By analyzing the achievements made in the management of scientific research and sci-tech innovation in Nanjing General Hospital during the "10th Five-Year Plan" period and their promotive effect on the overall construction of the hospital,this article holds that efficient sci-tech innovation depends on and gains motivation from efficient management innovation.It proposes that the realization of sci-tech innovation is predetermined by a first-rate talent contingent,based on a well-designed innovation platform,supported by blazing new trails in diagnosis and treatment,ensured by optimizing management strategies,and requires the correct handling of the following four relationships: initiative innovation vs talent cultivation,sustainable development vs key emphasis,initiative innovation vs serving the battlefield and market,and initiative innovation vs input and output.

Objective　To investigate the clinical significan ce of pelvic lymphadenectomy in advanced ovarian carcinoma. Methods　A total of 86 cases of advanced ovarian cancer with surgical treatment were assigned to 3 groups according to the size of residual focus and the performanc e of pelvic lymphadenectomy. Group A consisted of 42 cases with pelvic lymphaden ectomy and the diameter of residual focus smaller than 2 cm; Group B, 26 cases, underwent pelvic lymphadenectomy but with the residual focus larger than 2 cm; Group C con sisted of 18 cases without pelvic lymphadenectomy and the diameter of residual f ocus larger than 2 cm. All patients received CAP chemotherapy for 6 to 8 course of treatment and were in similar clinical stages and pathological grading. Results　The 5 year survival rate was 30.1% (13/42) in Group A, and 11.5% (3/26) in Group B with significant difference (P<0.05). Group C's 5 year survival rate was 11.1%(2/18). No significant difference was found betwee n Group B and C. Conclusion　Application of pelvic lymphadenecto my on those with residual focus less than 2 cm can apparently improve the patien ts' survival rate. But when the diameter of the focus is larger than 2 cm, pelvi c lymphadenectomy is not necessary.

Objective To investigate the effect of Gekko on experimental autoimmune myositis(EAM)animal model.Methods From Nov.2003 to May.2004,in the first hospital of Ji Lin university,Guinea pigs were immunized with rabbit muscle homogenate in Freund's adjuvant and a generalized myositis fundamentally similar to humanpolymyositis was established.These animals were divided at random into A,B,C,D groups.A group were treated with small dose Gekko [1 250 mg/(kg?d)],B group were treated with large dose Gekko [3 750 mg/(kg?d)],C group were treated with preinisone [3 mg/(kg?d)],D group received no treatment.Sign,serum muscle enzyme,electromyography(EMG)and muscle biopsy changes were compared.Results A,B,C groups became better.D group showed no significant change.Conclusion Gekko is effective in therapy of EAM guinea pigs.The result of this study provides an evidence that Gekko mightbe used for the treatment of PM.

Absctact: Objective To discuss the correlation between the TCM syndromes and the clinical pathological features of central air way non-small cell lung cancer.MethodsTCM syndromes were determined through inquiry and physical examination for 109 cases of lung cancer patients. Remaining specimens after excision and routine pathological examination were under HE staining for pathological diagnosis and study. The correlation between the TCM syndromes and the clinical pathological features was analyzed.ResultsThe histological types of central airway non-small cell lung cancer comprised squamous cell carcinoma (69/109, 63.3%), salivary type carcinoma (27/109, 24.8%), adenocarcinoma (10/109, 9.2%) and other rare carcinomas (adenosquamous, 2/109, 1.8%; sarcomatoid carcinoma, 1/109, 0.9%). The clinical and pathological features showed that the elderly, male, smoking patients most commonly suffered from squamous cell carcinoma, while the young, female, non-smoking patients suffered from salivary type carcinoma most frequently. The distribution characteristics showed that the qi-yin deficiency syndrome was most common in squamous cell carcinoma and salivary type carcinoma, accounting for 41.4% (29/70) and 40.7% (11/27) respectively; qi-deficiency and phlegm-dampness syndrome was most common in adenocarcinoma, accounting for 50.0% (6/12). TCM syndrome types were closely related to sex, to smoking history, and to Karnofsky score respectively, with statistical significance (P<0.05,P<0.01). The qi-yin deficiency syndrome was common in male, smoking patients, while the qi-deficiency and phlegm-dampness syndrome and yin-deficiency and heat-toxin syndrome were common in female and non-smokers. The qin-yin deficiency syndrome was common in patients of Karnofsky score≥60, and qi-deficiency and phlegm-dampness syndrome was most frequently found in <60 scores group.Conclusion The histological types of central air way non-small cell lung cancer are related to age, gender and smoking history of patients. Patients with different ages, genders and smoking histories distribute differently in TCM syndrome.

Objective:To study the effect of bone marrow stroma cell( BM SC) transplantation combined with multi-pore mineralization ossein(Bio-Oss) in the plerosis of mandibular defect.Methods:A round whole-layer defect in the diameter of 1.5 cm was created on each side of mandible in 16 whit e New Zealand rabbits.The rabbits were randomly divided into two groups.In group 1 BMSCs were collected and cultured with mineralization induce medium for 2 wee ks. Then cell suspension at the density of 5?10 7 /ml and gelatum were mixed a nd dripped into Bio-Oss bones, incubated in DMEM in 50 ml/L CO 2 incuba tor at 37 ℃ for 4-6 h.The BMSC-Bio-Oss was applied to make plerosis of the m andibular defects.In group 2 the defects were repaired with the Bio-Oss ossein only.Samples were collected after 8 and 12 weeks after opreation respectively an d observed with radiology and histology.Results:12 weeks after o peration, (1)in group 1 previous defects were basically consisted of new bone tissue;(2)in group 2 the previous defects were mainly consisted of fibrous tis sue. Conculsions:BMSC-Bio-Oss transplantation may effectively repair bone defect.

