Objective To analyse the causes of shunt obstructions after ventriculoperitoneal shunting for children hydrocephalus and their therapy. Methods Ventriculoperitoneal shuntings were done in 156 children with hydrocephalus, in 26 cases of them, the shunts were obstructed. Surgical interventions were performed, and causes of obstruction were found and corrected. Results There were eight kinds of obstructive causes in the ventricular catheters, three kinds in the peritoneal catheters. All obstructions were corrected surgically, 26 patients recovered soon without complications and mortality.Conclusion If the causes of ventriculoperitoneal shunt obstructions can be found and corrected in time, the prognosis of patients is good.

Objective To explore operating efficiency of county-level public hospital by using data envelopment analysis ,provide reference ,and basis for health decision-making .Methods The health resources data of 16 county-level public hospitals were ran-domly selected from 2008 to 2011 ,its relative efficiency were studied by data envelopment analysis method of CCR-CRS and BCC-VRS model ,the change trend from 2008 to 2011 were analyzed through the Malmquist productivity index .Results The average ef-ficiency value was 0 .938 in 16 county-level hospitals in 2011 ,7 hospitals was DEA efficient and 9 hospitals was non-DEA efficient (8 hospitals with Scale efficiency decline gradually ,another one with increasing gradually ) .The total factor productivity increased 2 .5% from 2008 to 2011 average annual ,the productivity first decreased from 2008 to 2009 ,and then increased from 2009 to 2011 . Conclusion The overall efficiency 16 county-level hospitals is not high ,it is necessary to develope hospital scale reasonable , strength hospitals′management level and improve technical ability of doctors .

Objective The aim of our study was to evaluate the efficacy and safety of tirofiban in patients with acute coronary syndromes with thrombus-containing lesions.Methods We randomized 38 acute coronary syndromes(ACS)patients with thrombus-containing lesions into tirofiban group and control group.In the tirofiban group,10～30 mL of tirofiban was administered intracoronar before and/or after percutanous transluminal coronary angioplasty(PTCA),then stent was implanted as needed.Intravenous tirofiban was used for 24～48 hours after the procedure.In the control group,standard percutanous coronary intervention(PCI)was used for the patients.TIMI thrombosis grade,TIMI blood flow,no reflow and/or slow flow,corrected TIMI frame count(cTFC),myocardial blush grade(MBG),left ventricular eject fraction(LVEF)were measured in the two-dimensions untrasonography;major adverse cardiac events(MACE)and bleeding were observed.Results TIMI thrombosis grade and cTFC decreased more in the tirofiban group than that of the control group[0.90?0.14 vs 1.53?0.54,P

BACKGROUND: Electrochemically deposited coating, as an alternative method of plasma spraying coating, has arose widely attention, however, few reports concerning its in vivo biological features, especially the effect of coating on early osseointegration and duration of bone healing is poorly understood. OBJECTIVE: To investigate the early osseointegration of electrodepositied calcium phosphate and calcium phosphate/chitosan coatings on rabbits' femurs. DESIGN, TIME AND SETTING: An open experiment. The experiment was performed at the Key Laboratory for Oral Biomedical Engineering of Ministry of Education, Stomatology School of Wuhan University from April 2008 to May 2009. MATERIALS: Eighteen male Japanese rabbits were supplied by the animals' center of Wuhan University. Ti_6Al_4V alloy was purchased from Baoji Titanium Nickel Co., Ltd. Chitosan with over 75% degree of deacetylation was produced by American Sigma Company.METHODS: ① Cylindrical titanium alloy implants (3.3×8.0 mm) were designed with a gap (0.3×4.0 mm) in the middle part by using precision machine tool. The implants were prepared electrodeposited calcium phosphate coating surface (ELD group) and electrodeposited calcium phosphate/chitosan coating surface (ELDC group) with 2.5 mA/cm~2 electric current and 52 V temperature. Meantime, the implants with sandblasted surface were prepared as the control group. Totally 36 implants were randomly inserted into the distal femur condyles of 18 rabbits, and the new bone formation was labeled by fluorescence staining. MAIN OUTCOME MEASURES: At weeks 2 and 4 after operation, the implants were subjected to histological and histomorphometric analysis. RESULTS: All groups were observed different-quantity new bone formation. However, only ELDC group was seen fibrous tissues intervened at bone-to-implant interface. The ELD coatings were heterogeneously degraded, and the majority of the ELDC coatings were degraded. The new bone within gaps of ELD and control groups could be seen under the confocal laser scanning microscope with a continuous process of bone apposition. Percentages of bone-to-implant contact within and outside of the gaps of ELD group at weeks 2 and 4 were significantly higher than those of ELDC and control groups (P < 0.05). Bone formation rates of ELD group were significantly higher than those of ELDC group at weeks 2 and 4 after operation (P < 0.05). CONCLUSION: ELD implants can promote early osseointegration and induce bone tissue growth into the gaps; however, ELDC implants go against osseointegration of rabbit femurs.

