Objective To evaluate the effect of desflurane on blood flow velocity in the middle cerebral artery (VmMCA) and cerebrospinal fluid pressure (CSFP).Methods Sixty patients were randomly assigned to two groups. In group A,the anesthesia was maintained with desflurane, and in group B, with isoflurane. In either group, patients were allocated to three subgroups according to different doses(05,08,1.1MAC). CSFP was measured through a lumbar subarachnoid catheter before surgical procedures,from induction to administration of the inhalational agent for 45min.VmMCA was measured by transcranial Doppler at baseline , postintubation and administration of agent for 45min. Results As compared with baseline,CSFP increased gradually and reached to 16.90?4.01mmHg in subgroup 1.1MAC of group A (P0.05). Compared with baseline, VmMCA increased significantly at 45th min following administration of agent in subgroup 11MAC of group A(P005). In group A , a significant parallel correlation existed between the MAC levels and the values of VmMCA or CSFP (r=0.52,P

Scientific research to a great extent,represents the comprehensive strength of a unit,directly determine the development prospects of this unit.At present,our country many medical institutions of scientific research strength is low,potential is insufficient,can't meet the development of medical institutions.This study from the aspects of management performance,to evaluate scientific research ability from various perspectives,statistical analysis of its influencing factors at the same time,Reflects the technical level of this unit,discipline construction,scientific research and development and performance,produced by scientific management for the unit provides an objective basis for scientific research management departments to formulate relevant policies to explore to improve the new management starting point,thus achieve the goal of science and technology.

Objective To systematically review findings on the effectiveness and safety of transcranial magnetic stimulation (TMS) for treating Parkinson's disease. Methods Foreign and Chinese databases were searched to find relevant trials. The searches were supplemented by searching the reference lists of the published trials. The studies were separated into two groups: those applying TMS at frequencies higher than 1 Hz, and those at 1 Hz or lower. Meta-analysis was performed with the aid of RevMan 5.0 software. Results Both low-frequency and highfrequency TMS can significantly reduce total scores on the Unified Parkinson's Disease Rating Scale (UPDRS) compared with sham stimulations. High-frequency TMS can significantly reduce UPDRS motor scores compared with sham stimulations. On the other hand, low-frequency TMS studies showed no significant overall improvement in motor scores, mental scores or in the activities of daily living (ADL) UPDRS scores. Low-frequency and high-frequency TMS studies also showed no significant overall improvement in Schwab and England ADL scores. Conclusions TMS therapy is safe and partially effective for treating Parkinson's disease.

Objective To understand the relationship between the requirement and the consumption of the health management, and provide the theoretical basis for the developing of China health management. Methods It took the survey to understand the relationship among 152 medical staffs from the six counties surrounding with Shi Jiazhuang downtown. Results 85.5%of medical staffs always and almost accept health advisory and provide health guidance. There are not the direct relationship between the requirement and the consumption(x2 = 9.39,P＞0.05 ). Health advice and guidance are not translated into the concepts of investment on the health management and disease prevention (x2 = 1.69, P＞0.05 ). The medical staffs don't realize it is important to invest on the health. Conclusions Related industries should strengthen the training on the health management, publicize this profession, promote the development of health management services and improve the national health quality.[ Key words] Health promotion ; Needs assessment; Economics

