Objective To study the valid correct method for reagent selection, calibration of analyzers, and internal quality control protocol. Methods Reagents were selected by comparing with BRENGER Mannheim(BM)reagent used in Hitachi 7170A. Analyzers were calibrated once a week. One internal quality control chart was set up for three analyzers. Specimens were analyzed by the three machines respectively. Results Except for amylase, all the results obtained from the three analyzers were not significant. Conclusion The recommended quality control protocol is useful to obtain comparable results from different automatic biochemistry analyzers.

Objective To investigate the feasibility and effects of modified Stoppa approach in treatment of anterior pelvic ring fractures.Methods The therapeutic effects of 21 patients with anterior pelvic ring fractures treated through the modified Stoppa approach from June 2008 to August 2011 were summarized and analyzed.According to Tile classification,there were seven patients with type A2 fractures,six with type B2 fractures,five type B3 fractures and three type C2 fractures.Surgical treatment through the modified Stoppa approach included anterior pelvic ring plates for 14 patients,anterior pelvic ring plates and external fixators for four and anterior pelvic ring plates and sacroiliac joint compressed cannulated screws for three.The fracture reduction and post-operative function were assessed by Matta criteria and Majeed system respectively.Results The incision length of the modified Stoppa approach ranged from 10 to 12 cm ( average,11 cm).The operation time ranged from 70 to 120 minutes ( average,95 minutes).The intra-operative blood loss ranged from 400 to 1 000 ml (average,700 ml ).According to the Matta criteria,all 21 patients obtained sound reduction,of whom 15 patients had bony union after 8-20 months follow-up post-operatively.The Majeed score in all patients showed a gradual increase postoperatively.Conclusions The modified Stoppa approach is characterized by convenience and directness in making incisions,clear operation field,easy reduction,few complications and fast recovery and hence is an ideal choice in surgical treatment of anterior pelvic ring fractures.

Objective To compare the biomechanical difference of two internal fixation approaches for the posterior pelvic ring fracture dislocation.Methods Six fresh adult cadaver pelvic specimens were tested biomechanically.Then,the specimens were subjected to Denis-I sacral pelvic fracture.The specimen was first fixed with improved Galveston fixation and then with improved Galveston fixation plus sacral rod.Biomechanical tests were performed from vertical and reversed directions on the fixed pelvis.Results Under vertical compression,the biomeehanical value of the improved Galveston fixation plus sacral rod was lower than that of the improved Galveston fixation,with no statistical difference between two methods(P ＞ 0.05).Under the reversed compression,the biomeehanieal value of the improved Galveston fixation plus sacral rod was lower than that of the improved Galveston fixation,with statistical difference between two groups(P ＜ 0.05).Conclusion The improved Galveston fixation combined with sacral rod can increase the anti-reverse stability of the posterior pelvic ring.

