objectives To provide the reference for the Research & Development departments of hospitals by analyzing the quantity of publications and their cited status for the top 20 hospitals in SCl and MEDLINE.and top 100 hospitals in domestic publications in 2006.Methotis The number of publications and their cited times for the first 20 hospitals in SCI and MEDLINE.and the top 100 hospitals in domestic publications in 2006 were analyzed with bibliometric analysis.Results In 2006.the average increased ratio of publications in SCI for top 20 hospitals was 47.58%.but the number of articles in MEDUNE WaS decreased.For top 100 hospitals.the increased number of domestic publications was 71.25,the number of cited publications WaS increased 160.14.Conclusions The SCI publications from top 20 hospitals increased sharply,but publicatiOils indexed by MEDLINE decreased respectively.

Objective To observe the effect of functional exercise guided by self muscle strength in early rehabilitation on patients after total knee arthroplasty (TKA). Methods From September, 2014 to September, 2015, 62 patients after TKA were randomly divided into ex-perimental group (n=31) and control group (n=31). The control group received conventional rehabilitation training, while the experimental group received rehabilitation training under the guidance of their own muscle strength standard. The degrees of swelling and pain seven days after TKA; the muscle strength seven and 15 days after TKA; the range of motion (ROM), the Keen Society Score (KSS) 15 days after TKA;and the postoperative hospital stay were compared. Results There was no significant difference in all the indexes above between two groups before TKA (t<0.960, P>0.05), and all of them improved after TKA (t>3.470, P<0.01). There was no significant difference in the de-grees of swelling (t=1.800, P=0.077) and pain (t=0.840, P=0.404) seven days after TKA. The score of quadriceps strength was higher in the experiment group than in the control group (t>2.280, P<0.05) seven and 15 days after TKA. There was no significant difference in the ROM of the knee and the score of knee between two groups (t>0.850, P>0.05), and the functional score was higher in the experiment group than in the control group (t=5.870, P<0.001) 15 days after TKA. The postoperative hospital stay was shorter in the experiment group (t=7.65, P<0.01). Conclusion Functional exercise under the guidance of their own muscle strength standard could contribute to the improvement of postoperative muscle strength and knee joint function, and shorten the hospitalization stay.

Conflicts may occur between patients' independent decision right,family members' interference right,and medical interference right.This article clarifies the applicable premise of medical interference right and explores its realistic predicaments from the ethical and legal perspectives.Reasonable system construction is a good solution to medical disputes,promoting a harmonious development of physician-patient relationship.

Objective To summarize the nursing experience in prehospital first-aid of patients with cardiac traumas in order to improve the cooperation capability of prehospital first-aid. Methods The nursing cooperation of prehospital first-aid of 33 patients with cardiac trauma was analyzed retrospec-tively. Results 24 cases of them were rescued successfully, and were completely recovered without se-quelas. 4 cases complicated with severe multiple trauma, died after arriving at hospital, and 3 cases com-plicated with multiple trauma died of complications, while 2 cases with injury of thoracic aorta died during the surgery. Conclusions Early emergency treatment and judgment of traumatic condition could pro-vide valuable chance for inhospital first-aid.

ObjectiveTo study the mastery, acquiring ways and need of studying the knowl-edge and skill of emergency treatment in non- medical junior college and technical secondary school students. MethodsThe survey was carried out in 600 non-medical junior college and technical sec-ondary school students to investigate their mastery and need of emergency knowledge, the results underwent analysis. ResultsThe mastery of the emergency knowledge was uneven in non- medical junior college and technical secondary school students. 100.0% of them can call 120 correcdy, 58.5% of them mastered the e-mergency treatment of carbon monoxide poisoning, and 25.0% mastered cardiac pulmonary resuscitation. All the students desired to hold the knowledge and skill of emergency treatment. Television, broadcast and internet were the main ways for them to master emergency knowledge. ConclusionsThe mastery of the knowledge and skill of emergency treatment is not good. It is urgent to educate and train them with the knowledge and skill of emergency treatment, and to improve knowledge and skill of emergency treatment.

BACKGROUND:Osteonecrosis of the femoral head (ONFH) results from an interruption of the blood supply to the femoral head or injury-caused death of chondrocytes and bone marrow components. Many osteogenesis-related factors, such as Runt-related transcription factor 2 (Runx2), bone morphogenetic protein (BMP), osteoprotegerin and osteocalcin, are involved in the subsequent repair process. The Runx2 gene has been shown to control osteoblast differentiation and formation by upregulating the transcription of various mineralization-related protein genes, alowing osteoblast precursors differentiation into osteoblasts, and playing a key role in bone repair.
METHODS/DESIGN:This retrospective, single-center, non-randomized, paralel-controled trial was performed at Shengjing Hospital of China Medical University, China. Fifteen patients with ONFH and 15 patients with osteoarthritis undergoing total hip replacement were included. Primary measure was Runx2messenger RNA (mRNA) expression in femoral head and neck tissue, and secondary measures included BMP-2, BMP-7 and osteoprotegerin mRNA expression, as wel as osteocalcin immunoreactivity. This trial was registered at ClinicalTrials.gov (identifier: NCT02735538) and acquired written approval from the Ethics Committee of Shengjing Hospital of China Medical University (approval No. 2016PS222K). Written informed consent was obtained from each included patient.
DISCUSSION:This study involved in the detection of mRNA expression of several bone repair-related genes, including Runx2, in the femoral head and neck of patients with ONFH was performed between 2010 and 2011. This observational study wil help clarify the role and possible clinical significance of Runx2 in femoral head necrosis, bone repair and reconstruction.

