Hospital construction is essentially disciplinary construction and personnel development. Improving the quality of department heads in an all round way and bringing into full play their potential and enthusiasm will be of great significance in promoting disciplinary and hospital construction and development. To give play to the role of department heads, it is imperative to enhance their quality, bring into full play their potential and enthusiasm, and appropriately handle relationships with them. Only by doing so can marked achievements be made in hospital construction and development.

Objective To study the adriamycin(ADR)-induced expression of ErbB4 in and apoptosis of cardiac muscle cells of rats with dilated cardiomyopathy and their intervention with neuregulin-1?.Methods Sixty male SD rats,weighing 200-250 g,were randomly divided into ADR 1 group(n=10),ADR 2 group(n=20),ADR+neuregulin-1? group(n=20),and normal control(NC) group(n=10).Rats in ADR1 and ADR2 groups were injected with 2.0 mg/kg of ADR through the tail vein,once a week for 8 and 12 weeks,respectively.Rats in ADR+neuregulin-1? group were injected with 2.0mg/kg of ADR through the tail vein,once a week for 8 weeks,followed by neuregulin-1? [10 ?g/(kg?d)],once a day for 5 d.Rats in NC group received normal saline [2 ml/(kg?d)],once a week for 8 weeks.Expression of ErbB4 was detected by Wes-tern blotting.Lesions of cardiac muscle were scored with HE staining.Apoptosis of cardiac muscle cells was detected with the TUNEL method.Results The apoptotic index of cardiac muscle cells was significantly lower in ADR+neuregulin-1? group than in ADR 1 group(P

Objective To investigate the cardiomyocyte apoptosis and protein expressions of bcl-2 and bax in adriamycin (ADM)-induced myocardial damage in rats treated with neuregulin-1? (NRG-1?).Methods Sixty male SD rats weighing 200 to 250 g were randomly divided into 3 groups:control,ADR-DCM and ADR+NRG groups.ADR-DCM group (n=20) was weekly injected 2.0 mg/kg of ADR via tail vein once a week for 8 weeks to produce cardiomyopathy.The rats of ADR+NRG group (n=20) was given an injection of NRG-1? at 10 ?g/(kg?d) via tail vein for 5 d after the establishment of cardiomyopathy by ADR injection.The animals from control group (n=20) received 2 ml/kg normal saline by injection,once a week for 8 weeks.Nine weeks later,rats were executed under anesthesia and their heart was resected.Apoptotic cardiomyocytes were detected by using the terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) method.The expressions of bcl-2 and bax protein were determined by Western blotting.Results The index of apoptotic cardiomyocytes was increased significantly in ADR-DCM group and ADR+NRG group compared with control group (P

目的探讨胸椎小关节紊乱症的最佳手法治疗及其机理。方法对408例确诊胸椎小关节紊乱症患者采用手法复位治疗,观察临床症状、体征的变化。结果408例患者治愈364例(89.2 2%)、显效28例(6.86%)、好转16例(3.92%),总有效率100%。结论双拇指对推手法复位是治疗胸椎小关节紊乱症的最佳手法,疗效确切、迅速,而且安全性高。

