Objective: Through managing objectives in our hospital, promote the hospital management. Methods:Use expert advice method to establish the target assessment index system, with the weighted index method to calculate the final score. Results: According to the characteristics of the department, develop differentiated, personalized indicators; objective management system consists of 3 level indicators medical examination standard (680 points), scientific research and teaching standards (220 points), departmental management assessment criteria(100 points), and 45 secondary indicator of internal medicine, surgical 49 second-level indicators. Conclusion: Objective management is the starting point of the hospital and meticulous management, and implementation of objective management enhance the awareness of the collective participation of the medical staffs at all levels, so that the department changes from passive management to active management, and it enhances department execution and promotes the hospital science directly.

Objective [WT5”BZ] To evaluate the effects of glycyl glutamine (Gly Gln) on the small intestinal graft. [WT5”HZ]Methods [WT5”BZ] Ten outbrid pigs undergoing small bowel autotransplantation were randomly divided into 2 groups. In STPN group, the animals received standard TPN devoid of Gly Gln,and in GTPN group,the animals received isonitrogenous (0 3?g?kg -1 ?d -1 )and isocaloric (nonprotein calory:137 9?kJ?kg -1 ?d -1 ) TPN with 2% Gly Gln.Animals were fed for 28 days. [WT5”HZ]Results [WT5”BZ] At the end of TPN,the mucosal contents of Gln (1 14?0 20)??mol/g tissue wet weight, protein (101?22)?mg/g and the villous contents of DNA (3 84?0 39) and RNA (3 31?0 14),the graft villous height (308?52) ?m, surface area (0 154?0 019) mm 2 and mucosal thickness(665?72) ?m were significantly higher in the GTPN group than that in STPN group ( P

Objective To evaluate the surgical methods and the results of treatment for open achilles tendon ruptures.Methods 56 patients with open achilles tendon ruptures were treated by Tsuge stuture or auxileary repair with free deep-fascia circuitously.Results 52 cases had the excellent results,3 case had the middle results,1 case had poor results that marginal skin of the wound were necrosis and subinfection.Conclusion It has a good effect that the open achilles tendon ruptures are treated by modified Tsuge stuture or auxileary repair with free deep-fascia circuitously.

Objective To compare the efficacy and safety of thrombolysis and anticoagulant therapy for post-traumatic acute submassive pulmonary embolism (PE) in middle-aged and elderly patients.Methods Totally 45 patients with post-traumatic acute submassive pulmonary embolism in our hospital were selected.Patients were divided into thrombolysis group (n =22) and anticoagulation group (n=23) according to their conditions.Symptoms and signs,blood gas analysis,D-dimer,echocardiography,CT pulmonary angiography (CTPA) were performed before and after thrombolysis or anticoagulant therapy.Results There were no significant differences in clinical curative rate between thrombolysis group and anticoagulation group [95.5％ (21/22) vs.91.3％ (21/23),x2 =0.32,P＞0.05],and no case was found dead in both two groups.There was a significant difference in hemorrhage rate between thrombolysis group and anticoagulation group [27.3％ vs.4.3％,x2 =4.53,P ＜ 0.05].At 24 hours after thrombolysis or anticoagulant therapy,the improvement rate of dyspnea,PaO2 level was significantly higher and the pulmonary arterial pressure was significantly lower in thrombolysis group than in anticoagulation group [45.5％ (10/22) vs.17.4％ (4/23),(80.4±8.1) mm Hg vs.(73.6±9.3) mm Hg,(51.2±6.2) mm Hgvs.(60.3±5.7) mm Hg,respectively,all P＜0.05],and there were no statistical significances at other time points between the two groups.Conclusions The clinical curative rate and fatality rate are similar in thrombolysis group versus anticoagulation group.Hemorrhage rate is higher in thrombolysis group than in anticoagulation group.Thrombolysis can relieve dyspnea rapidly,reduce pulmonary artery pressure and make the embolized blood vessels recanalized.Patients with low bleeding risk in a critical condition are suggested to take thrombolysis therapy,while patients with high bleeding risk in a light condition are suggested to take anticoagulant therapy.

Objective To investigate the correlation between IL‐6 ,hs‐CRP and blood lipids ,blood glucose in type 2 diabetes mel‐litus(T2DM) patients complicated with coronary heart disease .Methods 64 outpatients first diagnosed T2DM complicated with coronary heart disease were selected ,56 T2DM patients and 58 health examination were as compare from 2014 January to November in my courtyard .Interleukin‐6(IL‐6) ,high sensitivity C reactive protein(hs‐CRP) and total cholesterol(TC) ,low density lipopro‐tein‐C(LDL‐C) ,blood glucose and HbA1c were detected in 3 groups of person .Results T2DM group and T2DM complicated with coronary heart disease with fasting glucose ,HbA1c ,TC and LDL‐C was significantly higher than normal group ,the difference was statistically significant(P<0 .05);The level of IL‐6 ,hs‐CRP in patients T2DM with coronary heart disease complicated was signifi‐cantly higher than that of T2DM group ,and T2DM group was higher than that of healthy group ,the differences were statistically significant(P<0 .05) .Conclusion IL‐6 and hs‐CRP can be as a specific index to predict the disease process of T2DM complicated with coronary heart disease .