Objective To understand employment status of the eight-year program medical graduates from different medical colleges and put forward reasonable proposals on the current prob-lems. Method Through questionnaire, we conducted research among eight-year program medical graduates of three different grades (Grade 04,05,06) on the general condition of employment, research level, actual working time, expectations and actual salary, satisfaction with jobs and so on. Data statis-tics was done by Excel 2007. Totally, our research involved 11 medical colleges and 389 questionnaires. Results 94.34% (367/389) of the eight-year program medical graduates work in top three hospitals. The top five factors affecting the employment were reputation of the school 86.38%(336/389), reputation of the Principal Investigator 66.83% (260/389), social relations 60.15% (234/389), scientific research level 52.96% (206/389) and gender 46.79% (182/389). The amount of published papers from those graduates and their satisfaction with jobs vary greatly. Conclusion Eight-year program medical grad-uates employment faces both opportunities and challenges, and a clear training objective and improve-ment of continuing medical education system for the eight-year program medical graduates will have great significance on the promotion of their employment.

Objective To investigate the bactericidal mechanism of electrolyzed oxidizing water (EOW) against Pseudomona aeruginosa (P.aeruginosa).Methods Bactericidal mechanism of EOW against P.aeruginosa was studied through intracellular protein leakage,nucleic acid,and cell membrane calcium ion permeability,2 ％ glutaraldehyde was used as positive control group,and normal saline (NS) was used as negative control group.Results The killing rates of EOW and 2％ glutaraldehyde to P.aeruginosa were both＞99.99％ with 30-second contact time,and 100.00％ with 60-second contact time.After 60-second contact with EOW,NS,and 2％ glutaraldehyde,the protein leakage of P.aeruginosa detected by bicinchoninic acid (BCA) were (96.00 ± 7.42),(94.15 ± 7.49),and (216.97 ± 10.35)μg/mL,respectively,difference was significant(F =613.20,P＜0.01),2％ glutaraldehyde group was higher than EOW group and NS group;protein leakage did not change with the increase of contact time(all P＞0.05).Electrophoretogram of random amplified polymorphic DNA showed high intensity dense band between 500-1000 Kb in EOW group and NS group,while 2％ glutaraldehyde group was without amplified bands.The fluorescence intensity of calcium ion of EOW group and 2％ glutaraldehyde group were both lower than that of NS group.Conclusion Bactericidal mechanism of EOW may be due to the damage of membrane permeability of P.aeruginosa,which causes Ca2+ leakage,but fails to cause protein leakage,the damage to nucleic acid is not obvious,DNA may not be a bactericidal target of EOW.

Objective To study the tumorigenetic characteristics of side population (SP) cells and their exsistence in gastric cancer cell lines and tissues.Methods Flow cytometry and the DNA-binding dye Hoechst 33342 staining were used to analyze sorted SP cells in 3 gastric cancer cell lines(SGC-7901,BCIC-823 and MKN28).SP cells and non-SP cells(main population cells)isolated from SGC-7901 cell line weresubcutaneously injected into 36 nude mice with 500,5000 or 50 000 cells per mouse,respectively.Thetumorigenity was observed 8 weeks after injection.The expression of ATP-binding cassette sub-family Gmember 2(ABcG2)mRNA in three gastric cell lines and its level in gastric cancer tissues were detected by real-time PCR and immunostaining.respectively.Results The proportion of SP cells was accounted for 1.0%in SGC-7901 cells and 1.3%in BGc-823 cells.No SP cell was found in MKN28 cells.As low as 500 SP cells or 50 000 non-SP cells could initiate tumors in mice.The expression of ABcG2 mRNA was higher in SGC-7901(O.162)and BGC-823(O.096)cell lines than that in MKN28 cell line(0.005).The value of AtCG2 mRNA/beta-aetin mRNA and protein in gastric cancer tissues was different from those in gastritis tissues.Condasimm SP cells have strong ability of tumorigenesis compared with non-SP cells.The expression of ABCG2 is found in gastric cancer tissues and part gastritis tissues.The more the SP cells in gastric cell lines,the higher the expression of ABCG2.

Objective To better understand students' professional perception,humanistic education status quo and their preference to different humanistic education methods.Methods Questionnaire was conducted for 990 undergraduate students (2006 grade- 2010 grade) at medical school of Shanghai Jiao Tong university.SPSS 17.0 statistical software was used to analyze results of the questionnaire.Results Nearly 45％ students chose to major in clinical medicine out of personal interest.The identification of students for humanistic quality was lower than that for clinical knowledge and skills.More than 50％ students believed doctors were with high humanistic quality and there was a gap between students′ action and their understanding of the medical career identity and medical humanistic cultivation.More than 50％ students preferred activities that train medical and auxiliary skills.Nearly 67％ students also showed a shallow reading habit from regular internet surfing.Conclusion The professional perception of medical students are influenced by both social and historical factors influence.The gap between understanding and action is a consequence of current humanistic educational system.The humanistic educational methodology should conform to the psychological and s~ial characteristics of contemporary students.

