Currently,there are a few problems existed in managing the research outlay of hospital including mistiness of the managing boundary,disfluency of the guarantee chain,weakness of the cost-benefit consciousness,irrationality of resource configuring,lack of supervision mechanism,etc.These problems could be resolved by strengthening the inner management of the outlay,carding the management mechanism,broadening the channel of outlay,concerning about the cost accounting,optimizing the resource configuring and founding the performance evaluation mechanism.To offer a powerful guarantee for the material effect of scientific research and to promote the continuous development of scientific research healthily,we should explore the new way of strengthening the management of the scientific research outlay incessantly.

Objective To investigate the influence of atherosclerotic reference segments on coronary remodeling by intravascular ultrasound(IVUS) in patients with acute coronary syndrome(ACS). Methods One hundred and three consecutively enrolled patients [male 68 cases,female 35 cases,average age (60 ±11) years] with ACS were undergone by coronary artery angiography and IVUS with time selecting operation. The remodeling index(RI) was defined as lesion external elastic membrane cross section aere (EEM CSA) divided by the mean reference EEM CSA at the culprit vessel. Positive remodeling was RI≥ (67 cases), negative remodeling was RI <1(36 cases). The parameters of plaque were analysed between two remodeling groups, as well as compared between distal and proximal references. Results Only one patients do not have plaque at reference sites. In the analysis of 103 lesions and 102 reference sites, there were not significant different in plaque burden,plaque CSA,lumen CSA and lesion EEM CSA between two groups. Distal plaque burden[(39. 76 ±12. 54)% vs (32.38 ± 13.97)%, P <0.001] and plaque CSA [(6.14 ± 3.20)mm2 vs (4. 75 ± 3. 07) mm2, P = 0. 001] were larger than those at proximal reference. EEM CSA at distal reference was smaller than proximal one[(14. 99 ± 4. 12)mm2 vs (28. 37 ± 4. 48)mm2 , P <0. 001]. Plaque burden, plaque CSA and lumen CSA persented positive corelation between distal and proximal reference sites. Conclusions The reference segments lay a severe diffuse atherosclerosis in the group of ACS, which may influence assessment of coronary remodeling. Coronary remodeling as a process, a accurate evaluation could be result from the combination of static and serial approach by IVUS.

Objective To investigate the relationships between vascular factors and plaque morphology in the patients with acute coronary syndrome(ACS). Methods lntravascular ultrasound(IVUS) was performed on 56 consecutively enrolled patients with ACS. Cytometric bead array for seven vascular factors(sPE,t-PA, MCP-I, IL-8,IL-6,sVCAM-1, and sCD40L) was measured by cytometry. The others biomarkers were tested by ELISA or biochemistry. Differences in bio-factors were compared between vulnerable plaque and non- vulnerable plaque groups, accte myocardial infarction (AMI) and ustable angina (UA) patients, and occurring plaque rupture. The relationship between the parameters of morphology and vascular factors was analyzed. Results There were positive correlations between sVCAM-1sPE, sVCAM-1-sCD40L, sCD40L-sPE, IL-6-IL8,IL8-MCP4, and MCPI-sVCAM-1; CRP (18.868±4.907mg/L vs 5.806±3.553 mg/L)and IL-6 (19.5 pg/ml [9.2±44.6 pg/ml]vs 5.3 pg/ml [2.3～ 13.4 pg/ml])were elevated in the vulnerable plaque group(P <0.05). sCD40L(473.82±126.11 vs 237.94±34.78 pg/mi),sPE (107.214±39.90 vs 49.06±5.61 μg/L) and MCP-1(132.42±17.85 vs 127.174±13.27 pg/ml) were increased in the plaque rupture group(P < 0.05);There was correlation between tPA and plaque morphology(P < 0.05). Increases in sCD40L, MCP-1, sPE, and TC were independent factors for plaque rupture. Conclusions IL-6 and CRP may be biomarkers for vulnerable plaque and for diagnosis ofAMI, sCD40L, MCP-1 and sPE are potential markers when for plaque rupture patient present with severe ACS.