After serious-minded analyzing on the former service process,the manager of our hospital found the problems in the old construction and considered more reasonable design in the new service building.The patient-centered new outpatient building was aimed to meet patient's needs,improve service quality,allocate medical resource,innovate new pattern and optimize the work process.It will provide a bright future for the development of hospital.

Objective: This study aimed to analyze the high medical expenses of hospitalized medical insurance patients for the first ten systemic diseases.Methods: We investigated the medical expenses for the first ten systemic diseases among 10 900 hospitalized medical insurance patients of a hospital,calculated the average expenses and total payment for the treatment of each of the systemic diseases that involved 5% of the total patients,computed their percentage in the total expenses,and compared them with those of all the other hospitalized cases.Results: The medical cost of the 5% of the first 10 hospitalized systemic diseases accounted for 21%-29.9% of the total expenses of all the hospitalized patients,4.3-6.0 times that of the average expenses,and 30.8%-54.9% paid by the patients themselves.In addition,the hospital stay of these patients was 1.5-4.7 times that of the average.Conclusion: The high medical expenses involving 5% of the hospitalized patients with the first 10 systemic diseases amounted to a quarter of those paid by all the hospitalized patients.Effective measures have to be taken to keep high hospitalization expenses at a reasonable level.

Cinobufacini is an aqueous extract of Bufo bufo gargarizans Cantor dried skin, which has been widely used for cancer therapy in China. So far, its active components are still not very clear. In previous reports, bufadienolides with low-concentration were usually studied because of their anticancer effects. However, the high polarity constituents in cinobufacini are less investigated. The present study found that more than 50% contents of cinobufacini were water-soluble peptides. Then, in vitro anticancer experiments were carried out, including human stomach cancer cell lines BGC823 and MCG803, human colon cancer cell lines DLD-1 and HT-29, and human pancreatic cancer cell line MIAPACA-2. The IC50 for these cell lines model were ranged from 25-123 microgmL(-1). The results indicated that these peptides showed similar activity with cinobufacini injection. As a conclusion, this study provides a new and further understanding of anticancer components in cinobufacini injection.

BACKGROUND: A better understanding of medical students' attitude towards living liver donation in China would be of importance significance in the development of organ transplantation. OBJECTIVE: To investigate the medical students' attitude toward living liver donation in China and to analyze the factors that affect such an attitude.METHODS: A random sample of 250 medical students was taken and stratified by grades with 50 students in each grade. The attitude was evaluated by a modified psychosocial questionnaire from Spain. The questionnaire was completed anonymously and was self-administered. A bivariate analysis including the Student's t test and the Chi-square test was performed using SPSS software. RESULTS AND CONCLUSION: The questionnaire completion rate was 97.2% (n=243) for the medical students. Among the respondents, only 13.2% (n=32) of them were in favor of unrelated living liver donation. Another 66.3% (n=161) were only in favor if the donation was for a relative. Of the rest, 6.6% (n=16) did not agree with living liver donation, and the remaining 14.0% (n=34) were undecided. The factors related to this attitude were the decision of donating the organs of a family member (P=0.002), attitude toward deceased donation (P=0.000), a willingness to receive a donated living liver organ if one were needed (P=0.000), attitude toward living kidney donation (P=0.000). The medical students have a favorable attitude toward living liver donation in China. The students' attitude toward other types of organ donation and the willingness to accept living donated liver influence their attitude toward living liver donation. There is a great lack of education about the organ donation and transplantation for the medical students in China and more education programs should be incorporated into their traditional curriculum.

Thirty eight adult male rabbits were selected for the experiment. The experimental peptic ulcer was induced by means of injection of 40% acetic acid to the submucosa of the stomach. Animals of the control group were injected with normal saline instead and another control group consisted of normal rabbits without any treatment. The animals were killed by decapitation at different time intervals (3～49 days) after the operation. The adrenal tissues were prepared for histochemical studies from both experimental and control animals. The results were observed as follows:During the early stage of the peptic ulcer, the fascicular and reticular zones were the chief sites in the adrenal cortex where histochemical changes were involved. Three days after the peptic ulcer operation, the cells of the fascicular and reticular zones filled with sudanophilic lipid droplets and cholesterol droplets. Five days after the operation, both of lipid droplets and cholesterol droplets decreased; the content of ascorbic acid increased slightly; and the activity of succinic dehydrogenase also increased. The above changes were most conspicuous in the inner portion of the fascicular zone within ten days. After fourteen days, all the above histochemical changes began to recover and gradually returned to the normal level after eighteen to thirty five days. In the normal saline operation control group, the contents of lipid droplets and cholesterol droplets decreased in the fascicular and reticular zones after three days and returned to normal level during the period of ten to fourteen days after operation for saline injection.The above histochemical changes showed that the adrenal cortex was at an active functional state during the early period of the experimental peptic ulcer.