Objective To boost the transformation and sustainable development of medical scientific achievements. Methods Investigations in the form of questionnaires were made and descriptive statistics was conducted. Results Eighty to ninety percent of the achievements awards were allocated to the research project teams or the principal prize winners. Most of the achievements transformation awards were retained by the units while only ten to twenty percent went to the principal awardees and only two to three percent went to the management and intermediary personnel. There also existed such problems as weak awareness of achievements transformation and lack of scientificalness in the achievements review and evaluation system, assessment system and assessment indexes. Conclusion The awareness of scientific achievements transformation should be enhanced and the transformation should be implemented on a market oriented and commercial basis; the scientificalness of achievements review and evaluation should be improved; more awards should be given and more social fundraising activities should be conducted; and scientific research management should be included among the factors to be considered when allocating money awards.

OBJECTIVE: To investigate the clinical effects of the combined modality therapy for the patients with difficult-to-treat rhinosinusitis (DTRS). METHOD: The clinical data involving 42 patients with DTRS were analyzed retrospectively. All patients received revision endoscopic sinus surgery (ESS) and combined modality therapy systematically and individually. The clinical effects of all patients were observed 6- and 12-month following revision ESS. RESULT: Forty-two patients were followed up for 6 months, whereas 35 patients were followed for 12 months post operation. VAS scores of the patients significantly improved (P < 0.01) 6- and 12-month after revision ESS, but there was no statistic difference (P > 0.05) between 6- and 12-month post operation. Moreover, Lund-Kennedy scores by endoscopy significantly improved (P < 0.01) 6- and 12-month following ESS. Similarly, there was no statistic difference (P > 0.05) between 6- and 12-month postoperatively. Additionally, within 6 months follow-up, 16 of 42 patients (38.1%) were cured, 19 of 42 patients (45.2%) were improved, and 7 of 42 patients (16.7%) were ineffective. The total effective rate in all patients was 83.3% 6 months postoperatively. While within 12 months follow-up, 11 of 35 patients (31.4%) were cured, 15 of 35 patients (42.9%) were improved, and 9 of 35 patients (25.7%) were ineffective. Hence, the total effective rate in 35 patients was 74.3% after 12-month follow-up. There was no statistic difference (χ² = 1.019, P > 0.05) between 6- and 12-month postoperatively. CONCLUSION Appropriate revision ESS plus the combined modality therapy has been proven to be an effective method for the treatment of DTRS. The clinical effects in this study are significant and stable, and thus it is worthy of further clinical applications.
Combined Modality Therapy ; Endoscopy ; Humans ; Nasal Surgical Procedures ; Paranasal Sinuses ; surgery ; Postoperative Period ; Reoperation ; Retrospective Studies ; Rhinitis ; surgery ; therapy ; Sinusitis ; surgery ; therapy ; Treatment Outcome

Actins ; metabolism ; Breast ; cytology ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; Cell Differentiation ; Female ; Humans ; Keratins ; metabolism ; Neoplastic Stem Cells ; metabolism ; pathology ; Signal Transduction ; Stem Cells ; cytology ; metabolism

Introduction to the efforts made in Shanghai's clinical residency training.With joint efforts of both clinical training bases and community training bases, this approach integrates the instructional resources of medical schools, and hands-on training at community bases, in order to ease shortage of general practitioners, backup talents, and that of teachers.These efforts can effectively elevate competency of general practitioners.

The literature analysis and case analysis were used to analyze the current situation and problems of the patent protection of Chinese medicine.The patent of artemisinin was registered abroad as the failure case, while Tasly developed the construction of the patent net overseas as a successful case. The intellectual property right of traditional Chinese medicine has started late in China, so the Chinese pharmaceutical enterprises lacked awareness of the intellectual property protection of Chinese medicine, and it is difficult for us to have comprehensive intellectual propertyright protection in traditional Chinese medicine. The intellectual property system of Chinese medicine in China needs improvement.

