Hospital cultural construction cant be conducted without the participation of medical staff and shouhl be.assigned with rich ethical connotation.Whether hospital administrators can mobilize the subjective activity of medical staff or not in the hospital cuhural construction is a crucial factor in determining the coustruction outcome. Therefore,the hospital administrators should recognize the staff as masters of the hospital,respect the staff's human dignity,apply specific impulsing mechanisms to meet the staff's need based on concrete conditions,and build proper platforms for medical staff to maximize their potential and talents in order to mobilize their subjective activity in the hospital cultural construction.

In this investigation measurements of 5 items were taken on 100 skulls (200 temporal bones) kept in stock. The data obtained are as follows: (1) The sphenoidal angle is 117.6?. (2) The inclination of the long diameter of the isthmic part of meatus is 23.26?(3) The gradient of the posterior bony wall is 110.72?. (4) The visibility of the labyrinthine windows are classified into four types: in type 1, both windows are completely visible, 1.5%; in type II, partially invisible, 30.5%; in type III mostly invisible 61.5%; and in type IV, completely invisible, 6.5%. (5) The depth of the posterior tympanum: upper border of the oval window (external) is 3.37mm; lower border of the oval window (external) is 2.47mm and (internal) 2.38mm; upper border of the round window (external) is 2.07mm and (internal) is 3.07mm. From the above mentioned findings, the following conclusions could be drawn: The labyrinthine windows are not related to the inclination of the long diameter of meatus, but is closely related to the sphenoidal angle and the gradient of the posterior bony wall of the meatus, i. e. the greater the sphenoidal angle and the gradient of the posterior bony wall of the meatus, the poorer the visibility of the labyrinthine windows and the deeper the depth of the posterior tympanum except the depth of the lower border of the oval window. So it is considered that more attention should be paid to the gradient of the posterior bony wall when the posterior tympanotomy and transmeatal facial nerve decompression are being performed, and a large gradient is preferable.

A successful surgical treatment of two cases of hypopharyngeal stenosis and esophageal obliteration caused by alkaline chemical burns is reported.One patient has recovered respiring,swallowing and speaking functions,and the other also recovered all of these functions except the retained tracheal tube.During the modified jejuno-pharyngostomy,the pharyngojejunal anastomotic stoma was expanded to form a piriform fossa without bottom.Besides,the anastomotic stoma was lowered to the level of laryngeal vestibule so as to prevent food from leaking into the trachea.In the course of clinical observation,we found that different signs existed in different patients who took the corrosive.In the accidental cases,esophageal obliteration often appeared,but in the cases of committing suicide,the obliteration was usually accompanied with hypopharyngeal stenosis,which is very difficult to treat.So the authors emphasize that dilatation and dissection should be undertaken in early stage to prevent the occurrence of hypopharyngeal stenosis.

Fifty-nine patients (62 cases ) with chronic antritis were operated by Caldwell-Luc's operation with middle meatal antrostomy and followed up for 0.5 ~5 years. It was found that curative effect of the oper ation was quite well. Eghty patients treated with Caldwell-Lucs operation were followed up as control at the same time. Caldwell-Luc's operation with middle meatal antrostomy was found safe, easy to operate and not injurious to agger nasi, as well as partially recoverable to sinus function.

Objective To explore the organic and biological contamination in water body of Jin River of Tianjin. Methods Three sections were set up in the upper reaches, middle reaches and lower reaches of Jin River respectively. 6 sampling points were set up in each section of the river. The levels of BOD_5~(20), total count of bacteria, fecal coliform count of the river water were determined. The obtained data were assessed based on GB3838-2002 the National Criterion for Environmental Quality of Surface Water. Results The levels of BOD_5~(20) of river water samples collected from each section of Jin River exceeded the standard ruled by GB3838-2002 Grade V. The levels of fecal coliform count of water samples were between the national standards of Grade Ⅲ and Ⅴ of GB3838-2002. The water samples collected from different sections of Jin River water showed no significant differences in the levels of BOD_5~(20) and fecal coliform count, and significant difference in total count of bacteria. Significantly higher levels of total count of bacteria were observed in water samples collected from upper reaches of Jin River compared with those collected from lower reaches (P

Objective To explore the expression of Excision repair cross -completion 1 in non-small cell lung cancer and to analyze its clinical significance .Methods ERCC1 protein expression was detected by IHC method in 160 cases of non-small cell lung cancer tissue .We analyzed relationship between the ERCC 1 ex-pression and clinicopathological parameters of non -small cell lung cancer ,as well as its correlation between ER-CC1 expression and the prognosis .At the same time ,160 cases of intraoperative specimens were primarily cul-tured.The relationship between ERCC1 expression and the drug sensitivity of DDP was analyzed .Results ER-CC1 protein was mainly expressed in the nucleus .ERCC1 protein expression in lung cancer tissue showed no rela-tionship with age,gender,tumor size and pathological types .ERCC1 protein expression was associated with TNM stages and lymph node metastases .High expression of ERCC1was significantly correlated with poor prognosis in pa-tients,indicating that ERCC1 is the independent factor of NSCLC patients .MTT results showed that the positive ex-pression rate of ERCC1 in DDP sensitive groups was higher than in DDP resistant groups .Conclusion ERCC1 is an independent factor influencing the prognosis of non -small cell lung cancer ,and associated with DDP resistance .

