Objective To explore the clinical value of combined detection of CA15-3, TSGF, OPN and CA125 in the diagnosis and treatment of breast cancer. Methods The serum specimens from 187 patients with breast cancer (cancer group) were collected, tumor markers CA15-3 and CA125 were detected with electrochemiluminescence method, TSGF was detected with chemocolorimetry, and OPN was detected with enzyme-linked immunosorbent assay. Compared with 50 cases of patients with benign breast disease (control group), The relationship between these marker and clinical stage, recurrence and metastasis of breast cancer were analyzed. Results The serum levels of CA15-3, CA125, TSGF and OPN in cancer group were significantly higher than those in control group (P ＜0.05). Four markers in high clinical stage(Ⅲ and Ⅳ stage)[(83.21±28.67), (89.13±32.34), (278.66±137.23) U/ml and (97.4±11.7) ng/ml, respectively] were higher than those in low stage( Ⅰ and Ⅱ stage) [(60.03±19.35), (58.21±17.56), (155.79±113.11) U/ml and (77.5±10.81) ng/ml,respectively] (P ＜0.05), and those in lymphnode metastasis patients and in recurrence patients were significantly higher than those in corresponding groups (P ＜0.05). The sensitivity and specificity of the combined detection of four tumor markers were 96.3 % (180/187) and 80.0 % (40/50), respectively. The average time of combined detection of serum tumor markers was 2 months ahead of the mammographic features in the recurrence patients with breast cancer. Conclusion The dynamic combined detection of CA15-3, TSGF, OPN and CA125 are better markers for monitoring recurrence and metastasis of breast cancer,which are benefit to early diagnosis and interference.

Objective An incentive system was established to promote the rapid development of scientific research and to improve the scientific management ability.Methods The research incentive system, which including research awards, research fund management, research fund matching, and performance management, was implemented in our hospital, aimed to develop a clear quantitative assessment index to encourage research activity, and maximize the research outcome.Results It is clear that the research project application and output in output have been increased;and it positively associated with the number of years of implementation with the statistical significance.Conclusions Establishment of the research incentive system has encouraged the clinicians to make effort to conduct research projects which has largely increased the number of research projects and produced better outcomes.Applying such system has enhanced the capacity of core research of the hospital.

Heilongjiang Provincial Hospital has scored an initial success in dealing with medical disputes since the medical liability insurance and third-party mediation mechanism were introduced into the hospital in 2013.The paper identified problems found in the practice,and recommended the following:rationalizing the cost of insurance coverage,expanding scope of third-party mediation properly,enhancing professional authority in assessment of medical dispute cases,simplifying insurance compensation procedure,and consolidating the legal status of the medical dispute mediation institutions,for better resolution of such disputes.

Objective To observe the extent of bone coagulation and the thermal field distribution created in ablating the swine vertebral bodies in vitro with multi-polar radiofrequency and to discuss the correlation between the electrode position in the vertebral body and the safety of the spinal cord as well as the soft tissue injury around the vertebral body. Methods Thirty fresh adult porcine vertebrae, were randomly and equally divided into two groups. The depth of the electrode needle was 10 mm or 20 mm. When the ablation process reached to a stable state, the temperature at the scheduled spots was estimated. Twenty minutes after ablation, the vertebral body was cut along the electrode needle plane and also along the plane perpendicular to the electrode needle to observe the extent of bone coagulation. Results The temperature at the scheduled spots reached to a stable state in 3.5 minutes. The more close to the electrode the spot was,the more quickly the temperature rose. No soft tissue injury around the vertebral body was observed in both groups and no spinal cord injury occurred when the electrode needle was 10 mm or 20 mm deep in the vertebral body. Conclusion In treating vertebral metastases, the radiofrequency ablation is safe and reliable if the posterior wall of the vertebral body remains intact.

