The force of hospital culture is a kind of flexible spiritual productivity.First,it can improve in a comprehensive way the quality of a team and the ideological level of all the employees,make the cultural content permeate the various layers within the organizational framework,and ensure that the employees fulfill quality and quantity requirements in completing their tasks.Second,it can impel people to have a sense of identification,mission and pride concerning the hospital's overall objectives,increase the initiative of both individuals and the organization,and result in the exercise of self-control and self-management on the basis of mechanisms and ideology.Third,it can create a life-learning environment for the employees,raise their awareness of and capability for innovation and the hospital's mechanisms for innovation,and bring about enduring spiritual support to the core values of the hospital.Finally,it can make patients associate the hospital with a unique image of service,create a unique culture of service,and increase patients' trust in the hospital.

Objective To analyze risk factors for soft-tissue defects after surgery on leg trauma,to discuss methods for prevention of soft-tissue defects and its treatment.Methods A retrospective analysis was conducted on 217 cases of soft-tissue defects with bone exposure and / or internal fixation exposure after surgery on leg trauma from January,1999 to December,2012.Soft-tissue defects with various flaps were used in 201 cases,including neurocutaneous flap(89 cases),random flap(21 cases),free flap(75 cases),cross-leg flap(16 cases),and by skin grafting in 16 cases.For the 117 internal plate-fixated fractures,96 removed the plate and 21 cases did not remove the plate.For the 13 intramedullary nail fixations,4 cases of intramedullary nails were removed,9 cases were not removed.For the 56 cases of external fixation of the fractures,39 patients had unadjusted external fixation,17 cases re-adjusted external fixations.Results Of the 217 cases of soft-tissue defect after surgery on legs,201 cases were conducted flap surgery.The flap was completely necrosis in one case,and partial distal necrosis were in 14 cases,of which 6 cases healed after changing the dressing,5 underwent debridement and skin grafting,3 cases underwent flap surgery again.In cases of fracture patients,177 cases healed within 1 year,delayed union 23 cases,nonunion eight cases.Nonunion healing after bone grafting and re-fixation surgery.In 9 cases of uncontrollable osteomyelitis,6 patients underwent bone removal and bone transport surgery,3 patients underwent amputation.Conclusion Soft-tissue defects after surgery on leg trauma is a serious complication whose prevalence is associated,in a certain degree,with incorrect surgical time and methods.It is crucial for early repair of soft-tissue defects by using various kinds of proper flaps whenever soft-tissue complication occurs.In patients with early stage internal fixation,flap surgery without internal fixation removing is feasible if little soft-tissue defect,little exposed internal fixation and mild infection,otherwise it is necessary to remove internal fixation and re-fix by external fixation before flap surgery.

AIM:To investigate whether nimesulide a selective cyclooxygenase 2 (COX-2) inhibitor and piroxicam (an inhibitor of COX-1) protect the rat hearts against oxidative stress induced by hydrogen peroxide, superoxide anion or hydroxyl free radical. METHODS: Cardiac contractility, lactate dehydrogenase (LDH) and malondialdehyde (MDA) were analyzed by the Langendorff method in isolated rat hearts. Production of 6-Keto-PGF1?, a marker of COX activity, was measured in isolated rat hearts. RESULTS: Rat hearts were exposed to hydrogen peroxide (H2O2), pyrogallol (which produced superoxide anion) or Vit C+Fe2+ (which produced hydroxyl free radical) for 10 min followed by reperfusion for 30 min. H2O2 decreased cardiac contractility and increased LDH release, which was inhibited by nimesulide (3 mg/kg) LVDP 72%?10% vs 61%?11%, LDH (5.5?2.5)U/L vs (8.0?2.1)U/L, P

