Introduced in the paper are key measures and characteristics of the attending in charge system,following the theory of lean management and under leadership of the department head of the hospital.Authors hold the practice as enhancing administrative functionality of the department head, avoiding disadvantages incurred by traditional attending in charge system,and upholding quality of care management,making it a worthwhile attempt for China's healthcare system.

Objective To explore frequency distribution of vitamin D receptor (VDR) genotype and the correlations between polymorphism of VDR gene Bsm Ⅰ sites and bone mineral density in the patients undergoing maintenance peritoneal dialysis.Methods A case-control study was conducted based on 82 patients with maintenance peritoneal dialysis and 80 healthy people.The frequency distribution of VDR genotype in two groups was detected and analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Serum biochemistry and bone mineral density of the patients undergoing maintenance peritoneal dialysis were detected by dual energy X-ray absorption (DEXA) and automatic biochemical analyzer,respectively.All data was analyzed with SPSS 19.0 software.Results The frequency distribution of VDR genotype between case group and control group had no significant difference (P ＞ 0.05).The serum biochemical index such as Ca,P,alkaline phosphatase (ALP) and parathyroid hormone (PTH)] of patients with maintenance peritoneal dialysis had no significant difference among three VDR genotypes(P ＞0.05).Compared to VDR bb genotype,the serum Ca was significantly higher in VDR BB genotype (P ＜0.05).The bone mineral density (BMD) and T-Score of patients with VDR BB genotype were the lowest,the BB genotype was the highest,and the difference was statistically significant among three genotypes (P ＜0.05).Conclusions The frequency distribution of VDR genotype between case group and control group had no significant difference.However,there is a correlation between VDR gene BsmⅠ sites and bone mineral density of maintenance peritoneal dialysis patients.

OBJECTIVETo discuss the application of convoluted manipulation in pediatric femoral fractures.

METHODSFrom March 2015 to October 2016, 12 children with femoral fractures were treated by Chinese traditional manipulation including 8 males and 4 females with an average age of 6 years old ranging from 1 to 12 years old. The causes of injury were falls in 10 cases and traffic accidents in 2 cases. Of which 1 case was transverse fractures, 4 cases were oblique fractures and 4 cases were spiral fractures, 2 cases were comminuted fracture, 1 case was greenstick fracture. All patients underwent manual reduction within 1 to 2 days, plus small splint with cedar bark, and parallel lower limb traction.

RESULTSAll the 12 patients were followed up for 1-3 months, with an average of 2 months. All the 12 patients achieved clinical union, and the average healing time was 6 weeks. There was no obvious shortening and rotational angulation. At the last follow-up, Schatzker-Lambert distal femoral fracture evaluation results were excellent in 11 cases, good in 1 case.

CONCLUSIONSConvoluted manipulation is very important for reduction of femoral fractures in children, with the splint of cedar bark, satisfactory therapeutic effect can be achieved.

Depression is a widespread psychiatric disorder with complex pathogenesis and unsatisfactory therapeutic effects. As a native flavonoid, Isorhamnetin (ISO) has been deemed to exert neuroprotective effects by antioxidation and regulation of immunity. However, no reports of anti-depressed effect of ISO have yet been found. The present study was conducted to clarify the mechanism basis of anti-depressed effect of ISO utilizing behavioral, biochemical, molecular approaches in vitro and in vivo and bio-informatics analysis. The effects of ISO on depressed mice was investigated through the SPT and FST, and the lesions were examined by H&E staining. Besides, the inflammatory factor and indicator in kynurenine pathway were assessed through detection kits, and the microbiota were checked by 16sRNA. Molecular docking study was performed to investigate the target of ISO. Additionally, Western blot was used to test the activation of PI3K/AKT signaling pathway. The results indicated that ISO could enhance the sugar water preference of mice in SPT and reduce immobility time in FST. Further more, ISO suppressed peripheral and central inflammation, regulated the changes in kynurenine pathway and gut microbiota, inhibited activation of PI3K/AKT pathway, and presented good binding patterns with target proteins on PI3K/AKT signaling pathway. Collectively, these findings demonstrate that ISO alleviated depression-like behaviour by normalizing inflammation-induced dysregulation of the crosstalk between KP and gut microbiota disorder through regulated PI3K/AKT/NF-κB pathway.

