Description of the significance of the team learning theory in building a learning hospital.Building a flat structure in a learning organization, catering to the inherent needs of the hospital and its staff in development, selection of training materials conductive to building common vision of the team, effective and interactive means of training, and team trainings that are objective-specific, level-specific, hatched and focused.All these practices maximize the effectiveness of team learning, bringing forth in the hospital desirable changes in concepts, behavior, culture and performance in the building of a learning hospital

[Objective]: To study the in-vitro anti-HBV activity of Bushen Jianpi Formula (BJF). [Methods] 2.2.15 cell strain was cultured in vitro to observe the effect of BJF on its secretion of HBsAg and HBeAg. [Results] After the addition of BJF for ten days, median toxic concentration of BJF was 37.80g/L, median inhibitory concentrations of HBsAg and HBeAg were 19.05g/L and 9.55g/L, and the therapeutic index was 1.98and 3.96. [Conclusion] It is suggested that BJF has an in-vitro inhibitory effect on the secretion of HBeAg.

Objective In order to improve the surgical treatment for midpiece esophageal carcinoma, different surgical ways were com-pared. Methods From January 2010 to June 2012, 110 patients with midpiece esophageal cancer in our hospital were divided into the Ivor-Lewis group (55 cases) and the Sweet group (55 cases) according to different surgical ways, that is to say Ivor-Lewis surgery via right chest and Sweet surgery through left chest. Length of specimens, rang of tumor invasion, distance of removal, incidence of residual carcinoma in the esophageal edges, number of lymph nodes removed in chest and abdomen, and positive rate of carcinoma infiltrated lymph nodes were compared between the two groups. Questions of surgical anatomy were investigated through questionnaire among surgeons of the two groups, and the scores of both groups were analysed. Results The length of resected specimens and number of lymph nodes removed in Ivor-Lewis group was significantly lager than that of the Sweet group (P<0. 01). The positive rate of carcinoma infiltrated lymph nodes in Ivor-Lewis group was 1. 82%, which was significantly lower than 21. 82% in the Sweet group (P<0. 01). Results of questionnaire showed surgeons have gieven higher scores to Ivor-Lewis group. Conclusion Ivor-Lewis surgery is recommend for upper and midpiece esophageal carcinoma while Sweet surgery is more suitable for cardial and lower esophageal cancer.

This essay focused on the establishment of medical psychology professionals training mode, which is dedicated to preparing military psychological professionals for medical and healthcare institutions in the armed forces to be engaged in psychological assessment and diagnosis, psychological counseling and treatment, mental health education services in the future war.

Objective To investigate the relationship between portal vein pressure and liver regeneration after 90% portal branch ligation in rats.Methods Forty-five male SD rats underwent 90% portal branch ligation (including 5 rats underwent sham operation),and then the changes of portal vein pressure and weight of unligated hepatic lobes were detected.The morphological changes of hepatocytes of the unligated hepatic lobes were observed under a light microscope.Proliferative cell nuclear antigen(PCNA)index was detected by immunohistochemistry,and hepatocyte apoptosis of the unligated hepatic lobes by TUNEL method.All data were analyzed by Pearson rank correlation analysis and t test.Results Thirty-eight out of 40 rats survived(95%).The ligated hepatic lobes diminished progressively,whereas the unligated hepatic lobes regenerated.Preoperative portal vein pressure was(9.1±1.8)cm H_2O(1 cm H_2O=0.098 kPa),and it was increased significantly shortly after the ligation and reached (15.8±2.7)cm H_2O 12 hours later(t=6.847,P＜0.05).The portal vein pressure decreased from(13.6±2.3)cm H_2O at day 1 to(9.3±2.0)cm H_2O at day 28.Preoperative positive PCNA index was 7%±3%,which was significantly lower than 14%±5%at postoperative 12 hours,21%±6%at day 3 and 26%±7%at day 5(t=9.129,P＜0.05),and it began to return to normal at day 5.Few apoptotic hepatoeytes were observed in preoperative liver tissue and unligated hepatic lobes.The expression of PCNA in unligated hepatic lobes and portal vein pressure had apositive correlation at postoperative day 1,3,5(r=0.913,0.896,0.908,P<0.05)and a negative correlation at postoperative day 14(r=-0.926,P<0.05).Conclusions The regeneration of hepatocytes in unligated hepatic lobes is activated after 90% portal branch ligation,and the regenerated liver compensates the weight loss of the ligated hepatic lobes.Liver is regenerated mainly by speeding hepatocyte proliferation rather than reducing hepatocyte apoptosis.Changes of portal vein pressure may play an important role in liver regeneration.

Objective To evaluate the effects of interferon therapy after curative surgical intervention on improving prognosis of patients with hepatitis C-related hepatocellular carcinoma (HCC).Methods We searched randomized clinical trials from 1990 to 2015 on interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC from the Cochrane Library,the Cochrane Database of Systematic Reviews,MEDLINE and Embase.A Meta-analysis was carried out using Revman 5.Results There were 7 studies included in this research.The results showed that interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC reduced the recurrence rate of HCC at 3 years (RR =0.84,95％ CI 0.73 ～0.97,P ＜0.05).The therapy could not improve the 3-year survival rate in these patients (RR =1.04,95％ CI 0.90 ～ 1.21,P ＞ 0.05).Stratified subgroup analyses showed interferon therapy after liver resection reduced the recurrence rate (RR =0.62,95 ％ CI 0.39 ～ 1.00,P =0.05).For patients with tumors less than 3 cm,interferon therapy reduced the recurrence rate (RR =0.82,95％ CI 0.69 ～ 0.98,P ＜ 0.05).Conclusion Interferon therapy after curative surgical intervention improved prognosis in patients with hepatitis C-related HCC.