Objective To investigate the effect of BIS-guided closed-loop target-controlled infusion on perioperative Th1/Th2 balance in elderly patients undergoing laparoscopic radical gastrectomy under different anesthesia and sedation depths. Methods We applied random number table method to divide 73 elderly patients undergoing elective laparoscopic radical gastrectomy into BIS closed-loop target-controlled infusion group with BIS value of 55(group H, n=36) and BIS value of 45(group L, n=37).Intravenous blood samples were collected immediately before surgery (T1), 2h after surgery (T2), 24h after surgery (T3) and 72h after surgery (T4).IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ were determined by flow cytometry microsphere array.We compared operation duration, postoperative PACU stay time and postoperative hospitalization time between two groups. Results Compared with T1, IL-6 and IL-10 concentration in group H at T2, T3 and T4 significantly increased (P < 0.05), IL-4 and TNF-α in group H at T4 were significantly increased (P < 0.05), IL-2 and IFN-γ in group H at T2 and T4 were significantly increased (P < 0.05), the concentration of IL-6 and IL-10 in group L at T2, T3 and T4 were increased (P < 0.05), IL-2 in group L at T4 was decreased (P < 0.05), and IFN-γ/IL-6 in two groups were decreased at T2, T3 and T4(P < 0.05).Compared with group L, IL-6 and IL-10 in group H were significantly increased at T2(P < 0.05), IFN-γ/IL-6 in group H was significantly decreased (P < 0.05), IL-2 and IL-10 in group H were significantly increased at T4(P < 0.05).Operation duration, postoperative PACU stay time and postoperative hospitalization time had no statistical significance between two groups (P > 0.05). Conclusion The anesthesia and sedation depth of BIS-guided closed-loop target-controlled infusion set at 45 is better than 55 in maintaining Th1/Th2 balance in elderly patients undergoing laparoscopic radical gastrectomy, but it has no obvious effect on long-term prognosis.

Objective:To explore the safety and efficacy of ureteroscopy-assisted laparoscopic ureteroplasty in the healthy side-lying running position for the treatment of ureteral stenosis after pelvic surgery.Methods:The data of 92 patients with ureteral stenosis after surgery admitted to Ganzhou People’s Hospital from June 2017 to February 2023 were retrospectively analysed. There were 31 male patients and 61 female patients, with an average age of (46.4±23.3) years. Of the 92 patients, 53 patients had previously undergone stone fragmentation or stone retrieval surgery for urinary system stones, 35 patients had undergone gynecologic laparoscopic surgery for gynecologic diseases, 2 patients had previous intestinal surgery, and 2 patients had undergone laparoscopic ureteral reconstruction surgery. The mean preoperative serum creatinine was (120.33±16.52) μmol/L, the mean blood urea nitrogen was (14.28 ± 2.47) mmol/L, and the mean renal pelvis dilation was (3.23±2.47) cm. All patients were placed in healthy side-lying running position with general anesthesia. The patient's lower limbs were in the oblique supine position, and the angle of the lower limbs was 60-80°. By using a transabdominal approach, the narrow section of the ureter was mobilized and excised under the guidance of ureteroscopy. The posterior wall of the ureter was sutured and a zebra guidewire was placed into the renal pelvis. An F7 double-J stent was then retrogradely advanced over the guidewire. Then the anterior wall of the ureter was anastomosed to complete the surgery. The operation time, average length of hospital stay, perioperative complications, preoperative and postoperative pyelectasis and renal function changes were recorded, and the clinical efficacy were evaluated by comparative analysis.Results:Of the 92 patients, 90 patients were successfully treated with ureterovesical anastomosis. Two patients underwent ureterovesical reimplantation because of the low position and heavy adhesion of the stenosis segment. There were no cases of conversion to open surgery or intraoperative death. The mean surgery duration was (121.52±22.35) min, the mean drainage tube indwelling time was (3.16±1.23) d, and the mean hospital stay was (6.46±2.37) d. A patient with moderate hydronephrosis exhibited postoperative urinary leakage. Two patients developed symptoms of hematuria after ambulation. Following treatment with bed rest, adequate drainage, and appropriate hemostatic medication, all patients recovered smoothly and were discharged. The double J tube was removed 3 months after operation, and the CT reexamination after extubation showed that the degree of pyelectasis was (2.52±1.54) cm, the average serum creatinine was (89.64±15.21) μmol/L, and urea nitrogen was (9.42±1.36) mmol/L, which was all significantly different from that before operation ( P<0.05). The patients were followed up for 6 to 12 months, and there was no ureteral restenosis. Conclusions:Ureteroscopic-assisted laparoscopic ureteroplasty in the healthy side-lying running position is a safe and effective surgical method for the treatment of short segment (narrow segment <3 cm) ureteral cicatrix stenosis after surgery. And this surgical method has the advantages of accurate positioning of the narrow segment, safe and convenient ureteral free, exact ureteral anastomosis, and easy placement of double J tube.

