The responsibility system of attending doctors plays a positive role in raising hospital efficiency and optimizing medical resources deployment.For the change in the subject of medical liabilities following the introduction of this system,medical management needs to shift from department management to doctor management instead.In the meantime,appropriate rules and regulations are needed to normalize the roles and behavior of the medical office,department heads,and attending doctors in medical activities.This will ensure the successful operation of this responsibility system,and generate ideal medical,economic and social outcomes.

Spastic diplegia and hemiplegia are the common types of cerebral palsy which needs treat-ment in clinic. The paper discusses the classification of gait problems in these two types of cerebral palsy and ac-cording to gait analysis,recommended the management for them. Through the understanding of the classification, the treatment plan could be made individually regarding the GMFCS level of the patient and improve their functions.

Objective To study the levels of bone alkaline phosphate (BALP) in healthy children in the specific hospital.Methods Totally 990 healthy children from 0-16 years old were selected,all of whom received physical examination in the Xiasha branch of Zhejiang Provincial Hospital of TCM during August 2013 to April 2014.Serum was collected and tested for BALP levels with a Beckman Coulter Immunoassay System UniCel DxI 800.Z-test was used to verify age and gender grouping,after which the 2.5th and 97.5th percentile values of serum BALP levels were calculated.Results The levels of serum BALP(bilateral 95％ range) in healthy children were as follows:trottie stage (0-1 years old):37-300μg/L;infancy to school stage (＞ 1-9 years old):40-196 μg/L;puberty stage (＞9-16 year-old):25-284 μg/L (male),30-199 μg/L (female).The serum BALP levels of male children showed a weak correlation with height,while the correlation for female children was not significant.Conclusions The levels of BALP in healthy children of the specific hospital and area were established.Serum BALP levels in children varied with age and sex.

Objective:To observe the histological character of distraction osteogenesis(DO) in the mandible of goat using an intraoral tooth-supported distraction device. Methods:8 goats (7-9 months of age) were divided into 4 groups with 2 goats per group. After a bilateral mandibular corticectomy between the second and third premolars, self-produced intraoral tooth-supported distraction devices were cemented. 5 days after operation,the distraction devices were begun to be activated 0.25 mm every 12 hours to advance the anterior segment 8 mm in 16 days. The animals of 32 days group were injected with tetracycline fluorescence labeing at 10 ml/kg once perweek from the beginning of DO.The animals were sacrificed on day 8,16,32 and 48 separately post activation, and tetracycline fluorescence labeling,HE staining and Mallory's 3-color staining were performed. Results:Tetracycline fluorescence labeling showed that there was green-yellow fluorescence labeling new bone within the distraction gap; HE and Mallory's trichrome staining showed that new bone gradually formed from bilateral sides, gradually blending and remodeling. The fiber bundles and newly formed trabeculas and various cells in early phrases showed to be orientation-directed along the axis of distraction force. Conclusion: New bone can be formed and regenerated along the axis of distraction force within the distraction gap.

Objective To study the changes in the endothelial reserve capacity to release tissue plasminogen activator (tPA) and nitric oxide (NO) and its relation to vasodilation and to diabetic angiopathy. Methods The capacity of vascular endothelium to release tPA and NO was examined by venous occlusion of the upper arm. Brachial artery diameter was measured at baseline, during postocclusion reactive hyperemia (flow-mediated endothelium-dependent), and after sublingual nitroglycerol administration (endothelium-independent), using a high resolution ultrasound technique in 15 control subjects and 23 patients with type 2 diabetes mellitus. Vasodilation was expressed as the percentage change relative to the baseline diameter, while endothelial tPA and NO release was expressed as the percentage change relative to the baseline tPA and NO levels. Thickness of the intima of carotid artery was measured using ultrasound imaging. Results There was no significant difference in endothelium-independent vasodilation between control subjects and diabetics. However, significant reductions in endothelium-dependent vasodilation (P

