Objective To give an empirical study on the interests claims of employees in public hospitals. Methods By questionnaire investigation, to sum up data using factor analysis and pairedsamples T test, and to compare difference between different kinds of patients using ANOVA. Results The interests claims of employees can be summed up to seven factors and there is some significant difference between different kinds of employees. Conclusion At current stage, public hospitals need pay more attention to material interests claims of employees.

Objective To compare the efficacies of extended and standard radical pancreatoduodenectomy (RPD) for the treatment of pancreatic cancer in head of pancreas.Methods The clinical data of 96 patients with pancreatic cancer in head of pancreas who were admitted to the West China Hospital of Sichuan University from 2001 to 2011 were retrospectively analyzed.Forty-one patients who received extended RPD were in the extended group and 55 patients who received standard RPD were in the standard group.Blood loss,operation time,hospital stay,surgical complications,severity of complication,1-,3-,5-year survival rate,median survival time,time and location of tumor recurrence and 1-year quality of life of the patients in the 2 groups were compared.All data were analyzed by using rank sum test and analysis of variance.The survival rate was calculated by Kaplan-Meier method and was analyzed by Log-rank test.Results There were no significant differences in the age,diameter and differentiation of the tumor,and number of metastatic lymph nodes between the 2 groups.The operation time,operative blood loss,postoperative hospital stay were 364 minutes (310-650 minutes),680 ml (0-1800 ml) and 13.5 days (10-76 days) in the extended group,which were significantly higher than 315 minutes (260-306 minutes),305 ml (0-1000 ml) and 9.2 days (7-30 days) in the standard group (F=7.15,4.22,3.82,P＜0.05).The incidences of complications in grade 1 and 2 were 5％ (2/41) and 20％ (8/41) in the extended group,which were significantly lower than 25％ ( 14/55 ) and 49％ (27/55) in the standard group ( x2 =5.76,8.87,P ＜ 0.05).The incidence of complications in grade 3a was 41％ ( 17/41 ) in the extended group,which was significantly higher than 7％ (4/55) in the standard group ( x2 =14.10,P ＜ 0.05 ).There were no significant differences in the incidence of complications in grade 3b and 4a between the 2 groups ( x2 =1.44,0.88,P ＞ 0.05 ).There were no significant difference in the 1-,3-,5-year survival rate,median survival time,postoperative quality of life and time of tumor recurrence between the 2 groups ( x2 =0,0.13,0; F =0.49,1.03,t =0.32,P ＞ 0.05 ).Conclusion Standard RPD is optimal for patients with ordinary pancreatic cancer in head of pancreas.Extended RPD could be applied for patients with enlargement of group 16 lymph nodes and could receive R0 resection.

Objective To observe the changes of tongue and pulse parameters in the patients with chronic hepatitis B(CHB)after pegylated interferon alpha-2a(PEG-IFNα-2a)treatment,to investigate its value in evaluation clinical efficacy of PEG-IFNα-2a treatment.Methods 120 patients with CHB who confirmed to the standard received PEG-IFNα-2a antiviral therapy for 48 weeks,and followed up for 24 weeks.The tongue and pulse parameters were detected by DS01-A type digital tongue and pulse presentation analyzer.The changes of liver function,serum HBV markers,HBV DNA,tongue and pulse parameters were observed before and after treatment.Results 113 patients completed the course of treatment,46 cases received complete response(response rate 40.7%).The response rate of liver stagnation and spleen deficiency group was higher than that of blood stasis group(95%CI:0.010-0.677,P <0.05).The baseline of tongue and pulse parameters had no significant difference between response group and non response group(h3 /h1,t =1.799,P =0.074;h4 /h1,t =1.383,P =0.169;h5 /h1,t′=0.461,P >0.05;W/t,t′=0.688,P >0.05;R,t =1.317,P =0.190;G,t =0.346,P =0.729;B,t =1.720,P =0.088).After 48 weeks treat-ment,and followed up for 24 weeks,the tongue and pulse parameters of response group and non response group were compared with baseline,h3 /h1,h4 /h1 decreased,R value and G value increased,the differences were statistically sig-nificant(Response group:h3 /h1,t =3.004,P =0.003;h4 /h1,t =2.702,P =0.008;R,t′=2.258,P <0.05;G,t′=3.052,P <0.05.Non response group:h3 /h1,t =1.978,P =0.049;h4 /h1,t =2.487,P =0.014;R,t′=2.661,P <0.05;G,t′=2.318,P <0.05).But there were no significant differences between the response group and no response group after treatment(h3 /h1,t′=0.191,P >0.05;h4 /h1,t =0.390,P =0.697 2;h5 /h1,t′=0.957,P >0.05;W/t,t =0.149,P =0.881;R,t =1.343,P =0.181;G,t =0.994,P =0.322;B,t =0.565,P =0.572).Conclusion The changes of tongue and pulse parameters have improved after treatment with PEG-IFNαin patients with CHB. However,the value in predicting the efficacy of antiviral therapy may be limited.

