The paper points out that under the market economy, it is imperative to cherish the idea of resources = efficiency management so as to tap human resources and strengthen intensional building. It gives an account of how human resources were economized when the volume of operations increased by a large margin while the proportion between personnel and number of operations did not increase markedly. The many management measures adopted include: cultivating quality nurses specialized in operation, enhancing the high-tech content in the nursing specialty, building a knowledge-based echelon of management talents, setting up responsibility operating rooms, working out flexible shifts, and rationally utilizing contract nurses.

Objective To investigate the combined effects of fluoride (NaF) and arsenate (NaAsO2) exposure on proliferation,differentiation and bata-catenin expression in SD rat osteoblasts.Methods Osteoblasts were isolated from calvarias of twelve SD rats born in 1-3 days and cultured.The method was divided into 9 groups [F0.0As0.0 (control group),F0.5As0.0,F4.0As0.0,F0.0As0.1,F0.0As10.0,F0.5As0.1,F0.5As10.0,F4.0As0.1,F4.0As10.0] by factorial experiment design (3 factors and 2 levels).Osteoblasts were exposed to NaF (F-:0.0,0.5,4.0 mmol/L,F0.0,F0.5,F4.0),NaAsO2 (As3+:0.0,0.1,10.0 μmol/L,As0.0,As0.1,Asi10.0) and cultured for 72 hours.The proliferation and alkaline phosphatase (ALP) was determined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl (MTT) and Enzyme-linked immunosorbent assay (ELISA).The expression of beta-catenin was analyzed by quantitative real-time PCR (qPCR) and Western blotting after 72 hours of experiment.Results ①There was significant difference in cell proliferation and the activity of ALP among groups after 72 hours (F =14.022,14.425,all P ＜ 0.05).Compared with control group,the proliferation and the activity of ALP were significantly induced in F0.5 treated osteoblasts groups (0.313 ±0.023 vs0.455 ± 0.152,4.46 ± 0.72 vs 6.09 ± 0.68,all P ＜ 0.05),and the proliferation was significantly suppressed in F4.0As0.0 group (0.029 ± 0.014,P ＜ 0.05),the activity of ALP was significantly induced in F0.0As10.0 group (0.156 ± 0.010,6.29 ± 0.67) and the proliferation was significantly suppressed in F0.0As0.1 group (0.370 ± 0.029,3.68 ± 0.45,all P ＜ 0.05).②There was statistical difference in beta-catenin mRNA and protein expressions among groups with F-(F =7.782,559.455,all P ＜ 0.05) at As0.0 condition.There was significant difference in the expression of betacatenin mRNA and beta-catenin protein in F0.5As0.0 group compared with control group (1.00 ± 0.32 vs 1.99 ± 0.14,3.56 ± 0.15 vs 5.11 ± 0.26,all P ＜ 0.05),the beta-catenin protein was significantly suppressed in F4.0As0.0 group (1.10 ± 0.02,P ＜ 0.05).There was significant difference in the expression of beta-catenin protein of all groups with As3+ (F =154.736,P ＜ 0.05) at F0.0 condition.③Factorial analysis showed that fluoride or arsenic alone could affect the proliferation and the expression level of beta-catenin mRNA and protein (F =82.081,11.991,514.741;19.302,8.753,523.698,all P ＜ 0.05),the effect of arsenic on ALP activity of osteoblasts was also the main effect (F =17.444,P ＜ 0.05);and there was an interaction between fluoride or arsenic to cell proliferation and the activity of ALP and the expression of beta-catenin mRNA and protein (F =13.085,18.157,4.936,426.036,all P ＜ 0.05).Conclusions A biphasic pattern of fluoride or arsenic on proliferation and differentiation has been induced in SD rat osteoblasts.Fluoride or arsenic can affect bone metabolic by beta-catenin.

Objective:To probe into the expression and the clinic significance of LEA on colorectal carcinoma. Methods:The expression of LEA and CEA in 140 colorectal cancer specimens and 100 colorectal non-cancerous specimens had been detectd by immunohistcchemistry S-P method.Results:The expression of LEA was relative to tumor differentiation degree and exhibits higher selectivity in high differentiation ade-nocarcinoma ( P 0.05) . The positive rate of LEA in adenoma was much higher than surrounding non-cancerous mucosa and normal mucosa. In normal mucosa the positive rate of LEA was obviously lower than that of CEA ( P

Objective To quantify Contribution to LE at Birth from Mortality Variation for Some Diseases in Shanghai.Methods Health problem for population was classified into 5 group: infectious group,tumor,cerebrovascular group,injury and others.Cause elimination life table methods was employed to analyze the mortality registry data for Shanghai residents during 1953 to 1999.Chisquare for trend was used to analyze the variation for ASMR and Pearson correlation was used to describe the relationship between the variation of LE at birth and social economic factors.Results During 1953 to 1999,crude mortality rate(CMR),mortality rate by area,age-specific mortality rate(ASMR) from infectious group diseases showed obvious trends of descending.Also CMR and ASMR from injury for urban residents showed obvious trends of ascending.However,for suburb residents,CMR from injury had a trend of decline but ASMR had no significant trend.CMR from tumor and cerebrovascular group for Shanghai residents showed a rising trend but mortality rate by area and ASMR not.After 1979,the proportion of contribution for the rise of LE at birth for Shanghai urban residents from infectious group was about 33%,which was much higher than that of other 3 groups.The proportions of contribution in suburb male group from injury and cerebrovascular were 40.26% and 25.18%,respectively.The variation of mortality risk from tumor for urban male residents gave a negative contribution to respondent rise of LE at birth.Besides,the proportions of contribution in suburb female group from infectious disease(21.60%) and injury(12.55%) were largest.Compared to the mortality in 1996,among infectious group,injuries,tumor and cerebrovascular group,potential decline of mortality from tumor contribute the most to the rise of LE at birth,cerebrovascular group has the second,injury had the third and infectious group has the least.Development of Shanghai medical service resource showed a significant correlation with the rise of LE at birth.Conclusion Shanghai has successfully prevented and controlled the infectious disease group.The future strategy for disease prevention and control ought to focus on tumor,cerebrovascular diseases and injury.Based on the theory of risk competing,cause elimination life table method help greatly to set proper LE aims for public health plan.

