It presented in detail the acquisition of Qingdao Wan Jie Hospital by the Affiliated Hospital of Medical College Qingdao University, describing the operational mechanisms in organizational setup, specialty setup, personnel management, logistic management, hospital culture and branding of the newly acquired section. It also summarized the achievements in medical resources reorganization and advantages complementary without government investment in a fast and low-cost manner. It is demonstrated that hospital acquisitions are in line with the medical reform, as they expand the service coverage of public hospitals, and extend medical service to the communities and lower levels, thus enhancing hospitals' impact and reach to integrate medical resources in a short timeframe.

Objective To investigate the clinical effect of high dose of calcitriol on end-stage renal disease (ESRD) in patients with secondary hyperparathyroidism (SHPT). Methods The clinical data of patients with ESRDcomplicated with SHPT were retrospectively analyzed. According to the treatment method were divided into control group and observation group, the control group were given conventional dose of calcitriol treatment, the observation group were treated with high dose of calcitriol. The differences of calcium and phosphorus levels, parathyroid hormone (PTH) level and quality of life were observed between the two groups before and after treatment. Results The serum phosphorus, calcium and calcium-phosphorus product in two groups of patients before treatment had no significant difference. After treatment, the above indicators decreased in two groups of patients compared with those before treatment, and the observation group was significantly lower (P<0.05). Before treatment, there was no difference in the levels of PTH between the two groups. After treatment, the level of PTH in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in quality of life between the two groups before treatment. After treatment, the quality of life in the two groups were higher than before treatment, and the observation group was significantly higher (P<0.05). Conclusion High dose of calcitriol has good therapeutic effect for ESRD patients with SHPT and can significantly improve the patient's calcium and phosphorus and PTH levels, improve the quality of life of patients.

Objective To understand the etiology and clinical manifestation of malignant atrophic papulosis,to report the psychological care of one case with malignant atrophic papules,and patients to maintain a good psychological state.Methods Nursing measures such as strengthening skin care,reducing discomfort,avoiding aggravating the injury; attention to abdominal signs,detection of changes in disease condition,prevention of intestinal perforation,related medication education to increase medication compliance were given to this patients.Results The abdominal pain disappeared,lower limb muscle force recovered,and the patient was discharged after the disease condition was steady.Conclusions To patients with malignant atrophic papulosis,early detection and early treatment should be given to them.

Adult ; Aged ; Body Mass Index ; Case-Control Studies ; Humans ; Male ; Middle Aged ; Neck ; anatomy & histology ; Sleep Apnea, Obstructive ; pathology ; physiopathology ; Young Adult

Objective To evaluate the diagnosis accuracy for coronary stenosis from diameter measurements of differ?ent severities of stenosis by using gemstone spectral imaging (GSI). Methods Totally 3 different coronary artery models(in?ternal diameter:3.00 mm) that with different severities of stenosis (residual lumen diameter ratio:75%, 50%and 25%) were placed in a pulsating cardiac phantom (ALPHA 1-VT PC, Fuyo Corporation, Japan). The coronary phantom was scanned in two models:gemstone spectral imaging (GSI) and axial scan model(AXIAL). All the spectral imaging data were analyzed by using GSI viewer to reconstruct the VMS images (40-140 keV by 10 keV interval) and AXIAL. CT values (HU) of the re?mained lumen from all different stenosis lumens were measured. The residual rate (%) was calculated by dividing the diame?ters of the remained lumen to normal lumen on the reformatted short axial images. One-way ANOVA was used to compare the measurement difference of residual rates between VMS images. Student t-test was used to compare the measurement dif?ference of residual rate between VMS and AXIAL. Bland-Altman test was used to compare the measured residual rates and the gold standard. Results There were no significant differences in measured residual rate betweeb VMS images (P>0.05). From student t-test, only significant difference was found on 50%stenosis between 70 keV VMS and AXIAL(t=4.617,P<0.042). From the Bland-Altman test, measurement of residual rate was more accurate from 70 keV VMS than that of AXIAL by taking the stenosis rate of real model as gold standard(t=14.560,P<0.001). Conclusion VMS image (70 keV) shows more accurate rate than AXIAL images on both diameter measurement and evaluation of the coronary stenosis.

