The author analyzed the migrations of medical talents in a city -level public hospital for ten years trying to know the reserve changes and the potential crisis of human resource of hospital.By comparing job title, edu-cation background, age, sex of the new recruitments and resignations, and exploring the main reason of brain drain, the author proposed to set up the autonomous talent reserve strategy, improve the incentive talent management mecha-nism and establish the platform, which ensures to attract and keep talents for hospital.

Objective To investigate the application of theoretical K value and the calibration K value on Hitachi 7600 Automatic Biochemical Analyzer .Methods Rate method was employed to detect alanine aminotransferase (ALT ) ,aspartate aminotransferase (AST) ,gamma-glutamyl transpeptidase(γ-GT) ,creatine kinase(CK) and lactate dehydrogenase(LDH) .The theoretical K value and K values calibrated by two kinds of calibration serum were recorded as K ,K1 ,K2 and the three kinds of calibration results of enzymes mentioned above were compared .Results The theoretical K values of ALT ,AST ,γ-GT ,CK and LDH were all less than their two kinds of actual K values .The results of the calibration K value were significantly superior to that of the theoretical K value .The calibration results R2 value of five kinds of enzymes were all greater than 0 .95 .Conclusion The theoretical K value is not suitable for clinical laboratories ,and the two kinds of calibration serum can meet the needs of quality control and clinical work .

Objective: To investigate ketamine cardiotoxicity profile. Method:Four day-old spontaneously contracting neonatal primary myocardial cell cultures obtained from 2-to 3-day-old Wistar rats were divided into 4 groups, group A as control and group B,C and D treated with ketamine(1?10~(-5), 1?10~(-4)and 1?10~(-3)mol/L)for 2 to 24 h. The contractility, morphology,cytoplasmic enzyme (LDH, AST and CK) release content of myocardial cell and the concentration of electrolytes (k~+, Na~+, Ca~(2+) and Cl~-) in the medium were measured 2,4,8 and 24 h following ketamine administration. Result:In group B the beating rates of neonatal myocardial cell cultures increased (P

The blood vessels of the M.tensor fasciae latae,the iliotibial band and itsoverlying skin were dissected and measured in 30 lower limbs of 15 adult fresh ca-davers,the results were as follows:1.The branches of the lateral femoral circumflex artery may be classified intofour types:three-branch type(60.00%?8.94),dispersion type(20.00%?7.30),poly-branch type(10.00%?5.48)and two-branch type(10.00%?5.48).Amongthem,the three-branch type,which is divided into the ascending,transverse,anddescending branches,is the most common one.The caliber of the ascending branchis 2.22?0.09mm with a length of 2.70?0.22cm.The caliber of transverse branchis 2.16?0.07 mm with a length of 2.12?0.17cm.The caliber of descending branchis 2.87?0.11 mm with a length of 6.95?0.68cm.All of the three accompanyingveins consisted of vanae comitantes,the caliber and length of the vein are approxi-matly the same as those of the artery.2.The M.tensor fasciae latae is supplied by its main artery,which comes fromthe ascending branch of the lateral circumflex artery(90.00%?25.49).In a fewcases,it comes from the transverse branch(6.66%?4.55)or the deep femoralartery(3.33%?3.27).The caliber of the main artery of M.tensor fasciae latae is1.64?0.05 mm,and its length is 2.71?0.24 cm.The ascending branch and themain artery together make the vascular pedicle which length is 5.55?0.32 cm.Thecaliber and the length of the pedicle is large enough for ideal microsurgical vasanastomoses.3.The iliotibial band is supplied by the tractocutaneous artery,which comesfrom the perforating branch of myocutaneous artery of vastus lateralis and thedescending branches of lateral circumflex artery.It perforates the iliotibial bandand reaches to the subcutaneous tissues to supply the iliotibial band and its overly-ing skin.4.The skin territory of the M.tensor fasciae latae and iliotibial band issupplied by the pure cuteneous artery,the perforating branches of myocutaneousartery and the tracto-cutaneous artery.The main artery enters the muscle and sendsperforating branches into the overlying skin.All the three kinds of cutaneousarteries form abundant anastomoses in subcutaneous tissues.For this reason,if themain artery anastomoses with the artery of the host,an area in dimensions up to15?35 cm~2 of skin would survive in the anterolateral thigh.

Objective To investigate the value of improving the prediction accuracy of near-term risk for developing breast cancer by transforming the original mammography image and fusing the different types of image features using the algorithm of machine learning.Methods The craniocaudal (CC) full-field digital mammography (FFDM) of 185 women were downloaded from the clinical database at the university of Pittsburgh medical center.Firstly,the original gray images were segmented and transformed into virtual optical density images.Then the asymmetry features were separately extracted from original gray images and virtual optical density images.Two decision tree classifiers of the first stage were trained based on the features extracted from two types of image.And the scores output from the two classifiers were used as input to train the second stage of one decision tree classifier.Leave-one-case-out method was used to validate the prediction performance of near-term risk of breast cancer.Results Using two-stage decision tree fusion method to predict breast cancer,the area under the ROC curve (AUC) was 0.9612±0.0132.And the sensitivity,specificity and prediction accuracy were 96.63％(86/89),91.67％(88/96) and 94.05％(174/185).Conclusion The features extracted from virtual optical density image have higher discriminatory power of predicting breast cancer.Fusing the two kinds of image features twice by two-stage decision tree method can help to improve the prediction accuracy of near-term risk of breast cancer.