A retrospective study of endocrine dysfunction in 65 patients with Rathke's cleft cyst (RCC) was conducted. Before surgical operation, most patients with RCC had various degrees of pituitary dysfunction.Impaired gonadotropin secretion and prolactinemia were the prevalent abnormalities. Erectile dysfunction or diminished libido in male and menstrual disorder or galactorrhea in female were frequently seen. The panhypopituitarism appeared in a few patients with RCC. The patients would benefit by surgical removal, however,attention should be paid to avoid new damage of the pituitary gland during operation.

Objective To evaluate the effect of a nurse-led case management intervention on arm function and uncertainty for women with breast cancer.Methods 90 women with breast cancer were divided into the intervention group and the control group according to their nurses,with 45 patients in each group.All participants were followed six months after surgery.The intervention group attended a 6-month nurse-led case management program,while the control group received the routine care and follow-up only.Questionnaires on arm function and uncertainty were administered 1 month,3 months and 6months after the surgery respectively.Score changes were compared by repeated-measure ANOVA and MANOVA.Results The arm function of the intervention group was better than the control group,except for the 10th day after the operation,there were significant differences at other three time points.The disease uncertainty level of the intervention group was better than that of the control group,except for the dimension of unpredictability,there were evident differences in other dimensions at other three time points.Conclusions The nurse-led case management intervention could improve arm function recovery and decrease the uncertainty to disease of breast cancer survivors.

Objective To explore causes of complications after endovenous laser treatment (EVLT) , for patients with superficial varicosities of the lower extremities. Methods In this study, 207 patients with a total of 268 lower limbs were treated by EVLT combined with surgical procedures. According to CEAP classification, there were C2 in 268 limbs, C3 in 56 limbs, C4 in 101, C5 in 23 and C6 in 18. Simple EVLT was performed for 25 limbs in 21 patients; EVLT combined with external banding valvuloplasty of superficial femoral vein for 23 limbs in 23 patients; EVLT combined with ligation of great saphenous vein (CSV) and denudation of superficial varicosities for 220 limbs in 163 patients. Results An average of 10?5 (3-24) months of follow up was achieved in 175 cases. Early complications (within the first 2-weeks after operation) included bruising or ecchymosis (178 cases, 66.42%) and skin burning (56, 20.90% ). Three month complication included painful induration or trabs (235 cases, 87. 69% ) as well as thrombophlebitis (28, 10. 45% ). Long-term complication (after 3 months) included skin numbness or pain at medial knee or ankle region (15,5. 60% ). Recanalization of CSV occurred in 4( 1. 49% ) treated limbs. Residual or reoccurred varicose veins were found in 13(4. 85% ) cases. Movement related swelling appeared in 6(2. 24% ) lower limbs. Conclusion EVLT is effective for patients with superficial varicosities of the lower extremities. Minor complications most often subsided within 3 months. Strict surgical protocol and high ligation of the GSV could prevent local recurrence of the varicose veins and the recanalization of GSV.

Purpose:To evaluate the significance of duct endoscopy on the early diagnosis of breast cancer with nipple discharge. Methods:From Oct. 1997 to Aug.1999,11 cases of breast cancer were found in 393 patients who underwent duct endocopy for nipple discharge. These 11 cases were followed up, and their endoscopic presentation were reported. Results:The presentation of ductal cancer under duct endoscopy was characterized by irregularity of the duct wall and the lumen, such as patch like elevation and aberrant bleeding. However,the presentation of a ductal neoplasm had no particularity. The diagnostic sensibility and specificity of duct endoscopy on breast cancer was 82%(9/11) and 98.7%, respectively. All patients received sugical biopsy. 5 non palpable breast cancers, who received surgical biopsy were located by ductoscopy and diagnosed as DCIS with/without micro invasion. Conclusions:Through duct endoscopy, breast cancer can be diagnosed early due to the finding of intraductal change on duct wall and lumin. We can also succeed in locating the malignant lesion and carrying out biopsy directly by using duct endoscopy. The highly suspecious lesion found by duct endoscopy should be further confirmed by histological diagnosis.