To promote the development of key discipline construction in hospitals,we described the integration of refined management into the construction of key disciplines and different aspects including personnel training,featured specialty,research,and hardware were discussed.We concluded that refined management in essential to the development of hospital,and a mechanism needs to be established to ensure the long-term effect.

Objective To study the relationship between u rinary,serum laminin (LN) and urinary albumin (Alb) in type 2 diabetes mellitus.Methods Urinary,serum LN and urinary creatinine (Cr) were measure d in 116 patients with type 2 diabeties mellitus and 31 normal controls .Results ①Urinary LN/Cr in DM microalbumi nuria (DMMA) group was higher than control group (group C) (P

OBJECTIVE:To analyze the effect of precision filtration infusion apparatus and other methods on reduction of ADR induced by Acanthopanax injection. METHODS:532 patients receiving intravenous infusion of Acanthopanax injection were randomly divided into observation group and control group;observation group used disposable precision filtration infusion appara-tus,while control group used disposable ordinary infusion apparatus. The occurrence of ADR were compared between 2 groups. RE-SULTS:The incidence of ADR in observation group(2.68%)was significantly lower than in control group(7.75%),with statisti-cal significance(P<0.05). CONCLUSIONS:Intravenous infusion of Acanthopanax injection with disposable precision filtration in-fusion apparatus can effectively reduce the occurrence of ADR.

Because of the particularity of the interventional therapy,that is,the interventional management covers a large scope in clinical application and involves the diagnosis and treatment of various diseases of multiple systems and organs,the clinical interventional practice has really brought an unprecedented challenge for the administration of the nursing care in the intervention ward.In our hospital,independent nursing group for the intervention ward was established two years ago.For the past two years,we have constantly groped and summarized the reasonable and effect administration of interventional nursing care.Pertinent administrative measures,such as nurse training,strengthening of communication with physicians and focusing on key links in nursing care and promptly finding out the weak points in clinical work,have effectively improved the quality of clinical nursing,in this way the clinical nursing practice has been integrated into the interventional therapy and the safe and high-quality nursing service has been provided to the patients.

Objective To explore the DSA mainfestations of MoyaMoya disease.Methods 19 patients, underwent CT before DSA, showed intracranial hemorrhage. All patients were then examined by angiography via femoral artery approach. Results All cases were diagnosed as MoyaMoya disease through DSA. The findings of DSA showed characteristic manifestations as the following: 1. Stenosis or occlusion of the invoved arteries. 2. Smoke like capillary vascular network spreading from supraseller cistern to cerebral base. 3. Development of collateral circulation. Conclusions DSA is the main method for the diagnosis of MoyaMoya disease, CT can only localize the site of cerebral hemorrhage.

Objective: To investigate the coverage of enterovirus 71 (EV71) vaccine among children born between 2018 and 2021 in Ningbo City, Zhejiang Province, so as to provide insights into formulating EV71 vaccination strategy. Methods: Data pertaining to demography and EV71 vaccination among children born between 2018 and 2021 in Ningbo City were obtained from the Zhejiang Immunization Information Management System, and the coverage of vaccination, full-dose vaccination and timely vaccination of EV71 vaccine were analyzed. Results: Totally 416 176 children were born between 2018 and 2021, including 216 977 boys (52.14%) and 199 199 girls (47.86%). The coverage rates of vaccination, full-dose vaccination and timely vaccination was 61.50%, 58.70% and 32.53%, respectively. The coverage rates of vaccination, full-dose vaccination and timely vaccination among local children (71.43%, 70.04% and 40.24%) were higher than those among migrant children (54.05%, 50.18% and 26.73%; P<0.05). The coverage rates of vaccination, full-dose vaccination and timely vaccination among urban children (67.72%, 65.06% and 40.37%) were higher than those among rural children (54.11%, 51.14% and 23.21%; P<0.05). The coverage rates of vaccination were 54.98%, 61.24%, 65.10% and 66.72%, the coverage rates of full-dose vaccination were 52.16%, 58.72%, 62.44% and 63.39%, and the coverage rates of timely vaccination were 22.47%, 25.86%, 39.14% and 48.03% by the born year from 2018 to 2021, all showing increasing trends year by year (P<0.05). Conclusion The coverage of vaccination, full-dose vaccination and timely vaccination of EV71 vaccine appears a tendency towards a rise among the 2018-2021 birth cohorts in Ningbo City, while the coverage of timely vaccination need to be improved. Health education for EV71 vaccination should be enhanced for rural and migrant children.

Objective To evaluated the clinical outcomes of intravesical instillation resiniferatoxin(RTX) for the treatment of patients with idiopathic overactive bladder(IOAB).Methods 26 cases with IOAB were randomly divided into test(A,14 cases) and control(B,12 cases) groups.The patients in group A were treated by intravesical instillation with 40ml of 0.5% idocain retained within the bladder for 3 minutes at first and with 100ml of 100nmol/L RTX retained within the bladder for 30 minutes late.The patients in group B were treated by the same method,however,the furacilin solution(placebo) at a dilution 1∶5000 was used instead of 100nmol/L RTX.The efficacy(daily voiding frequency,urgent uresis,FDV,MCBC,Qmax) of the 2 groups were evaluated before,1 month and 3 months after treatment.Results The pre-treatment comparion with prost-treatmen at 1 month and 3 months of A group was significant(P0.05).14 patients(54%) had slightly stimulating symptom in the urethra or bladder,and were otherwise generally well tolerated.Conclusion Single administration of RTX is safe and effective in patients with IOAB.