Thirty two upper limbs of 16 adult fresh cadavers were studied.Suspension ofbarium sulfate in red latex were injected prior to medial arm flap dissection.Thearm flaps were observed and measured under the magnifying spectacles(3X),and X-ray photographs were taken.The main results obtained are summarized as follows:1.In 30 specimens,there are 386 branches arising from the brachial artery——pure cutaneous branches(67,17.36?1.93%),pure muscular and myocutaneous branches(186,48.182?2.54%)and mixed branches(133,34.46?2.42%).2.The brachial profundal artery arises from the brachial artery about 2 to 3cm.below the lower margin of pectoralis major.The caliber of the artery is 2.22?0.14mm.It supplies the triceps brachii and the skin of medial and dorsal surfaceof the upper part of arm.3.The superior ulnar collateral artery arises from the brachial artery about 6cm,below the lower margin of the pectoralis major.The caliber of the artery is1.71?0.08mm.It supplies the long and medial head of Triceps Brachii and the skinof middle and lower part of arm.It is a main artery of medial arm flap.4.The inferior ulnar collateral artery arises from the brachial artery about 18cm,below the lower margin of pectoralis major.The caliber of the artery is 1.50?0.07mm.5.The myocutaneous artery of biceps brachii arises from the brachial arteryabout 8cm,below the lower margin of pectoralis major.The caliber of the artery is1.63?0.13mm.It gives off a larger cutaneous artery.6.An abundance of anastomoses is formed by these cutaneous arteries and arich network of arteries may be seen.The caliber of some of the cutaneous arteries isabove 1mm.7.The venous drainage consisted of venae comitants.The medial arm flap is generally thin,soft and non-hair-bearing,the caliberand length of the pedicles of the arteries are large enough for microsurgical vasoanas-tomosis.It is a suitable donor site for free transfer of skin flap and the optimaldimension is 8?20cm.

As a rehabilitation strategy in the project of community development, community-based rehabilitation (CBR) can improve quality of life effectively in the community disabled, possessing the characteristics of wide coverage, convenience, being economical and effectiveness, so it has been developed and promoted in our country. At present, there are various problems in CBR, which could not meet the diverse demand of people with disablities in community. As a result, it is important to propagandize rehabilitation concept, built rehabilitation team, strengthen multidisciplinary cooperation and emphasize the development of the disabled rehabilitation system in rural community.

Objective: To investigate the cinlical features and therapeutic methods of unex-pected gallbladder carcinoma. Methods: A retrospective analysis was performed in 19 cases of unexpected gallbladder carcinoma treated in our hospital from April 2002 to April 2008. Results: Ten cases in early stage were perfomed gallbaldder resection and local lymph node removal, and the average survival time was 18.7 months; 4 cases were perfomed extend radical resection, and the average survival time was 12.3 months; 5 cases were performed palliative resection, and the survival time was less than 6 months. Conclusions: Frozen section examination during opera-tion is key to diagnose unexpected gallbladder carcinoma. Radical resection is the first option once the diagnosis is confirmed, and the method can be decided according to Nevin classification and B ultrosound scaning during opreation.

Objective:To investigate the surgical indication and effect of surgical treatment for giant cavernous hemangioma of the liver(LHG).Methods:The clinical data,including selection of operations,management for severe operative bleeding and postoperative supplementary treatment,of 15 patients with giant LHG treated by surgical measures from 2003 in our hospital were summarized and assessed.Results:Nine cases accepted decollement of LHG,and the recovery courses were all right,6 cases accepted embolization of hepatic artery,in which 2 cases accepted operation afterward.Conclusions:Decollement or embolization of hepatic artery were effective in the treatment of giant cavernous hemangioma.

Objective To investigate the indications,techniques and effects in surgical treatment of stale acetabular comminuted fractures.Methods A retrospective review was made on 24 cases (24 hips) of obsolete acetabular fractures undergone delayed reconstruction due to the combined injuries in other organs from October 2003 to June 2010.There were 18 males and 6 females,at 22-68 years of age [mean (42.2 ± 10.5) years].Mean time from injury to operation was (4.6 ± 1.3) weeks (range,3-6 weeks).According to Letournel classification,there were 11 simple fractures including six posterior wall fractures,one anterior wall fracture,one posterior column fracture,one anterior wall fracture and two transverse fractures and 13 compound fractures including six posterior column with posterior wall fractures,two transverse with posterior wall fractures,one T-shape fracture,two posterior semitransverse fractures and two both-column fractures.Surgery was performed via ilioinguinal approach in two cases,posterior acetabular approach in 13 and the combined approaches in nine.Results All 24 cases were available to average (15.6 ± 10.5) months of follow-up (range,10-36 months).Quality of reduction based on Matta standard was anatomic in 21 cases,unsatisfactory in two and poor in one.Clinical results evaluated using modified d' Aubigne-Postel score were excellent in 21 cases,good in two and poor in one.There were one femoral head necrosis,11 heterotopic ossification and six sciatic nerve transient palsy after operation.Conclusion Delayed open reduction and internal fixation is effective in treatment of obsolete acetabular comminuted fractures.