Objective To explore the relationship between the prothrombotic state and blood coagulation-fibrinolysis system changes with deep venous thrombosis(DVT)in aged patients after total joint arthroplasty,and to propose preventive measures.Methods 400 patients who underwent total hip or knee replacement from January 2003 to June 2011 were classified into suspected DVT(n=200 cases)and non-suspected DVT(n=200 cases)according to Well's clinical scoring system.The patients were divided into 4 subgroups based on the measures to prevent DVT:low molecular weigh heparin group,intermittent pneumatic bag compression group,combined above measures group,control group who refused any preventive measures.Plasma thrombin-antithrombin complex(TAT),plasmin-α2 antiplasmin complex(PAP)were determined preoperatively.Venous Doppler ultrasound was performed before surgery,4 d and 10 d after surgery to detect the presence of DVT.Results Totally 71 cases(17.8％)were diagnosed as DVT and 5 cases(1.3％)as pulmonary thromboembolism(PTE).The incidence of DVT in suspected DVT group(28.5％,57 cases)was lower than in non-suspected DVT group(7.0 ％,14 cases)(x2 =31.66,P＜ 0.01).Among patients with suspected DVT,the DVT prevalence in combined measures group(2.0 ％,1 cases)was decreased than in low molecular weigh heparin group(14.0％,7 cases),intermittent pneumatic bag compression (34.0％,17 cases)and control groups(64.0％,32 cases)(x2=4.89,17.34,18.01,all P＜0.05).In the patients with non-suspected DVT,the DVT prevalence in combined measures group(0.0％)was lower than in control group(24.0 ％,12 cases)(x2 =13.64,P＜0.01).The average preoperative level of TAT[(9.63±3.06)μg/L]in patients with DVT was higher than without DVT[(2.59±0.87)μg/L](t=35.70,P＜0.01),while PAP level in patients with DVT[(38.52± 21.13)μg/L]was reduced than without DVT[69.75±30.26)μg/L](t=8.27,P＜0.01).Conclusions The levels of TAT and PAP before total hip or knee replacement are predictive for lower extremity DVT.The clinical effectiveness of Well's scoring on DVT prevention is dependent on the different TAT and PAP state.

Objective To investigate the influence of tethered cord syndrome (TCS) on the up-per urinary tract and its etiology. Methods Forty patients with TCS diagnosed by spinal MRI were enrolled in this study. There were 21 males and 19 females with mean age of 23 years old. The course of disease ranged from 1 to 40 years. Urinalysis, mid-stream urine culture, serum creatinine(SCr), urinary system ultrasound, IVU, eystography and urodynamic study were carried out on all patients. Results Urinary tract infection was found in 17 patients and increased level of SCr was found in 6 pa-tients (251.64±98.5μmol/L). Of the 29 patients who underwent urinary system ultrasound examina-tion, 12 cases had hydronephroais and dilated upper ureter. Of the 30 patients who underwent IVU, 10(33.3%) had ureterectasia and hydronephrosis, 22 cases had bladder turriform or Christmas tree like deformity with diverticulum and trabeculum. Of the 22 patients accepted cystography, 17 cases had vesieoureteral reflux on 27 sides. Post-void residual (PVR) was evaluated in 35 patients and found increased in 31 cases. Cystometry had been done in 33 patients. The mean value of maximal detrusor pressure (Pdetmax) during filling phase was 41.2±20.9 cm H2O. The detrusor compliance was 22.35±18.8 ml/cm H2O. During voiding phase, detrusor-sphincter dyssynergia(DSD)was observed in 16 patients, detrusor areflexia was observed in 16 patients and detrusor underactivity was observed in 13 patients. Resting urethral pressure profilemetry was measured in 16 patients. Maximal urethral closure pressure (MUCP) was 76.1±33.1 cm H2O. The upper urinary tract deterioration was de-fined as increased SCr, hydronephrosis or vesicoureteral reflux. There were 20 patients diagnosed as upper urinary tract deterioration. The compliance of the upper urinary tract deteriorating group and the no-deteriorating group was 9.4±7.8 vs 19.3±15.8 ml/cm H2O, Pdetmax was 43.1±21.2 vs 24.0±11.9 cm H2O, PVR 189.0±138.0 vs 47.8±36.8 ml, MUCP 86.2±32.4 vs 46.8 5±20.8 cm H2O, incidence of damaged detrusor 100.0% vs 69.2% and DSD 65.0% vs 23.1%, respectively. There were significant differences between the 2 groups(P<0.05). And when comparing the VUR group with no VUR group, the incidence of urinary tract infection was 94.1%(16/17) vs 20.0%(1/ 5) (P=0.003). And when comparing urinary tract infection group with no infection group, the inci-dence of upper urinary tract deterioration was 88.2% (15/17) vs 21.7%(5/23)(P=0.000). Condn-sion Low compliance bladder, high Pdetmax during filling phase, increased PVR, high MUCP, damage of detrusor contractive function and DSD are the risk factors for upper urinary tract deteriora-tion in the TCS patients.