Objective To evaluate the effect of cesarean section (CS) and vaginal delivery (VD) on postpartum stress urinary incontinence (SUI) and pelvic floor muscles strength and to find out the correlated obstetric factors and preventions for postpartum SUI. Methods Totally, 788 women, who visited the antenatal clinics, delivered and had the follow-up at 6-8 weeks after delivery in Beijing Obstetrics and Gynecology Hospital in the year of 2008, were enrolled in this study and were divided into 3 groups: CS group (n=212); normal vaginal delivery (NVD) group (n=534) and forceps delivery (FD) group(n=42). Women in the NVD and FD group were merged into one VD group and then divided into SUI and non-SUI group. Information of delivery mode and the correlated obstetric factors were obtained through questionnaires and medical records. Femiscan pelvic floor muscle examine system was applied to measure the pelvic floor muscle strength to understand the relationship between postpartum SUI and pelvic floor muscle strength. Results (1) Incidence of SUI: The overall proportion of women who complained of urinary incontinence (UI) during pregnancy was 15.4% (121/788), and it was 15.9% (85/534), 11.9%(5/ 42) and 14.6% (31/212) in the NVD, FD and CS group, respectively(P>0.05). The overall incidence of postpartum SUI was 17. 1% (135/788), and it was 19.1% (102/534), 26.2% (11/42) and 10.4% (22/212) in the NVD, FD and CS group, respectively, with significant difference between the NVD and FD group, and between the CS and NVD group (all P < 0.01). (2) The associated obstetric factors of postpartum SUI: Among the VD group, 113 women were in the postpartum SUI group and 463 in the non-SUI group. Univariate analysis and logistic multivariate analysis showed that delivery mode, neonatal birth weight and UI during pregnancy were risk factors of postpartum SUI. CS decreased and higher neonatal birth weight and UI during pregnancy increased the risk of postpartum SUI. In the VD group, neonatal birth weight, forceps delivery and UI during pregnancy increased the incidence of postpartum SUI(P<0.01), but no correlation was found with labor analgesia, duration of labor, episiotomy, breast feeding, volume of postpartum bleeding, gestational weeks at delivery, induction and pre-pregnant BMI, etc (all P>0.05).(3) Pelvic floor electromyogram: Pelvic floor muscles strength in the CS group was significantly higher than that of the VD group [activity value: (19. 7±9.9) μv vs (14. 8±8.4) μv; work value: (84. 5±37.2) μv vs (78. 8±28.2) μv; peak value: (25.5±12. 5) μv vs (19. 7±11.8) μv, all P<0.01]. Among women in the VD group, the relaxation value and the ratio of relaxation value over activity value (r/a) in the postpartum SUI group were significantly lower than those in the non-SUI group [relaxation value: (1.7±1.8) μv vs (3.0±3.9) μv; r/a ratio: 0. 2±0. 2 vs 0. 3±0. 5, all P <0.01]. The r/a ratio in the VD group showed no difference compared to that in the CS group (0. 2±3.5 vs 0. 2±0. 2, P>0.05).Conclusion Women experienced vaginal delivery, either NVD or FD, have a higher incidence of postpartum SUI than those delivered through CS. UI during pregnancy, forceps delivery and neonatal birth weight are risk factors of postpartum SUI.

With the advent of the knowledge economy,hospital management of scientific research work is facing new challenges.At present,administrators in charge of scientific research in most primary hospitals of China do not have the systematic training on knowledge and skills involving research management.Thus,training a master business and familiar with the operation of modern hospital science and technology management of high-quality management personnel is urgent needed.As long as Do a good job on training of the management personnel of scientific research in the primary hospital,can enrich the scientific research management team,do good on the management work of sci ence and technology in the hospital,hospital work to be continuous development of science and technology and enhance.

OBJECTIVE: To detect the expression of differential expression genes(DEGs) on microarray chips of macrophages exposed to nano-silicon dioxide(SiO_2) dust, and to screen the leading signaling pathway of nano-SiO_2 dust exposure-related diseases. METHODS: The gene chip GSE13005 of RAW264.7 macrophage intervened by nano-SiO_2 dust was obtained from the public gene chip database developed by the National Center for Biotechnology Information. The macrophages in the control group were cultured in complete medium without adding SiO_2 dust, whereas the macrophages in the exposure group were treated with SiO_2 dust with the final concentrations of 5, 20, and 50 mg/L. The gene expression data of macrophages was analyzed by RMA Express 1.2.0 software and R language 3.5.1. The Kyoto Encyclopedia of Genes and Genomes(KEGG) was used to screen DEGs and perform gene ontology(GO) enrichment analysis on related genes and signaling pathways. RESULTS: A total of 67 DEGs of macrophages were screened after SiO_2 dust treatment, of which 48 genes were up-regulated and 19 genes were down-regulated. GO enrichment analysis results showed that the main functional items of participating DEGs were reaction of amine, regulation of viral genome replication,negative regulation of amino acid transport, ovulation, bronchodilator response, chemokine activity, negative regulation of muscle cell differentiation, response to lack of amino acid, positive regulation of glomerular mesangial cell proliferation, and positive regulation of vascular smooth muscle cell proliferation. KEGG signaling pathway analysis results suggested that DEGs could function through 7 signaling pathways including nuclear transcription factor-κB(NF-κB) signaling pathway, p53 signaling pathway, glioma, melanoma, toll-like receptor signaling pathway, renal cell carcinoma and salmonella infection. Further functional enrichment revealed that NF-κB signaling pathway changed most significantly after macrophages were exposed to nano-SiO_2 dust. CONCLUSION: Exposure to nano-SiO_2 could induce the abnormal expression of 67 genes in macrophages. The genes that participated in macrophage activation process induced by nano-SiO_2 dust exposure are related to NF kappa B signaling pathway.

