The amount of the funds supported by National Natural Science Foundation of China (NSFC) played as an important role in judging the capabilities and tendency of scientific research.It is believed that the supporting rate of NSFC is promoted via scientific management policies.To explore the tendency and potential of scientific management plan in the first affiliated hospital of Xi'an Jiaotong University,we analyze the projects supported by NSFC of our hospital from 2002 to 2011.Accordingly,our outcomes show the supporting rates of variable programs from NSFC were similar to the average for whole nation.The inspiring policies encourage our staff to put their passion on the scientific research and funding application.The quality of bidding documents for NSFC is partially improved by the suggestions and lecture of invited experts who took the charge of evaluation of funds from NSFC for actively guide,so as to increase goal average.Of note,a cohort of the researchers at the age below 45 did the main contribution to scientific research developing and programs application from NS-FC.Furthermore,we will pay more attention to reach 3 point following:1.the policy of matching fund to strengthen the competition of the researchers all over the nation.2.the policy of Integrated research resources for the major programs.3.further improvement of projects supervision.

Objective To determine the main predictors of circulatory crisis after replantation in patients with severed distal finger so as to establish the theoretic basis in reducing the morbidity of circulatory crisis. Methods 65 severed distal fingers underwent replantation were respectively reviewed. All the clinical parameters including age, sex, dominant hand or finger, preservation of the severed finger, platelet level, ischemia duration, cause of injury, manner of venous drainage, repair of artery, order of reparation and plane of division were investigated as predictive risk factors for circulatory crisis of finger after replantation. In order to find the risk factors of circulatory crisis, the data was dealt with t test, ?2 test, analysis for variance or multivariate Logistic regression analysis. Results 13 replanted finger suffered from impaired circulation in 65 fingers. Univariate analysis demonstrated that many factors were significantly correlated with the circulatory crisis of finger, such as the manner of venous drainage(?2=6.714,P=0.035), the cause of injury (?2=9.049,P=0.011), the preservation of severed finger(?2=6.452,P=0.040), the age(?2=14.838,P=0.001), the platelet level(uc= 2.961, P=0.003). The multivariate Logistic regression analyses showed that platelet level (OR=1.015, P=0.030), the age(OR=0.349, P=0.031) and the manner of venous drainage(OR=0.278,P=0.036) were the significant independent predictors for circulatory crisis. The incidence of circulatory crisis in patients less than 6 years old was 61.5%, significantly higher than any other age group(P

Objective:To study Clinical Effect of Anterolateral Approach ofor the Patients with Hip Arthroplasty and the effect on the serum CRP,IL-6,D-Dimer in levels.Methods:102 Patients with Hip Arthroplasty who received therapy from February 2013 to January 2015 in our hospital,Patients were asked to be divided into observation group and control group.Among them,the control group of 54 cases,through the conventional approach to hip arthroplasty;48 cases of observation group.Serum CRP,IL-6 and D-dimer levels were compared between the two groups before and after surgery,and the efficacy of the two groups was compared by follow-up.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group (P＜0.05),Serum CRP,IL-6 and D-dimers increased in both groups at 12 h after surgery and decreased gradually at 7 and 14 days.The levels of serum CRP,IL-6 and D-dimer in the observation group were significantly lower than those in the control group at 12 h,7 d and 14d(P＜0.05).Conclusion:The clinical effect of the anterolateral approach on hip arthroplasty is more significant than that of conventional approach,and can effectively reduce the levels of serum CRP,IL-6 and D-dimer,and is more favorable for postoperative recovery.

