Objective To research the significance of detection of cholyglycine(CG) and total bile acid (TBA ) in intrahepatic cholestasis of pregnancy(ICP) .Methods Totally 85 gestational patients of ICP and 85 normal pregnancy pregnant women(control group) were chosen .Indexes including CG ,TBA ,ALT ,AST and TBIL were detected ,and the results were compared .Results In ICP group ,the levels of serum CG ,TBA ,ALT ,AST and TBIL were significantly higher than those in the normal control group ,and the differences were statistically significant(P< 0 .05) ;The positive rates of serum CG and TBA in ICP were significant higher than those in control group(P< 0 .05) .Conclusion The level of CG and TBA in intrahepatie cholestasis of pregnancy are significantly increased and might be sensitive indicators of gestaional diabetes in intrahepatie cholestasis of pregnancy ,the joint detection is of great clinical significance for ICP early diagnosis and monitoring .

Objective To observe the clinical effects of anti-vascular endothelial growth factor (VEGF) agent for retinopathy of prematurity (ROP) in different zones.Methods Retrospective analysis was performed on 24 ROP patients (46 eyes) who received intravitreal injection of anti-VEGF agent in our hospital from April 2013 to April 2014,including 15 patients (28 eyes) with Zone Ⅰ ROP and 9 patients (18 eyes) with Zone Ⅱ ROP.All the patients receive intravitreal injection of anti-VEGF agent Ranibizumab.The patients were observed for postoperative progression of fundus conditions,and the recovery rate and progression rate following initial injection were compared statistically between two groups.Results There was no statistically significant difference between the two groups in gestational age at birth or birth weight (both P ＞0.05);And statistically significant difference was found between two groups in gestational age at surgical correction (P =0.001).Following initial injection,the recovery rates were 32.14％ and 66.67％,and the progression rates were 67.86％ and 33.34％ in Zone Ⅰ ROP group and Zone Ⅱ ROP group,respectively,there was statistically significant difference between the two groups in recovery rate (x2 =5.263,P =0.022).The progression rate in Zone Ⅰ ROP group was higher than that in Zone Ⅱ ROP group,there was statistically significant difference (x2 =-2.269,P =0.023).During follow-up,no complications of intravitreal injection as cataract,endophthalmitis or retinal tears was observed;Only 2 patients experienced corneal edema,and 4 patients experienced subconjunctival hemorrhage.Conclusion Intravitreal injection of anti-VEGF agent is effective for both Zone Ⅰ and Zone Ⅱ ROP.While for Zone Ⅰ ROP,the surgery success rate is low and the reoperation rate is high,such treatment can provide favorable time and conditions for reoperation.

[Objective] Examine the expression of Galectin-3 (Gal-3),B cell lymphoma-2 protein (Bcl-2) in epithelial ovarian cancer tissues with regard to clinicopathological and survival variables,testing whether they can serve as prognostic markers and provide evidence for further research.[Methods] 98 EOC tissues and 10 normal ovarian tissues were collected,as well as their clinical documents.The expression of Gal-3 and Bcl-2 was tested via immunohistochemical staining analysis.Then the correlation between these two proteins and the clinicopathological and survival variables of these patients were evaluated.[Results] Of the 98 EOC,Gal-3 and Bcl-2 were all cytoplasmic staining.Gal-3 was observed in a majority of the EOC tumor cell proper (75/98,76.5％) but not in normal ovarian tissues.Bcl-2 was observed in a majority of the EOC tumor cell proper (50/98,51.0％) but not in normal ovarian tissue.Spearman bivariate correlation test show that there was no correlation between the expression Gal-3 and Bcl-2 (P =0.867).Gal-3 expression in EOC was associated with histology and platinum sensitivity (P =0.043,P =0.038),while Bcl-2 was associated with FIGO stage (P =0.029).Cox univariate analysis revealed that Gal-3,Bcl-2 expression,platinum sensitivity,stage were associated with overall survival (P =0.008,P =0.021,P ＜ 0.001,P ＜ 0.001).Further multivariate analysis showed that only Gal-3 expression,platinum sensitivity,stage affected the survival of these patients (P =0.014,P =0.021,P ＜ 0.001).[Conclusions]The expression of Gal-3 and Bcl-2 in EOC was significantly higher than that in normal ovarian tissue,supposed that they may involve in the development and progression of EOC.Gal-3 expression was associated with histology,platinum sensitivity and survival,it may be an independent predictive factor for EOC prognosis.There was no correlation between the expression Gal-3 and Bcl-2 in EOC,the functional mechanism between these two protein need further research.

