " hierarchy three-level index system" , and " intellectual science and technology evaluation and service system" , is established for efficient evaluation of science and technology.Results:The " science and technology evaluation and service system" has run with benefit in Fuwai Hospital for years.With the multi-factor evaluating feature, it solves the drawbacks of traditional evaluating system, thus improving accuracy of evaluation and helping implementation of national policies.If the system is extended to other hospitals, it would advocate the feature and strength of Fuwai science and technology evaluation system as well as provide pluralistic reference and advice for decision-making departments.Conclusions:Science and technology evaluation is such a systemic work, with all issues of different levels along the whole evaluating process to be considered.Drawbacks exist in the traditional method which depends on a single final score.By the practice of Fuwai Hospital, the innovative " four in one" evaluation system has been validated to be more scientific.

Effect of aminolevulinic acid-based photodynamic therapy on expression of vascular endothelial growth factor and proliferating cell nuclear antigen in condyloma acuminatum tissues / 中华皮肤科杂志

Objective To evaluate the effect of aminolevulinic acid-based photodynamic therapy (ALA-PDT) on the expression of vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) in condyloma acuminatum (CA) tissues.Methods A total of 56 patients with CA were enrolled from Department of Dermatology,The First Affiliated Hospital of Zhengzhou University from October 2016 to September 2017,and skin lesions were obtained before and 1 week after the first ALA-PDT treatment.Immunohistochemical SP method was used to determine the expression of VEGF and PCNA in keratinocytes in the CA tissues.Chi-square test and rank sum test were carried out to analyze differences between pre-and post-treatment expression rate and intensity of VEGF and PCNA,and Spearman correlation analysis was conducted to analyze the correlations between the protein expression of VEGF and PCNA.Results The expression rates of VEGF and PCNA in keratinocytes in the CA tissues were 71.43％ (40/56) and 73.21％ (41/56) respectively before ALA-PDT,and 44.64％ (25/56) and 41.07％ (23/46)respectively after ALA-PDT.There were significant differences between pre-and post-treatment expression rate and intensity of VEGF and PCNA (expression rate:x2 =8.25,11.81 respectively,both P ＜ 0.05;expression intensity:H =11.29,12.22 respectively,both P ＜ 0.05).The expression of VEGF was positively correlated with the expression of PCNA in the CA tissues before and after the ALA-PDT treatment (rs =0.202,0.273,respectively,both P ＜ 0.05).Conclusion The expression of VEGF and PCNA decreased in CA tissues after ALA-PDT treatment,which may be one of the mechanisms underlying the treatment of CA with ALA-PDT.

Design and practice of hierarchy three-level index system for scientific research performance evaluation / 中华医学科研管理杂志

Objective By using the approach of "hierarchy three-level index system",this study aims at achieving precise scientific research performance evaluation,improving the proportion of high-tech products,and complementing the accumulative effect of conventional evaluation system.Methods This study transforms the conventional "plat three-level index system" into ‘hierarchy three-level index system',which consists of three levels of indexes,namely the national level,provincial level and local level.Candidates are categorized into three echelons according to the criteria for inclusion.Candidates of each echelon are evaluated and ranked by three-level indexes.Fuwai hospital's scientific advanced departments and individuals were evaluated by these two methods mentioned above,and the results were compared.Results These two index system are basically the same regarding to the overall evaluation pattern.Hierarchy three-level index system better displays the‘ quality strategy',allowing units with greater proportion of high-tech products to stand out as well as reducing the accumulative effect of massive production of medium-and-low-end products.Conclusions "Hierarchy three-level index system" is the remedy for the deficiencies of the conventional "plat three-level index system",it improves the reliability and validity of technology evaluation.Therefore,the system will contribute to the selection of scientific brains and the establishment of technology innovation system.

Effect of aminolevulinic acid-based photodynamic therapy on expression of vascular endothelial growth factor and proliferating cell nuclear antigen in condyloma acuminatum tissues / 中华皮肤科杂志

