The kinetic changes of the renin-angiotensin-aldosterone system (RAAS) were studied in 54 cases of epidemic hemorrhagic fever (EHF). It was found that plasma angiotensin Ⅱ (A T-Ⅱ) levels began to increase during the febrile period, reached the peak values during the hypotensive or oliguria period, and then dropped gradually during the polyuria period. However, the plasma angiotensin Ⅰ (AT-Ⅰ) levels decreased markedly lower in patients at the hypotensive or oliguria slage than in those at other stages. The plasma aldosterone (ALD) increased, corresponding to AT-Ⅱ during the hypotensive or oliguria period. The above changes were parallel to the severity of the disease and the quantity of BUN. From the results of our studies, it is concluded that the increased plasma AT-Ⅱ concentration and the activation of RAAS are related to hypovolemia and may be the most important factor of acute renal failure. Therefore, it is critical treatment at the early stage of EHF to maintain the equilibrium of body fluids and to resist the effects of activated RAAS.

The changes of plasma levels of atrial natriuretic factor (ANF) were observed by adioimmunoassay in patients with hemorrhagic fever renal syndrome(HFRS). Plasma ANF concentration was 975.48?120.9 pg/ml in 51 patients and 264.45?31.48 pg/ml in 20 normal subjects(p0.05). The significance of measuring plasma ANF concentration in discussed.

Objective To solve the problem of hospital Bureau class cost accounting system to manage the Branch class cost. Methods The system was optimized by extracting the raw data of localization, collecting income and expenditure account of flexible specialization, and setting subclass accounting ratio ways of rationalization. Results The optimization subsystem has been a fundamental change in cost accounting management and creates more effective. Conclusion According to the special requirement of sanatorium financial process, information system and cost accounting ways, the new system can be optimized in design and implementation method and achieve better effects during the implementation and operation.

TongJi University School of Medicine has performed teaching reforms in the early stage of medical students through curriculum integration of life science,the introduction of PBL,and designing of comprehensive experiments to achieve comprehensive professional competence of medical students.The results showed that the training system is beneficial to the cultivation of students' clinical thinking and early medical professional competence.It has been recognized by both students and faculty.Preliminary practice has proved to be successful.

Thought and consciousness of experimental design were carried in the experimental teaching and the classical physiological experiments were merged. Innovational design and practice were penetrated through the whole experimental class. After consulting literature, designing experi-ments, observing the phenomenon, dealing with the data and summurizing the results, the designers experienced the basic research procedure, got the innovate results, gained the chance to further study and improved the innovative capability.

Objective:To explore the learning curve of central pancreatectomy (CP) and provide an excellent reference for surgeons to get the point of this operation.Methods:Clinical data of 73 patients who underwent CP in the same operation team from January 2006 to January 2018 were collected and retrospectively analyzed by the moving average method (MAM) and the cumulative sum method (CUSUM). Data was analyzed by statistical package for social science (SPSS) software.Results:According to the MAM and CUSUM curves, the learning process of CP could be divided into two stages. At the first stage ( n=1-11), the median operation time was 340 minutes and the median intraoperative hemorrhage was 400 ml. In the second stage ( n=12-73), the median operation time was 213 minutes and the median intraoperative hemorrhage was 100 ml. The difference was statistically significant ( P<0.001). There were no significant differences between the two stages of patients in terms of other aspects ( P>0.05). Conclusions:CP can be mastered after 11 cases of exercises. In the first 11 operations, surgeons should get familiar with the operation process, respond actively to emergencies and accumulate experience to gain this surgical technique fast.

Objective:To explore the learning curve of central pancreatectomy (CP) and provide an excellent reference for surgeons to get the point of this operation.Methods:Clinical data of 73 patients who underwent CP in the same operation team from January 2006 to January 2018 were collected and retrospectively analyzed by the moving average method (MAM) and the cumulative sum method (CUSUM). Data was analyzed by statistical package for social science (SPSS) software.Results:According to the MAM and CUSUM curves, the learning process of CP could be divided into two stages. At the first stage ( n=1-11), the median operation time was 340 minutes and the median intraoperative hemorrhage was 400 ml. In the second stage ( n=12-73), the median operation time was 213 minutes and the median intraoperative hemorrhage was 100 ml. The difference was statistically significant ( P<0.001). There were no significant differences between the two stages of patients in terms of other aspects ( P>0.05). Conclusions:CP can be mastered after 11 cases of exercises. In the first 11 operations, surgeons should get familiar with the operation process, respond actively to emergencies and accumulate experience to gain this surgical technique fast.