Objective To give an empirical study on the interests claims of patients in public hospitals. Methods By questionnaire investigation, to sum up data using factor analysis and pairedsamples T test, and to compare difference between different kinds of patients using ANOVA. Results The interests claims of patients can be summed up to six factors and there is no significant difference between different kinds of patients. Conclusion At current stage, public hospitals need improve medical technique and cut down medical expenses.

OBJECTIVE To evaluate the infection of central venous catheterization in tumor patients with chemotherapy and analyze its risk factors and the role of nursing intervention. METHODS The prospective overall monitoring method was used,including catheterization,maintenance,observation and monitoring. RESULTS Of 446 cases with chemotherapy,the infection rate was 2.24% (10 cases). The infection mainly correlated with age,catheterization time,chemotherapy duration,venous nutrition,complication and hormone. CONCLUSIONS The infection of central venous catheterization is inevitable due to multiple risk factors. The measures to prevent and reduce hospital infection are holding the key steps of central venous catheterization,executing the management system of sterilization,keeping tract smooth,cutting down time of central venous catheterization and strengthening nursing education about central venous catheterization.

Objective To explore the clinical result and complications of noncyclic-PPH surgery in treating internal hemorrhoids.Methods In this study,we evaluate the clinical outcome,such as clinical efficacy,operation time,length of hospital stay,postoperative pain degree and incidence of complications in 120 hemorrhoid patients,randomly divided into control group (60 cases) and observation group (60 cases)based on digital table method,receiving respectively noncyclic-PPH,or PPH (procedure for prolapse and hemorrhoids).Results Two groups were similar in average operation time and average length of hospital stay (P ＞ 0.05).The postoperative VAS score at each time point,was significantly lower in noncyclic-PPH group than the control group (P ＜ 0.05).Non-cyclic PPH group were also significantly lower in postoperative complications than the control group (P ＜ 0.05).Conclusion Compared with PPH surgery,patients with noncyclic-PPH have fewer pain complications or trauma.

Objective To evaluate the feasibility of the lateralization of unilateral medial temporal lobe epilepsy(mTLE)by using arterial-spin-labeling(ASL)based perfusion MR imaging and investigate the changes of perfusion in the regions related to mTLE network and the relationship between the perfusion and the clinical status.Methods Twenty-five patients with left-sided and 23 with right-sided mTLE were enroiled,and 30 healthy volunteers were recruited.The cerebral blood flow(CBF)of related region was measured based on pulsed-ASL sequence on Siemens 3 T scanner.The CBF of the mTLE group were compared with that in the controls by using ANOVA analysis.The asymmetric indices of CBF in the medial temporal lobe were calculated as the lesion side compared with the normal side in matched region in mTLE group.Results Compared with the volunteers,the patients with mTLE showed the decrease of CBF in the bilateral medial and lateral temporal,the frontal and parietal regions relating to the default-mode network and more serious in lesion side.The CBF values of the medial temporal lobe were negatively correlated with the epilepsy duration(r =-0.51,P ＜0.01).The asymmetric index of CBF as-0.01 has a 76.0％(19/25)sensitivity and a 78.3％(18/23)specificity to distinguish the lesion side.Conclusions The decrease of CBF in the temporal and extra-temporal region by ASL-based MRI suggests the functional abnormalities in the network involved by mTLE.The ASL technique is a useful tool for lateralizing the unilateral mTLE.