ObjectiveTo discuss the potential relationship of plaque burden (PB) and coronary remodeling in acute coronary syndrome (ACS) patients.MethodsNinety-one patients with ACS in Qingdao Municipal Hospital during January 2011 to June 2014 underwent the conventional coronary angiography and intravascular ultrasonography (IVUS). The remodeling of 60 cases were positive (remodeling index [RI]>1) and those of 31 cases were negative (RI<1). All 91 patients were included in this study, including 9 cases (PB<60%), 19 cases (60%≤PB<70%), 48 cases (70%≤PB<80%) and 15 cases (PB>80%). The difference of plaque cross-sectional area (P-CSA), lumen cross-sectional area (L-CSA), external elastic membrane cross-sectional area (EEM-CSA), average EEM-CSA, PB between positive remodeling andnegative remodeling were compared by independent-samplest test. ANOVA was used to compare P-CSA, L-CSA, EEM-CSA and RI among patients with different PB. The relevance of PB, P-CSA, EEM-CSA, L-CSA and RI were analyzed by Pearson correlation analysis.ResultsThere were no signifi cant differences in P-CSA, L-CSA, EEM-CSA and PB between patients with positive remodeling and negative remodeling. Average EEM-CSA of patients with negative remodeling were signifi cantly greater than that of patients with positive remodeling ([13.24±1.98] mm2vs [17.30±3.16] mm2,t=2.46,P<0.05). P-CSA, EEM-CSA and L-CSA had signifi cant differences (F=24.56, 28.97 and 7.14,P<0.001) while RI had not statistical signifi cant difference among patients with different PB. With the increase of PB, P-CSA and EEM-CSA increased (P-CSA: [6.01±1.68], [9.12±2.00], [11.42±2.05] and [14.05±4.00] mm2, EEM-CSA: [11.43±1.90], [13.64±2.93], [15.14±2.64] and [16.64±4.08] mm2), L-CSA reduced ([5.44±0.89], [4.52±0.99], [3.72±0.74] and [2.60±0.63] mm2). PB was positively correlated with P-CSA and EEM CSA (r=0.76, 0.50,P<0.001), but was negatively correlated with L-CSA (r=-0.74, P<0.001). RI had no relationship with PB, P-CSA, L-CSA and EEM-CSA.ConclusionsCoronary artery remodeling is a very complicated dynamic process. Except the PB, other factors probably affect the direction of remodeling. RI is not suitable as the index for the assessment of vascular remodeling.

Objective To investigate the relationship between β-fibrinogen (β-Fg) gene -455G/A,- 148C/T polymorphisms and atrial fibrillation (AF) with cerebral infarction.Methods Polymerase chain reaction-restriction fragment length polymorphism was used to detect the genotypes of -455G/A and -148C/T in 97 patients with AF with cerebral infarction (AF with cerebral infarction group),80 patients with AF alone (AF group),and 98 health subjects (healthy control group).Results The A allele frequencies of -455G/A in the AF with cerebral infarction group and the AF group were 0.304 and 0.344 respectively.They were significantly higher than 0.179 in the healthy control group (all P＜0.05).The T allele frequencies of - 148C/T in the AF with cerebral infarction group and the AF group were 0.348and 0.369,respectively.They were significant higher than 0.240 in the healthy control group (all P＜0.05).Conclusions The A allele of -455G/A and the T allele of -148C/T were associated with AF with cerebral infarction and AF.

[Objective] To summarize image manifestations in intestinal tuberculosis (ITB) examined by multi-slice computed tomography enteroclysis (MSCT) and evaluate the diagnostic value of MSCTE in ITB,[Methods] The imaging findings were retrospectively analyzed in 15 cases of ITB that were confirmed by endoscopy or postoperative pathologic examination,including the location,number,shape,edge,surrounding tissue alterations of ITB and other associated changes in the peritoneum,mesentery and solid abdominal organs,and compared with endoscopy and pathology.[Results] In 15 patients,ileocecum was involved in 13 cases (87％),4 cases (27％) showed multi-segmental symmetric intestinal mural thickening,9 patients (60％) showed solid masses,1 case (7％) showed multi-segmental symmetric intestinal mural thickening and solid masses,1 case (7％) showed homogenous enhanced masses and perforation,12 cases (86％) showed enlarged lymph nodes (LNs) with rim enhancement,and 2 cases (13％) showed the comb sign of enhanced mesenteric vessels.Based on enhancement pattern of MSCTE,ITB was divided into three types:homogenous enhancement type (n=5);target sign type (n=2);caseous necrosis type (n=2).[Conclusion] The imaging features of ITB are diverse.MSCTE can clearly display the shape of intestinal mucosa,the alterations of intestinal wall and the relationship between lesion and adjacent tissues,which provides valuable information for the clinic diagnosis of ITB.

