Objective To evaluate the effectiveness of wechat-based transitional care in the acoustic neuroma patients with postoperative facial palsy.Methods 90 acoustic neuroma patients with postoperative facial palsy were randomly enrolled into 2 groups by tossing coin,45 cases in each group.Control group received routine discharge education,while the experimental group received wechat-based transitional care for three months.The rehabilitation adherence,the level of facial palsy,the ocular infection and the quality of life at patients discharged and three months after operation were compared between the two groups.Results Three months after operation,the cases of high,middle,low level of rehabilitation in the experimental group were 28,12,5,which were more than the control group whose cases were 15,21,9 (x2=7.528,P＜ 0.05).Facial palsy and the quality of life of the experimental group were 66.7％ (30/45) and (71.62±6.36) points,which was significantly higher than 42.4％ (19/45) and (63.75±11.28) points in the control group (x2=5.421 and 4.073,P ＜ 0.01).The incidence of ocular infection in the experimental group was 8.9％ (4/45) which was significantly lower than 31.1％ (14/45) in the control group (x2=6.671,P ＜0.05).Conclusions Wechat-based transitional care achieves good effectiveness in patients with postoperative facial palsy,which could improve the level of rehabilitation,facial palsy and the quality of life,and reduce the incidence of ocular infection,is worthy of promotion.

Objective:To evaluate the efficacy and safety of selective arterial embolization in the treatement of obstetrical and gynecological bleeding.Methods:16 cases with obstetrical and gynecological hemorrhage,including postpartum,trophoblastic disease,uterine fibroids,ectopic pregnant and artifical abortinal bleeding were treated by selective arterial embolization.Results:The embolization successfully controlled the bleeding in all patients.No serious complication happened.Conclusion:Selective arterial embolization is safe and effective,it′s complicationis is lower and patient′s fertility can also be preserved.

ObjectiveTo discuss the effect of evidence-based nursing in improvement of unhealthy emotion and treatment compliance of patients undergoing painless gastroscopy. Methods134 patients from May 2008 to December 2010 undergoing painless gastroscopy were chosen as study object.According to voluntariness of the patients and their families,they were divided into the evidence-based nursing group (70 cases) and the routine psychological care group (68 cases).The satisfaction degree with nursing,unhealthy emotion,and the compliance during treatment process were evaluated with SAS and SDS.ResultsThe satisfaction degree of patients in the evidence-based nursing group was 92.86％,higher than 79.41％ in the routine psychological care group.No significant difference was shown in SAS and SDS score before treatment between two groups,but unhealthy emotion and treatment compliance after treatment significantly improved,and the improvement degree of the evidence-based nursing group was more evident. ConclusionsApplication of evidence-based care model in painless gastroscopy has more obvious advantages in improvement of unhealthy emotions and treatment compliance compared with routine nursing.It has more important value for clinical practice and is more conducive to improve the quality of life of patients.

Objective To investigate the effect of liver phosphatidylinosital 3-kinase/protein kinase B (PI3-K/AKT) pathway on the decrease of insulin sensitivity in fetal growth restriction (FGR) rats.Methods Twenty pregnant female rats were randomly divided into two groups one day after conception:normal-protein group and low protein group (n=10,respectively).Rats in low-protein group was given low protein diet (8.00％ protein) during pregnancy to build FGR model,while normal-protein group was given normal protein diet (20.00％ protein).On day 3,7,14,30,60 and 90 after birth,fasting blood samples of 8 male FGR offsprings from low-protein group and 8 normal offsprings from normal-protein group were collected to measure fasting plasma glucose and insulin level.Then insulin resistance index and insulin sensitivity index were calculated to determine insulin sensitivity.On day 7,14,30,60 and 90 after birth,liver tissue of 8 male FGR and normal offsprings were collected,insulin receptor substrate 1,2 (IRS1/IRS2)and glucose transporter 4 (GLUT4) mRNA expression were measured by real-time fluorescence polymerase chain reaction and the protein expressions of IRS1,PI3-K (subunit p110β),and AKT and phosphorylated AKT (pAKT) were measured by Western blot.The relationships between the expression changes of key molecules of PI3-K/AKT pathway and insulin sensitivity were analyzed by correlation and multiple linear regression method.Results (1) Mean birth weight of baby rats in low-protein group was significantly lower than that of normal-protein group [(4.92±0.36) g vs (6.43±0.59) g,t=14.73,P＜0.05].The incidence of FGR in low-protein group was 88.2％ (97/110); and for male offsprings,it was 94.1 ％ (48/51).(2) Compared to normal offsprings,fasting plasma glucose levels of male FGR offsprings were significantly higher from the age of 60 days to 90 days.Insulin levels and insulin resistance index were significantly higher and insulin sensitivity index was lower from the age of 30 days to 90 days,P＜0.05 respectively.(3) Compared to normal offsprings,IRS1 (0.45 ± 0.02 vs 0.68± 0.03,t=16.633,P＜0.05) and IRS2 mRNA (0.34±0.10 vs 0.70±0.19,t=4.864,P＜0.05) expressions in FGR offsprings were lower from day 7 after birth to day 90 (0.48±0.03 vs 0.59±0.05,t=5.237,P＜0.05; 0.49±0.20 vs 0.70±0.11,t=2.253,P＜0.05).There were no differences in expressions of GIUT4 mRNA and AKT protein between two groups (P＞ 0.05).IRS1,PI3-K and pAKT protein expressions of FGR offsprings decreased significantly from day 14 (0.22±0.05 vs 0.52±0.11,t=7.024,P＜0.05; 0.46±0.03 vs 0.97±0.08,t=17.508,P＜0.05; 0.62±0.10 vs 0.89±0.08,t=6.100,P＜0.05) to day 90 (1.11±0.08 vs 1.32±0.14,t=3.714,P＜0.05; 0.63±0.07 vs 1.00±0.19,t=5.206,P＜0.05;0.28±0.03 vs 0.45±0.10,t=4.880,P＜0.05).(4) The pAKT protein expression level of FGR rats was positively correlated with insulin sensitivity index (r=0.704,P＜0.05) ; while negatively correlated to the level of fasting plasma glucose (r=-0.609,P＜0.05),fasting insulin (r=-0.561,P＜0.05) and insulin resistance index (r =0.577,P＜ 0.05).Conclusions The changes of some key molecules' expressions of PI3-K/AKT pathway in liver might be involved in the insulin resistance in FGR rats.