Background and purpose:Numerous researches indicated that the expression of pituitary tumor transforming gene1 (PTTG1) was correlated with the severity of glioma tumors. However the specific mechanism of PTTG1 is not clear in glioma. In this study, we explored the role and significance of PTTG1 in the invasion of glioma cells. Methods:Western blot was used to detect the expression of PTTG1 protein in various glioma cell lines. siRNA plasmid was used to transfect U87 cells. Western blot was used to analyze the expression of PTTG1 protein in transfected U87 cells. Matrigel invasion assay was used to detect the invasive ability in the cells being transfected in vitro. Western blot was used to analyze epithelial growth factor (EGF) induced protein phosphorylation of ARK5 and Akt in the cells being transfected PTTG1 plasmid (siPTTG1/U87) and scrambled siRNA (Scr/U87). Results:The expression of PTTG1 protein was higher in all glioma cell lines. After transfection, the invasion of siPTTG1/U87 was obviously decreased after 5 min with EGF stimulation than the Scr/U87, the phosphorylation of ARK5 and Akt was significantly enhanced. However, whether or not the existence of EGF, the phosphorylation of ARK5 and Akt had no differences in siPTTG1/U87. Conclusion:In glioma cells, PTTG1 protein is high expressed and maybe have an important function in glioma cells invasion through Akt-ARK5 signaling pathway.

Objective To evaluate the locating effects of a portable ultrasound for leg perforator flaps,and the clinical effects of leg perforator flaps for the wounds of the extremities.Methods Since December 2009 to March 2011,thirty-one cases of soft tissue defects of the extremities were treated with free vascularized leg perforator flaps in our center.A portable ultrasound were used for the locating of the perforator arteries of the leg before the operations.These flaps include 24 cases of the fibular artery perforator flaps (4 with simultaneous fibula transfer),three cases of the posterior tibia artery perforator flap,two cases of the medial gastrocnemius artery perforator flap,and 2 cases of the lateral gastrocnemius artery perforator flap.The flap size ranged from 15.0 cm × 8.0 cm to 1.0 cm × 1.5 cm.The caliber diameter of the perforator artery ranged from 0.2 mm to 1.8 mm.The wounds included 21 cases of the hand,five cases of the forearm,and 5 cases of the leg.Results The coincidence rate intraoperatively of the portable ultrasound was 96.8％.All the flaps survived and the wounds healed uneventfully.The donor site of the flaps were either closed directly or closed with partial split-thickness skin graft.Conclusion The portable ultrasound is an effective,reliable and accurate instrument for locating the leg perforator flaps.The leg perforator flaps have the advantages of convenient harvest,satisfactory thickness,less donor site morbidity,and high survival rate.

AIM:To investigate the effect of puerarin on acute high glucose-induced attenuation of ACh relaxation in isolated rat aortic rings, and to elucidate its underlying mechanism. METHODS: The thoracic aortic rings with endothelium of male Sprague-Dawley rats were mounted on a bath system. Isometric relaxation of aortic rings was measured. RESULTS: ① After incubation with high concentration of glucose (44 mmol/L), the vascular relaxation responses to ACh decreased. ② After coincubation with puerarin (10-10-10-8 mol/L) and high glucose, the high glucose-induced attenuation of ACh relaxation responses of artery was partly inhibited in a dose-dependent manner. ③ After incubation with puerarin for 2 h, the HO-1 activity of thoracic aorta increased. ZnPPIX (an inhibitor of heme oxygenase-1) abrogated the protective effect of puerarin. CONCLUSION: Puerarin prevents the acute high glucose-induced attenuation of endothelium-dependent relaxation in aortic rings. The mechanism might be involved in the activation of heme oxygenase-1.

Objective To evaluate the results of NiTi shape memory alloy four-corner arthrodesis concentrator (NTMA-FCAC) for carpal collapse. Methods We reviewed retrospectively 13 patients who underwent scaphoid excision with four-corner arthrodesis using NTMA-FCAC for carpal collapse from August 2006 to June 2009. There were eight males and five females, with an average age of 38 years (range, 23-61years). The cause of carpal collapse was SNAC in 7 cases, perilunate dislocations in five and SLAC in one.The injury mechanisms included traffic accidents (5 cases), falling from a height (4 cases), crashes (3 cases)and sprain (1 case). Objective measurements included grip strength and range of the wrist. Radiographs were performed in all patients. A visual analogue scale (VAS) was used to assess wrist pain. The results were evaluated according to the Krimmer wrist scores. Results The mean follow-up time was 26.5 months (range,6-36 months). Clinical evaluation yielded the mean grip strength of (32.49±6.21) kg (80.8% of opposite side).The mean range of the wrist reached over 53% of the healthy side. Non-union and wound infection were not seen. The mean VAS scores had improved from 4.46±1.27 preoperatively to 1.31 ±0.95 postoperatively. The mean pain scores under stress had improved from 7.00±1.41 preoperatively to 2.62±1.26 postoperatively.There were remarkable differences between them. The mean Krimmer wrist score was 79. Conclusion Four-corner arthrodesis using NTMA-FCAC is an effective method for carpal collapse, preserving a majority of wrist function.