The purpose of this study is to explore the clinical application of an improved operating astral lamp. Most operating astral lamps now used in hospitals are not equipped with protective equipment for sudden power cut. Once the power cut occurs, the operation will be influenced and a medical dispute between patients and medical staffs can not be avoided.

OBJECTIVE: To investigate the preservation of the structure and function of the trachea and larynx, the management of laryngotracheal defect when trachea and larynx was involved. METHOD: To review the management and clinical results of 13 cases of thyroid papillary carcinoma with larynx and trachea involvement, the preservation of laryngotracheal structure and relative defect reconstruction of our department from 2007-2014. Those patients being performed total laryngectomy was excluded. 3 males and 10 females, aged from 46 to 67 years old with median age of 53 were included. Among them 8 cases were recurrent. The extent of the tumor foci was estimated with the help of computed tomography and laryngofiberoscope before surgery. Selective neck dissection, total thyroidectomy and related laryngotracheal resection was performed for the first time operation patient, while selective neck dissection, recurrent foci and related larynx and trachea resection was performed for those recurrent patients. Three kinds of modalities were applied to manage the laryngotracheal defect including to reconstruct with pedicled sternocleidomastoid clavicular periosteocutaneous flap, pedicled trapizius muscular flap and to preserve the remaining larynx and trachea and perform a stoma of larynx and trachea which repaired by a second-stage procedure. The patients were followed-up from half an year to 3 years. RESULT: Ten patients out of 13 decannulated while another 3 cases, 2 of which were performed local flap to reduce the stoma, wore tracheal tubes all time. CONCLUSION Either flap transfer or laryngotracheal stoma before second stage repair might preserve partial laryngotacheal anatomy and function in selected cases thus improve the life quality of the patients.
Aged ; Carcinoma ; surgery ; Carcinoma, Papillary ; surgery ; Female ; Humans ; Laryngectomy ; Larynx ; surgery ; Male ; Middle Aged ; Neck Dissection ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; Trachea ; surgery

BACKGROUND: At present, there has been no definite experiment systemically evaluating adherent separation and density gradient centrifugation to isolate bone marrow mesenchymal stem cells (BMSCs). Whether the two methods produce different influences on BMSC induction and differentiation remains unclear.OBJECTIVE: This study was designed to verify difference of these two isolation methods in chondrogenic differentiation of BMSCs.DESIGN, TIME AND SETTING: A controlled observation was performed at the Shengjing Hospital Affiliated to China Medical University from March to September 2005. MATERIALS: Twenty Japanese big-ear rabbits, aged 2-3 months, weighing 1.2-2.0 kg, were included for this study. METHODS: BMSCs were isolated by adherent separation and density gradient centrifugation. Two groups of BMSCs were taken from the same passage and induced towards chondrogenic differentiation with transforming growth factor beta 1. MAIN OUTCOME MEASURES: Growth of BMSCs was observed under an inverted microscope to draw growth curves; Type II collagen expression was detected by immunohistochemistry. Type II collagen mRNA expression was determined by in situ hybridization. RESULTS: The growth curves demonstrated that cellular growth velocity of the two groups tended to be the same. Immunohistochemistry results showed that the efficiency of adherent separation and density gradient centrifugation for promoting chondrogenic differentiation of BMSCs was 76.1% and 77.7%, respectively, and in situ hybridization results showed that the efficiency was 70.3% and 71.0%, respectively. No significant difference in differentiation efficiency existed between the adherent separation and the density gradient centrifugation. CONCLUSION: Adherent separation and density gradient centrifugation had no different influences on BMSC growth and chondrogenic differentiation.

Objective To reflect the spatial distribution of brucellosis among 7 counties in Qinghai Province from 2011 to 2013 with Geographic Information System (GIS) map.Method Epidemiological situations were overlay analyzed in infectious rate and prevalence rate with QHEndemic-GIS and SPSS 17.0 by statistics and mapping.Results Brucellosis was detected in 7 counties through the spatial distribution map.The infectious rate and prevalence rate of brucellosis were showing a phenomenon of high and low alternation in 3 years;meanwhile the prevalence in Gonghe County showed an obviously upward trend with the rates of 0.50％ (1/201),1.50％ (3/200),and 3.73％ (9/241),respectively.Conclusions GIS could reflect the state of brucellosis infection directly and correctly.Prevalence of brucellosis in the 7 counties has showed a sporadic phenomenon,and the prevalence of brucellosis has covered a wide region and many populations are at risk of this disease.The prevalence has showed an up-ward trend in these regions,which provides a scientific basis for prevention and control of brucellosis in these key regions.