Objective The aim of this study was to observe the growth difference and expression of cytochrome C of skin hair follicles in neonatal mice .Methods The morphology of different skin hair follicles of neonatal mice ( postnatal day 1-9)were observed by HE staining histology and cytochrome C was detected by immunohistochemistry .Results The skin hair follicles in different parts of neonatal mice showed differences not only in morphology but also in developmental pe -riods.Hair follicle growth in the back and tail skin had a nonlinear and growing period .After the nonlinear and growing pe-riod they began to grow rapidly .The tail development was slightly slower than that on the back .The hair follicles of vibris-sae were very special , and started to develop without a stable period .Conclusions The results of morphological observa-tion and cytochrome C immunohistochemistry demonstrate that differences exist in the hair follicle morphology and develop -mental times in the skin of different parts of the body in neonatal mice .

Objective:To study the clinical effect of Maizhiling tablets combined with salmon calcitonin in the treatment of elderly femoral neck fracture after artificial femoral head replacement and the influencing factors of hip joint function 6 months after operation.Methods:Prospective research methods were used in this article.A total of 84 elderly patients with femoral neck fracture who underwent artificial femoral head replacement in the Affiliated Hospital of North China University of Science and Technology from January 2017 to June 2019 were selected and randomly divided into the treatment group (41 cases) and the control group (43 cases) by the random number table method.The treatment group was treated with Maizhiling tablet and salmon calcitonin nasal spray plus basic calcium; the control group was treated with basic calcium.Independent sample t test was used to compare the visual analogue score (VAS) on the 5th day after operation, the time of complete disappearance of congestion in thigh, and the time of first ambulation after operation between the two groups.The bone mineral density (BMD) of contralateral femoral neck and Harris score of hip joint function were compared between the two groups at 14 days, 3 months and 6 months after operation by repeated measurement variance analysis.Multivariate Logistic regression was used to analyze the influencing factors of hip joint function at 6 months after operation.Results:VAS score on the 5th day after surgery: (6.34±1.54) points in the treatment group and (7.02±1.50) points in the control group.Complete regression time of thigh congestion: (12.12±2.27) d in the treatment group and (13.88±2.58) d in the control group.The first postoperative activity time was (5.93±1.52) d in the treatment group and (7.84±1.05) d in the control group, and the differences of the above indexes between the two groups were statistically significant ( t value was 2.051, 3.313, 6.673, respectively, all P<0.05). The BMD values of the contralateral femoral neck in the treatment group were (0.543±0.123), (0.561±0.119), (0.606±0.105) g/cm 2 at 14 days, 3 months and 6 months after operation, and (0.530±0.092), (0.517±0.089), (0.526±0.090) g/cm 2 in the control group.The results of variance analysis of repeated measurements showed that Fintra-group=55.726, P<0.01; Finter-group=4.206, P<0.05; Finteraction=57.654, P<0.01.There were significant differences between 3 months, 6 months and 14 days after operation in the treatment group (all P<0.01), and between 3 months and 6 months after operation ( P<0.01). In the control group, there was significant difference between 14 days and 3 months ( P<0.01), and between 3 months and 6 months ( P<0.01); 6 months after operation, the difference was statistically significant ( P<0.01). The Harris scores of hip joint in the treatment group were (82.12±8.18), (85.49±6.61), (87.10±6.57) points and (78.91±5.75), (81.44±6.42), (83.67±6.97) points in the control group.The results of repeated measurement ANOVA showed that Fintra-group=64.526, P<0.01; Finter-group=6.529, P<0.05; Finteraction=0.501, P>0.05.There were significant differences between 3 months, 6 months and 14 days after operation (all P<0.01). There were significant differences between 3 months and 6 months after operation ( P<0.05). There were significant differences between the groups 14 days, 3 months and 6 months after operation ( P<0.05 or P<0.01). Multivariate logistic regression analysis showed that age( OR=1.318, 95% CI1.002-1.732, P=0.048) and treatment method ( OR=29.168, 95% CI 1.030-824.623, P=0.048) were risk factors for hip function on the replacement side, and Harris score of hip function 14 days after surgery ( OR=0.624, 95% CI 0.447-0.873, P=0.006) were protective factors for hip function 6 months after surgery. Conclusion:Maizhiling tablets and salmon calcitonin nasal spray have good effects on removing blood stasis, relieving pain, effectively improving bone mineral density and promoting the recovery of joint function after artificial femoral head replacement for senile femoral neck fracture.The younger age of patients, postoperative treatment with Maizhiling tablets combined with salmon calcitonin and good recovery of hip function in 14 days after operation are the protective factors of good hip function in 6 months after operation.