AIM: The objectives of the present study were to examine the effect of Jumi(JM) extraction on relaxation of isolated rat aortic rings,and to elucidate its mechanisms.METHODS: The thoracic aortic rings with and without endothelium of male Sprague-Dawley rats were mounted on a bath system.Vasodilatation of aortic rings preconstricted with 10-6 mol/L of phenylephrine(PE) was measured.RESULTS: JM extraction(0.5-8 g/L) caused a concentration-dependent relaxation in aortic rings.The extent of relaxation was larger in endothelium-intact aortic rings than that in endothelium-denuded aortic rings.Both L-NAME [a nitric oxide synthase(NOS) inhibitor] and high potassium(20 mmol/L KCl) partly abolished the relaxation action of JM extraction in endothelium-intact aortic rings.Pretreatment with L-NAME also inhibited the relaxation response to JM extraction in endothelium-denuded aortic rings.After incubation with JM extraction,NOS activities enhanced both in endothelium-intact and endothelium-denuded aortic rings.CONCLUSION: JM extraction causes relaxation of aortic rings through endothelium-dependent and independent pathways.The mechanisms might be involved in NOS and endothelium-derived hyperpolarizing factor.

AIM:To investigate the effect of high glucose on the expression of an endoplasmic reticulum stress marker glucose-regulated protein 78(GRP78),and explore its underlying mechanism.METHODS:(1) Human umbilical vein endothelial cells(HUVECs) were exposed to normal glucose(5.5 mmol/L) and high glucose(30 mmol/L) for 24 h,36 h or 48 h.Cell viability was determined by MTT method.Cell apoptosis was detected by flow cytometry analysis.The expression of proteins was evaluated by Western blotting analysis.RESULTS:After treated with high glucose for 24-48 h,the expression of GRP78 increased early but decreased at 48 h of incubation,while cyclooxygenase-2(COX-2) expression increased in a time-dependent manner.COX-2 selective inhibitor nimesulide inhibited high glucose induced changes of GRP78 expression and also inhibited high glucose induced cell apoptosis.CONCLUSION:Prolonged high glucose exposure changes the expression of GRP78 in a COX-2 dependent manner in HUVECs.

AIM: To explore the protective effect of curcumin on high glucose-induced decrease in contraction of isolated rat aortic rings, and to elucidate its underlying mechanism. METHODS: The thoracic aortic rings with endothelium of male Sprague-Dawley rats were mounted on a bath system. Isometric contractions of aortic rings were measured. HO activity was also evaluated. RESULTS: (1)Four hours after incubated with 44 mmol/L of glucose (high glucose),the vascular contraction responses to phenylephrine (PE) decreased compared to control group (containing 11 mmol/L of glucose). (2)Coincubation with curcumin (3×10~(-11)-3×10~(-10) mol/L) and high glucose,the high glucose-induced decrease in contraction responses to PE of arteries was partly inhibited. (3)Four hours after incubation with curcumin,the HO activity in thoracic aorta increased. ZnPP,an inhibitor of HO-1,completely abrogated the protection effect of curcumin. (4)Methylene blue,an inhibitor of guanylate cyclase (GC),partly abolished the protective effect of curcumin. CONCLUSION: Curcumin prevents the high glucose-induced decrease in contraction responses to PE in intact aortic rings. The mechanism might be mainly involved in the activation of HO-1 and GC.