Objective Establishing the scientific research competitiveness evaluation index system of Shanghai hospitals.Methods Delphi method and Analytic Hierarchy Process were applied.Results Thirty-four experts were invited to provide evaluation index and weighted scores.The positive coefficient from two rounds of expert's consultation were 88.24％ and 94％.The expert's opinion of authority coefficient of each indicator's was greater than 0.7.The degrees of coordinative consistency was high.Kendall concordance coefficient was increasing with the increasing of consulting times.After two rounds of Delphi expert consultation,2 level-one indictors,10 level-two indictors and 47 level-three indictors were confirmed.Conclusions After two rounds of Delphi expert consultation,using all objective indicators,an Index System for research competitiveness evaluation in the hospitals in Shanghai has been created and could be used with scientific,objectivity and feasibility.

Objective This paper analyzed the development and current situation of patents from first class hospitals in Shanghai,reflecting the development of scientific researches,providing medical science research management with data support as the basis of decision making.Methods Based on patent search and analysis of State Intellectual Property Office of The P.R.C and Incopat,a technology innovation intelligence platform with global patent information,patents from first class hospitals in Shanghai published before the year of 2015 are analyzed from aspects including patent category,legal status,time trend,applicants of invention patent,proprietor and inventors of authorized invention patents,transfer of invention patents,etc.Results First class hospitals in Shanghai had 1979 invention patents,which accounted to 56.38％ of the total.71.21％ of invalid invention patents fell into abeyance because of withdraw,rejection,and abandon,which was 2.47 times of those due to termination.Eight hospitals including Shanghai Ninth People's Hospital and Huashan Hospital were at the top of both the invention patent application list and the authorized invention patent list,both accounting to more than sixty percent.Conclusions The number of invention patents has gone through germination stage,developing rapidly in recent years,the ratio of authorized inventions appears to decline slightly after rise.The reasons of patent invalidation are worthy of attention,the information about legal status of patents can be reasonably used,applicants and inventors shows uneven distribution,patent quality should be emphasized with quantity rise,cross regional and cross border cooperation can bring about complementary advantages.

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Objective:To explore the hepatocyte insulin sensitivity of intrauterine growth retardation ( IUGR) rats and establish an insulin resistance cell model in vitro.Methods: An IUGR animal model was established by protein malnutrition during the mother pregnancy .On 60 d and 90 d after birth , the offspring rats were fasted for 12 hours and then their angular vein blood was collected to measure the fasting plasma glucose and fasting serum insulin level , then the insulin resistance index ( HOMA-IR) and insulin sensitivity index ( ISI) were calculated .The insulin sensitivity was evaluated by HOMA-IR and ISI.Primary hepatocytes from each group were respectively isolated by two-step perfusion with collage-nase and were defined as normal hepatocytes group and IUGR hepatocytes group .The normal hepatocyte group was divided into two groups: control group and insulin induction group .Insulin induction group was established by primary cultures of normal hepatocyte incubated with varying dilutions of insulin . CCK-8 was used to detect the viability of the cultured hepatocytes .Glucose oxidase-peroxidase method kit was used to measure glucose consumption of the hepatocytes .Results:HOMA-IR was significantly higher in IUGR rats than in the normal rats at the age of 60 days ( t=-17 .02 , P<0 .05 ) and 90 days ( t=-12.52, P<0.05).ISI was significantly lower than in the normal rats aged 60 days (t=5.61, P<0.05) and 90 days (t=12.42, P<0.05).There were no significant differences in hepatocyte viability among the control group , IUGR group and insulin induction group after incubation of 48 h on day 60 (F=1.34, P=0.29) and day 90 (F=0.22, P=0.81).The glucose consumption of the IUGR group and insulin induction group were significantly decreased compared with the control group on day 60 ( F=9.28, P=0.002) and day 90 (F=56.60, P<0.001), while there was no significant difference be-tween the IUGR group and insulin induction group (P=0.08, P=0.10).Conclusion:The insulin sen-sitivity of hepatocytes of IUGR rats decreased from adolescence to adulthood .High-dilution insulin may induce insulin resistance cell model in vitro.

The purpose of this study was to reveal the current situation of health technology transfer in Shanghai hospitals,and to analyze the problems and needs.Questionnaire and interview were adopted for the study.We found that in the past 3 years,the transformation rate of patent technologies at Shanghai Tertiary Hospitals was 5.88％.The transfer routes mainly involves proactive enlist of enterprises by project leader,technology brokerage,exhibitions of patents achievements,friends' recommendation,etc..The main factors impacted the transfer included poorer quality of patent,lacking efficient management,and lacking channels for transfer.In order to improve the transfer of patents,hospitals need to provide information service,technology assessment,project packaging,patents application,consultant,and relevant trainings etc.Other things that could promote health technology transfer are to improve scientific research system,to enhance the quality of scientific achievements,and to develop technology brokerage.