Objective To investigate the status quo of psychological pressure in female infertility patients so as to provide the basis for carrying out the psychological counseling aiming at these patients .Methods The random sampling was adopted and the questionnaire survey was conducted on 1 760 female infertility patients .Results The patients with psychological pressure accounted for 84 .43% of the investigated patients .The cases number of psychological pressure in the patients with in‐vitro‐fertilization and embryo transfer(IVF‐ET) treatment was significantly more than that in the patients with pregnancy‐guiding and artificial insemina‐tion (P<0 .01);the cases number of psychological pressure in the patients with higher educational degree was more than that in the patients with lower educational degree (P<0 .01);the cases number of psychological pressure in technicians ,teachers ,staffs ,cadres and civil servants was more than that in the workers ,farmers ,merchants and the people with the other occupations (P<0 .01);the cases number of psychological pressure in the patients with 2-5 year infertility was more than that in the patients with the other infertility years (P<0 .01);the cases number of psychological pressure in the patients with visiting doctors for twice or over was more than that in the patients with visiting doctors for the first time (P< 0 .01) .Conclusion The female infertility patients in Chongqing have large psychological pressure .The doctor should actively communicate with patients ,answer the patient doubt ,ease the patient emotion ,mobilize the patients′family and society to care the patients .

Objective To evaluate the clinical value of prone flexed posture lumber CT/MRI examination for lumber disc herniation. Methods Supine posture CT/MRI (SPCT/MRI) and prone flexed posture CT/MRI (PFPCT/MRI) examinations were performed on 1200 patients with lumber disc herniation.The imaging findings on SPCT/MRI and PFPCT/MRI of each case were compared. According to the CT/MRI diagnostic criteria for encapsulated lumber disc herniation ( HLDH ), adhered lumber disc herniation (ALDH) and ruptured lumber disc herniation ( RLDH), the 1200 cases were divided into three groups. On the basis of PFPCT/MRI findings, 868 cases were selected for percutaneous lumbar diskectomy (PLD) with half to twelve years follow up. Treatment effects of PLD on HLDH, ALDH and RLDH were analyzed with x2test. Results Among 249 ALDH cases diagnosed by SPCT/MRI 35 were identified as HLDH by PFPCT/MRI. Among 163 RLDH cases diagnosed by SPCT/MRI, 9 HLDH and 17 ALDH were identified by PFPCT/MRI. In 868 cases treated with PLD, the effective rate of HLDH ( n = 832), ALDH ( n = 25 ), RLDH ( n =11 ) were 825/832 (99. 2% ), 13/25, and 1/11 respectively. The effective rate of HLDH is significantly different from that of ALDH and RLDH ( x2 = 369. 69, P ＜ 0. 01 ). Conclusion PFPCT/MRI may change the grouping result of lumber disc herniation made by SPCT/MRI and can be used to objectively select patients for PLD.

Objective To study the clinical features of children with rotavirus enteritis complicated with respiratory infection.Methods The clinical features of 32 children with rotavirus enteritis were evaluated retrospectively complicated with respiratory infection (respiratory infection group) and 37 children with rotavirus enteritis complicated without parenteral infection (control group).Results 1. The respiratory symptoms became alleviative as the alimentary symptoms changed for better. 2. Duration of diarrhea weve(7.06?1.50)d in respiratory group was significantly longer than that in control group (4.73?1.31)d (t=6.90 P