Objective To explore the approaches to improve the detection of early gastric and precancerous lesions for basic level hospi-tals. Methods The 72 patients with abnormal gastric mucosa observed by gastroscope arranged with pathology after acetic acid-indigo car-mine dyeing were considered as the dyeing group, and 68 patients with abnormal gastric mucosa observed by gastroscope directly arranged with pathology were considered as the control group. The dyeing conditions of gastric mucosa were observed and compared to pathology detec-tion. The detection rate of early gastric cancer and precancerous lesions in the two groups were compared. Results After acetic acid-indigo carmine dyeing, there were 16. 7% of demonstrated discoloration, 63. 9% of poor dyeing, and 14. 3% of even dyeing. The detection rate of early gastric cancer and high grade intraepithelial neoplasia in patients with mucosa discoloration (91. 7%) was obviously higher than that in patients with poor dyeing (8. 6%) or even dyeing (0. 0%). The detection rate of low grade intraepithelial neoplasia or intestinal metaplasia in patients with poor dyeing (82. 6%) was obviously higher than that in patients with mucosa discoloration (8. 3%) or even dyeing (14. 3%). The detection rate of early gastric cancer and precancerous lesions in dyeing group (13. 9%,63. 9%) was obviously higher than that in control group (2. 9%,29. 4%). Conclusion The acid-indigo carmine dyeing could increase the diagnosis of early gastric cancer and precancerous lesions in basic level hospital. It is adaptable to extend approach in basic level hospital for its low cost and simple operation.

Objective:To study the protective effect of platelet-rich plasma on never function in the rats with traumatic brain injury (TBI),and to clarify its mechanisms. Methods:Sixty SD rats were randomly divided into sham group (opened skull bone window only),TBI group and platelet-rich plasma treatment group (PRP group) (n=20).The rats in PRP group were injected with platelet-rich plasma through vessel on the 1st day,the 2nd day and the 6th day after operation while the rats in sham group and TBI group were treated with saline at the same time.The neurological function defects were assessed with modified neurological severity score (mNSS)on the 1st, 3rd and 7th after operation.Then 10 rats were taken from each group and executed,and the brain tissues were taken.The brain sections were prepared for the histological observation and the others of each group were tested with Morris water maze.Results:Compared with sham group,the mNSS scores of the rats in TBI and PRP group were increased (P <0.05);the mNSS score of the rats in PRP group was decreased compared with TBI group (P <0.05).The injured volume of rat brain tissue was reduced significantly in PRP treated group compared with TBI group (P <0.05).The Nissl staining results showed that the injury area in PRP group had a more neat rows and a larger number of new blood vessels compared with TBI group.The immunohistochemical staining results showed the injured area had a higher level expression of GFAP+ cells in TBI group compared with PRP group,but the amount of neuN+ cells was smaller than that in PRP group (P <0.05).The Morris water maze test results showed that there were a shorter escape latency time,more times acrossing platform and a larger swimming time during platform quadrant in PRP group compared with TBI group (P < 0.05).Conclusion:Platelet-rich plasma has a significant role in protecting the neurological function of TBI rats.

Objective To investigate the application of U100plus laser in treating incarcerated in gallbladder stones. Methods The clinical data of 52 patients accepted U100plus laser lithotripsy of gallbladder neck incarcerated were retrospective analyzed. Results All 52 patients were successful treated by surgery. Twelve patients with gallbladder wall edema, drainage tubes were used to prevent bile leakage after gallbladder surgery. After 2~4 d, the ultrasound examination showed that no abnormal drainage, and tube was removed. The mean operative time was 40 min. The mean intraoperative bleeding was 2 mL. Patients were able to get out of bed 1 day after surgery. The average length of hospital stay was 4 d. Pa-tients were followed up for 6 to 30 months, and no special discomfort, The ultrasonography showed no stone recurrence. Conclusion U100plus laser lithotripsy is a safe and effective method for treating incarcerated gallbladder stones.

Objective To compare the blood transfusion effects in salvaged autotransfusion and allogeneic blood trans-fusion in the operation of the lower lumbar fractures under combined spinal-epidural anesthesia. Methods A total of 60 patients who accepted lumbar fractures operation under combined spinal-epidural anesthesia in our hospital from January 2012 to January 2014 were chosen as study objects. According to different blood transfusion ways, 60 patients were divided into the control group and the observation group, with 30 patients in each group. Patients in the control group accepted allogeneic blood transfusion, and patients in the observation group accepted salvaged autotransfusion. The blood transfusion effects and complications in the two groups were compared. Results The infection rate in the ob-servation group was 3.33%, and the infection rate in the control group was 20.00%. The infection rate in the observa-tion group was significantly lower than that in the observation group(P<0.05). In addition, the differences in the average amount of blood transfusion, blood recovery and hospitalization time were statistically significant (P<0.05). Conclu-sion Compared with allogeneic blood transfusion, salvaged autotransfusion has lower postoperative infection rate, shorter hospitalization time and blood recovery, and it is worth promoting salvaged autotransfusion for further applica-tion in lumbar fractures operation.