Economization of water,electricity and gas plays an important part in the construction of an economical hospital.The metering and accounting system for water,electricity and gas management in our hospital can rationally and accurately account the consumption of water,electricity and gas.Under this system,we have implemented quota management and cost control in the medical departments,efficiency assessment in the production and supply units,cost inclusion in the internal services unit,cost collection from the logistics support contractor units,and the maintenance of pipeline leakage,which has proved to be a set of effective and scientific solutions to the promotion of the efficiency of water,electricity and gas management in the hospital.

Purpose To detect the distribution of cerebral microbleeds (CMB) in patients with hypertension and evaluate its related risk factors in order to reduce long-term risk of cerebral hemorrhage in large areas. Materials and Methods A consecutive 110 patients of hypertension and 50 patients of non-hypertension in the departments of cardiovascular medicine and neurology were enrolled. All the patients underwent T2 star weighted angiography (SWAN) sequence scan of head. The location and quantity of CMB and other related information of patients were recorded. The distribution of CMB in patients with hypertension and correlation between CMB and age, sex, level of hypertension, duration of time, hemoglobin, platelets, smoking, diabetes, hyperlipidemia were also analyzed. Results A total of 472 CMB were detected in the hypertension group, of which 212 CMB (44.9%) were found in deep brain, 149 (31.6%) were in cortical and subcortical region, 111 (23.5%) under the tentorium. The highest distribution of CMB was in thalamus (98, 20.8%), followed by basal ganglia (78, 16.5%), temporal lobe (64, 13.6%) and brainstem (62, 13.1%). The univariate analysis showed that CMB group had significantly higher rate of hypertension and diabetes than that without CMB and the average age in CMB group was also higher (P<0.05). The results of multivariate analysis showed that age and hypertension were independent risk factors for CMB. In hypertension group, there was statistically significant difference in the incidence of CMB between patients aged 45 and older and those aged under 45 (P<0.05);the differences were significant between the patients with hypertension duration time less than 5 years, those with hypertension duration time 5 to 10 years and those over 10 years (P<0.05);the differences also existed between the patients with hypertension at class I and those patients with hypertension at class II and III (P<0.05). The quantity of CMB in patients with hypertension was correlated with duration time (P<0.05), but not correlated with age and the severity of hypertension (P>0.05). Conclusion Hypertension and age are independent risk factors for CMB. Patients aged 45 and older, with more than 5 years duration of hypertension, or with hypertension at class II and III, should be paid more attention in clinic. If necessary, magnetic resonance examination is suggested to be used, in order to reduce long-term risk of cerebral hemorrhage.

Objective To observe the clinical efficacy of acupuncture in treating malignant pleural effusion (MPE).Method Eighteen MPE patients confirmed by histopathological and/or cytological examinations were treated by acupuncture by selecting Yunmen (LU 2), Qimen (LR 14), Zhangmen (LR 13), Jingmen (GB 25), Guanyuan (CV 4), Zhongji (CV 3), Shuidao (ST 28), and Guilai (ST 29) as the major points. The treatment was given once every other day, 3 times a week, 4 weeks as a treatment course, and the therapeutic efficacy was evaluated 1 course later.Result Of the 18 patients, 6 got complete remission, 9 got partial remission, 2 achieved stable condition, while 1 didn’t respond to the treatment, and the total effective rate was 83.3%. Of the 5 cases with encapsulated pleural effusion, 2 got complete remission and 3 got partial remission, and the total effective rate was 100.0%. The amount of pleural effusion (anteroposterior diameter of the fluid), comprehensive score of symptoms, item scores of the symptoms, and Karnofsky Performance Status (KPS) score were changed significantly after treatment (P<0.01).Conclusion Acupuncture is an effective method in treating MPE of moderate volume, and it can swiftly improve the symptoms and promote the quality of life.

Objective To observe the role of the health education model in pain self- efficacy for patients with cancer pain. Methods Sixty- four patients suffering from cancer pain were enrolled into the study and self- contrast experiment was made on each patient. The health education model was set up and health education for each patient with cancer pain was implemented. The pain, self- efficacy, cancer pain knowledge before and after the intervention were observed by Numerical Rating Scale (NRS),Chronic Pain Self- efficacy Scale(CPSS) and Cancer Pain Knowledge Questionnaire. Results NRS score were (5.38 ±0.19) points and (1.05 ± 0.11) points before and after the intervention, and there was significant difference (t =25.288, P = 0.000). Before intervention, pain management self- efficacy, physical function self- efficacy, symptom coping self- efficacy of CPSS scores were (10.38 ±0.37) , (20.97±0.81) , (16.86 ± 0.49) points, while after the intervention, the scores were (19.31± 0.30) , (33.25 ± 0.60) , (29.75 ±0.51) points, there were significant differences ( t = -33.225, -18.236, -18.235, all P = 0.000). Before and after the intervention, the answer rate of Cancer Pain Knowledge Questionnaire was 50.00%(32/64) and 87.50%(56/64), there was significant difference( χ2=20.51, P < 0.01). Conclusions To set up the health education model and implement health education for each patient with cancer pain can improve the patient′s pain management and enhance self-efficacy.