Objective To investigate the effects of preemptive analgesia with parecoxib sodium on postoperative analgesia and delirium after nerve injury-free surgery for fracture of thoracic and lumbar vertebrae and to promote the postoperative rehabilitation of the patients. Method 80 patients meeting the criteria were selected. and randomly divided into observation group and control group.40 patients each group. The observation group used parecoxib sodium for preemptive analgesia. while the control group used sufentanil. and the analgesia effects and the incidences of delirium were observed. Results The differences in operative time and intra-operative blood loss between the patients of the two groups were statistically insignificant. In 2 h. 6 h. 12 h.24 h and 48 h after the surgery.the VAS score and the accumulative time of intravenous self-controlled analgesia pump being pressed of the observation group were significantly lower than those of the control group. and the differences were statistically significant (P<0.05). The first time for the patients of the observation group to press the intravenous self-controlled analgesia pump is (3.84±0.62) h after the surgery, is significantly later than that of the control group (1.05±0.47)h.and the difference is statistically significant (P<0.05). The incidence of delirium in 7 days after the surgery in the patients of the observation group was 10.00%. and is significantly lower than that of the control group (25.00%) (P<0.05). Conclusion Using parecoxib sodium for preemptive analgesia before nerve injury-free surgery for fracture of thoracic and lumbar vertebrae can elevate the postoperative analgesia effects of the patients.decrease the incidence of postoperative delirium, and is highly safe and consequently worthy of clinical application.

Objective To evaluate clinical and pathologic factors associated with pelvic lymph node metastasis in patients with early-stage squamous cell carcinoma of the uterine cervir.Methods From February 2004 to January 2007,135 patients with stage Ⅰ b-Ⅱ a cervical squamous cell carcinoma in Women's Hospital,School of Medicine,Zhejiang University,were retrospectively studied.The relationship between pelvic lymph node metastasis and age,clinical stage,tumor size,grade of differentiation,depth of muscular invasion,lymphatic vascular space invasion,pretreatment level of serum squamous cell carcinoma antigen,pretreatment plasma level of fibrinogen,pretreatment leveh of hemoglobin and platelet were evaluated by univariate and multivariate analyses.Results Totally 3996 lymph nodes were dissected in 135 patients,with an average of 29.6 lymph nodes in each patient.12.6%of the patients(17/135)had metastasized pelvic lymph nodes.Univariate analysis indicated that tumor size(P=0.003),depth of muscular invasion(P=0.004),vasular space invasion(P<0.01),pretreatment levels of platelet(P=0.006)and fibrinogen(P<0.01)were significantly related to pelvic lymph node metastasis.Multivariate logistic regression analysis showed that lymphatic vascular space invasion(OR:3.674,95%CI:1.825-7.393,P<0.01)and pretreatment plasma level of fibrinogen(OR:4.568,95%CI:1.779-11.725,P=0.002)were significantly related to pelvic lymph node metastasis in patients with early-stage squamous cell carcinoma of the uterine cervix.Conclusion In early-stage cervical squamous cell carcinoma,lymphatic vascular space invasion and higher pretreatment plasma levels of fibrinogen are risk factors of pelvic lymph node metastasis.

Objective To evaluate the clinical features,therapies and prognosis in patients with mucosa-assoeiated lymphoid tissue (MALT) lymphoma in ocular adnexal marginal zone (OAML).Methods A retrospective analysis was made upon clinical data from 21 patients with OAML admitted into Beijing Tongren Hospital from June,2008 to December,2011.Results There were 12 (57.1 ％) men and 9(42.9％) women,with a median age of 57 (23-79) years old.Majority of patients had localized pathological changes.Among them,16 patients (76.2％) were in stage Ⅰ E,and 5 (23.8％) in stage Ⅳ E.Surgical resection as the sole treatment was performed in 13 patients (61.9％),and positron emission tomography CT(PET-CT) imaging demonstrated normal fluorine 18-fluorodeoxyglucose (FDG) uptake after surgical resection,who were managed with no further therapy.All the 13 patients were followed up for median 14 (5-38) months,and all in complete remission.Combination chemotherapy was given to 8(38.1％) patients.Three patients in stage Ⅰ E treated with COP (cyclophosphamide,vineristine and prednisone) or CHOP (cyclophosphamide,adriamycin,vincristine and prednisone) were all in partial remission.Five patients in stage ⅣE were treated with COP/CHOP in combination with rituximab,and all in complete remission.The 3-year overall survival rate and disease-free survival rate in the total patients were 100.0％ and 74.9％ respectively.Conclusions The patients with OAML generally have localized disease,show indolent clinical course,and present low lymphoma-related mortality.Surgical resection is a very important treatment in the patients with local disease.Systemic chemotherapy should be considered in patients at advanced stages.Rituximab in combination with chemotherapy can improve the remission rate.