Objective@#To evaluate the effect of aminolevulinic acid-based photodynamic therapy (ALA-PDT) on the expression of vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) in condyloma acuminatum (CA) tissues.@*Methods@#A total of 56 patients with CA were enrolled from Department of Dermatology, The First Affiliated Hospital of Zhengzhou University from October 2016 to September 2017, and skin lesions were obtained before and 1 week after the first ALA-PDT treatment. Immunohistochemical SP method was used to determine the expression of VEGF and PCNA in keratinocytes in the CA tissues. Chi-square test and rank sum test were carried out to analyze differences between pre- and post-treatment expression rate and intensity of VEGF and PCNA, and Spearman correlation analysis was conducted to analyze the correlations between the protein expression of VEGF and PCNA.@*Results@#The expression rates of VEGF and PCNA in keratinocytes in the CA tissues were 71.43% (40/56) and 73.21% (41/56) respectively before ALA-PDT, and 44.64% (25/56) and 41.07% (23/46) respectively after ALA-PDT. There were significant differences between pre- and post-treatment expression rate and intensity of VEGF and PCNA (expression rate: χ2 = 8.25, 11.81 respectively, both P < 0.05; expression intensity: H = 11.29, 12.22 respectively, both P < 0.05) . The expression of VEGF was positively correlated with the expression of PCNA in the CA tissues before and after the ALA-PDT treatment (rs = 0.202, 0.273, respectively, both P < 0.05) .@*Conclusion@#The expression of VEGF and PCNA decreased in CA tissues after ALA-PDT treatment, which may be one of the mechanisms underlying the treatment of CA with ALA-PDT.

Practice and discussion on optimizing expenditure management of scientific research in hospital / 中华医学科研管理杂志

Objective:Combined with the hospital's optimization of expenditure management measures, this paper discusses how to enable scientific research personnel with appropriate discretion right to use scientific research funds and further improve the efficiency of the use of scientific research funds under the background of the reform of Release, manage and service.Methods:Through the implementation of information management system, policy revision, reconstruction of the approval process of expenditure, integration of multi department management resources and other ways, the efficiency of expenditure has been improved.Results:After optimizing the management of expenditure, the management efficiency and the efficiency of scientific research personnel is improved, the burden of scientific research personnel is reduced, and the expected effect of expenditure management is achieved.Conclusions:The optimization of expenditure management can improve the efficiency of expenditure to some extent, but more reform is still needed to promote the development of scientific research.

Application of bioelectrical impedance vector analysis to evaluate volume status of hemodialysis patients with hypertension / 中华肾脏病杂志

Objective:To evaluate the volume status of hemodialysis patients with hypertension by bioelectrical impedance vector analysis, and investigate the effect of high volume status on the prognosis of patients with hypertension.Methods:The study subjects came from the patients with pre-dialysis systolic blood pressure>160 mmHg (mean systolic blood pressure of 6 times of treatment) in the Affiliated BenQ Hospital of Nanjing Medical University. According to the volume status assessed by bioelectrical impedance vector analysis, patients were divided into two groups: fluid overload group and non-overload group (including normal fluid status and fluid decline). The clinical data, laboratory test results, ratio of intracellular and extracellular water (ICW and ECW), body cell mass, lean body mass and the percentage of total body weight, fat percentage of body weight, resistance/height, reactance/height, phase angle and illmarker were compared between two groups. Kaplan-Meier survival curve was used to compare the difference of survival rate between the two groups.Results:A total of 51 hemodialysis patients with hypertension were enrolled in this study, including 19 patients in fluid overload group and 32 patients in non-overload group (27 patients with normal volume status and 5 patients with decreased volume). The levels of albumin, prealbumin, hemoglobin, hematocrit and serum phosphorus in patients with fluid overload decreased significantly compared with non-overload patients (all P<0.05), and the proportion of lymphocytes increased in fluid-overload patients ( P<0.05). The ratio of extracellular water and illmarker index in fluid overload group were significantly higher than those in the other group (both P<0.01). However, phase angle, resistance/height, reactance/height were lower than those in patients with non-overload (all P<0.01). After 20 months of clinical observation, the control rate of blood pressure (pre-dialysis systolic blood pressure<160 mmHg) in fluid overload group was lower than that in the non-overload group (26.3% vs 43.8%), but not statistically significant ( P=0.218). The all-cause mortality rate of patients in the fluid overload group was higher than non-overload group (26.3% vs 15.6%). Kaplan-Meier survival curve analysis suggested that the difference in survival rate between the two groups was not statistically significant. Conclusions:The extracellular fluid of hemodialysis patients with hypertension and fluid overload increases significantly, and the nutritional status evaluation index decreases compared with that of patients without increased volume. Increased proportion of lymphocytes may be related to the micro-inflammatory status. Blood pressure is more difficult to control in hypertensive patients with fluid overload and the clinical prognosis can be worse in patients without increased volume.