Objective:To explore the abnormalities of efficiency in resting state functional brain network in patients with paranoid schizophrenia and the correlations between efficiencies and clinical symptoms.Methods:A total of 73 patients with schizophrenia (SZ group) met with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) criteria for schizophrenia and 70 healthy controls (HC group) were included .All subjects were checked by using functional magnetic resonance imaging (fMRI), and positive and negative syndrome scale(PANSS) were used to assess the symptoms.Abnormalities of global and local efficiency of brain regions in brain functional network were analyzed by graph theory.Pearson correlation was used to analyze the correlation between the abnormal global efficiency and local efficiency of brain regions of SZ group and PANSS.SPSS 20.0 software was used for dependent-sample t-test, ANOVA test and Pearson correlation analysis. Results:Compared with the HC group, SZ group showed increased global efficiency in bilateral thalamus(left: 0.26±0.06, 0.28±0.04, t=2.03, P=0.044.right: 0.26±0.06, 0.28±0.05, t=2.08, P=0.040), right orbital part of middle frontal gyrus(0.21±0.04, 0.23±0.05, t=2.25, P=0.026), cerebellar lobule Ⅸ(0.19±0.06, 0.21±0.05, t=2.56, P=0.011) and vermis Ⅲ(0.15±0.08, 0.19±0.07, t=3.27, P=0.001), while decreased global efficiency in bilateral parahippocampal gyrus(left: 0.25±0.05, 0.22±0.05, t=-3.34, P=0.001.right: 0.27±0.04, 0.23±0.05, t=-4.96, P=0.000), superior occipital gyrus(left: 0.27±0.03, 0.26±0.03, t=-2.70, P=0.008.right: 0.27±0.02, 0.26±0.03, t=-2.73, P=0.007), superior parietal gyrus(left: 0.27±0.03, 0.26±0.05, t=-2.63, P=0.010.right: 0.27±0.03, 0.25±0.05, t=-2.76, P=0.007), paracentral lobule(left: 0.28±0.03, 0.26±0.07, t=-2.47, P=0.015.right: 0.28±0.04, 0.25±0.07, t=-3.06, P=0.003), left precental gyrus(0.28±0.04, 0.27±0.04, t=-1.98, P=0.049), left cuneus(0.26±0.04, 0.25±0.04, t=-2.08, P=0.039), left lingual gyrus(0.29±0.03, 0.28±0.03, t=-2.28, P=0.024), left middle occipital gyrus(0.29±0.03, 0.28±0.03; t=-2.74, P=0.007), left middle temporal gyrus(0.28±0.03, 0.26±0.03, t=-2.73, P=0.007), temporal pole in left middle temporal gyrus(0.20±0.06, 0.18±0.06, t=-2.59, P=0.011) and right hippocampus(0.27±0.04, 0.26±0.06, t=-2.05, P=0.042).Compared with the HC group, SZ group showed increased local efficiency in bilateral caudate nucleus(left: 0.33±0.06, 0.35±0.05, t=2.54, P=0.012.right: 0.33±0.07, 0.35±0.04, t=2.77, P=0.007) and left superior occipital gyrus(0.39±0.03, 0.40±0.02, t=2.17, P=0.031), while decreased local efficiency in bilateral parahippocampal gyrus(left: 0.35±0.04, 0.32±0.07, t=-3.16, P=0.002.right: 0.34±0.04, 0.32±0.07, t=-2.91, P=0.004), left supplementary motor area(0.36±0.02, 0.35±0.05, t=-2.01, P=0.047), left inferior parietal but supramarginal and angular gyrus(0.35±0.03, 0.34±0.05, t=-2.65, P=0.009), left cerebellar crus Ⅱ(0.37±0.03, 0.36±0.04, t=-2.01, P=0.046), lobule ⅦB(0.37±0.03, 0.35±0.07, t=-1.98, P=0.049), right posterior cingulate gyrus(0.36±0.04, 0.34±0.07, t=-2.07, P=0.041), right superior parietal gyrus(0.37±0.03, 0.36±0.05, t=-2.19, P=0.031), right precuneus(0.36±0.02, 0.35±0.04, t=-2.36, P=0.020), right paracentral lobule(0.37±0.02, 0.36±0.06, t=-2.07, P=0.041) and right temporal pole in middle temporal gyrus(0.33±0.08, 0.30±0.09, t=-2.09, P=0.038).The global efficiency of bilateral paracentral lobule and left temporal pole in middle temporal gyrus in SZ group were negatively correlated with the negative scale scores( r=-0.25, -0.25, -0.26, all P<0.05).The global efficiency of right hippocampus in SZ group was positively correlated with total scores of PANSS( r=0.23, P=0.049).The global efficiency of left middle temporal gyrus in SZ group was negatively correlated with total scores of PANSS( r=-0.23, P=0.049).The local efficiency of right paracentral lobule in SZ group was negatively correlated with the positive scale scores( r=-0.24, P=0.038). Conclusion:The brain networks of patients with first-episode paranoid schizophrenia may have regional dysfunction in the transmission efficiency and fault-tolerant ability of resting state brain functional network, and the abnormalities of efficiency may be associated with the severity of psychiatric symptoms in several brain regions.

Since human society entered the 21st century, the rapid development of medical technology also gave birth to a series of negative effects:medical service technology first, trust crisis of the doctor-patient relation-ship, and medical industry money worship. Especially in recent years, due to the lack of humanistic spirit in medi-cal institutions, the doctor -patient relationship is of the worst state in the history. Therefore, it is urgent to strengthen the medical humanities education in the construction of hospital culture. Aiming at the problems existing in the current medical industry, this paper expounds the importance of strengthening the humanistic education in the construction of hospital culture.