The authors introduced,against the backdrop of the new round of accreditation,organization and practice of the hospital.In accordance with the five management elements of planning,organization,leadership,coordination and control,and the level management theory,the hospital divided,based on a top-down design and step-by-step implementation,the process into four stages of mobilization and deployment,study and training,self-assessment and rectification,supervised self-assessment and constant improvement.These efforts aim at exploring the key points and methodology of hospital accreditation,proposing such key points as the combination of the accreditation with building a long-term mechanism,that of theory with practice,that leadership with full staff involvement,that of top-down design with step-by-step implementation,that of training and rectification,that of self-assessment and supervision,and that of system management with implementation of provisions.This way the hospital accreditation may upgrade the hospital as a whole.

Objective:In order to understand the changing trends of gastric cancer incidence and mortality in early-onset and late-onset in China from 2000 to 2019.Methods:The Global Burden of Disease research data was collected, and Excel and R 4.2.1 softwares were used to examine the incidence rate, mortality rate, and disability-adjusted life years (DALY) of Chinese people from 2000 to 2019, with a focus on gender, age, and year.Results:In 2019, the crude incidence rates were 7.06/100 000 (95% UI: 6.63/100 000-7.59/100 000) and 114.52/100 000 (95% UI: 108.79/100 000-121.63/100 000) for early- and late-onset gastric cancer, respectively. The crude mortality rate for early-onset gastric cancer was 3.29/100 000 (95% UI: 3.11/100 000- 3.50/100 000), while the crude mortality rate for late-onset gastric cancer was 81.88/100 000 (95% UI: 78.15/100 000-86.04/100 000). Additionally, the crude DALY rates for these two types of gastric cancer were 156.48/100 000 (95% UI: 148.82/100 000-165.84/100 000) and 1 750.13/100 000 (95% UI: 1 661.21/100 000-1 852.99/100 000). The standardized incidence of early-onset gastric cancer decreased from 5.49/100 000 in 2000 to 4.76/100 000 in 2019, and that of late-onset gastric cancer decreased from 143.45/100 000 in 2000 to 123.02/100 000 in 2019.The standardized mortality rate of early-onset gastric cancer decreased from 4.16/100 000 in 2000 to 2.18/100 000 in 2019, and that of late-onset gastric cancer decreased from 140.82/100 000 in 2000 to 91.49/100 000 in 2019. The standardized DALY rate for early-onset gastric cancer in 2019 was 105.87/100 000 (95% UI: 87.98/100 000 -125.60/100 000), lower than 198.84/100 000 (95% UI: 179.47/100 000- 219.83/100 000) in 2000. The standardized DALY rate for late onset gastric cancer in 2019 was 1 821.11/100 000 (95% UI: 1 509.42/100 000-2 158.53/100 000), lower than 2 932.52/100 000 (95% UI: 2 665.92/100 000-3 252.60/100 000) in 2000. Conclusions:The standardized mortality rate of early-onset gastric cancer in China showed a decreasing trend from 2000 to 2019. The standardized mortality rate of late onset gastric cancer showed a trend of first increasing and then decreasing. Notably, the incidence, mortality, and DALY of late-onset gastric cancer were significantly higher than those of early-onset gastric cancer during this period. Additionally, male incidence, mortality, and crude DALY rates were higher than female.

Integrated medical education, namely medical education under the concept of integration, is an important trend in the development of global medical education, and also an important task in the re-form of medical universities and colleges in China. The integrated medical education abroad originated from Europe and America, and developed relatively well. It started late in China and was limited to integration of some subjects. At present, the reform of integrated medical education in domestic colleges and universities is still facing the problems and challenges such as lag of teaching ideas, limited content of reform, insufficient teachers' ability, difficulty to change learning habits, deviations of learning purposes, lack of integrated learning, lack of system, poor mechanism, weak guarantee and so on. In the future, we should make efforts to teach, learn and manage, give full play to the leading role of "teaching", improve the main position of"learning", and constantly improve the guarantee function of "management".

Objective To evaluate the effectiveness and safety of moxibustion for knee osteoarthritis and the methodological quality of systematic reviews(SRs).Methods SRs of moxibustion for knee osteoarthritis were retrieved from CNKI,VIP,Wanfang Data,SinoMed,PubMed,Cochrane Library,Embase and Web of Science was conducted from the establishment of the databases to February 10,2022.AMSTAR 2 was used to assess the methodological quality of SRs.The randomized controlled trials(RCTs)included in these SRs were screened and summarized according to inclusion standard.RevMan 5.4 software was used for Meta-analysis,and GRADE approach was used to assess the certainty of evidence.Results A total of 15 SRs were included.The evaluation results of the AMSTAR 2 showed that the methodological quality was very low for 14 SRs,and low for other 1 SR.A total of 36 RCTs were included.Meta-analysis results showed that compared with the non-steroidal anti-inflammatory drugs(NSAIDs),the moxibustion group had better effects on improvement of WOMAC scores[mean difference(MD)=-5.95;95%confidence interval(CI):-9.25 to-2.65;low quality],relieving pain[MD=-1.26;95%CI:-2.19 to-0.32;very low quality],and improving effective rate[risk ratio(RR)=1.16;95%CI:1.11 to 1.22;low quality].In the moxibustion group,some patients experienced blisters,and most healed in 3 days.Conclusion Moxibustion has advantages in pain reduction and improving effective rate compared with routine Western therapy for knee osteoarthritis.However,well-designed high-quality RCTs are needed for further verification.