Objective:Correct application of material management system, promote the standardized management of material, and provide accurate data to the full cost accounting and military hospital economic management information system.Methods: Strictly regulate material process, scientific and reasonable use of material management system, pay attention to the accumulation of experience, good at finding problems, ensure the data accuracy; extracted materials information through the full cost accounting and the military hospital economic management information system, classification and summary of various kinds of data needed. Results: Effective monitoring of the flow of material, realize fine management of material, improve work efficiency, for the full cost accounting and the military hospital economic management information platform to provide accurate data.Conclusion: The correct application of material management system, for the material use and management departments to provide convenient and at the same time, also deliver a strong support for financial work.

Objective To investigate the relationship between juxtapapillary duodenal diverticular (JPDD) and choledocholithiasis,and the effects of JPDD on endoscopic sphinctemtomy(EST) in treatment of choledocholithiasis.Methods Fifty-one cases of choledocholithiasis combined with JPDD (choledocholithiasis combined with JPDD group) and 210 cases of choledocholithiasis without JPDD (choledocholithiasis without JPDD group) were treated by EST,and the clinical data of patients in the two groups were retrospectively analyzed.The relationship between JPDD and choledocholithiasis was studied.The JPDD' influence on the intubation success rate of endoscopic retrograde cholangiopancreatography (ERCP),the success rate of the stone removal by EST and complication were analyzed.Results The incidences of choledocholithiasis in patients of JPDD diameter ＜ 1 cm,1-3 cm and ＞ 3 cm were 39.3％(11/28),53.2％ (33/62) and 7/8 respectively.The larger the JPDD diameter,the higher the incidence of choledocholithiasis,and there was statistical difference (P ＜ 0.01).The incidence of choledocholithiasis in peripheral type JPDD was significantly higher than that in parallel type and circumvolution type [81.0％(17/21) vs.41.9％(26/62) and 8/15],and there were statistical differences (P ＜0.05).There was no statistical difference in the intubation success rate of ERCP between the two groups (P ＞ 0.05),but the success rate of the stone removal by EST in choledocholithiasis combined with JPDD group was significantly lower than that in choledocholithiasis without JPDD group [91.8％ (45/49) vs.99.5％ (208/209)].The incidence of EST incision bleeding was significantly higher than that in choledocholithiasis without JPDD group [11.1％ (5/45) vs.1.9％ (4/208)],and there was statistical difference (P ＜ 0.01) ; there were statistical differences in the incidences of others complication between the two groups (P ＞ 0.05).Logistic regression analysis showed that JPDD was independent risk factor for EST incision bleeding (P =0.043).Conclusions JPDD is relative with choledocholithiasis.JPDD makes EST a little more difficult and risky,while EST is still a safe and effective therapy for choledocholithiasis patients combined with JPDD.

Aim To study the effects of ferulic acid (FA) on E-selectin expression in human umbilical vein endothelial cells (HUVECs) activated by lipopolysaccharide and leukocyte-endothelial cell adhesion. Methods The effects of FA on E-selectin and E-selectin mRNA expression were determined by flow cytometry and reverse transcription polymerase chain reaction. The effect of FA on HL60-HUVEC adhesion was evaluated with the method of staining the cells by Rose Bengal. Results The expression of tively). Conclusion FA can inhibit the expression of E-selectin and E-selectin mRNA and HL60-HUVEC adhesion. This may contribute to its protective effect against ischemia-reperfusion injury.

An auxiliary training system was explored for the development of creativity of long-termsystem medical undergraduates through scientific researches in spare time.In practice,professionals from research groups of different disciplines were recruited for developing wide-scope theoretical and technical bases of the undergraduates through training among these research groups followed by focused researches on topics of the running projects of these professionals.The undergraduates were engaged in a serial of research activities,including the discovery of problems for reasoning out scientific research projects,the writing of their project proposals,the summary of their data and the writing of reports,to develop their creativity and their qualification for scientific researches.

Objective To study the postoperative delirium in predicting dementia in elderly patients with femoral neck frac‐ture and provide prevention advises for postoperative delirium .Methods 120 elderly patients with femoral neck fracture were in‐cluded .All patients were tested normal by Clinical Dementia Rating (CDR) preoperative .Basic imformation and postoperative deliri‐um in predicting dementia were recored in detail .After one year of follow up ,all patients were tested by CDR again and divided into dementia group and without dementia group .Results There were 40 patients (33 .3% ) with delirium postoperative with dementia 1 week after operation;there were 16 patients got 0 .5 -3 .0 CDR score after one year follow up (40 .0% ) .There were 80 patients (66 .7% ) did not experience delirium postoperative 1 week after operation ,and 4 patients (5 .0% ) with dementia got CDR score higher than zero after one year folloew up;the difference was statistically significant (P<0 .05) .Single factor analyse showed that there were close correlation between age ,introverted ,level of education < 6 years ,diabetes mellitus ,delirium ,LDL‐C level and de‐mentia (P<0 .05) .Multiple factors showed that age ,diabetes history and delirium were the independent risk factors of dementia in elderly patients with femoral neck fracture (P<0 .05) .ROC curve showed that the AUC area of postoperative delirium in predic‐ting dementia in elderly patients with femoral neck fracture was 0 .878 .Conclusion In elderly patients without the history of de‐mentia ,age ,diabetes history and delirium after hip fracture surgery are the major predictor of dementia within half years .

