Purpose: To investigate the clinical effect of miniature needle-knives in treatment of calcanodynia.Methods: Of 96 calcanodynia patients, 64 were treated with a needle-knife and 32, by local block therapy. The curative effects were evaluated. Results: The effective rate was 96.8% in the needle-knife group and the 78.1%in the local blockage group. There was a significant difference in curative effect between the two groups (P＜0.01). Conclusion: Needle-knife lysis has a marked effect on calcanodynia.

Objective To explore the expression,correlation and clinical significance of mammalian target of rapamycin (mTOR) and vascular endothelial growth factor (VEGF) in gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).Methods From October 1995 to December 2012,the paraffin tissue specimens of 114 pathological diagnosed GEP-NEN were collected.The expressions of mTOR and VEGF at protein level were detected with EnVision immunohistochemical staining method.Chi-square test was performed to compare the differences in the expressions of mTOR and VEGF among every clinicopathological factors of patients.Spearman's correlation analysis was used to find out the correlation between the expressions of mTOR and VEGF.Kaplan Meier method and Log-rank test were implemented for survival analysis.Results The overall positive expression rates of mTOR and VEGF in GEP-NEN tissues were 66.7％ (76/114) and 71.1％ (81/114),respectively.The expressions ofmTORand VEGF at protein level were not correlated with gender,age,functional status of tumor,location of tumor,grading and classification of tumor and distant metastasis (all P＞0.05).The co-expression rate of mTOR and VEGF in GEP-NEN tissues was 51.8％ (59/114).The expression of mTOR was positively correlated with the expression of VEGF at protein level (r=0.205,P=0.029).Among 82 followed-up patients,the mean survival time of patients with mTOR positive or negative expression was 8.3 and 7.9 years,and respectively,and there was no statistical significance (x2 =0.201,P=0.654).The mean survival time of patients with VEGF positive or negative expression was 9.6 and 5.9 years,respectively,and the difference was statistically significant (x2 =4.415,P=0.036).Among the patients with G1 grading tumor,classified as neuroendocrine tumor and without distant metastasis,the survival time of patients with positive VEGF expression was longer than that of patients with negative VEGF expression (11.8 years vs 7.3 years,x2 =5.349,P=0.021; 11.2 years vs 6.8 years,x2=6.375,P=0.012; 11.2 years vs 7.2 years,x2 =4.630,P=0.031).Conclusions mTOR and VEGF proteins are highly expressed in GEP-NEN with different location,grading and classification.The expression of them is positively correlated.The prognosis of GEP-NEN patients with positive VEGF expression is better.

Objective To explore the value of serum chromogranin A (CgA) in clinical diagnosis and efficacy evaluation of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).Methods From January 2011 to December 2012,87 GEP-NEN patients were enrolled,which included 50 patients with lesions and 37 patients without lesions after surgery.Eighty-four healthy subjects were taken as control group.The serum CgA levels of all subjects were measured with enzyme linked immunosorbent assay.Nonparametric test,receiver operating characteristic curve and Cox regression univariate analysis were performed for analysis.Results The median of serum CgA level of GEP-NEN patients with lesions was 97μg/L,which was significantly higher than that of patients without lesions after surgery (42 μg/L,Z=3.451,P=0.001) and healthy control (47 μg/L,Z=3.149,P=0.002).The value of 95 μg/L was taken as diagnostic cut-off value for healthy controls,patients without lesions and patients with lesions,the sensitivity and specificity were 54.0％ and 90.1％,respectively.The median of serum CgA level of the patients with distant metastasis was 231 μg/L,which was higher than that of patients without distant metastasis (46 μg/L,Z=3.340,P=0.001).After treatment,the serum CgA levels of 12 patients with complete remission,partial remission or stable tumor decreased more than 20％ of baseline values.The serum CgA levels of five patients increased more than 20 ％ of baseline values and the tumors of them showed progress.Cox regression analysis showed that there was no correlation between CgA levels of patients with lesions and prognosis (r=1.000,P=0.252).Conclusion Neuroendocrine marker CgA has high diagnostic value in GEP-NEN,and can be used as an important biomarker in clinical diagnosis and efficacy evaluation of GEP-NEN.

Objective:To explore the effect of OH cards based group counseling on decompression for chief resident nurses.Methods:In November 2019, a total of 60 chief resident nurses were recruited from two districts of a ClassⅢ Grade A specialized hospital in Shanghai by the convenient sampling method. A total of 58 chief resident nurses participated and completed the questionnaires in the whole process, and they were given OH cards-based decompression group psychological counseling. Before the group psychological counseling, Chinese Version Perceived Stress Scale (CPSS) was used to measure the chief resident nurses' stress. Before and after the group counseling, the Self-made Stress Visual Simulation Score, Self-made Positive and Negative Emotion Visual Simulation Score, State Anxiety Inventory (S-AI) in Chinese version of State-trait Anxiety Inventory (STAI) and Nurses Coping Style Questionnaire were used to evaluate the changes of the chief resident nurses' stress, positive and negative emotion, state anxiety and coping style.Results:Before group psychological counseling, the total CPSS score of 58 chief resident nurses was (30.03±7.10) , which was at a relatively high level. After OH card-based decompression group psychological counseling, the Self-made Stress Visual Simulation Score and the score of negative emotion dimension in S-AI of 58 chief resident nurses were reduced. The Self-made Positive and Negative Emotion Visual Simulation Score and scores of problem solving, avoidance and self-blame, seeking social support and behavior disengagement of Nurses Coping Style Questionnaire were all increased, while the score of alleviating emotional distress dimension was decreased. Compared with those before group psychological counseling, the differences were all statistically significant ( P<0.05) . Conclusions:Group psychological counseling based on OH cards can effectively reduce the pressure of chief resident nurses, reduce negative emotions and state anxiety and improve their coping styles.

