The principal investigator responsibility system has been progressively under implementation at some of the domestic medical universities. However, since there are big differences between military medical universities and civilian ones in terms of organizational structures, tasks to be committed, functions and personnel systems, military medical universities have to consider own characteristics and well handle the following four pairs of relations in the process of implementing principal investigator responsibility system: the relation between the subject groups and the teaching and research sections, the relation between the subject research and the discipline construction, the relation between the subject research and the personnel training, and the relation between the collective assessment and the individual assessment in the process of performance assessment.

Recently the methylotrophic Pichia pastoris,with many advantages such as high expression,stable genetics and protein secretion,has been used extensively as a host expressing heterologous proteins.The optimal seed medium among seven media MM,MD,MGY,BMGY,YMPD,YMPGy and MGyB is BMGY with addition of 4mL/L PTM1 The high density synthesized medium in shake flask culture is as follows: Glycerol 4%(NH 4) 2SO 4 10g/L,CaSO 4 0.93g/L,K 2SO 4 18 2g/L,MgSO 4?7H 2O 14 9g/L,add 0.1mol/L PBS(pH=6 0) to 1 0 liter.The harvested yeast cell optical density (OD 600 ) reached 65 or more after 26 hours cultivation.By analysis of SDS\|PAGE,the results of Pichia pastoris culture by methanol inducement for 72 hours showed that the expression of recombinant human serum albumin had been achieved by methanol inducement after 12 hours,and the mount of targeted protein reached the summit after 24 hours inducement by methanol.The high density synthesized medium in shake flask culture in this experiment,which is similar to the mediums of batch fermentation and batch\|fed fermentation,is benefit to direct the P.pastoris fermentation in the fermentor.

Objective To evaluate the efficacy and safety of the TVT-Secur procedure for female stress urinary incontinence (SUI). Methods Analyze retrospectively the preoperative, intraoperative and postoperative complications and follow-up data of 27 SUI patients from October 2008 to May 2010. 20 cases were simple SUI, and 7 cases were mixed SUI. The average age was 56.1 ± 10.7 years (range, 35-77), the average parity was 2.8-±- 1.4 (range, 1-6), the average body mass index was 25.6±2.5, and the average course of the disease was 6.8±7.2 yeas (range, 1-30). Two cases had past history of pelvic surgery without any anti-incontinence surgery. Mashall-marchett test was positive in all patients, with an average abdominal leak point pressure (ALPP) of 60.9±27.5 cm H2O (range, 27- 120 cm H2O). The mean International Consultation on Incontinence-Short Form (ICIQ-SF) score was 11.2 ± 1.8 (range, 7- 14) before surgery. Results 27 patients underwent TVT-Secur procedure, of which 19 cases underwent "U" procedure, and 8 cases underwent "H" procedure. The mean operation time was 15.3±1.4min (range, 13- 19 min). There were no intraoperative bladder or urethral injury, and no obturator vessel or nerve damage. The blood loss was 10 to 50 ml, and the maximum urinary flow rate was 25. 4±13. 1 ml (range, 4-50 ml). Three eases had mild dysuria(11. 1%), and 3 cases had wound effusion(11. 1%). Followed up for 12. 6 ±6. 7 months (range, 3-21 months). 10 cases complained of bladder overactivity symptoms such as frequency, urgency, and urge incontinence, and no case had vaginal erosion. Therapeutic efficacy: 15 cases were cured (56%), 8 cases were improved (30%), and 4 cases were ineffective (15%). Conclusions TVT-Secur procedure is a simple, safe and minimally invasive surgery, while the cure rate is low. The long-term efficacy needs great amount of clinical data and long-term follow-up to prove.

Objective To explore the effect of high viscosity combined with compactiontechnique on the treatment of patients with osteoporotic vertebral compression fractures (OVCF) by percutaneous kyphoplasty (PKP).Medthods The clinical data of 80 patients with OVCF were retrospectively analyzed.Among them,40 patients with OVCF by PKP were treated with high viscosity and compaction technique,and 40 patients with OVCF were treated with traditional PKP.Operation time,the amount of bone cement perfusion,the incidence of bone cement leakage,the incidence of vertebral refracture,the height of vertebral body recovery after operation,the loss of vertebral height after 12 months,vertebral wedge angle before and after operation,VAS pain score,ODI score were compared between two groups.Results There was no significant difference in the height of fracture vertebral body between two groups (P ＞ 0.05),but there were significant differences in postoperative vertebral height increase,the loss of vertebral height after 12 months between two groups (P ＜ 0.05).There were no significant differences in pain relief and functional improvement effect between two groups (P ＞ 0.05),but there were significant differences in bone cement leakage rate and amount of bone cement injection between two groups (P ＜ 0.05).There was significant difference in recovery of postoperative vertebral wedge angle between two groups (P ＜ 0.05),but there were no significant differences in adjacent vertebral fractures,the VAS pain score and ODI spine score between two groups (P ＞0.05).Conclusion Application of high viscosity combined with compaction technique can relieve the painand improve the quality of life in patients with OVCF by PKP.