ObjectiveTo investigate the effect of hypoxia-inducible factor-1α (HIF-1α) on the stemness and epirubicin sensitivity of hepatoma cells. MethodsHepatoma cells were selected for experiment. HepG2 hepatoma cells transfected with HIF-1α overexpression plasmid were selected as experimental group, and those transfected with pcDNA3.1 empty plasmid were selected as control group; HepG2 cells alone were selected as HepG2 group. Quantitative real-time PCR was used to measure the mRNA expression of HIF-1α; Western blot was used to measure the protein expression of HIF-1α; flow cytometry was used to measure the expression of CD133 on the surface of hepatoma cells. The three groups of cells were treated with epirubicin at different concentrations (0, 6.25, 12.5, 25, and 50 μmol/L) for 24 hours; MTT assay was used to measure cell viability, and flow cytometry was used to measure apoptosis after treatment with epirubicin (50 μmol/L). A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the t-test was used for further comparison between two groups. ResultsCompared with the HepG2 group and the control group, the experimental group had a significant increase in the mRNA expression of HIF-1α (both P＜0.001), and Western blot showed high expression of HIF-1α in the experimental group. The percentage of CD133 cells was 0.040%±0.003% in the HepG2 group, 0.030%±0.010% in the control group, and 20.110%±0.600% in the experimental group, and the experimental group had a significantly higher positive rate of CD133+ than the HepG2 group and the control group (both P＜0.001). At an epirubicin concentration of 25 and 50 μmol/L, the HepG2 group and the control group had significantly inhibited cell viability and a significantly lower cell viability than the experimental group (both P＜005). After the treatment with 50 μmol/L epirubicin for 48 hours, the experimental group had a significantly lower cell apoptosis rate than the HepG2 group (67.9%±2.5% vs 93.6%±1.5%, P＜0.001) and the control group (67.9%±2.5% vs 93.0%±1.2%, P＜0001). ConclusionHepG2 cells are successfully transfected with HIF-1α overexpression plasmid, and HIF-1α can increase the percentage of liver cancer stem cells and improve their resistance to epirubicin.

Objective Regional homogeneity (ReHo) and functional connectivity (FC) were used to study obsessive-compulsive disorder(OCD),and to explore the mechanism of OCD in resting state.Method Resting-state functional magnetic resonance imaging (RS-fMRI) was performed in 55 patients with OCD (OCD group) and 50 normal controls (control group) matched by sex,age,nationality and education.The data and screening abnormal brain areas were analyzed and compared by DPARSFA2.3 and Rest software in OCD group.Whole brain FC analysis was performed with abnormal brain areas as seed points.Result Compared with the control group,ReHo in right thalamus (MNI:x=9,y=-24,z=6,t=4.3217) and left superior marginal gyrus (MNI:x =-45,y =-30,z =27,t =3.6320) increased and ReHo in right caudate nucleus (MNI:x=3,y=15,z=9,t=-3.1687) decreased in obsessive-compulsive disorder group,and the difference was statistically significant(P＜0.05).Using left superior marginal gyrus,fight thalamus and right caudate nucleus as seed voxels,the whole brain FC analysis showed that there were abnormal functional connections between bilateral cerebellar foot 1/2 area and left supramarginal gyrus,right thalamus and right caudate nucleus (P＜0.05) and the left supramarginal gyrus-bilateral cerebellum feet 1 area-right thalamic circuit and left supramarginal gyrus-bilateral cerebellum feet 1,2-right caudate nucleus-right thalamic circuit existed in 0CD group.Conclusion The left supramarginal gyrus-bilateral cerebellum feet 1 area-right thalamic circuit and left supramarginal gyrus-bilateral cerebellum feet 1,2-right caudate nucleus-right thalamic circuit may play an important role in the mechanism of OCD.

OBJECTIVE: To explore the feasibility of enhanced recovery after surgery (ERAS) in treatment of children with congenital choledochal cyst. METHODS: One hundred and thirty children with congenital choledochal cysts admitted in the Children's Hospital of Zhejiang University from June 2017 to June 2019 were divided into ERAS group (=65) and control group (=65) according to admission order. The intestinal tract condition during operation, time of operation, surgical results, time for eating after operation, abdominal drainage after operation, length of hospital stay after operation, total hospital expenses and complications were compared between two groups. RESULTS: Compared with the control group, the satisfaction of intestinal operation field, recovery of gastrointestinal function after operation,time required for the volume of peritoneal drainage fluid to be less than 50 mL,time of abdominal drainage tube removal, and length of hospital stay were all improved in ERAS group (<0.05 or <0.01).ERAS group had more peritoneal effusion after removal of abdominal drainage tube (<0.01), but the incidence of edema after operation was lower (<0.05). The satisfaction of parents in the two groups was similar, but the cooperation of parents in the ERAS group was improved (<0.05) and the total cost of hospitalization was reduced (<0.01). CONCLUSIONS ERAS has advantages over the traditional scheme and can be used in the clinical treatment of children with congenital choledochal cyst.
Case-Control Studies ; Child ; Choledochal Cyst ; economics ; surgery ; Enhanced Recovery After Surgery ; standards ; Humans ; Length of Stay ; Postoperative Complications ; prevention & control