BACKGROUND: The direct ratio is formed between the size of osseous defect around implant and the required time of complete repair. It is viewed that bone implantation is suggested if osseous defect is larger than 1 mm, which benefits the bone regeneration and early fixation of implant.OBJECTIVE: To compare the effects between coralline granules and hydroxyapatite (HA) during union after immediate implantation.DESIGN: Group observation and controlled experiment was designed.SETTING: Department of Stomatology Renmin Hospital of Wuhan University.MATERIALS: HA coated implant, HA granule, coralline granule and 3adult mongrel dogs.METHODS: The experiment was performed in Department of Stomatology, Renmin Hospital of Wuhan University from August 2002 to April 2003.Under anesthesia, 6 foramens were drilled on femurs of 3 dogs (3 foramens on each side) to result in osseous defect. Coralline granules were embedded in the osseous defect around the implant in all of proximal ends (coralline granule group, CG group), HA granules were embedded in the osseous defect around the implant in all of distal ends (HA group) and nothing was embedded in the defect around the implant in the center (the control). One dog was sacrificed under anesthesia on the 2nd, 3rd and 4th months after operation successively and the samples were collected from the implanted section in each group for X-ray examination and scanning electronic microscopic observation.MAIN OUTCOME MEASURES: X-ray examination on implanted sections and scanning electronic microscopic observation on samples in each the 4th month, it was observed that implants and osseous tissue were closely integrated in CG group and HA group and there was still partial osseous on samples in each group: on the 4th month, it was discovered that the regenerated osseous tissue was matured completely in CG group and few coralline granule residue was left. In HA group, the regenerated osseous tissue was matured completely, but there was still a large amount of HA granules left and the granules had not been absorbed obviously. In the control group, the space appeared partially in the implanted cervical region.CONCLUSION: The implantation of artificial bone is suggested if the osseous defect around immediate implant is larger than 1 mm. As the implanting materials, coralline granules and HA granules act on the most advantageous guide activity. Coralline granules can be degraded and substituted with osseous tissue,but HA granules cannot be absorbed, which affects osseous reconstruction.

Objective: To explore the effect of PDCA nursing model combined with token reward on the compliance and negative emotions of children with hypospadias. Methods: A total of 120 children with hypospadias who were admitted to Children′s hospital affiliated to Zhengzhou University from February 2017 to December 2017 were selected as study subjects. According to the time of admission, they were divided into observation group and control group, with 60 cases in each group. The control group was given routine nursing care, the observation group was given PDCA nursing mode combined with token rewards intervention on the basis of routine care. The self-made children's behavioral compliance assessment table was used to compare the compliance of the two groups of children. Achenbach Child Behavior Check List (CBCL) scores were performed before and after the intervention. The hospitalization time and the incidence of complications were calculated. Results: There was no significant difference in CBCL scores between the two groups at admission (t=0.965, P=0.102). The scores of compliance and CBCL scores of the observation group were (43.12±3.99) points and (17.62±7.30) points respectively, the scores of control group were (30.67±4.53), (24.23±6.67), the difference was statistically significant (t=15.977, 5.184, P<0.01). The hospitalization time and complication rate of the observation group were (18.73±0.84)d, 15.00% (9/60), which were significantly lower than (20.92±1.90) d, 31.67% (19/60) of the control group, and the difference was statistically significant (t=8.166, χ²=4.658, P<0.01 or 0.05). Conclusions The PDCA nursing model combined with token reward can improve the compliance of children with hypospadias and improve their negative emotions.

OBJECTIVETo assess the association of neural development-related genes LIS1and TSNAX with bipolar disorder in a Chinese Han population.

METHODSThree hundred and eight five patients (including 188 males and 197 females) from Guangzhou Brain Hospital with bipolar disorder meeting the Diagnostic and Statistic Manual of Bipolar Disorder (BDI) (Fourth Edition) criteria and 475 healthy controls from the local community were recruited. Ten single nucleotide polymorphisms (SNPs) of the LIS1 and TSNAX genes were genotyped by GoldenGate genotyping assay on an Illumina Beadstation 500 machine. Association analyses of SNPs and haplotypes were performed with Plink 1.07 software.

RESULTSAnalysis of the total sample has failed to find any association of SNP or haplotype of the two genes with BDI (P> 0.05). When patients were divided into subgroups with or without psychotic symptom, no significant association of the two genes was found with psychotic BDI or non-psychotic BDI (P> 0.05). No significant association was found between any SNP and haplotype of two genes and female BDI or male BDI, nor were significant association found between age of onset and LIS1 and TSNAX gene polymorphisms.

CONCLUSIONOur results indicated that LIS1 and TSNAX genes are not associated with susceptibility to bipolar I disorder in Chinese Han population.

1-Alkyl-2-acetylglycerophosphocholine Esterase ; genetics ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; ethnology ; genetics ; Bipolar Disorder ; ethnology ; genetics ; Case-Control Studies ; DNA-Binding Proteins ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Microtubule-Associated Proteins ; genetics ; Middle Aged ; Polymorphism, Single Nucleotide ; Young Adult

The number of investigator initiated research (IIR) is increasing. But the recognition and management of IIR in China is still in its infancy, and there is a lack of specific and operable guidance for the implementation process. Based on our practical experiences, previous literature reports, and current policy regulations, the authors took prospective IIR as an example to summarize the implementation process of IIR into 14 steps, which are as the following: study initiation, ethical review, study registration, study filing, case report form design, database establishment, standard operating procedure making, investigator training, informed consent, data collection, data entry, data verification, data locking and data archiving.