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.

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 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.

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 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 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.

Acute-On-Chronic Liver Failure ; complications ; virology ; Adult ; DNA Mutational Analysis ; Female ; Genetic Variation ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; complications ; virology ; Humans ; Male ; Middle Aged

ObjectiveTo investigate the independent risk factors of 30-day mortality of nontraumatic acute chest pain in emergency department so as to get non - traumatic acute chest pain risk score,MethodsThe clinical data of 532 patients with non - traumatic acute chest pain were reviewed.The independent risk factors of 30 - day mortality were identified after analysis of medical history,symptom and sign,laboratory findings by uuivariate analysis and logistic regression.Non- traumatic acute chest pain risk score was made as per the odds ratios of these risk factors. ResultsThe average age of the patients was (55.7 + 12.7 ) years,and 45 patients ( 8.4％ ) died after 30 days.In patients with non - traumatic acute chest pain,history of hypertension (OR:4.28; 95％ CI:1.59-11.55 ),prolonged chest pain (OR:1.1; 95％ CI:1.05-1.15),dyspnea (OR:6.61; 95％CI:2.40-18.10) and tachycardia (OR:1.02; 95％CI:1.00-1.04),high leucocyte count (OR:1.18; 95％CI:1.06-1.31) and D - Dimer ( OR:1.002; 95％ CI:1.001-1.002 ) predicted 30 - day mortality independently,whereas chest pain relieved by medicine (OR:0. 15; 95％ CI:0.04-0.65),high blood oxygen saturation (SaO2) (OR:0.89; 95％CI:0.83-0.98) and normal hematocrit (OR:0.92; 95％CI:0.86-0.99) were good markers to predict optimistic prognosis.Non - traumatic acute chest pain risk score was higher in 30 - day dead group than those in survival group significantly ( P ＜ 0.01 ),and mortality was significantly different between groups with various risk stratification (P ＜ 0. 01 ).Conclusions Clinical physician can predict 30 - day mortality and evaluate prognosis in patients with acute chest pain by using non - traumatic acute chest pain risk score quickly and effectively.