Objective To study the effect of behavior-changes-in-stages theory on defecation function of lower rectal cancer after sphincter-preserving operation. Methods 84 patients with lower rectal cancer undergoing sphincter-preserving operation from June 2013 to June 2016 were divided into control group (n=42)and intervention group (n=42)according to their willingness to care.The control group implemented routine nursing,mainly for diet intervention,wound care,bowel function training and in the intervention group the behavior-changes-in-stages theory was used.Comparisons were done between the groups in terms of the anus incontinence defecation function and quality of life for 6 months after operation. Result The degrees of anus incontinence and defecation function in the intervention group were both significantly better than those in the control group 6 months after the operation (P<0.05). Conclusions The behavior-change-in-stages plays a significant role in the postoperative rehabilitation.It can significantly reduce the anus incontinence, better the bowel function,improve the quality of life and promote rehabilitation.

Objective:To observe the retinoblastoma (RB) reexamination of children with new and recurrence retinoblastoma under special circumstances.Methods:From January 2, 2020 to March 15, 2020, 30 children with RB who had fundus examination in Henan Children's Hospital were enrolled in this study. Among them, 14 were male, 16 were female; 18 were monocular and 12 were binocular. The average age was 37.07±18.15 months. The mean age of initial diagnosis was 20.23±13.77 months. Two patients had a family history (6.67%). In 42 eyes, stage B, C, D and E were 7, 8, 20 and 7 eyes, respectively. Twenty-one eyes had finished the treatment course and 21 eyes were during treatment. All the children underwent RetCam fundus examination, orbital MRI, ocular B-ultrasound and so on. Whether the children had new tumor or recurrence at different treatment stages was observed.Results:Among 7 eyes in stage B, there was no recurrence or new tumor at the end of treatment or in the process of treatment. Among 8 eyes in stage C, there were 1 eye with new tumor and 1 eye with activity tumor at the end of treatment. Among 20 eyes in stage D, there were 1 eye with recurrence tumor at the end of treatment, 3 eyes with new tumor and 7 eyes with activity tumor at the end of treatment. Among 7 eyes in stage E, 5 eyes had eyeball enucleation and 2 eyes were receiving treatment; there were 1 eye with activity tumor at the end of treatment, 1 eye with recurrence tumor, 1 eye with activity tumor. Among 18 monocular eyes, there were 11 eyes in the treatment process, 2 eyes with new tumor, 1 eye with recurrence tumor and 3 eyes with activity tumor. Of the 24 binocular eyes, 10 were receiving treatment and there were 3 eyes with new tumor, 6 eyes with activity tumor. Twenty-one eyes had finished the treatment course, the average time required for follow-up was 3.71±0.31 months, and the average time delayed for follow-up was 6.43±1.66 weeks. There was a recurrence of tumor in 1 patient who had finished the whole treatment, the incidence was 4.76%. In the course of treatment, 21 eyes were required to have a follow-up time of 3 weeks, and the average delayed follow-up time was 6.00 ± 1.89 weeks. There were 5 eyes with new tumors, with a incidence of 21.74%. Nine eyes still had activity and needed to be treated in time.Conclusions:The higher the risk of tumor staging, the more relapses and new tumors. The patients who are being treated, the time of delayed follow-up, the higher the recurrence or new tumor than the children who have finished the treatment course and delayed the follow-up. The children who have relapsed or new tumor in the treatment course of binocular are higher than the children who have monocular.

Objective:To establish a supportive and effective management mode of scientific research project application, promote the capacity building of scientific research in the hospital.Methods:Retrospective analysis was conducted on the national and provincial scientific research projects of Xinhua Hospital Affiliated to Shanghai Jiaotong University Medical School from 2010 to 2019, and the practical effect of " point to point" management mode of scientific research project application was evaluated.Results:The funding rate of Xinhua Hospital, especially national scientific research projects and provincial talents projects, was greatly improved by adoption of the multi-dimensional " point to point" management mode of scientific research project application. The number of national scientific research projects increased from 34 (26.02 million) in 2010 to 72 (51.0851 million) in 2019.The number of provincial talents projects increased from 5 (1.05 million) in 2010 to 26 (6.5 million) in 2019.Conclusions:The " point to point" management mode of scientific research project application plays an important role in promoting the overall funding rate. Enhancement of comprehensive capacity of hospital scientific research can be achieved by further improvement of this management mode, early initiation and arrangement of funding application depending on the " close partner" entity, emphasizing scientific research talents cultivation.