Objective To explore the role of severity of limb ischemic injury in the treatment of popliteal artery injury.Methods A retrospective analysis was conducted of 259 patients with popliteal artery injury who had been treated from January 2002 to December 2014.They were 187 males and 72 females with a median age of 37.6 years (range,from 14 to 68 years).The time from injury to revascularization was from 4 hours to 29 days.According to the Rutherford classification system,the limb ischemic injury was categorized into 4 grades:grade Ⅰ:presence of sense and motion;grade Ⅱ:presence of sense but loss of active motion;grade m:loss of sense or motion;grade Ⅳ:stiffness.For all the patients with injury of grades Ⅰ and Ⅱ,limb salvage was adopted and opening decompression to osteofascial compartment was performed depending on the intraoperative and postoperative limb swelling.For the patients with grade Ⅲ injury,opening decompression to osteofascial compartment was performed to explore the activity of muscles in those with a strong will to preserve their limbs.When the muscle activity was poor but bright red bleeding was found at the broken muscle ends and there were no fish-like changes in muscles,limb salvage was suggested;otherwise amputation was chosen.For all the patients with grade Ⅳ injury,amputation was suggested.Results Of the 146 cases of limb salvages,142 were successful and 4 failed due to uncontrollable infection,giving a total success rate of 54.83％ (142/259).Complete rupture of the popliteal artery occurred in 23 cases,incomplete rupture or tear in 17,contusion and thrombosis in 219.No patient died due to popliteal artery injury or its complications.The patients with injury of grades Ⅰ,Ⅱ,Ⅲ and Ⅳ were respectively 51,88,67 and 53;their success rates of limb salvage were respectively 100.00％ (51/51),96.59％ (85/88),8.96％ (6/ 67) and 0.For the patients whose time from injury to revascularization was ＜ 6 h,6 h to 12 h,13 h to 24 h,25 h to 1 w,and ＞ 1 w,the success rates of limb salvage were respectively 80.77％ (42/52),54.58％ (73/134),20.51％ (8/39),33.33％ (6/18),and 81.25％ (13/16).The 142 patients whose limbs had been salvaged obtained an average follow-up of 31.4 months (range,from 6 months to 8 years).Of them,those with grade Ⅰ injury obtained normal plantar sensation and active ankle flexion and extension.Of the 85 patients with grade Ⅱ injury,all recovered normal or nearly normal plantar sensation,29 achieved partial recovery of active ankle and digital flexion and extension,but the other 56 obtained no recovery of active ankle motion.Of the 6 patients with grade l injury,none obtained recovery of motion function,4 achieved partial recovery of plantar sensation but the other 2 had no recovery.Conclusion The classification of popliteal artery injury into 4 grades according to its severity of ischemic injury can provide helpful guidance to the treatment and prognosis assessment of the popliteal artery injury.

Objective To investigate the most important risk factors leading to failure of replantation of severed distal fingers so as to provide theoretic foundation for an improvement of survival rate. Methods Medical records of 65 amputated distal fingers underwent replantation were retrospectively studied to determine the independent risk factor for failure by using univariate and multivariate statistical analyses. Results Of 65 fingers treated with replantation, 8 (12%) failed. Univariate analysis showed that the increase of platelet level was the risk factor leading to failure of replantation (P= 0.041) . Manner of venous drainage (? 2=12.483, P=0.002), injury cause (? 2= 7.992, P= 0.018) , reconstruction of arteries (? 2=4.158, P=0.041) and preservation of the severed finger (? 2=6.240, P=0.044) were significantly correlated with the failure of replantation. However, multivariate logistic regression analyses showed that platelet level (OR=1.020, P=0.046) and manner of venous drainage (OR=0.154, P=0.040) were the significant independent predictors for failure of replantation. Six (38%) out of 16 amputated fingers replantation by means of single venous anastomosis resulted in failure. Of 26 amputated fingers treated with single venous drainage by bloodletting of finger tip, one (4%) failed. However, only one finger (4%) failed when 23 amputated fingers were treated with venous reflux by a combination of these two ways. Conclusions High level of platelet and venous reflux through anastomosis are the independent predictors affecting replantation of the severed fingers. Augmentation of anticoagulation as well as venous drainage determined by concrete lesion condition contribute to a higher clinical survival rate of replantation.

Objective To investigate the viral etiology and the epidemilogy of acute upper respiratory tract infection in Hebei Province from 2013 to 2015,providing scientific basis for diagnosis,prevention and control of the respiratory tract infection.Methods l 551 throat swab samples of the acute upper respiratory infection patients from four hospitals in Hebei Province were collected,Multiplex real-time PCR was used to detect 15 kinds of respiratory tract viruses for all specimens after nucleic acids extraction.Results Totally 714 positive samples were obtained from 1 551 samples,with a positive rate of 46.03％.Human rhinovirus(186,11.99％)was detected as the most common viral species,followed by human parainfluenza 3(167,10.77％),respiratory syncytial virus (122,7.87％),adenovirus (108,6.96％),influenza B virus (56,3.61％),human metapneumovirus(40,2.58％),influenza A virus(39,2.51％),human boca virus (38,2.45％),human parainfluenza 1 (35,2.26％),human coronavirus-229E/NL63 (33,2.13％),human enterovirus (32,2.06％),human parainfluenza 4(31,2.00％),human coronavirus-OC43 (30,1.93％),and human parainfluenza 2(11,0.71％).176 cases (11.35％) were detected as co-infection.The infection rate(56.07％) of under 5 years old group was higher than that of other groups.Conclusions The predominant respiratory viruses,who are responsible for acute upper respiratory tract infections in Hebei Province,are HRV,PIV3,RSV,ADV and IFV.Each virus possess the specific epidemiological feature.