A total of 115 patients with type 2 diabetes recruited from Quanzijie Township Health Service Center were divided into integrated management group (n=54) and specialist management group (n=61). Patients in integrated management group were managed by specialists, general practitioners (GPs) and community nurses jointly; while patients in specialist management group were managed by specialists only. Subjects were followed up every 4 weeks for 24 weeks. Total 366 person/time diabetes education courses were given to subjects in integrated management group during the intervention. After intervention, the fasting glucose, 2 h postprandial glucose and glycosylated hemoglobin were decreased significantly in both groups (P<0.05), while the triglyceride level in the integrated management group was significantly lower than that in the specialist management group (P<0.05). In conclusion, patients with type 2 diabetes managed by integrated mode can achieve similar glucose control effect as specialist management mode in primary care settings and their triglyceride level can be also significantly decreased.

Objective: To explore the effect of "diabetes specialists-community general practitioners-community nurse co-management mode" and "diabetes specialist management mode" on diabetic nephropathy (DN) in primary medical institutions. Methods: Patients with type 2 diabetes admitted to Quanzijie Health Clinic of Jimusar County of Xinjiang Uygur Autonomous Region from October 2017 to March 2018 were enrolled. The Patients were divided into co-management group or specialist management group according to their administrative villages. The treatment plans of the two groups were formulated with reference to the current guidelines. The subjects of the co-management group were jointly managed by a fixed team composed of diabetes specialists from Jimusar Traditional Chinese Medicine Hospital, community general practitioners and community nurses from Quanzijie Health Clinic, and required to attend diabetes education courses every month. The diabetes specialist of Jimusar Traditional Chinese Medicine Hospital was responsible for the formulation and management of the treatment plan of the research object. Follow-up was fulfilled once every 4 weeks for 24 weeks in two groups. Before and after intervention, blood glucose, blood pressure, urinary albumin/creatinine ratio (UACR), estimated glomerular filtration rate (eGFR) as well as the utilization rate of angiotensin converting enzyme inhibitors/angiotensin Ⅱ receptor blocker (ACEI/ARB) were collected. Results: A total of 115 patients accomplished this study with 54 patients in co-management group and 61 patients in specialist management group. After 24 weeks of intervention, fasting glucose level, postprandial glucose level 2 hours after breakfast, glycosylated hemoglobin (HbA1c), Log UACR in co-management group and specialists management group were significantly decreased compared with baseline [fasting glucose level (mmol/L): 8.06±1.92 vs. 9.16±2.83, 8.21±2.10 vs. 9.06±1.89; postprandial glucose level 2 hours after breakfast (mmol/L): 12.26±3.78 vs. 14.11±5.28, 12.47±3.63 vs. 14.00±3.88; HbA1c: 0.074±0.014 vs. 0.082±0.023, 0.076±0.014 vs. 0.081±0.016; Log UACR (mg/g): 1.63±1.56 vs. 2.25±1.44, 1.84±1.65 vs. 2.43±1.56, all P < 0.05], but there was no statistical significance between the two groups [fasting glucose level (mmol/L): -1.10±0.47 vs. -0.85±0.36, postprandial glucose level 2 hours after breakfast (mmol/L): -1.85±0.88 vs. -1.53±0.68, HbA1c: -0.008±0.004 vs. -0.006±0.003, Log UACR (mg/g): -0.61±0.29 vs. -0.59±0.29, all P < 0.05]. There were no significant changes in blood pressure, serum creatinine and eGFR in the two groups before and after intervention. There were 18 and 24 patients with hypertension in co-management group and specialist management group, respectively. The utilization rates of ACEI/ARB in both groups after intervention were significantly higher than those before intervention [88.9% (16/18) vs. 22.2% (4/18), 95.8% (23/24) vs. 29.2% (7/24), both P < 0.01]. At the end of the study, the utilization rate of ACEI/ARB was similar between the two groups [88.9% (16/18) vs. 95.8% (23/24), P > 0.05]. Conclusion Both "diabetes specialists-community general practitioners-community nurse co-management mode" and "diabetes specialist management mode" can effectively decrease glucose levels and UACR levels of patients with type 2 diabetes as well as the standard use of antihypertensive agents, which has positive effects on the prevention and treatment on DN.