Objective:To explore the relationship between lipid accumulation product (LAP) and disease activity, nutritional status in patients with Crohn disease (CD).Methods:The clinical data of 74 patients with CD in the Affiliated Hospital of Yangzhou University from July 2020 to June 2021 were retrospectively analyzed. The patients were divided into active group (32 cases) and remission group (42 cases) according to simplified Crohn disease activity index (CDAI). The general clinical data, laboratory examination results and body fat indexes were recorded, body fat indexes including body mass index (BMI), waist circumference, waist-to-height ratio, LAP and nutritional risk screening 2002 (NRS2002) score. Spearman method was used for correlation analysis; the receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of LAP in predicting the disease activity and nutritional status in patients with CD.Results:The proportion of males, body weight, hemoglobin, albumin, total cholesterol, triglyceride and high-density lipoprotein cholesterol in active group were significantly lower than those in remission group: 46.9% (15/32) vs. 71.4% (30/42), (53.58 ± 8.13) kg vs. (61.05 ± 9.38) kg, (109.94 ± 23.70) g/L vs. (134.19 ± 18.03) g/L, (34.01 ± 5.71) g/L vs. (39.15 ± 4.27) g/L, (3.23 ± 0.68) mmol/L vs. (3.66 ± 0.74) mmol/L, (1.12 ± 0.36) mmol/L vs. (1.34 ± 0.55) mmol/L and (0.91 ± 0.23) mmol/L vs. (1.04 ± 0.33) mmol/L, the nutritional risk rate, platelet count, C-reactive protein and erythrocyte sedimentation rate were significantly higher than those in remission group: 68.8% (22/32) vs. 19.0% (8/42), (317.97 ± 130.19) ×10 9/L vs. (194.00 ± 51.91) × 10 9/L, 14.15 (6.15, 41.35) mg/L vs. 1.51 (0.22, 5.58) mg/L and 40.00 (20.50, 64.25) mm/1 h vs. 9.00 (3.00, 20.00) mm/1 h, and there were statistical differences ( P<0.01 or <0.05); there were no statistical difference in age, height, total protein and low-density lipoprotein cholesterol between the two groups ( P>0.05). The BMI, waist circumference, waist-to-height ratio and LAP in active group were significantly lower than those in remission group: 19.46 (17.70, 21.45) kg/m 2 vs. 21.08 (18.87, 23.12) kg/m 2, (72.51 ± 5.92) cm vs. (77.67 ± 7.27) cm, 0.44 ± 0.03 vs. 0.46 ± 0.04, 13.42 (5.07, 17.72) cm·mmol/L vs. 15.49 (9.37, 31.71) cm·mmol/L, the NRS2002 was significantly higher than that in remission group: 3.00 (1.00, 3.75) scores vs. 1.00 (0, 2.00) scores, and there were statistical differences ( P<0.01 or <0.05). Spearman correlation analysis result showed that LAP was positively correlated with BMI, waist circumference and waist-to-height ratio ( r = 0.701, 0.766 and 0.829; P<0.01); LAP was negatively correlated with NRS2002 score, platelet count and erythrocyte sedimentation rate ( r =- 0.609, - 0.249 and - 0.243; P<0.01 or<0.05). ROC curve analysis result showed that the areas under the curve of LAP predicting disease remission and nutritional status improvement in patients with CD were 0.645 and 0.832 (95% CI 0.520 to 0.770 and 0.739 to 0.925), the best cut-off values were 20.89 and 12.86 cm·mmol/L, the sensitivities were 45.2% and 81.8%, and the specificities were 87.5% and 73.3%. Conclusions:LAP has good predictive value for disease remission and nutritional status improvement in patients with CD.

Objective:To observe the clinical features of eyes in children with methylmalonic acidemia (MMA).Methods:A retrospective clinical case study. From June 2019 to June 2022, 13 children with MMA visited on the Department of Ophthalmology of Henan Children's Hospital were included in the study. The anterior segment and fundus were examined under surface or general anesthesia. Best corrected visual acuity (BCVA) and refraction were performed in 9 cases; fluorescein fundus angiography (FFA) was performed in 3 cases; flash electroretinogram (FERG) was performed in 6 cases; flash visual evoked potential (FVEP) was detected in 6 cases; optical coherence tomography (OCT) was performed in 3 cases.Results:Among the 13 pediatric patients with methylmalonic acidemia, 6 cases were male and 7 cases were female. The average age at first visit was 45 months. All cases suffered from hyperhomocysteinemia; 9 cases were with epilepsy; 2 cases were with infantile spasms; 11 cases were with stunting, 13 cases were with repeated pulmonary infection during growth period; 4 cases were with hydrocephalus; 1 cases was with hypertension and renal insufficiency. Genetic dectection results of 8 cases were recorded, MMACHC:c.609G>A:p.W203* mutation site was found in all cases. One case was accompanied by corneal ulcer. There were 10 cases with nystagmus, 4 cases with macular degeneration, 3 cases with hyperopic refractive error and esotropia. Nine cases underwent BCVA examination, BCVA was light perception-0.6. In OCT, 2 cases of 3 cases showed retinal thinning and photoreceptor cell layer atrophy in the macular area. In FFA, 2 cases of 3 cases showed circular transparent fluorescence in the macular area. Five cases of 6 cases who with FVEP had different degrees of P100 peak time delay and decreased amplitude, and 4 cases of 6 cases with FERG had decrease of a and b wave in light and dark adaptation. Conclusions:The clinical phenotypes of eyes in children with MMA are various and the severity was different; most of them are accompanied by nystagmus, and the fundus lesions are common in the characteristic bovine eye like macular region. Those with macular disease have severe visual impairment.