Objective:To analyze the changes in biological characteristics including infectivity, growth and pathogenicity of Chlamydia muridarum ( Cm) after serial passage in vitro in special conditions in order to provide reference for screening attenuated live vaccines and virulence-related genes. Methods:Wild-type Cm strain (G0) was cultured for several passages using conventional cell culture method under alternate unassisted and assisted culture conditions. Then, the 28th generation (G28) of Cm was selected and compared with the parental G0 strain in terms of centrifugation dependence, attaching ability, intracellular growth curve, plaque size and fallopian tube lesions after genital tract infection in a mouse model. Results:Compared with the parental G0 strain, the G28 strain showed significantly decreased dependence on centrifugation during cell infection ( P<0.05) and increased attachment capacity to cells ( P<0.05). No significant differences were observed in the growth curves 32 h after cell infection or in the plaque sizes between the parental G0 and G28 strains. In the in vivo virulence test, fallopian tube lesions were observed in 87.5% of G0-infected mice and 37.5% of G28-infected mice ( P<0.05). Conclusions:Compared with the parental G0 strain, the G28 strain showed significantly enhanced in vitro infection ability, but decreased in vivo pathogenicity, which brought hope for further identification of virulence genes, isolation of attenuated strains with single genotype and development of live attenuated Chlamydia vaccines.

Objective To investigate the associations of cognitive function with apolipoprotein E (APOE) gene polymorphism and chronic diseases among long-lived people in Zhongxiang City of Hubei Province.Methods A total of 110 long-lived elderly residents aged 90 years and over were collected.Their cognitive function was determined face-to-face using questionnaires by trained interviewers.According to mini-mental state examination(MMSE) scores,subjects were divided into a no dementia risk group and a high dementia risk group.General demographic characteristics,activities of daily living,depression state and nutrition status were compared between the two groups.Correlations of dementia with APOE gene polymorphism and chronic diseases were analyzed.Results The average MMSE score was 22.3±4.8.Among the 110 long-lived people,18 cases had a high risk for dementia,accounting for 16.4％,and 92 cases had no risk of dementia,accounting for 83.6％.The risk of dementia in long-lived elderly people was correlated with activities of daily living,mental state,nutritional status and falls(all P＜0.05).There were 8 cases with the APOE gene ε4/ε3 genotype in the high dementia risk group and 16 cases with the APOE gene ε4/e3 genotype in the no dementia risk group,with the former group showing a higher frequency of the APOE ε4/ε3 genotype (44.4％ vs.17.4％,x2 =6.46,P＜0.05).The former group also seemed to have a higher APOE ε4 frequency,but the difference was not statistically significant(22.2 ％ vs.10.3 ％,x2 =3.96,P =0.055)Chronic diseases prevalent in the long-lived people were hypertension(86 cases,78.2 ％),hearing loss (72 cases,65.5％),hyperlipidemia(56 cases,50.9％),anemia(43 cases,39.1％),impaired vision(39 cases,35.5 ％),chronic kidney diseases(25 cases,22.7 ％),chronic heart diseases (18 cases,16.4 ％) and osteoarthritis(18 cases,16.4％).No correlation was found between the risk of dementia and chronic diseases(P＞0.05).Conclusions Cognitive function is highly correlated with activities of daily living,mental state and nutritional status among long-lived elderly people in Zhongxiang City.The risk of dementia has a correlation with the APOE gene e4/e3 genotype but not with chronic diseases in long-lived people.

With the great development of medical education reform,clinical competency has become the requirements and goal of talent training in Medical Imaging in medical universities within and beyond China.The aim of this article is to review the role of non-standardized assessment at raising students'clinical competency in the course of Diagnostic Medical Imaging in our university.To achieve the goal of reinforcing student's thought of medical imaging and their clinical competency,building up high-quality educational evaluation system,strengthening the teaching faculty,facilitating the combination of theory teaching and practice teaching,improving the practice ability and the awareness of services after their formal induction,and therefore cultiva-ting effective and practical medical imaging talents for our nation.