Objective To study surgical therapy of the serious medial collateral ligament ruptures of the knee. Methods 12 patients with acute medial collateral ligament ruptures were treated operatively.Their degrees of injury were all Ⅲdegree that superficial and deep collateral ligaments were completely ruptured.Some of them were accompanied with the injury of medial joint capsule ligament or anterior cruciate ligament or posterior cruciate ligament.The torn medial collateral ligaments were anatomically corrected by their ends with direct suture or staple internal fixation.They were followed 6 to 18 months. Results 12 patients were graded with the Lysholm score .The postoperative score (mean, 76; range, 59 to 90) was higher compared with the preoperative score (mean, 35; range, 20 to 54), P

Objective To investigate the value of ionic-contrast esophagogram in diagnosis of intrathoracic anastomotic leakage after oesophagectomy.Methods The data of 728 patients suffered esophagectomy were retrospectively collected.723 patients without clinical manifestations of anastomotic leakage were divided into group A(esophagogram before eating,n=465) and group B(non-esophagogram before eating,n=258).The incidence of anastomotic leakage was compared between the two groups.Results The discovery rates of anastomotic leakage in group A and B were 0.43%(2/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two group(P=0.55).The total incidence rates of anastomotic leakage in group A and B were 0.65%(3/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two groups(P=0.84).5 patients with clinically suspected anastomotic leakage,all had loculated pleural effusion,4 cases had fever,and 2 cases had abnormal chest drainage.Finally,4 cases(80%) were confirmed to be anastomotic leak by esophagogram.Conclusion Routine ionic-contrast esophagogram before eating do not improve intrathoracic anastomotic leakage detection rate after esophagectomy,but when patients have fever,loculated pleural effusion and abnormal chest drainage,esophagogram is necessary and can improve the detection rate of esophageal anastomotic leak.CT radiography may detect smaller anastomotic leakage than conventional esophagogram.

Objective To explore the application of the virtual private network(VPN) to picture archiving and communication system(PACS) for the remote access and management of PACS.Methods The client-ports(namely the remote computers) were connected to Internet by broadband such as ADSL,and the web server of PACS was connected to Internet by broadband router with VPN function so that the remote computers could access the web server of PACS remotely.By the VPN technology,the system administrators of PACS could diagnose and maintain the general malfunctions of the radiology's local network,and thus the remote management came true.Results The remote access and management of PACS had been available in our hospital for half a year since the application of the VPN technology in PACS.By more convenient medical services the work efficiency had been greatly improved.Conclusion The application of VPN technology to PACS,which is characterized by low expense,dependable performance,simple maintenance,can realize remote access and management of PACS.

Objective To evaluate the effect of chest backplate in treating multiple rib fractures in patients with focal abnormal breathing.Methods The clinical data of 36 patients with multiple rib fractures and focal abnormal breathing who were treated by Chrisofix chest backplate were analyzed.Results Thirtyfour patients were cured by chest backplate and other conservative treatments,and 2 patients underwent rib internal fixation surgery.The numeric rating scales scores before and after the application of the chest backplate were (8.1 ± 0.7) scores and (5.2 ± 0.5) scores respectively(P ＜ 0.01).Seven patients had skin blisters forming around the shield,which were cured by liquid extraction with a syringe and gauze covered with povidone iodine.No patients stopped treatment because of allergy.Conclusions Chest backplate is an effective,easy and inexpensive method for patient with multiple rib fractures and focal abnormal breathing who doesn't need exploratory thoracotomy.It is worthy to spread in clinical treatment.

Purpose To prepare the sustained-release tablet of tetramethylpyrazine phosphate with hydroxypropylmethylcelluose(HPMC) as matrix material. MethodsThe paddle method and the HPLC method were erspectively used determined the cumulative drug released in vitro and the serum concentration in vivo.ResultsThe cumulative drug released in the first hour was about 20%, while in 12 hours it was above 85%. Drug release behavior can be best described by Higuchi equation, and the release rate decreased as the viscosity and/or the amount of HPMC increased. Compared with the market tablet on the rabbits, the sustained release tablet had the decreased peak concentration (P < 0.05 ); the prolonged peak time and mean residence time (P< 0.05).ConclusionsThe matrix tablet was a good sustained-release dosage form and it had a good in vitro-in vivo correlation.

Objective To investigate the clinical significance of WDHD1 protein expression in esophageal squamous cell carcinoma.Methods The expression of WDHD1 protein in esophageal squamous cell carcinoma,adenocarcinoma of esophagus and normal esophagus tissues by immunohistochemical MaxVision was detected.Results The expression of WDHD1 protein in the tissues of esophageal squamous cell carcinoma was significantly higher than that in the normal esophagus tissues and adenocarcinoma of esophagus (15.68 ± 3.01 vs.3.89 ± 2.98 and 4.66 ± 2.46)(P ＜ 0.05),there was no significant between normal esophagus tissues and adenocarcinoma of esophagus (P ＞ 0.05).The expression of WDHD 1 protein in the tissues of esophageal squamous cell carcinoma,high-middle differentiation tissues was higher than poorly differentiation,TNM stage Ⅲ + Ⅳ stage was higher than Ⅰ + Ⅱ stage,depth of invasion T3 + T4 was higher than T1 + T2,with lymph node metastasis tissue was higher than without,differences was statistically significant (P ＜0.05).Conclusions The higher expression of WDHD1 protein is the marker of high invasive and low histological grade of esophageal squamous cell carcinoma,and WDHD1 in esophageal squamous cell carcinomas may play an important role in development.