【Objective】 To objectively evaluate the quality control level of blood testing process in blood banks through quantitative monitoring and trend analysis, and to promote the homogenization level and standardized management of blood testing laboratories in blood banks. 【Methods】 A quality monitoring indicator system covering the whole process of blood collection and supply, including blood donation service, blood component preparation, blood testing, blood supply and quality control was established. The questionnaire Quality Monitoring Indicators for Blood Collection and Supply Process with clear definition of indicators and calculation formulas was distributed to 17 blood banks in Shandong province. Quality monitoring indicators of each blood bank from January to December 2022 were collected, and 31 indicators in terms of blood testing were analyzed using SPSS25.0 software. 【Results】 The proportion of unqualified serological tests in 17 blood bank laboratories was 55.84% for ALT, 13.63% for HBsAg, 5.08% for anti HCV, 5.62% for anti HIV, 18.18% for anti TP, and 1.65% for other factors (mainly sample quality). The detection unqualified rate and median were (1.23±0.57)% and 1.11%, respectively. The ALT unqualified rate and median were (0.74±0.53)% and 0.60%, respectively. The detection unqualified rate was positively correlated with ALT unqualified rate (r=0.974, P<0.05). The unqualified rate of HBsAg, anti HCV, anti HIV and anti TP was (0.15±0.09)%, (0.05±0.04)%, (0.06±0.03)% and (0.20±0.05)% respectively. The average unqualified rate, average hemolysis rate, average insufficient volume rate and the abnormal hematocrit rate of samples in 17 blood bank laboratories was 0.21‰, 0.08‰, 0.01‰ and 0.02‰ respectively. There were differences in the retest concordance rates of four HBsAg, anti HCV and anti HIV reagents, and three anti TP reagents among 17 blood bank laboratories (P<0.05). The usage rate of ELISA reagents was (114.56±3.30)%, the outage rate of ELISA was (10.23±7.05) ‰, and the out of range rate of ELISA was (0.90±1.17) ‰. There was no correlation between the out of range rate, outrage rate and usage rate (all P>0.05), while the outrage rate was positively correlated with the usage rate (r=0.592, P<0.05). A total of 443 HBV DNA positive samples were detected in all blood banks, with an unqualified rate of 3.78/10 000; 15 HCV RNA positive samples were detected, with an unqualified rate of 0.13/10 000; 5 HIV RNA positive samples were detected, with an unqualified rate of 0.04/10 000. The unqualified rate of NAT was (0.72±0.04)‰, the single NAT reaction rate [(0.39±0.02)‰] was positively correlated with the single HBV DNA reaction rate [ (0.36±0.02) ‰] (r=0.886, P<0.05). There was a difference in the discriminated reactive rate by individual NAT among three blood bank laboratories (C, F, H) (P<0.05). The median resolution rate of 17 blood station laboratories by minipool test was 36.36%, the median rate of invalid batch of NAT was 0.67%, and the median rate of invalid result of NAT was 0.07‰. The consistency rate of ELISA dual reagent detection results was (99.63±0.24)%, and the median length of equipment failure was 14 days. The error rate of blood type testing in blood collection department was 0.14‰. 【Conclusion】 The quality monitoring indicator system for blood testing process in Shandong can monitor potential risks before, during and after the experiment, and has good applicability, feasibility, and effectiveness, and can facilitate the continuous improvement of laboratory quality control level. The application of blood testing quality monitoring indicators will promote the homogenization and standardization of blood quality management in Shandong, and lay the foundation for future comprehensive evaluations of blood banks.