Sharing medical data may reduce unnecessary repetitive studies and promote the cooperation between research groups.By analyzing the mature practices of some other countries,we proposed solutions to China's current problems in sharing medical research data,such as formulating sharing policies,strengthening platform construction and enhancing international cooperation.

The acceptance assessment is an important part of research project management.By analyzing the content,methods,process and model of the current acceptance assessment of medical research projects in China,we summarized and elaborated the main problems in the medical research management.By referring to the mature practices of some other countries,we proposed the solutions to improve the quality of acceptance assessment in China,i.e.,balancing the qualitative and quantitative assessment,improving the quality of peer-review,constructing information platform,introducing independent third party assessment and construing the overall process evaluation system.Our study may provide important reference for constructing the high-quality evaluation system of medical research projects in China.

Objective To study the therapeutic effect of EUS-guided biliary drainage (EUS-BD) on patients with malignant obstructive jaundice when ERCP failed.Methods From January 2014 to January 2016,all patients with malignant obstructive jaundice during hospitalization underwent EUS-guided biliary drainage (group A,36 cases) or PTCD treatment (group B,30 cases) by draw after failed ERCP.Operation success rate,liver function recovery time,complication rates,length of hospital stay and hospital costs were observed and compared.Results There was no significant difference in the operation success rates between two groups [94.44％ (34/36) VS 86.67％ (26/30),P＞0 05)].And there were significant differences in liver function recovery time (25.79± 6.48 d VS 30.24 ± 8.49 d),incidence of complications [5.56％ (2/36) VS 23.33％ (7/30)],length of hospital stay (21.54±4.73 d VS 25.68 ± 8.56 d) and hospitalization costs (23.5±8.4 thousand yuan VS 32.8±6.5 thousand yuan,P＜0.05).Conclusion EUS-guided biliary drainage could be the first option for its noninvasiveness and efficacy,when ERCP failed in patients with malignant obstructive jaundice.

Objective To investigate the clinical features of macrophage activation syndrome (MAS) associated with systemic lupus erythematosus (SLE).Method The clinical data of 15 patients with SLE-induced MAS diagnosed in Peking Union Medical College Hospital from July 2011 to December 2014 were retrospectively analyzed.Results Fourteen patients were female.The average age was 28.07.When MAS occurred,the average duration of SLE was 20.47 months,and the average SLE disease activity index (SLEDAI) was 18.4.All 15 patients developed fever,hematocytopenia and impaired liver function in the course of MAS,while patients with splenomegaly,coagulation disorders and neuropsychiatric symptoms were 11,14 and 8,respectively.All 15 patients presented leukocpenia and thrombocytopenia.Hypofibrinogenemia,elevated ferritin and hemophagocytosis in bone marrow were respectively observed in 7,11 and 12 patients.Glucocorticoids were used in all patients,among whom eight received pulse methylprednisolone therapy.Thirteen patients were treated with immunosuppressants,including cyclosporine A,tacrolimus,cyclophosphamide and mycophemolate mofetil.Complete remission was achieved in 14 patients.One patient died of MAS.Conclusions In patients with SLE,MAS was most commonly seen in young females with short SLE duration and active disease.Fever,splenomegaly,hematocytopenia,coagulation disorders and liver damage are the most remarkable clinical manifestations.Early diagnosis and intensive therapy are the key parts to improve clinical outcome.

Objective To improve the understanding of drug-induced lupus (DIL) and the differences from systemic lupus erythematosus (SLE).Methods Clinical manifestation and treatment of patients with definite DIL were retrospectively analyzed.Results Six patients with DIL were enrolled in this study,including 4 females and 2 males.Two patients were diagnosed after receiving interferon,one after soluble tumor necrosis factor receptor fusion protein,one after propylthiouracil,one after penicillamine,and one after levofloxacin.High titer of antinuclear antibody was identified in all six patients,including 3 with positive anti-dsDNA antibody.One patient had positive anti-Sm antibody.One patient had positive anti-RNP antibody.One patient had anti-nucleosome antibody.One patient had anti-histone antibody.One patient had antimitochondrial antibodies-M2,and one patient had anticardiolipin antibodies.Conclusion Patients with DIL are not as severe as those with SLE.After cessation of suspected drugs and administration of standard treatment,the clinical outcome of DIL is satisfying.

As a critical part of national scientific and technology system reform, construction of national innovation system is a fundamental measure of innovation driven development strategy.Medical science and technology innovation system (MSTIS) is an important component of national innovation system (NIS).It is essential to elaborate the content, characteristics and process of the MSTIS.Based on the development status of Chinese economy and society and the framework of NIS, we evaluated the characteristics of medical science and technology development, and ultimately concluded and elaborated the content and characteristics of MSTIS from the following aspects: innovation force, innovation subjects, innovation activities, and innovation environments.We also prospected the future process of MSTIS, i.e., promotion of innovation force, ability construction of innovation subjects,scientific plan of innovation activities, and improvement of innovation environment.