Objective:To investigate the association between pulse pressure(PP) and new-onset diabetes in overweight and obese people.Methods:A prospective cohort study was conducted in overweight or obese participants selected from Kailuan Study who underwent 2006-2007 annual checkup and met the inclusion and exclusion criteria. PP was calculated by blood pressure and participants were divided into 4 groups according to PP quartile. The cumulative incidence of new-onset diabetes of different PP groups was calculated by Kaplan- Meier method and compare by Log- Rank test. The multivariate Cox proportional hazards model was used to analyze the association between different PP groups and new-onset diabetes. Results:During an average follow-up of 8.45 years, 8 922 diabetes was identified. The cumulative incidence rate of the Q1, Q2, Q3, and Q4 groups were 22.12%, 24.48%, 27.97%, and 33.44% respectively, which were statistically different( χ2=368.16, P<0.01). Cox proportional hazards regression analysis showed that after adjusting for multiple confounding factors, compared with Q1 group, the hazard ratio for diabetes in Q2, Q3, and Q4 groups were 1.07(1.00-1.14), 1.13(1.05-1.21), and 1.17(1.09-1.27) respectively. And the HR of diabetes event in pulse pressure(per 1 SD increase) was 1.04(1.02-1.07). Similar results were found in participants who were over-weight, obese, with normal blood pressure or hypertensive without drugs use. Conclusion:PP is positively correlated with the new-onset diabetes. High PP is one of the risk factors for developing diabetes in overweight and obese people.

Medical talent is the core competitive strength for the development of hospitals.Effective recruitment helps hospitals select talents that meet the demands of high-quality development.This article takes public hospitals in Guangzhou as an example and employs literature review and interviews to construct a competency model for public hospital physicians.This model encompasses six dimensions and 20 elements,including clinical skills,knowledge proficiency,professional spirit and qualities,teamwork ability,doctor-patient communication skills,and lifelong learning ability.The established model is applied to various recruitment modules,such as defining recruitment needs,expanding recruitment channels,selecting candidates,standardizing recruitment processes,and improving recruitment evaluation systems,thereby proposing corresponding recruitment strategies for public hospital physicians.

Objective The basic biological, echocardiography and gene sequencing parameters of mice overexpressing Slit2 gene (Slit2-Tg mice) were collected and evaluated, and to provide a reference for the application of Slit2-Tg mice in biomedical research. Methods Slit2-Tg and C57BL/6 J mice were inbred. The genotypes of the mice were determined by a PCR assay. The blood samples were collected for blood routine and biochemical tests. The tissues of main organs were collected for protein expression and pathological analysis. Echocardiography and transcriptome sequencing was carried out for analyzing the heart function and gene expression, respectively. Results The litter size was significantly higher in the Slit2-Tg mice than in C57BL/6 J mice. Human Slit2 gene and protein expressions were detected in the main organs of Slit2-Tg mice. Organ coefficient of spleen was significantly increased in Slit2-Tg mice, but the tissue structure appeared normal. There were significant changes in the counts of erythrocytes, platelets, eosinophils, and biochemistry of glucose, globulin, urea nitrogen, triglycerides, HDL, and atherosclerosis index. Echocardiography showed no significant differences in the morphology and function of the Slit2-Tg hearts except in the left ventricular anterior wall thickness at the end-diastolic state. Compared with the C57BL/6 J mice, 535 genes out of 17513 genes in the Slit2-Tg hearts were increased or decreased, mainly involving 15 biological process or signal transduction pathways. Conclusions This study has collected the biological parameters of Slit2-Tg mice and suggests that this model animal is suitable for the studies of cardiovascular diseases.

Objective To establish a set of operational status assessment indicators to meet the needs of informationized hospital management.Methods Assessment indicators were selected and weights were set respectively through literature review,field interview,and questionnaire survey.Six target dimensions were key performance indicators medical business,operational performance,cost control,medical insurance,balance and risk management,and development capability.Thus a set of operational status evaluation indicators was established in IT means,and based on the informationization level of a tertiary A general hospital in Zhejiang province.Results In the principle of public welfare,objectivity,effectiveness and prospectiveness,we analyzed and sorted out relevant data in the current hospital informationization,identifying six quantitative indicators,15 level-1 indicators,and 86 level-2 indicators.Conclusions It is feasible to build a set of assessment indicators for hospital operation and management in view of both technology and methodology.