Objective To explore the effect of high viscosity combined with compactiontechnique on the treatment of patients with osteoporotic vertebral compression fractures (OVCF) by percutaneous kyphoplasty (PKP).Medthods The clinical data of 80 patients with OVCF were retrospectively analyzed.Among them,40 patients with OVCF by PKP were treated with high viscosity and compaction technique,and 40 patients with OVCF were treated with traditional PKP.Operation time,the amount of bone cement perfusion,the incidence of bone cement leakage,the incidence of vertebral refracture,the height of vertebral body recovery after operation,the loss of vertebral height after 12 months,vertebral wedge angle before and after operation,VAS pain score,ODI score were compared between two groups.Results There was no significant difference in the height of fracture vertebral body between two groups (P ＞ 0.05),but there were significant differences in postoperative vertebral height increase,the loss of vertebral height after 12 months between two groups (P ＜ 0.05).There were no significant differences in pain relief and functional improvement effect between two groups (P ＞ 0.05),but there were significant differences in bone cement leakage rate and amount of bone cement injection between two groups (P ＜ 0.05).There was significant difference in recovery of postoperative vertebral wedge angle between two groups (P ＜ 0.05),but there were no significant differences in adjacent vertebral fractures,the VAS pain score and ODI spine score between two groups (P ＞0.05).Conclusion Application of high viscosity combined with compaction technique can relieve the painand improve the quality of life in patients with OVCF by PKP.

Objective:To explore the predictive factors of pathological complete response (pCR) after neoadjuvant chemoradiotherapy for middle-low rectal cancer.Methods:A case-control study was conducted. The inclusion criteria were as follows: (1) colonoscopy, digital examination or magnetic resonance imaging (MRI) showed a distance from the lower edge of the tumor to the dentate line of no more than 10 cm; (2) complete clinicopathological data were available; (3) preoperative biopsy revealed adenocarcinoma; (4) preoperative pelvic MRI or endorectal ultrasonography was performed; (5) no distant metastasis was found. Exclusion criteria: (1) preoperative radiotherapy and chemotherapy were not administrated according to the standard; (2) simultaneous multiple primary cancer and familial adenomatous polyposis were observed. According to the above criteria, clinicopathological data of 245 patients with middle-low rectal cancer undergoing preoperative neoadjuvant chemoradiotherapy in Changhai Hospital of Navy Medical University from January 2012 to December 2019 were retrospectively collected. Univariate analysis and multivariate logistic analysis were used to identify the clinical factors predicting pCR. pCR is defined as complete disappearance of cancer cells under the microscope in cancer specimens (including lymph nodes) after neoadjuvant chemoradiotherapy.Results:A total of 72 patients with pCR were enrolled in this study. Univariate analysis showed that preoperative T stage, tumor circumference, tumor morphology, carbohydrate antigen (CA) 19-9, interval between the end of neoadjuvant therapy and operation were associated with pCR (all P<0.05). The above 5 variables were included in multivariate logistic analysis and the results revealed that the T stage (OR=5.743, 95% CI: 2.416-13.648, P<0.001), tumor circumference (OR=7.754, 95% CI: 3.822-15.733, P<0.001), tumor morphology (OR=0.264, 95% CI: 0.089-0.786, P=0.017) and the interval between the end of neoadjuvant therapy and operation (OR=0.303, 95% CI: 0.147-0.625, P=0.001) were independent predictive factors of pCR, while CA 19-9 level was not an independent factor (OR=1.873, 95% CI:0.372-9.436, P=0.447). Conclusion:By knowing the clinical features of preoperative T stage, tumor circumference, tumor morphology and the interval between neoadjuvant chemoradiotherapy and operation, patients with higher likelyhood of pCR after neoadjuvant chemoradiotherapy may be identified.

Objective:To explore the predictive factors of pathological complete response (pCR) after neoadjuvant chemoradiotherapy for middle-low rectal cancer.Methods:A case-control study was conducted. The inclusion criteria were as follows: (1) colonoscopy, digital examination or magnetic resonance imaging (MRI) showed a distance from the lower edge of the tumor to the dentate line of no more than 10 cm; (2) complete clinicopathological data were available; (3) preoperative biopsy revealed adenocarcinoma; (4) preoperative pelvic MRI or endorectal ultrasonography was performed; (5) no distant metastasis was found. Exclusion criteria: (1) preoperative radiotherapy and chemotherapy were not administrated according to the standard; (2) simultaneous multiple primary cancer and familial adenomatous polyposis were observed. According to the above criteria, clinicopathological data of 245 patients with middle-low rectal cancer undergoing preoperative neoadjuvant chemoradiotherapy in Changhai Hospital of Navy Medical University from January 2012 to December 2019 were retrospectively collected. Univariate analysis and multivariate logistic analysis were used to identify the clinical factors predicting pCR. pCR is defined as complete disappearance of cancer cells under the microscope in cancer specimens (including lymph nodes) after neoadjuvant chemoradiotherapy.Results:A total of 72 patients with pCR were enrolled in this study. Univariate analysis showed that preoperative T stage, tumor circumference, tumor morphology, carbohydrate antigen (CA) 19-9, interval between the end of neoadjuvant therapy and operation were associated with pCR (all P<0.05). The above 5 variables were included in multivariate logistic analysis and the results revealed that the T stage (OR=5.743, 95% CI: 2.416-13.648, P<0.001), tumor circumference (OR=7.754, 95% CI: 3.822-15.733, P<0.001), tumor morphology (OR=0.264, 95% CI: 0.089-0.786, P=0.017) and the interval between the end of neoadjuvant therapy and operation (OR=0.303, 95% CI: 0.147-0.625, P=0.001) were independent predictive factors of pCR, while CA 19-9 level was not an independent factor (OR=1.873, 95% CI:0.372-9.436, P=0.447). Conclusion:By knowing the clinical features of preoperative T stage, tumor circumference, tumor morphology and the interval between neoadjuvant chemoradiotherapy and operation, patients with higher likelyhood of pCR after neoadjuvant chemoradiotherapy may be identified.

Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.