Integration and sharing of biological samples are the most effective approach for making use of their stock and improving their utilization efficiency. Although great success has been achieved in development of Biolog-ical Samples Library in China, efforts are not made in promoting sample resource sharing. The problems in develop-ment of Biological Samples Library were thus summarized in this paper by content analysis, such as no unified crite-ria, poor administrative management, and imperfect ethical supervision of sample sharing.

BACKGROUND:Col agen/bioactive glass composite materials possess excellent osteogenic potential and biocompatibility, but its application in bone tissue engineering is limited by mechanical property and degradation. OBJECTIVE:To construct col agen/bioactive glass/chitosan composite scaffolds with good mechanical property, anti-degradation ability and bone repair property.
METHODS:Bioactive glass/col agen composite scaffolds with chitosan as dispersant were prepared by lyophylization. Fourier transform infrared spectroscopy, scanning electron microscope, X-ray diffraction, and dynamic biomechanical testing were used to characterize the structure and properties of the composite scaffolds. RESULTS AND CONCLUSION:Results show that charge-attractions in pre-prepared bioactive glass/chitosan solution increased the homogeneity of bioactive glass dispersed in col agen gel and the compressive modulus and strength increased significantly due to the homogeneity and intermolecular interactions between chitosan and col agen. The enzymatic degradation rate and mineralization activity in the simulated body fluid were also lower because of a high degree of embedment of bioactive glass in col agen/chitosan matrix, and entanglement of col agen in chitosan at molecular level, which decreased the exposure of bioactive glass to the simulated body fluid, and col agen to enzyme solution.

Objective To evaluate brush cytology under endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary strictures, and to analyze the factors influencing the diagnosis yield.Methods Brush cytology was applied in 144 patients with suspected malignant biliary strictures at ERCP.Brushing in bile duct was performed for 10 times from 2004 to 2006, while at least 20 times of brushing and repeated manipulation were performed at biliary strictures from 2007 to 2009. Cytological samples were processed immediately after brushing and analyzed by the same pathologist. Efficacy of brush diagnosis was evaluated based on reference to histopathology after surgery and/or clinical diagnostic criteria. Results Malignant stricture was finally diagnosed in 96 patients, and benign diseases in other 48. Brush cytology was positive in 78 of 96 patients with malignant stricture ( sensitivity 81.3% ), and negative in all patients without malignancy ( specificity 100. 0% ). Overall accuracy of diagnosis was 87.5%. Positive rate of malignancy by brush between 2007 and 2009 was 87.7% (50/57), while that between 2004 and 2006 was 71.8%, which were significantly different ( P ＜ 0. 05 ). The positive rate was not correlated with stricture location or tumor type. No major complications occurred, except for 4 moderate acute pancreatitis, 3 cholangiolitis and 2 biliary bleeding. Conclusion Brush cytology is of high sensitivity and specificity for malignant biliary stricture.Repeated brushing and manipulation can facilitate diagnosis yield.

Objective: To summarize the application and efficacy of fresh autologous pericardial tri-leaflet pulmonary artery conduit for right ventricular outflow tract reconstruction in patients with complex congenital heart disease (CHD). Methods: A total of 18 relevant patients received fresh autologous pericardial tri-leaflet pulmonary artery conduit for right ventricular outflow tract reconstruction in our hospital from 2007-08 to 2012-12 were studied. The patients were at the mean age of (2.12±2.02) years with body weight ≥ (9.41±3.62) kg including 10 male. Echocardiography was followed-up at 1 month, 3-6 and ≥12 months post-operation. Results: All 18 patients had successful operation. 2 patients died at early post-operative stage including 1 with severe infection and respiratory failure, 1 with low cardiac output syndrome. 16 survivors had the average ICU stay time (140.2±124.5) h, mechanical ventilation (94.4±87.6) h, transcutaneous O2 saturation at quiet condition without O2 inhalation at (97.1±3.34) %. There were 3 patients lost contact during followed-up period and 13 received periodical examination. No obvious calcification was found in chest X-ray; echocardiography showed infrequent stenosis of right ventricular outflow tract, pulmonary valve ring and main pulmonary artery; left and right pulmonary artery stenosis at the second place. Conclusion: The safety and efficacy of fresh autologous pericardial tri-leaflet pulmonary artery conduit for right ventricular outflow tract reconstruction was fine for treating relevant patients, the mid and long term effect should be further observed.