Objective To investigate the effect of targeted monitoring on the control of central venous catheter associated infection, study the difference of CVC?RI infection rate and the distribution of pathogenic bacteria in the general hospital and the maternal and child hospital, and analyse the main pathogenic bacteria drug resistance characteristics. Methods From January 2013 to December 2014,685 cases patients with central venous catheterization in the Port Hospital of Hebei Port Group Company Limited,and four cooperative hospitals ( Affiliated Hospital of North China University of Science and Technology, People′s Hospital of Tangshan, Tangshan Port Economic Development District Hospital, Maternal and Child Health Care Hospital of Laoting County) were selected as the research objects. The difference of infection rate before and after the targeted monitoring in 2014 was compared. The tip of the catheter and the peripheral blood were cultured in the patients with suspected infection,bacterial identification and drug sensitivity test were carried out using Compact VITEK2 automatic bacteria identification/drug sensitivity analyzer. Results The infection rate of CVC?RI of five hospitals was 18. 75%( 60/320 ) in 2013, 11. 51%( 42/365 ) in 2014, the difference of infection rate was statistically significant before and after the implementation of the target monitoring(χ2=7. 059,P<0. 05) . The CVC?RI infection rate was 15. 52%(81/522) in the general hospital,12. 88%(21/163) in the maternal and child hospital,the difference was not statistically significant(P>0. 05). In 102 cases of CVC?RI,105 bacterial strains were detected in 91 cases,gram positive bacteria accounted for 51. 43%( 54/105) ,gram negative bacilli accounted for 40. 95%( 43/105) ,fungi accounted for 7. 62%( 8/105) . There was no significant difference in the proportion of pathogenic bacteria in the general hospital and the maternal and child hospital(P>0. 05). Grampositive cocci were mainly staphylococcus aureus and coagulase negative staphylococci,they were completelysensitive to linezolid, quinupristin/ dalfopristin, tigecycline, and vancomycin. They were high sensitivity torifampicin,while highly resistant to gentamicin, tetracycline, penicillin; Gram negative bacilli were mainlypseudomonas aeruginosa and escherichia coli,they were high sensitivity to meropenem,imipenem,while resistantto multiple antimicrobia1s. Conclusion Adhere to the implementation of targeted monitoring help to reduce theoccurrence of CVC?RI. The isolation of pathogenic bacteria from multiple drug resistance should be paid moreattention.

BACKGROUND:Epidemiologic reports have indicated that excessive weight-bearing exercise is one of important risk factors for lumbar degeneration, but the effects of weight-bearing activity on normal lumbar motion pattern are stil not clear. OBJECTIVE:To measure the changing characteristics and rules of position at the center of rotation of the lower lumbar spine during a weight-lifting activity of normal person. METHODS: Fourteen asymptomatic subjects with a mean age of (25±5) years were recruited for this study. The L4-5 and L5-S1 segments of each subject were CT-scanned to construct 3D models using dual X-ray imaging system and spiral CT examination combined technology in the aid of computer software. The physiological load and lumbar spinal 3D motion under the loading condition were reproduced when matching the flexion, neutrality and extension in the dual X-ray imaging system and on dual oblique lumbar X-ray image. Coordinate systems were established at the vertebral body of L4-S1 to obtain the center of rotation during flexion-to-neutral, neutral-to-extension and the ful flexion-extension motion. RESULTS AND CONCLUSION: (1) Under physiological load, the center of rotation of L4-5 of normal person was located about 1.0 mm anterior to the central axis of the vertebral body, and the center of rotation of L5-S1 was located about 0.7 mm anterior to the central axis of the vertebral body. (2) With weight loading, the center of rotation of both two segments shifted backward about 0.5 mm. There was no statistical difference between these two loading conditions. (3) When the center of rotation in flexion and extension was calculated respectively, the moving range of the center of rotation at both L4-5and L5-S1 became larger due to taking loads of 10 kg (P < 0.05). In flexion, the center of rotation at L5-S1 significantly shifted forward during a weight-lifting activity (P < 0.05). (4) These results confirm that compared with non-weight-bearing condition, the trajectory of the center of rotation was found to be increased when taking loads, especialy during the flexion-to-neutral motion.