The pediatric reference intervals in clinical laboratory play an important role in diagnosis of illness,therapeutic monitoring,prediction of prognosis and health evaluation.Compared with establishing reference interval for adults,there are more challenges to establish pediatric reference intervals.Therefore,the procedure and key technologies of direct method and indirect method are stated based on the characteristics of children population and pediatric,by which to define,transfer and validate pediatric reference intervals.This study will provide systematically methodological ideas for clinical laboratories to establish pediatric reference intervals.

BACKGROUND: Intra-articular injection of sodium hyaluronate can safely and effectively treat knee osteoarthritis and obviously improves the pain and function of knee joint. The efficacy of extracorporeal shock wave therapy for early-and middle-term knee osteoarthritis still remains controversial. OBJECTIVE: To compare the effects of extracorporeal shock wave therapy and intra-articular injection of sodium hyaluronate for early-and middle-term knee osteoarthritis. METHODS: According to the inclusion criteria, a total of 77 patients with knee osteoarthritis were enrolled, and randomly divided into extracorporeal shock wave therapy group and sodium hyaluronate therapy group. The extracorporeal shock wave therapy group underwent 5 sessions of 2 000 shockwave pulses performed on the affected knee with the dosage adjusted to 0.2 mJ/mm2 energy. The sodium hyaluronate group was administered intra-articularly sodium hyaluronate once per week for 5 weeks. The results were assessed with the Visual Analogue Scale, Lequesne index and Western Ontario and McMaster Universities Osteoarthritis Index. RESULTS AND CONCLUSION:① After 5 weeks of treatment, the Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne index in the two groups were significantly decreased compared with the baseline (P ＜ 0.05). All above indexes in the extracorporeal shock wave therapy group were significantly lower than those in the sodium hyaluronate therapy group (P ＜ 0.05).② These results indicate that the extracorporeal shock wave therapy and sodium hyaluronate therapy are effective for early-and middle-term knee osteoarthritis, and the former is more significant.

Percutaneous nephrolithotripsy is the first line treatment for complete staghorn calculi, but there are risks such as renal function damage, bleeding, and infection. A case of complete staghorn calculi 8.3 cm×4.5 cm and mean CT value of 1 321 HU was reported. Urine culture suggested proteus mirabilis infection. The patient was given sensitive antibiotics for 3 days, and was treated with one session of natural orifice transluminal endoscopic lithotripsy with intelligent control of renal pelvic pressure. KUB on the first postoperative day showed residual stones of 1.0 cm×0.5 cm. There were no complications.

In order to optimize the undergraduate teaching methods and improve students' comprehensive competitiveness, this study explored the scientific research training methods of medical laboratory undergraduates during medical internship. On the premise of ensuring that students carry out clinical practice according to the internship plan, the research group leads students to carry out scientific research training in their spare time. The scientific research training was divided into two stages. In the first stage, on the basis of informed consent and independent choice, the students in the control group were trained by self-regulated learning and teachers' question answering, while the students in the experimental group were trained by the way of centralized scientific research lectures and scientific research practice. In the second stage, all the students were in independent research and exploration under the guidance of teachers within 5 months. The results showed that in the process of independent research, the time of topic selection in the experimental group [(3.5±1.1) days] was significantly shorter than that in the control group [( 5.4 ± 1.9) days], and the time of topic design in the experimental group [(12.2±2.5) days] was significantly shorter than that in the control group [(14.6±3.1) days]. It shows that carrying out scientific research training in the medical internship stage of undergraduates is helpful to increase the efficiency of students' later independent research and accelerate the process of independent research.