Objective To screen the differential proteins in the brain (neocortex and hippocampus) between the rats with cortical dysplasia (CD) and control ones,and investigate the role of their alteration in the development of epilepsy in CD.Methods Cortical dysplasia was induced in rat pups via in utero delivery of BCNU.A two-dimensional electrophoresis (2-DE)-based approach was used to construct the expression profiles of proteins in both the neocortex and hippocampus at different age groups (postnatal day 7 and 60) and to detect proteome changes between CD rats and control ones.Following gel image analysis,protein spots that differed in abundance between CD and control rats were identified by using Matrx-assisted laser desorption/ionization (MALDI) mass spectrometry (MS) and MS/MS.Results A total of 57 kinds of protein were screened out (P ＜ 0.05),in which 35 were found up-regulated and 22 were down-regulated compared with the control,35 from neonatal stage (postnatal day 7) and others from adult stage.Finally,12 among them were identified,including tubulin,alpha-lB,Beta-actin,tubulin beta-2A,GAP-43,UbCKmit,GAPDH and TMBr-3,etc.Conclusions Changed expression of specific proteins which were found in our study are involved in construction of brain 's cytoskeleton,synaptic function,mitochondrial function and so forth.Thus,they may be related to the pathogenic mechanisms of epileptogenicity of CD.

Objective:To research the effect of lumbar spinal nerve block combined with ultrashort wave on the pain and biomechanics of lumbar back muscle of patients biomechanics with lumbar disc.Methods:98 patients with lumbar disc herniation in our hospital from February 2014 to August 2016,according to the lottery method divided into control group and research group.The control group was treated with Lumbar spinal nerve block.The research group was based on the control group treated with ultrashort wave,clinical curative effect,changes of the visual analogue scale (VAS),60 ° /s angular velocity,120° /s average apical power (AP),peak torque (PT),lumbar dorsiflexion / dorsal flexion (F/E),serum levels of substance P (SP),β-endorphin (β-EP),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) before and after treatment,and adverse reactions were compared between two groups.Results:The total effective rate of research group was95.91％,which was significant higher than that of the control group,the difference was statistically significant (P＜0.05).After treatment,The VAS,F/E,serum levels of SP,IL-6 and TNF-α of two groups were significantly lower than those before treatment,the above indicators of research group were significantly lower than those of the control group.The AP,PT and serum levels of β-EP between two groups were significantly higher than those before treatment,the above indicators of research group were significantly higher than those of the control group (P＜0.05).No statistical difference was found in the incidence of adverse effects between the two groups (P＞0.05).Conclusion:Umbar spinal nerve block combined with ultrashort wave was more effective than lumbar paravertebral nerve block treatment alone in the treatment of lumbar disc herniation,it could effectively relieve the pain and improve the low back muscle biological mechanics performance and reduce the inflammatory response.

Objective To compare the short‐term clinical effects of single segment and two segments of Dynesys dynamic in‐ternal fixation system for treating lumbar degenerative disease .Methods 40 cases of degenerative lumbar disease treated by the Dynesys dynamic fixation system combined with posterior approach decompression from 2009 July to March 2012 were selected and performed the evaluation on the clinical effects by the waist and leg pain visual analogue scale (VAS) ,the Oswestry disability index (ODI) and the orthopaedic spinal association of North America (NASS) index .The imaging method was used to observe the mobili‐ty of operative segment and proximal adjacent segment and the degenerative change of intervertebral height .Results All of the 40 cases were followed up .The VAS score and ODI score at postoperative 3 months and last follow‐up were significantly decreased when compared with the pre‐operative scores (P<0 .05);there was no statistically significant differences in the VAS score and ODI score at 3 months and last follow‐up between the single segment group and the 2‐segment group (P> 0 .05) .The NASS index showed no statistically significant difference in the postoperative effect satisfaction between the two groups (P>0 .05);there was no statistically significant difference in the variation of the intervertebral height between before operation and at the last follow‐up (P>0 .05) .There was statistically significant difference in the motility of proximal adjacent segment at the last follow‐up between the two groups (P<0 .05);but comparing the motility of proximal adjacent segment between the last follow‐up and pre‐operation , only the single segment group showed statistically significant difference (P< 0 .05) .Conclusion The Dynesys dynamic fixation system combined with posterior approach decompression operation has good clinical effect in the treatment of lumbar degenerative disease .Meanwhile ,the single segment method has more significant effect on the motility of proximal adjacent segment than the double segments method .