Objective To analyze the influence of general anesthesia (GA) on bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in treating Parkinson's disease (PD) through microelectrode recording (MER),and discuss the differences between different modes of anesthesia.Methods A retrospective analysis was performed on clinical data of 31 PD patients accepted bilateral STN-DBS in our hospital from June 2015 to June 2017.Nine patients accepted surgery under GA (A group):4 patients were treated with intravenous anesthesia (A1 group),and 5 patients were treated with inhalation anesthesia (A2 group);22 patients accepted surgery under local anesthesia LA group.MER indexes,including STN discharge frequency,STN recorded length,and maximum target error,and short-term (6 months) efficacy were recorded.A linear regression analysis was performed to find possible influence factors on discharge frequency and improving rate of UPDRS scores.Results The discharge frequencies of B group,A1 group and A2 group were 51.42 Hz±6.28 Hz,35.79 Hz±7.02 Hz and 43.18 Hz±5.87 Hz,respectively,with significant differences (F=12.181,P=0.000);as compared with that in the B group,the discharge frequencies of A1 group and A2 group were significantly lower (P＜0.05).The STN recorded lengths of B group,A1 group and A2 group were 5.48 mm±0.33 mm,5.06 mm±0.15 mm and 5.22 mam±0.16 mm,respectively,with significant differences (F=4.115,P=0.027);as compared with that in the B group,the recorded lengths of A1 group and A2 group were significantly shorter (P＜0.05).A1 group had the maximum target error,but no significant differences were noted among the 3 groups (P＞ 0.05).Six months after the surgery,the UPDRS-Ⅲ scores and Schwab-England scores of A group and B group were decreased and daily levodopa equivalent (LEDD) was decreased.As compared with B group,A group had significantly better improvement in Hoehn & Yahr grading (P＜0.05).Disease durations were positively correlated with discharge frequency (r=0.539,P=0.002);age and improving rate of UPDRS scores were negatively correlated (r=-0.572,P=-0.001);preoperative LEDD and improving rate of UPDRS scores were positively correlated (r=0.725,P=-0.000).Conclusions Bilateral STN-DBS performed under GA in PD enjoys good efficacy,which shows no obvious difference as compared with that under LA.Inhalation anesthesia had less influence on electrophysiology than intravenous anesthesia.

OBJECTIVE To interpret Teacher Training Syllabus for Clinical Pharmacist Training Program （2023 edition） （hereinafter referred as to the “new syllabus”）， and to provide reference and guidance for promoting the implementation of the new syllabus and realizing the quality-improving goal of the reform of the clinical pharmacist teacher training program initiated by China Hospital Association. METHODS From the perspective of the management and based on the position of the designer， the new syllabus was interpreted from four aspects： the background of its compilation and release， the process of its compilation and its characteristics， the key improvements of the program and the points for attention about its subsequent implementation. RESULTS & CONCLUSIONS The development and release of the new syllabus provide a “construction blueprint” for the reform of the clinical pharmacist teacher training program of the China Hospital Association. The whole process of compiling the new syllabus is characterized by four basic features： theory-led， goal-oriented， research-based， and synergistic. Compared with the previous syllabus， in addition to the adjustment of the text structure，the new syllabus presents more complete and clearer competence requirements for clinical teaching competence in terms of training objectives； in terms of training content， it further structures the group of task items， pays attention to the 育。E-mail：zhenjiancun@163.com sequential planning and time arrangement of items， and puts forward both quantitative and qualitative refinement requirements for each specific training task；in terms of training methods， it emphasizes the interaction of lecturing， demonstrating and guiding， and the progression of observation， operation and reflection， with the intention of guiding teacher trainees to “learn how to teach by teaching”. In the subsequent implementation of the new syllabus， it is necessary for the teacher training bases to attach great importance to the guarantee of training conditions and process quality management， and to organize the teacher training team to do a good job in the two training programs of “clinical pharmacist training” and “clinical pharmacist teacher training”. Based on further improving the connection between the two training programs， the teacher training team should continue to explore the scientific model of clinical pharmacist teacher training oriented by clinical teaching competence.