Objective To explore the scientific management based on the needs of the clinical medical practitioners and the comprehensive promotion of the discipline construction of the hospital.Methods Totally 150 clinical professional technical staff and 33 academic leaders were investigated to explore the research needs and suggestions of them by questionnaire and expert interview.Results Among141 subjects,78.7％ (111/141) medical staff thought that the major factors of restricted themselves to scientific research were the clinical heavy task and pressure and no time,and 58.2％ (82/ 141) of them want to do research but lack of scientific research methods.Their favorite knowledge and skills were the research methods for 75.9％ (107/141),and the knowledge about the research proposal design for 58.9％ (83/141).The discipline construction evaluation of our hospital was divided into the key disciplines,the dominant disciplines,the developing of disciplines and the supporting of disciplines.And each discipline of level has its different needs.Conclusions To enhance of the scientific management of the scientific research base on the practical demands of the various disciplines can comprehensively promote the construction of the disciplines of the hospital.

Female ; Forced Expiratory Volume ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Male ; Positive-Pressure Respiration ; methods ; Pulmonary Ventilation ; Respiratory Insufficiency ; physiopathology ; therapy ; Treatment Outcome

A large number of documents will be generated in the process of new drug research,including lots of references.These data accumulate into institutional repository.Up to now,the management of document knowledge base in the process of new drug research has not yet been published.The paper uses the reference management software,combined with the document knowledge management system,to analyze and research the management model and method for establishing institutional repository.

Some problems were present with the universities combination,such as the relative scarcity of medical students and some students'lower enthusiasm for medicine.The university should establish policies to improve the quality of medical students,such as enlarging self-determination right to recruit medical students,strengthening the specialty thought of students.And further reformation and self-enhancement of medical college were more important for attracting excellent students.

Objective To provide a good anatomical foundation for transposition of the branch of median nerve superficial flexor muscle repairing the movement branch of ulnar nerve to recover the function of intrinsic muscle, by anatomic study of the muscle branch of the superficial flexor muscle of the median nerve and the movement branch of ulnar nerve. Methods Twenty adult upper limb specimens immersed fixed by formalin were elected and expose the midian nerve and ulnar nerve. Then every anatomical index was measured. Simulate to manipulate that the branch of superficial flexor muscle repair the motor b ranch of ulnar nerve. Calculate the number of myelinated nerve fibers of the branch of superficial flexor muscle. Results The distance between the position into muscle and styloid process of radius and styloid process of ulna: (21.4±1.8)mm, the distance that can be separated: (27.1±1.2)mm, the transverse diameter: (1.2±0.2)mm, anteroposterior diameter: (0.7 ± 0.1 )mm. No injury separated distance between the sensory branch and motor branch of ulnar nerve: (7.1 ± 0.7)cm. The 4th muscular branches of median nerve flexor digitorum superficialis was 1378.9± 107.9. Conclusion The 4th muscular branches of median nerve flexor digitorum superficialis can be used to repair the motor branch of the ulnar nerve to recover the function of intrinsic muscle of hand.

Objective To study the prenatal diagnosis and clinical significance of fetal hyperechogenic kidneys.Methods Thirty one cases with fetal hyperechogenic kidneys were prenatally diagnosed with ultrasound.Autopsy was conducted and histological examination of the kidney was performed when pregnancy was terminated.A close follow-up was given for cases continuing pregnancy.Umbilical cord blood was collected for fetal chromosome analysis after delivery.Results(1)6 fetuses were complicated with other organ abnormalities,3 fetuses had abnormal chromosome,and 2 cases had a family history.(2) 12 cases chose to terminate pregnancy,10 of whom were oligohydromnios.Causes for fetal hyperechogenic kidneys were infantile polycystic kidney disease(IPKD,10 cases),adult polycystic kidney disease (APKD,1 case),polycystic kidney dysplasia(PKD,1 case)after postmortem histological examination. (3)Nineteen cases continued pregnancy,2 neonates with oligohydramnios died during neonatal period,both of them were IPKD;3 cases that were IPKD,IPKD and KPD respectively died 3 months,8 months and 1 year after birth,respectively;one case presented with hypertension symptom 26 months after birth,which was diagnosed as IPKD.The other 13 cases had no clinical manifestation and a close following-up is being undertaken for them at present.Conclusions(1)Fetal hyperechogenic kidneys could be caused by IPKD, APKD,or PKD,and are sometimes a normal variant.(2)Aminotic fluid volume is a key factor for prognosis;a suggestion for termination would be given to cases with fetal hyperechogenic kidneys and oligohydromnios.(3)For cases with fetal hyperechogenic kidneys,a complete and careful ultrasonography should be given to both parents and fetus,and fetal chromosomal analysis is suggested prenatally.