Objective:To analyze the characteristics and hot spots of hospital management projects funded by National Natural Science Foundation of China(NSFC), for the reference for furthering improving the modernization level of hospital management.Methods:The NSFC funded research projects in hospital management during 2010-2020 was searched. Project name, keywords, approval year, affiliation and other informations were obtained. CiteSpace was used for bibliometric analysis of these research projects, while all the data acquired were subject to descriptive analysis and frequency analysis.Results:The number of hospital management projects funded by NSFC increased from 4 in 2010(0.93 million yuan) to 32(9.94 million yuan) in 2020, totaling 192 projects and 72.76 million yuan. These numbers consisted of 90 general projects(46.9%) and 79(41.1%) youth fund projects respectively. All the funded projects were distributed in sub-disciplines under the NSFC first-level discipline of macro management and policy, namely health management and policy(154) and medical/drug management and policy(38). The hotspots of the funded projects covered performance evaluation, payment method, public health system, health economics, hierarchical diagnosis and treatment, utility theory, regional medical alliance, essential medicine system, capitation and incentive strategy, and so on.Conclusions:Recent years are witnessing a rising trend in the number and grants of NSFC projects on hospital management. More and more funds are granted to universities, especially young researchers, and a hospital management research system has been initially taken shape. Hospital management in China should take into full account of the management characteristics and the status quo of the medical and health field, focus on performance appraisal incentive mechanism, hierarchical medical system, construction of medical alliances. and patient medical experience as well. In addition, the cooperation between hospitals and universities should be strengthened in order to promote the translation of research results.

How to give full play to the advantages of rehabilitation institutions, and to improve service quality and administration efficiency are some of the complex issues faced by the high-level administrators of rehabilitation institutions. This paper studied a total of 67 institutions to investigate the operation and management model of rehabilitation institutions in China, as well as their advantages and disadvantages.

The establishment of an efficient performance management system is crucial for a rehabilitation institution. This article discussed the concept of performance, performance management and ways to establish an efficient performance management system.

The incidence of gastroparesis is increasing,and its treatment mainly includes drug conservative treatment,gastric electrical stimulation,pyloroplasty,botulinum toxin injection,and pyloric stent placement.Gastric peroral endoscopic pyloromyotomy(G-POEM)is a new procedure for the treatment of refractory gastroparesis,which has the advantages of minimally invasive,safe and effective.This article reviewed the progress of research in G-POEM in treatment of refractory gastroparesis.

Objective To provide evidence-based references for the prevention of surgical site infection(SSI)by sum-marizing the best evidence for the prevention of SSI in adult inpatients.Methods The'6S'evidence resource pyramid model was used to systematically search the related evidence in domestic and foreign databases,guideline websites,and academic socie-ty websites from the inception of the database to September 30,2023.Four researchers evaluated the quality of the included guidelines,and two researchers independently evaluated the quality of other types of literature and rated the level of evidence.Results A total of 12 articles were included,including 6 clinical decision making and 6 clinical guidelines.Thirty best items of the evidence were summarized from 7 aspects:diagnosis,clinical symptoms,influencing factors,patient prevention strategies,preventive strategies for medical staff,intraoperative and postoperative treatment,and consultation and education.Conclusion Clinical staff should develop a standardized management plan for infection prevention based on corresponding evidence to reduce the incidence of SSI instead of taking a single measurement.Moreover,they need to formulate a standardized work process for preventing SSI based on the clinical practice and patients'preference.

Objective:To gain a deeper understanding of the comorbidity status of elderly patients with coronary heart disease and the effect of comorbidity on their hospitalization costs.Methods:Using the convenient sampling method, a total of 8 334 elderly hospitalized patients diagnosed with coronary heart disease in Beijing Hospital from January 2018 to December 2021 were selected as the research objects. General Inforamtion Questionnaire and Charson comorbidity index (CCI) were used to investigate the comorbidity of patients.Results:Among the 8 334 elderly patients with coronary heart disease included, 88.18% (7 349/8 334) had comorbidity, and there was a statistically significant difference in hospital costs among patients with different CCI scores ( P<0.01). Elderly patients with coronary heart disease with comorbidity had higher hospital costs. The results of the binomial logistic regression analysis showed that comorbidities increased the hospitalization costs of elderly coronary heart disease patients in both the unadjusted model and the gradually adjusted model for age, gender, occupation, education level, admission department, admission status, admission year, admission mode length of stay and disease classification ( P<0.05) . Conclusions:The comorbidity in elderly patients with coronary heart disease is serious, which is an important factor affecting hospitalization costs. In medical practice, it is necessary to strengthen the comprehensive management of elderly patients with coronary heart disease, pay attention to the influencing factors of hospitalization costs, optimize prevention and treatment strategies, control the occurrence and progression of comorbidities among patients, deepen the reform of medical insurance payment methods such as grouping payments based on disease diagnosis, so as to accurately reduce hospitalization costs and promote the sustainable and healthy development of the medical and health system.