At present, the general surgery is facing various challenges. In order to meet the requirement of the 21 st century,some measuresshould be adopted to solve the problems listed as follows:The most important measure is to select a capable man to be the chief of the department and to make out a strategic scheme for future development. It also needs to know the ability level of the department in surgical science so that can carry forward the department's advantages and make up its disadvantages. The senior surgeons in the department should concentrate themselves along some special branch of general surgery while the young and the middle-aged surgeons build up their fundamental knowledge as well as the surgical technique in order to make a start for a mastering higher specialized skill. All members of the department should put in their effort together to develop new technique along the front line of the medical science to get close connection with the up-to-date international progress of surgery. The “young successor" out of competition should be supported and cultivated to be an excellent surgeon in the next century.

Objective To sum the clinical experiences of the treatment in congenital heart disease single ventricle with extracardiac conduit (EC) fenestration.Methods Ninety-five patients diagnosed with univentricular heart disease underwent EC using Gore-Tax conduits at the Department of Children's Heart Center,Justus-Liebig-University Giessen Germany from June 1996 to July 2010.According to EC with or without fenestration,the patients were divided into two groups.Seventy-one routine fenestration of the extracardiac conduit (the fenestration group),58 patients (58/71) of children with high-risk preoperative intraoperative fenestration,13 cases (13/71) were due to low cardiac Rankinginterventional fenestration; extracardiac conduit fenestration (non-windowed group) did not undergo surgery in 24 patients (24/95).Results The fenestration had no death; Three died in non-windowed group.Postoperative effusions and postoperative mean pulmonary artery pressure in group without fenestration ((14.2 ± 2.3) d and (15.1 ± 3.4) mm Hg respectively) were significantly higher than group with fenestration ((10 ± 3.2) d and (13.2 ± 2.8) mm Hg respectively).It had significant differences(P =0.016).In the group with fenestration and without fenestration,postoperative oxygen saturation((90.3 ±4.0)％,(91.7 ±5.2)％),postoperative thrombosis (11.3％ (8/71),12.5％ (3/24)),and postoperative neurological problems (18.3％ (13/71),20.8％ (5/24)) did not differ between cohorts.Conclusion It is effective and safe to treat congenital heart disease single ventricle with EC.EC with fenestration can improve acute postoperative mortality by rising cardiac output,thereby can reduce early postoperative mortality.

Objective To investigate the clinical effects of surgical small incision treatment of patent ductus arteriosus (PDA) in premature infants with titanium clip.Methods One hundred children received and cured by our hospital from January 2010 to January 2013 were divided into two groups.Group A:body weight ＞ 1.5 kg of patent ductus arteriosus (PDA),71 cases of premature children; group B:body weight ＜ 1.5 kg of low body weight preterm the children PDA,29 cases.The operations were performed in the newborn intensive care unit (NICU).The patient was placed in a lateral position with the left arm abduction under general anesthesia.A 1.5-2.5 cm long posterolateral mini-thoracotomy was made and the pleural cavity was entered via the 2-3rd intercostal space.The PDA was closed with two titanium clips.Results Ninety-nine cases were cured,1 died.2 residual shunt postoperatively.One patient on postoperative 5 day was found wound infected,wound healing after the use of antibiotics by intravenous.There was no significant difference in incidence of postoperative complications and mortality rate between group A and group B (P ＞ 0.05).Majority of children successfully weaned from the ventilator due to the rapid improvement of hemodynamics and lung conditions.In group B,mechanical ventilation time (12.6 ± 7.5) d and postoperative hospital stay (21.0 ± 15.4) d was significantly longer than group A ((9.6 ± 4.2) d and (12.0 ± 10.8) d),the difference between the two groups was significant (t =7.35,9.12,P ＜ 0.05).Conclusion (1) It is a viable treatment that bedside minimally invasive titanium clip closed ductus arteriosus in preterm children PDA.(2) As the treatment of low body weight premature children is poor,the tolerance of the surgical trauma of the surgery as a minimally invasive,simple method is particularly suitable for low body weight premature children PDA.

Cardiomyopathies ; diagnosis ; pathology ; Humans

Biliary Tract Diseases ; complications ; surgery ; Humans ; Hypertension, Portal ; complications ; etiology ; surgery ; Liver Cirrhosis ; complications ; surgery ; Perioperative Care

Cell Culture Techniques ; Humans ; Myocytes, Cardiac ; cytology ; Stem Cells ; cytology