This paper reviewed and analyzed the management and performance of 43 key clinical pmjeets in recent ten years in Fudan University(the clinical part of original Shanghai Medical University).It was found that hardware equipments of clinic,the ability of disease prevention,diagnosis and treatment obviously improved,the talent training and personnel structure received outstanding outcome,the academic level of basic researches got obvious promotion,the preponderant disciplines established gradually and consolidated,and the center radiation effect showed preliminary success under the aid of key project fund.Constructing the key clinical projects should boost actively amalgamation of medicine and sciences and pay a great attention to develop the medicine auxiliary discipline to further enlarge the clinical research achievements and fully display the guidance function for the development of our country~clinical medicine discipline under the new situation.

Since the beginning of 973 plans and major scientific research programs,the ministry of science and technology has organized the implementation of a number of major projects under the principle guidance of top-level design,co-ordinate arrangements,advantage integration and dynamic adjustment.Prominent advance of technology and expansion of innovation capacity has become possible with the success of those major projects.As a dominant force of basic science research,universities took part in the designing and implementing of most of 973 major scientific research programs.In this paper,participating universities,such as Peking University,Tsinghua University,Fudan University,Zhejiang University,Shanghai Jiaotong University,University of Science and Technology of China,Nanjing University,were analyzed in their roles played in those projects,and the questions of how universities should make the adjustment to their planning and management to meet the requirements of future national research programs were discussed.

Objective To investigate the adhesion mechanism of Lactobacillus acidophilus FN001外to Peyer's patches. Methods Adhesion of L. acidophilus FN001 to mice Peyer's patches was studied in vitro using a fluorescent quantization method. The nature of adhesion mediator was studied by the effects of physical, chemical and enzymatic pre-treatments of the bacteria on their adhesion and effect of sugars on in- hibition of adhesion. The presence of lectin-like proteins in the cell surface was determined by hemagglutina- tion. Effect of L. acidophilus FN001 on inhibition of adhesion of pathogens to Peyer's patches was also stud- ied. Results The adhesion of L. acidophilus FN001 was strongly inhibited in the presence of D-mannose and methyl-ct-D-mannoside. Pretreatment of L. acidophilus FN001 with pepsin and trypsin decreased the ad- hesive capacity indicating that cell surface proteins are involved in adhesion to Peyer's patches. L. acidophi- lus FN001 could agglutinate rabbit red cell in mannose specific manner and protease pretreatment could de-crease hemagglutinin, suggesting that L. acidophilus FN001 has mannose specific lectin (s). In adherence inhibition assay, L. acidophilus NF001 could significantly inhibit adhesion of E. coli ATCC25922 to Peyer's patches when L. acidophilus NF001 were applied to Peyer's patches first or at the same time with pathogen. Conclusion It was concluded that a mannose-specific protein mediated adhesion of L. acidophilus FN001 to the Peyer's patches, and L. acidophilus FN001 could inhibit adhesion of pathogen with similar lectins speci- ficity to Peyer's patches.

The State Key Specialized Scientific Projects bring the unprecedented opportunity for the development of variety disciplines and provide the critical timing for the improvement of science and technology of university. Meanwhile, it presents new challenges to develop the frontier of sciences and to promote cooperation and cross of different disciplines. Through the process of the programs, we will expect to train and find team leaders and outstanding scientists. This paper presented the brief outline how the researchers from the Departments of Infectious Disease and School of Pharmacy in Fudan University collaborated in a cross-discipline manner and integrated the research resources based on the objectives of the research programs. During the application, they reorganized research teams, combined the overlapping research fields to focus the direction of research fields according to the national and research needs. In the process of their application, they finally promoted the capacities for their competition and innovation which were undoubted to help us to establish headship/main forces in the fields of infectious disease precaution and devolvement of new clinical medicine in the future.

Objective To investigate the infection prevention effect of prophylactic use of antibiotics for cancer inpatients with leukocyte count ≤ 1 × 109/L.Then to provide the basis for rational use of antibiotics.Methods It was retrospectively surveyed that the infection situation and prophylactic usage of antibiotics in the 426 cancer inpatients with leukocyte count ≤ 1 × 109/L caused by radiotherapy and chemotherapy.Results In the 426 inpatients,the infection rates of patients with and without prophylactic use of antibiotics were 11.0％ and 20.9％ respectively.The difference was statistically significant (x2 =6.815,P =0.009).The leukocyte count median values of patients with and without infection were 0.73 × 109/L and 0.77 × 109/L respectively.The difference had no statistical significance(Z =-1.257,P =0.209).The main infection sites were lower respiratory tract,upper respiratory tract and gastrointestinal tract with infection rates of 48％,12％ and 11％,respectively.The top five pathogens were Klebsiella pneumonia,Enterobacter cloacae,Escherichia coli,Enterobacter aerogenes and Staphylococcus aureus.The most use of antibiotics were cephalosporin.Conclusion When the leukocyte counts of cancer inpatients are less than or equal to 1 × 109/L induced by chemotherapy and radiotherapy,reasonable prophylactic use of antibiotics can reduce hospital infection rates.

The clinicopathological data of 173 cases of inflammatory myofibroblastic tumor (IMT)were retrospectively analyzed.Among them 125 were males and 48 females with a mean age of 47.9 y (5-78 y).The lesions of 117 cases were located in lungs,41 cases in eyes,8 in ileocecum,2 in liver,2 in spleen,1 in abdominal wall,1 in maxillary sinus and 1 in face.The average diameter of lesions were 3.5 cm,ranging from 1.0 cm to 7.0 cm.The clinical manifestations were not specific,depending on the locations of tumor.The imaging examinations were helpful for diagnosis.The prcsence of slender-spindled myofibroblasts and proliferation of fibroblast cells,with infiltration of chronic inflammatory cells were the basic histopathological features of the disease.Combined with the histological characteristics and immunohistochemical staining IMT can be differentiated from other spindle cell tumors.Appropriate surgical resection is the main treatment for IMT.