Objective To identify hot research areas of nursing human caring in PubMed from 2012 to 2016, and to explore the present research status and development directions. Methods PubMed was searched using key words human caring. BICOMB 2.0 and SPSS 11.5 software were used to analyze high-frequency keywords and conduct co-word clustering analysis. Results We searched for 3088 related articles and extracted 42 high-frequency keywords (30.97%). Seven hot research areas were identified,including:human caring in nursing practice;nursing models,nursing theories;nursing education of human caring;hospice care;relationship between human caring and nurse-patient relation;human caring of cancer patients;family system,social support and human caring. Conclusion Analysis of research areas of nursing human caring in past 5 years is beneficial to understanding the present research status and development directions,and providing references for practice,research and education of human caring.

Objective To use a simple bedside technique to verify the pathophysiological mechanism of pulmonary hypertension (PH) in different races. Method The Valsalva maneuver (VM) was performed in patients referred to a specialty PH clinic. The blood pressure response of patients to VM was in different fashions. The blood pressure (BP) was measured by using cuff and stethoscope. When the cuff was inflated to 15 mmHg above the systolic pressure, sound could be heard by auscultation during VM and when the cuff was deflated the sound disappeared over 3 heart beats which was considered as abnormal BP response, and less than 3 heart beats defined as normal BP response. The right heart catheterization in patients with PH as a part of the standard evaluation. Results This study included 84 patients with a mean age of (63 ± 16) years. Those with abnormal BP response to VM had higher pulmonary artery wedge pressure (PAWP) [(22.5±6.6) vs. (11.9±4.3) mmHg, P ＜0.0001] and lower pulmonary vascular resistance [(5.8 ± 4.0) vs. (8.1 ± 4.6 ) WU, P = 0.01]. Blood pressure response to VM did not correlate with mean pulmonary artery (PA) pressure [(46.2 ± 9.9) vs. (43.4 ±10.4) mmHg, P =0.20] or cardiac index (both 2.4 ± 0.6 L/min/m2). The abnormal BP response to VM had high sensitivity (89.4%), specificity (86.1%) and accuracy (86.9%) for determining PAWP＞ 15 mmHg.Conclusions BP response to Valsalva maneuver provides important information about left heart filling pressures in patients with PH.

Objective To evaluate the efficiency of transcatheter closure of secundum artrial septal defect (ASD) using Amplatzer occluder device in 5 years.Methods There were 18 children with ASD.Each ASD was occluded using Amplatzer occluder device through the percutaneous procedure.The closure procedure was guided by fluoroscopy and transthoracic echocardiography.All patients were followed up by physical examination,color flow echocardiography,chest radition,electrocardiography at 48 h,1month,3 month,6 month,one year,two years,three years,four years and five years.Results Cardiac murmur disappeared or lightened.Arrhythmia and right heart volume in all patients were improved after the procedure.A case revealed a trival shunt of short duration and vanished after one month color flow echo.A case has “spring′s beat” in heart when she goes to bed in three years after the procedure.Another patient had serious headach after closure and recoved after heparin therapy.Conclusions Transcatheter closure of secundum ASD using amplatzer occluder device is safe and efficient by follow-up.In order to prevent cerebral embolism,heparin should be injected in vein in two days.

Objective To evaluate the clinical outcomes and report the second-look arthroscopic findings of reconstructed anterior cruciate ligament (ACL) using deep-frozen allograft.Methods Sixty-six patients undergoing ACL reconstruction using deep-frozen allograft in our institute with at least twelve months follow-up from January 2012 to March 2016 were included and received second-look arthroscopy.The patients consisted of 51 males and 15 females with an average age of 30.6 years (range,18 to 55 years) at the time of ACL reconstruction.Knee functions were evaluated by Lysholm score and International Knee Documentation Committee (IKDC) score.Knee stability was evaluated by drawer test,Lachman test and KT-1000 arthrometer.Second-look arthroscopic evaluation was performed in all patients,focused on continuity of the reconstructed ACL,the synovial coverage and subjective tension of the graft,and the prevalence of cyclops-like lesion and other changes after reconstruction procedures.Resuits All patients were followed up for average 18.3 months (range,12 to 36 months).Thirty-one patients underwent second-look arthroscopy from 12 to 18 months,and the other 35 patients underwent second-look arthroscopy from 18 to 36 months after ACL reconstruction.No infection,rejection reaction and other serious complication were reported after operation.The knee range of motion was normal in all cases,except that 10° extension limitation in one case.The Lysholm score significantly improved from preoperative 54.95±9.01 to 12 months postoperatively 86.14±5.86,and the IKDC improved from 54.79±9.12 to 85.11±5.77.Lachman test was positive in 8 cases,but negative in 58 cases postoperatively.KT-1000 arthrometer measurement showed that the side-toside difference significantly improved from preoperative 6.70± 1.24 mm to postoperative 1.52± 1.02 mm.Complete discontinuity occurred in 2 cases of the reconstructed grafts,graft tear in 4 cases.Cyclops-like mass was identified in 2 cases.The overall synovial coverage was slightly better in the patients who were followed up more than 18 months than those less than 18 months.However,there was no significant difference among the groups in the field of graft tension.The patients with taut grafts showed statistically better KT-1000 values (1.14±0.35 mm) than those with lax grafts (2.95±1.38 mm).Conclusion Frozen allograft could be a reasonable choice for ACL reconstruction.However,the graft integration and remodeling could tend to be slow.