Objective 600 questionnaires from hospital employee were collected and conducted statistical analysis to identify the internal and external factors that have influence on the staff develop ment of scientific research level,which also aimed to figure out the way to raise employee awareness of scientific research,as well as enhancing the scientific and technological development in hospital.Methods Questionnaire survey was conducted to establish a database,SPSS18.0 survey data descriptive analysis applied,variance analysis using x2 test,P ＜0.05 was considered statistically significant.Results Statistical analysis and comparative study were conducted to figure out the awareness of hospital scientific and technology development from employees from different positions with different education levels,the difference was statistically significant (P ＜0.05).Hospital staff have generally high level awareness of scientific research,obey the normal distribution basically,recognition rate is more than 93.5％,particularly,higher education staff have a better awareness and contribution to the development of the hospital.Conclusions According to the analysis,this paper proposed to build a platform for the establishment of performance evaluation and incentive system,to improve the management system and other measures to further enhancing the research and development of hospital staff awareness,thereby increasing the overall scientific research level of the hospital.

Objective Through the root cause analysis of a particular hospital award-winning achievements during 2004-2015 to find out a way to improve and guide medical research output,especially the new ideas,new methods of scientific research management.Methods Using SPSS18.0 sta tistical analysis software to conduct analysis of the 97 winning outputs of the hospital during 2004 2015,indicators including the numbers and grades,the types of research,discipline distribution and other 6 aspects were comprehensively analyzed.Results Since 2012,the hospital administrative policies went through an evolving process of "repeal,change,establish",research management entities adjustment management policies to match the current situation in a timely manner,fine management of research were adopted,as a result,the achievements output is increased and becoming more balanced distribution of subjects.Conclusions To maintain a well-developing position of the research output,we must combine the national policy on scientific research with the management of our own development;bring in the competition for talent,as well as both positive and negative incentives.Strengthen the scientific and technological talent team building to establish a team good at medical practice and research,to form a connected effect based on the advantage subject,promote the balanced development of various disciplines,thereby further improving the hospital research outputs.

OBJECTIVE To provide reference for improving the rational use of antimicrobial drugs in primary township medical institutions. METHODS Based on the county prescription pre-review center， a team led by anti-infective clinical pharmacists constructed the management mode for the use of antimicrobial drugs in county-level medical communities with clinical pharmacists as the main team by finding out the main problems in the use of antimicrobial drugs in primary township medical institutions， providing feedback on the problems， organizing relevant training for the problems， improving the customization rules of the prescription pre-review software， implementing the automatic interception and pharmacist online prescription review and other measures. Data on the use of antimicrobial drugs were collected and compared in the 15 primary township medical institutions between January-June in 2022 （before the implementation of the mode） and January-June in 2023 （after the implementation of the mode）. RESULTS Compared with before the implementation of the mode， the utilization rate of antimicrobial drugs in outpatients of primary township medical institutions decreased from 24.97% before the implementation of the mode to 19.39% after the implementation of the mode； the utilization rate of antimicrobial injection in outpatients decreased from 66.10% to 46.80%； the utilization rate of intravenous drip of antimicrobial drugs in outpatients decreased from 52.33% to 40.35%； the rates of combined use of antimicrobial drugs in outpatients decreased from 12.70% to 8.19%； the reasonable rate of antimicrobial prescribing in outpatients increased from 55.28% to 73.93%. After the implementation of the mode， the proportion of antimicrobial prescriptions for each diagnosis was basically the same as before； the defined daily dose system （DDDs） and proportion of a few antimicrobial drugs changed compared with before according to the anatomical therapeutic chemical classification of drugs， among which DDDs of lincomycin， gentamicin and other drugs declined significantly； DDDs of antimicrobial drugs for each classification was basically the same as before according to AWaRe classification. CONCLUSIONS The management mode of the use of antimicrobial drugs led by anti-infective clinical pharmacists is constructed in the prescription pre-reviewing center of county-level medical communities， which can effectively improve the rational use of antimicrobial drugs in the primary township medical institutions.