Objective According to analyse SCI papers published by hospital faculties during the period of 2010-2015,this paper discussed influential factors and strategies for paper publishing from the perspective of hospital scientific research management,proposed suggestions to administrative department and leaderships for decision making.Methods Taking SCI database developed by Institute for Scientific Information (ISI) as data resource.Literature analysis method was used to analyze the SCI papers during 2010 2015 in terms of publishing amount,subject development,periodical distribution,foundation support,citation analysis,etc.Results The amount of the SCI papers increased sharply each year with a wide spread of extensive subjects which reveals the development of the medical research.However,the average Impact Factor of the paper is still struggling behind that of the top medical institutes.Most papers published in the hospital is supported by National Science Foundation of China (NSFC).Conclusions This paper proposed that the hospital needs to establish a series of policies to strengthen the project management and talent training in the long run,encourage publishing high quality papers to promote the development of disciplines,increasing the investment for constructing research platforms and also making good use of administration for better research.

Objective To study the relationship of interleukin-18 (IL-18)gene-137G/C polymorphisms in the promoter region with cerebral infarction(CI) and the effect of integrin gene polymorphisms on plasma lipid and lipoprotein levels. Methods Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) were used for the detection of integrin genotypes in 190 patients with CI and 210 healthy controls. The plasma lipid and lipoprotein levels were measured by routine method. Results The distributions of IL-18 gene -137G/C polymorphism was significantly different between CI group and control group(P ＜0. 05＝ ,The relative risk suffered from CI of C allele was 1.624 times of the G allele (OR = 1.624,95% CI: 1.134 ～ 2.324), The level of plasma lipid C allele carriers was significantly higher than no carriers(P ＜0.05＝. Conclusion IL-18 gene-137G/C polymorphism was associated with CI, C allele may be genetic susceptibility gene for CI.

Objective To investigate the clinical results of the anterolateral thigh free flaps for the soft tissue coverage of Gustilo grade-Ⅲ B open bone fractures in lower extremities.Methods The anterolateral thigh free flaps were applied to treat 42 Gustilo grade-11Ⅲ B open fractures.Ten flaps were performed through an emergency procedure.Sixteen were performed at early stage and the other 16 were performed at later stage .The results of the therapy were analyzed after long time follow up. Results All limbs were salvaged and all the flaps survived without protracted course to obtain soft tissue coverage.The follow up ranged 11 to 47 months.The healing time of the bones were significant prolonged in the later stage therapy group compared with the emergency therapy group and the early stage therapy group.In the later stage therapy group,the incidences of the bone infection and nonunion were also higher than the other two groups,and the second stage bone transplantation to repair bone defect and nonunion were needed in 76% patients in this group.The lower limb functions of the later stage treated group were worse than those of the other two groups.Compared to the early stage treated group,better lower limb functions could be obtained in the emergency treated group. Conclusion Delayed soft tissue coverage resulted in higher incidence of complications.The immediate soft tissue coverage of severely injured limbs complicated by Gustilo grade-Ⅲ B open fractures and massive soft tissue defects had the advantages over traditional methods.Hard work though it was,one-stage soft tissue coverage using anterolateral thigh free flaps could obtain better lower limb function.

Objective To analyze the outcome of the flow-through anterolateral thigh flap for reconstruction in the Gustilo type Ⅲ C traumatized extremities.Methods From June 2008 to June 2011,sixteen flow-through anterolateral thigh flaps were used for limb salvage.All in this series suffered from Gustilo type Ⅲ C open fractures in upper (4 cases) or lower extremities (12 cases).All patients had the presence of wide segmental soft tissue defects and segmental artery defects with compromised circulation.Four patients received primary operations and 12 patients received debridement combined with vacuum sealing drainage and secondary operations.Results All patients were followed up from 12 months to 40 months (average of 22 months).The mean age was 37.5 years old (from 18 to 62 years).The mean timing of free flap transfer was 6.7 days after injury (from 5 hours to 16 days).The mean artery defect was 12 cm in length (from 6 to 16 cm).All the flaps survived completely with a soft tissue texture.After operation,infection occurred in one patient,venous thrombosis occurred 1 day post-operatively in one patient,local flap necrosis occurred in two patients.No donor site morbidity was noted.In the last follow-up,according to Johner-Wruhs and Berton scores,the overall excellent/good rate for lower and upper extremities were 83.3％ and 75.0％ respectively.Conclusion Flow-through anterolateral thigh flaps provide for reconstruction of both the vessels and soft tissue simultaneously.Because of avoiding sacrificing one of the major vessels,it particularly indicates for only one major artery survival in the extremity.The clinical results show that the above reconstruction technique is useful for upper and lower extremities salvage.