AIM: To observe the effects of cimetidine(Cim) on platelet function and thrombosis. METHODS: After incubated with Cim in vitro , rat platelets were activated with ADP or thrombin. The platelet aggregation, platelet malondialdehyde(MDA) formation, platelet intracellular free calcium([Ca 2+ ] i), and thromboxane B 2 (TXB 2) were measured. The effects of Cim on electric-induced thrombosis in rat carotid artery were examined. RESULTS: Cim potentiated ADP induced platelet aggregation , increased the thrombin induced [Ca 2+ ] i and MDA formation, decreased TXB 2. Also, Cim shortened the duration of electric-stimulated occlution time in rat carotid artery. CONCLUSION: Cim increased platelet function and accelerated thrombosis.

Adult ; External Fixators ; Humans ; Male ; Manipulation, Orthopedic ; Middle Aged ; Shoulder Dislocation ; therapy

State-owned capital not only had the social public welfare characteristic, but also the vitality and driving force of capital. In this research, Zhejiang Medical and Health Group was studied based on analyzing questions of state-owned corporate hospitals. We also introduced practice and effectiveness of state-owned capital in the reform of 3 state-owned corporate hospitals in this group. This paper aimed to explore a new way for state-owned capital to participate in public hospital reform. At the same time, it also provided suggestions for the transformation and development of state-owned corporate hospitals.

Child ; Child, Preschool ; Epiphyses ; injuries ; Female ; Humans ; Humeral Fractures ; therapy ; Infant ; Male ; Musculoskeletal Manipulations ; Treatment Outcome

Objective To explore the characters of lower urinary tract symptoms (LUTS) in patients with Parkinson's Disease (PD).Methods From Oct 2013 to Jun 2016,after evaluating of movement disorder by modified Hoehn-Yahr(H-Y) scale and LUTS by international prostate symptom score (IPSS),urodynamic study was performed in PD patients with LUTS.The incidence of every symptom of LUTS,the relationships between the IPSS categories and urodynamic study were analyzed.Results 64 patients (containing 26 male and 38 female) with 40-80 (62.7 ± 10.2) years old were included.2,4,30,19,12 and 6 patients were belonged to modified H-Y scale 1-4,respectively.Frequency (50 patients,78.1％) was the most common LUTS,while frequency all day (20 patients,31.3％) was the most common symptom for the most severe LUTS.IPSS was 1 7.5 ± 7.8 (4-35) and quality of life was 5.1 ± 0.6 (4-6) for the patients.There was no significant correlation between modified H-Y scale and IPSS (P ＞ 0.05).According to the criteria of IPSS,28 patients (43.8％) only had irritative symptoms,3 patients (4.7％) only had obstructive symptoms,while 26 patients (40.6％) had mixed symptoms and 7 patients (10.9％) belonged to no one.Urodynamic study showed 11 patients (39.3％) with only irritative symptoms had detrusor overactivity(DO),6 patients (23.1％) with mixed symptoms had DO + bladder outlet obstruction (BOO) or DO + detrusor underactivity,however,there was no one with BOO in the three patients with only obstructive symptoms.Conclusion Frequency was the most common LUTS,while frequency all day was the most common symptom for the most severe LUTS in PD patients.Irritative and mixed symptoms were common in PD patients with LUTS,but the urodynamic results were not consistent with the category of LUTS in most of the patients.LUTS severity was not correlated with movement disorders in PD patients.

The research on brain functional mechanism and cognitive status based on brain network has the vital significance. According to a time-frequency method, partial directed coherence (PDC), for measuring directional interactions over time and frequency from scalp-recorded electroencephalogram (EEG) signals, this paper proposed dynamic PDC (dPDC) method to model the brain network for motor imagery. The parameters attributes (out-degree, in-degree, clustering coefficient and eccentricity) of effective network for 9 subjects were calculated based on dataset from BCI competitions IV in 2008, and then the interaction between different locations for the network character and significance of motor imagery was analyzed. The clustering coefficients for both groups were higher than those of the random network and the path length was close to that of random network. These experimental results show that the effective network has a small world property. The analysis of the network parameter attributes for the left and right hands verified that there was a significant difference on ROI2 ( = 0.007) and ROI3 ( = 0.002) regions for out-degree. The information flows of effective network based dPDC algorithm among different brain regions illustrated the active regions for motor imagery mainly located in fronto-central regions (ROI2 and ROI3) and parieto-occipital regions (ROI5 and ROI6). Therefore, the effective network based dPDC algorithm can be effective to reflect the change of imagery motor, and can be used as a practical index to research neural mechanisms.