Objective To determine whether the supplementation of ω-3 polyunsaturated fatty acids in parenteral nutrition (PN) confers treatment benefits to outcomes of septic patients.Methods The databases of MEDLINE,EMBASE,Cochrane central register of controlled trials,the CNKI and the Wanfang biomedicine were searched to identify prospective randomized controlled trials (RCTs) which compared the ω-3 polyunsaturated fatty acids supplemented with the standard PN on outcomes of adult patients with sepsis from January 1996 to June 2013.The methodological quality of the included studies was evaluated,and the Cochrane Collaboration RevMan 5.0 was used for data analysis.Results A total of 12 studies enrolling 721 patients were included.Significant reduction in 28-day mortality [relative risk (RR) 0.77,95％ confidence interval (95％CI) 0.59 to 0.99,P=0.04],short intensive care unit [ICU,weighted mean difference (WMD)=-3.10,95％CI-5.98 to-0.21,P=0.04] and hospital length of stay (WMD =-3.12,95％CI-4.65 to-1.60,P＜0.000 1) were observed in patients receiving ω-3 polyunsaturated fatty acids supplemented PN.There was no differences in days of mechanical ventilation between patients with or without adding ω-3 polyunsaturated fatty acids in PN (WMD =1.33,95％ CI-5.09 to 7.75,P=0.69).Conclusions Meta-analysis results demonstrated that PN supplemented with ω-3 polyunsaturated fatty acids was beneficial in improving the outcomes of patients with sepsis.However,this conclusion must be interpreted with caution due to the low quality of the enrolled trials.

Objective To isolate and identify the pathogenic bacteria from peripheral blood of a patient with septicemia of unknown etiology and to analyze their drug resistance genes.Methods Two peripheral blood samples were collected from the patient after having fever.Several assays including culturing bacteria on blood agar plates by using streaking technique,Gram-staining of bacterial colonies and microscopic observation,VITEK 2-compact automatic bacterium detection and analysis system as well as a sequencing analysis of the 16s rRNA gene were performed to identify the bacterial pathogens in blood samples.Microdilution test was performed to detect the drug susceptibilities of isolated bacteria to antibiotics.Confirmatory tests were performed to detect the production of β-lactamase and extended spectrum β-lactamase by the isolated strains and the phenotypes of AmpC enzyme and carbapenemase.PCR was used to identify the β-lactamase-encoding genes in the isolated strains by using the primers of 19 common β-lactamase-,AmpC enzyme-and carbapenemase-encoding genes in Enterobacteriaceae strains and the primers of 21 annotated gene sequences encoding the β-lactamase of a Ralstonia mannitolilytica strain.The PCR products were sequenced and analyzed after T-A cloning.Results Ralstonia mannitolilytica strains were isolated from the two peripheral blood samples.The isolated strains were sensitive to ceftriaxone,cefepime,ciprofloxacin,ofloxacin,tigecycline and compound sulfamethoxazole (SMZ-TMP),but resistant to the other 11 tested antibiotics.Results of PCR amplification by using the primers of common genes encoding β-lactamase of Enterobacteriaceae strains were all negative.Fragments of genes encoding the β-lactamase of the isolated Ralstonia mannitolilytica strain were successfully amplified,which were TK49_09850,TK49_12955,TK49_14470,TK49_14495and TK49_18990.The sequences of the amplified gene fragments were not similar to those of the common β-lactamase-encoding genes in Enterobacteriaceae strains.Conclusion The patient was infected with Ralstonia mannitolilytica.The isolated Ralstonia mannitolilytica strain showed a high-level drug resistance with a noticeable diversity against different β-lactam antibiotics.The genes encoding β-lactamase of the isolated Ralstonia mannitolilytica strain were completely different to those of Enterobacteriaceae strains.

Little is reported about the role of PTEN gene in the progression and prognosis of GISTs. This study examined the clinical implications of the tumor suppressor gene PTEN as a prognostic factor in the GISTs. Immunohistological staining and immunoblotting were employed to examine the PTEN protein expression, and its association with clinical measures. Clinicopathological features were reviewed by a retrospective examination of medical records. Reduced PTEN expression was significantly associated with tumor diameter, mitotic figure count, metastasis and pathological stage of tumor (P<0.05), and was not correlated with age, gender and tumor location (P>0.05). The 3-year survival rate of the patients with reduced PTEN expression was significantly lower than those with high PTEN expression (P<0.01). These results suggest that the expression of PTEN gene was significantly linked with the progression and metastasis of GISTs and it is an independent prognostic factor.

Objective To evaluate the effect of osteopontin(OPN) on the adhesion and migration of hepatic stellate cells(HSC) and focal adhesion kinase(FAK)phosphorylation.Methods The proliferation of HSCs was determined by MTT.The adhesion rates were shown by toluidine blue colorimetric assay.The HSC migration rates were examined by HE staining.The expression of FAK phosphorylation was examined by Western blotting analysis.Results ①Compared with control group,OPN at concentrations of 8 mg/L,16 mg/L and 32 mg/L promoted the adhesion of HSCs(P

In order to improve teaching quality of medical organic chemistry,problem-based learning was introduced.The characteristic,implementary process and outlines of problem-based learning were discussed in combination with the characteristic of organic chemistry in medical university.