Objective To study the state of doctors' psychological capital in public hospitals,and to analyze the characteristics of such capital,so as to better leverage the capital as a hospital management tool.Methods A quantitative and qualitative research was made on the state of doctors＇ psychological capital.Results The doctors' task-oriented psychological capital scored 4.25,and guanxi-oriented psychological capital 4.41; “modesty and prudence”scored the highest in all dimensions of the doctors' psychological capital,“optimism and hope”lowest; the doctors with different genders,ages,seniority,and monthly average income have a difference in psychological capital.However,no significant difference was found with varying titles,hospital levels,and employment models.Conclusion The doctors were found with a strong psychological capital to cope with stress.Better psychological capital will raise quality of care in practice.

Objective To explore the effect of nursing of Traditional Chinese Medicine on cognitive function among aged people with mild cognitive impairment in elderly care institution. Methods A total of 66 cases with mild cognitive impairment elderly that previously were screened out from two pension institutions in Taiyuan city as the research objects. According to the endowment institutions where the objects of study dwelled was divided into control group (34 cases) and intervention group (32 cases). The intervention group accepted nursing of Traditional Chinese Medicine plan for four months. The control group received the disease related knowledge health education. The cognitive function of the two groups were assessed using the Montreal Cognitive Scale (MoCA) before and after the intervention. Results Before the intervention, two groups had no statistical significance in each dimension score and total score of MoCA. After the intervention, four dimensions scores including ability of visual spatial and execute , attention , delayed recall , directional force and the total score of the intervention group respectively were (2.67±1.09) points, (4.07±1.08) points, (1.97±0.81) points, (4.83±0.99) points, (18.80±1.74) points while the control group were (2.15 ± 0.71) points, (3.30 ± 0.63) points, (1.39 ± 0.97) points, (4.24 ± 1.41) points, (15.06 ± 2.98) points, and the difference was statistically significant (t=1.91-6.06, P < 0.05 or 0.01) ;Before intervention the language score, delayed recall score and the total score of the intervention group were (1.43±0.77) points, (1.57±1.10) points, (17.27±1.99) points, respectively while after the intervention were (1.80 ± 0.66) points, (1.97 ± 0.81) points, (18.80 ± 1.74) points, there was statistically significant difference (t =-2.16,-2.11,- 4.34, P < 0.05 or 0.01). Conclusions Nursing of Traditional Chinese Medicine can delay the process of cognitive decline of mild cognitive impairment in the elderly, and have a certain effect on prevention and treatment of patients with mild cognitive impairment.

Objective The aim of this study was to explore the clinical value of dual-source CT(DSCT)in the diagnosis of coronary artery fistula(CAF)before and after surgery. Methods A retrospective analysis was performed in 15 cases of patients with CAF,11 cases of which was treated by surgery during extracorporeal circulation. Results CAF arose from right coronary artery in 8 cases and left coronary artery in 7 cases,with the latter including 3 cases of ramus nodi sinuatrialis fistula,2 cases of anterior descending branch fistula,and 2 cases of left circumflex fistula. CAF entered into right atrium(6 cases),right ventricle(5 cases),left ventricle(4 cases)and left atrium(1 case). There were dilatation of coronary artery in 8 cases,localized aneurysm in 4 cases,normal coronary artery in 3 cases,single fistula orifice in 11 cases,and multiple fistula orifice in 4 cases. 11 patients underwent surgery under cardiopulmonary bypass(CPB).The postoperative imaging revealed fistula has been sutured in 10 patients with no residual fistula,including fistula vascular ligation in 3 cases,the proximal imaging and distal occlusion in right coronary artery angioplasty in 1 case,and pseudo diverticulum in 2 cases. Conclusion DSCT examination has significant value in preoperative diagnosis and postoperative follow-up for CAF.

Objective To study the dosimetric impact of different angle fields in intensitymodulated radiotherapy (IMRT) and the feasibility of beam angle optimization (BAO) for multiple intracranial metastases.Methods In total,11 patients with multiple intracranial metastases were included in these analyses.Two treatment techniques were designed for each patient:the 7 equal spaced fields (BAF group) IMRT,and 7 fields by beam angle optimization (BAO group) IMRT.The dose distribution in the target,the dose to the organs at risk and normal brain tissues,and total MU in two groups were compared to explore the dosimetric differences.Results In comparison to the BAF group,the BAO group reduced the maximum dose to left and right lenses by an average of 45％,37％ (t =-5.707,-4.438,P ＜ 0.05);the mean dose to the left and right eyes were reduced by an average of 42.6％,44.5％ (t =-4.380,-5.638,P ＜0.05);the maximum dose to the right eyes were reduced by an average of 32.5％ (t =-2.518,P ＜ 0.05).The maximum dose of the right optic nerve and the mean dose of normal brain tissue were reduced by an average of 23％ and 3％ (t =-3.105,-3.437,P ＜0.05),respectively.For the target dose,conformity and homogeneity in PTV,no statistical differences were observed between the two groups (P ＞ 0.05).The BAO group reduced the maximum dose of the brainstem and the optic chiasm,as well as the number of MU,however,the differences were not statistically significant (P ＞ 0.05).Conclusions In comparison to the BAF group,the BAO group shows a similar target dose and reduces the dose for the organs at risk.For multiple intracranial metastases,IMRT protocols with BAO are feasible and beneficial.