Objective:To analyze the clinical features and genetic factors of neonatal 17β-hydroxysteroid dehydrogenase type10 (HSD10) deficiency.Methods:The clinical characteristics and genetic test results of a child with HSD10 deficiency coming from Children′s Hospital of Nanjing Medical University in April 2019 were retrospectively analyzed.The keywords" 17β-hydroxysteroid dehydrogenase type 10 deficiency" or " 2-Methyl3-Hydroxybutyryl-CoA dehydrogenase deficiency" or " HSD10" , etc.were searched in various databases, including CNKI, Wanfang, Weipu, Embase and PubMed to review the cases collected from all published data until May 31, 2020.Results:The patient was a newborn male who developed symptoms on the first day after birth.The main signs were metabolic acidosis, increased blood ammonia and lactate, and hypotonia.Trio whole exom sequencing in the patient and his parents identified hemizygous NM001037811: c.650G>A, p.R217Q in the HSD17B10 gene that is inherited from the mother.Since the child died on the third day after birth, no further central nervous system examination was performed.The mother of the child has intellectual disability, the sibling sister is normal and the HSD17B10 locus is wild type.By lite-rature reviewing, 5 newborn cases with clear medical records and genetic test results were listed.All patients were male, and had onset of HSD10 deficiency within 1 week after birth.The main phenotypes include metabolic acidosis (increased blood ammonia and lactate), hypoglycemia, hypotonia, and convulsions.All 6 children died in early infancy.The corresponsive HSD17B10 variants were c. 740A>G/p.N247S, c.677G>A/p.R226Q, c.257A>G/p.D86G and c. 650G>A/p.R217Q, which did not indicate the hot spots of mutation. Conclusions:HSD10 deficiency in the neonatal period is relatively rare.The clinical diagnosis is difficult due to the serious condition and short course of the disease.Severe metabolic acidosis, hypotonia, and convulsions in neonatal patients are the main reasons for the poor prognosis, which can be attributed to the hemizygous variation and heterogeneity of the mutation site in male patients.c.650G>A may be closely associated with severe neonatal HSD10 deficiency, but the molecular biological mechanism needs to be further clarified.HSD10 deficiency has a poor prognosis and lacks effective treatment.

Objective To assess the association between polymorphisms in HIF1α gene and prognosis of advanced hepatocelluar carcinoma.Methods We collected prognosis data from a cohort of 448 advanced HCC patients treated by transarterial chemoembo-lisation,and used 5ml peripheral blood from patients for extraction DNA.Three SNPs (rs2301 1 13、rs2057482 and rs1 957757 )in HIF1αgene were selected and genotyped.Multivariate Cox proportional hazards model,Kaplan-Meier curve and log-rank test were used for prognosis analyses.Results The variant-containing genotypes (WV+VV)of SNP rs2301 1 13 exhibited a significant associ-ation with a better overall survival in HCC patients who had tumor size smaller than 5 cm (hazard ratio [HR],0.58,95% confidence interval [CI],0.35-0.96,P =0.036).In the patients taken single tumor subgroup,the variant-containing genotypes (WV+VV) of SNP rs2301 1 13 exhibited a significant association with a better overall survival (log-rank P =0.048),comparing to those carrying wild-type genotype.Conclusion Our results suggest that polymorphisms in HIF1αgene may serve as an independent prognosis bio-marker for advanced HCC patient.

Objective To explore the clinical value of total hemihepatic vascular exclusion (THHVE) in right hepatectomy for hepatocellular carcinoma (HCC). Methods One hundred and twenty-three consecutive patients who underwent right hepatectomy for HCC between February 2006 and December 2008 were studied retrospectively. THHVE was used in 58 patients (group A) and Pringle maneuver in 65 patients (group B). The patient's demographics,surgical procedure and outcome were collected and compared between the two groups.ResultsThe tumor size was significantly bigger in group A than group B (7.69±3.70 cm vs.6.08±4.07 cm,P＜0.05).The vascular occlusion time in group A was significantly longer than groupB (28.55±8.67 min vs.19.85±6.71 min,P＜0.05). However, intraoperative blood loss in group A was significantly less than group B (304.31±270.36 ml vs.542.62±876.84 ml,P＜0.05),and the elevation of serum alanine aminotransferase (ALT) on day- 1,-3 and- 7 after operation in group A were significantly lower than group B (P＜0.05).The postoperative complication rate in group A was lower than group B (18.97％ vs.38.46％,P＜0.05).ConclusionTHHVE was a safe and efficacious technique in right hepatectomy for HCC.It significantly decreased blood loss,alleviated liver injury and reduced postoperative morbidity and mortality.

Objective To investigate the changes of serum apolipoprotein A-I and its clinical significance to acute respiratory infection.Method Totally 44 patients with acute respiratory infection were divided into three groups according to various concentration of Serum apolipoprotein A-I.They were procaleitonin(PCT)＜0.5 ng/ml group,0.5 ng/ml≤PCT＜2 ng/ml group and PCT≥2 ng/ml group.We measured apolipoprotein A-I,C-reactive protein,procalcitonin and albumin within 24 hours after admission.Results With the increase of serumPCT,the production of ApoA-I and albumin were down-regulated,while CRP up-regulated.Conclusions Apolipoprotein A-I has a sound relationship with the acute respiratory infection.It can be used as one of the diagnostic criteria in severe infection patients who have disorders of lipometabolism.

As a new service form,community medical service provides primary health care for residents and it is operated with reasonable medical expenses.The function and service range of community medical service have reached consensus in medical industry,but the key issues of how to gain the market by competitive products and reasonable price have not been solved.This article analyzes the position of community medical service in healthcare system to clarify its unique attributes.The article further discusses the contents and pricing characteristics of community medical service,and the main influencing factors.The article introduces the issues dealing with community medical service product development,including the procedure of development,key points at different stages of development and the related research methods for the development of new service products.