Objective:To explore the effect of different doses of lidocaine on recovery quality of patients with iodine-deficiency goiter after general anesthesia resection.Methods:Using a prospective design, 108 patients who underwent iodine-deficiency goiter resection in Yantai Yeda Hospital from April 2018 to April 2020 were selected as the research subjects. The patients were divided into control group (normal saline), lidocaine group A (1 mg/kg) and lidocaine group B (2 mg/kg) by random number table method, 36 cases in each group. The corresponding dose of lidocaine or the equivalent dose of normal saline was pumped into the vein after anesthesia induction and intubation for 30 minutes. The changes in the diastolic blood pressure (DBP), systolic blood pressure (SBP) and blood glucose (GLU) levels of the three groups were observed before administration, immediately after the operation, immediately after opening the eyes, immediately after extubation, and 10 minutes after extubation; at the same time, arousal and restlessness score (RS), sedation score (Ramsay), visual analogue score (VAS) and adverse reactions(coughing, nausea and vomiting, respiratory depression) occurrence were recorded.Results:At the moment of eye opening, immediately after extubation and 10 minutes after extubation, DBP (mmHg: 77.26 ± 4.85, 73.45 ± 4.37, 70.94 ± 4.45, 83.53 ± 6.19, 77.86 ± 5.33, 74.14 ± 5.20, 73.86 ± 5.73, 68.41 ± 5.16, 63.09 ± 5.24), SBP (mmHg: 129.17 ± 6.54, 121.25 ± 6.07, 116.24 ± 5.86, 137.48 ± 6.62, 129.53 ± 6.38, 123.07 ± 6.25, 125.65 ± 6.13, 117.48 ± 6.09, 108.17 ± 6.04), GLU level (mmol/L: 5.83 ± 0.36, 5.37 ± 0.29, 5.12 ± 0.26, 6.69 ± 0.34, 5.84 ± 0.30, 5.57 ± 0.27, 5.61 ± 0.32, 5.25 ± 0.31, 4.97 ± 0.28) of lidocaine group A and lidocaine group B were significantly lower than those of control group, the difference were statistically significant ( F=17.520, 25.755, 36.034, 41.028, 45.525, 74.330, 10.397, 49.756, 52.348, P < 0.05); among them, the DBP, SBP and GLU levels of lidocaine group A and lidocaine group B were lower than those of control group, and lidocaine group B was lower than lidocaine group A ( P < 0.05). The RS and VAS of lidocaine group A and lidocaine group B were significantly lower than those of control group, and Ramsay was higher than that of control group ( P < 0.05); and the RS and VAS of lidocaine group B were lower than those of lidocaine group A, the Ramsay was higher than that of lidocaine group A ( P < 0.05). The incidence of coughing, nausea and vomiting in lidocaine group A and lidocaine group B were lower than those in the control group ( P < 0.05); and there was no respiratory depression in the three groups. Conclusions:Thrity minutes after induction of anesthesia, continuous pumping of 2 mg/kg lidocaine can maintain blood pressure and GLU of patients undergoing general anesthesia for iodine-deficiency goiter, and effectively reduce restlessness, pain and adverse reactions during the recovery period. It is a satisfactory dose for thyroid surgery patients to wake up and comfortably.

Due to its effectiveness and specificity,RNA interference (RNAi) technology is widely used in the treatment of tumor,viral infectious and metabolic diseases.Noninvasively tracing the delivery of therapeutic RNA molecules in vivo and evaluating the therapeutic effects are important to promote the clinical application of RNAi technology.Molecular imaging allows noninvasive visualization of biological processes at the cellular and molecular level in vivo.It can be used to monitor the biodistribution of therapeutic RNA molecules and to assess the effects of the RNAi.This article reviews the advance of molecular imaging in monitoring the delivery of RNAi molecules and evaluating the therapeutic effects of RNAi.

Objective To discuss effect of serum immunoglobulin M (IgM) and superoxide dismutase (SOD) by percutaneous epidural steroid injections in patients with lumbar disc herniation.Methods 137 patients with lumbar disc herniation were selected in Central of Hospital of Wuhan,all patients were randomly assigned joint group and O3 group, all patients were given ozone (O3) injection treatment, before treatment the joint group was given percutaneous epidural steroid injections, the joint group on the basis of O3 injection method was divided into multi-way group and routine group, followed up for 6 months, analyzed all patients therapeutic effect and recurrence rate,used enzyme-linked immunosorbent method to detect patients with serum IgM, SOD level, Pearson analysis method was used to analyze the relationship between the two groups.Results The joint group treatment effective rate was 91.89%, O3 group treatment effective rate was 79.73%, the former was higher than the latter, the difference was statistically significant ( P<0.05), The joint group serum IgM, SOD level was better than O3 group(P<0.05), In six months, multi-way group recurrence rate was 10.81%, routine group recurrence rate was 18.92%,O3 group recurrence rate was 31.08%, multi-way grou P

[Objective] To compare the effects of modified Ermiao Liquid (MEL) and Jingwanhong Ointment (JO), both of which have the actions of clearing heat and toxin, cooling blood and anti - inflammation, in treating burn wound. [ Methods] Two hundred and seventy - two cases of Ⅱ -degree burn were randomly allocated to MEL group (Group A, n = 150) and JO group (Group B, n = 122) . Healing-time for burn wound was compared in the two groups. [Results] Healing-time for superficial Ⅱ -degree and deep Ⅱ -degree burn wound was both shortened in MEL group as compared with that in JO group (P

Objective To explore the diagnostic value of serum miRNA-182 in colorectal cancer(CRC).Methods A total of 53 CRC patients were enrolled in this study,serum miRNA-182 was detected by quantitative real time polymerase chain reaction(qRT-PCR).The results were compared with those of patients with benign intestinal diseases and healthy controls.Results The content of serum miRNA-182 in CRC patients was significantly higher than those in patients with benign intestinal diseases and healthy group(P<0.05).The ROC curve showed that the area under the curve of serum miRNA-182 was 0.846,the confidence interval was 0.768-0.925,the diagnostic sensitivity was 77.1%,and the specificity was 81.1%.Serum miRNA-182 levels were correlated with TNM stage(P=0.011) and distant metastasis(P=0.002) in patients with CRC,but no significant correlation with other clinical parameters(P>0.05).Serum miRNA-182 level in CRC patients after surgery was significantly lower than that before operation(P<0.01),and which was significantly higher in patients with recurrence/metastasis after surgery(P=0.019).Conclusion Serum miRNA-182 level increased significantly in CRC patients,and which was closely related to the disease and malignant progression,serum miRNA-182 could be used as a potential marker for clinical diagnosis and disease evaluation of CRC.