Objective Investigating and analyzing problems and influencing factors in the process of hospital-level research project management,proposing effective and feasible recommendations,and to prove a reference for hospitals administrative management development.Methods The research analyzed factors including researchers,the departments and implementation.Results Since 2005,the total funding to support research projects in the hospital-level project reached 6.345 million yuan,the pass rate in middle-term examination was 84.94％ and was 71.81％ in final examination,with the majority of them were senior researchers.Conclusions Problems founded in this study includes the participate rate was low inyoung and middle-aged researchers,the quality of hospital-level research is also low,lack of research time,and the research outcome is not satisfied.We suggest strengthen the management of the research process,improve the mechanism of scientific rewards and punishments,integrate the disciplines resources,and improve the quality of hospital-level research project.

[Objective]To discuss the clinical experience of treating primary insomnia with Professor GU Xizhen, the famous Chinese doctor in Jiangsu Province. [Methods]To study the understanding of the etiology and pathogenesis of primary insomnia by Professor GU Xizhen, summarize the experience of treating primary insomnia based on the use of the key suppressing Yang and basing on the syndrome differentiation.[Results]Professor GU Xizhen thinks that the movement of the Ying and Wei is the most important physiological mechanism for the formation of sleep, and that Yang does not enter the Yin is the basis of the pathologic theory, the deficiency of Qi and blood and the dysfunction of the viscera are the pathogenic factors. Based on the urgent cure of the symptoms, delayed treatment of the fundamental principles, put forward the treatment when suppressing Yang into Yin first, on the basis of the emphasis on tonifying Qi and blood, Yin and Yang, clearing heat, removing the wet, regulating Qi activity etc, matching specific time of the drug. It can relieve both primary and secondary symptoms and get good results.[Conclusion]The treatment of primary insomnia by the Professor GU Xizhen is very effective. It deserves further study and promotion in clinical practice. One medical case is attached to prove the above conclusion.

[Objective]To explore the application of alcohol in unearthed medical literature,so as to provide reference for the clinical application of alcohol in modern Chinese medicine.[Methods]Based on the unearthed literatures such as Wushier Bingfang,Wuwei Medical Bamboo Slips of Han Dynasty,ZHOU Jiatai Medical Bamboo Slips of Qin Dynasty,Tianhui Medical Bamboo Slips and so on,combined with the relevant records in the handed down literature,the application of alcohol in the unearthed literatures was compared and summarized.[Results]Although there is no specific reason for the use of alcohol in the unearthed medical literature,a comprehensive analysis can be made from the related records in the contemporaneous literature.The analysis showed that in the pre-Qin,Qin and Han Dynasties,most of the alcohol was yellow wine,which was used in the way of alcohol mixing,alcohol decoction and impregnation,and was widely used in the treatment of various diseases.It is concluded that the alcohol has the effect of"changing the medicinal properties,direct to the disease""warming the channels and clearing the collaterals,removing blood stasis and relieving pain""correcting the odor,enhancing the drug effect"and so on.The application of alcohol in the later literature showed different characteristics in each period,but all developed on the basis of the application of alcohol in the Qin and Han Dynasties.[Conclusion]Alcohol has great potential in the clinical treatment of modern Chinese medicine,but the soaking and decocting time of alcohol for medicine,the effect of different temperatures is worth further study.

Objective:To evaluate the role of deubiquitinase OTUD1 in acute lung injury in septic mice and the relationship with transforming growth factor-beta activated kinase 1(TAK1)-mitogen-activated protein kinase (MAPK) signaling pathway.Methods:Twenty male wild-type (WT) and 20 OTUD1 gene knockout (KO) C57BL/6N mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=10 each) using a random number table method: wild-type+ sham operation group (WT-Sham group), wild-type+ sepsis group (WT-SEP group), OTUD1-KO+ sham operation group (KO-Sham group) and OTUD1-KO+ SEP group (KO-SEP group). The acute lung injury was induced by cecal ligation and perforation (CLP) in anesthetized septic mice. Mice were sacrificed at 24 h after operation, blood samples were collected from the abdominal aorta, and lung tissues were collected. Blood gas analysis was performed using the i-STAT blood gas analyzer, PaO 2 and FiO 2 were recorded, and the oxygenation index (OI) was calculated. The morphology of lung tissues was examined with a light microscope for evaluation of lung injury, and lung injury scores were calculated. The wet to dry lung weight (W/D) ratio was measured, and the activities of MPO were measured. The concentrations of TNF-α and IL-6 in plasma were detected by enzyme-linked immunosorbent assay, and the expression of OTUD1, phosphorylated TAK1 (p-TAK1), phosphorylated p38 (p-p38), phosphorylated c-Jun amino-terminal kinase (p-JNK) and phosphorylated extracellular signal-regulated kinase (p-ERK) was detected using Western blot. Results:Compared with WT-Sham group, the PaO 2 and OI were significantly decreased, the lung injury score, W/D ratio, MPO activity, and plasma TNF-α and IL-6 concentrations were increased, and the expression of OTUD1, p-TAK1, p-p38, p-JNK and p-ERK protein in lung tissues was up-regulated in WT-SEP group ( P<0.05). Compared with WT-SEP group, the PaO 2 and OI were significantly decreased, the lung injury score, W/D ratio, MPO activity, and plasma TNF-α and IL-6 concentrations were increased, and the expression of OTUD1, p-TAK1, p-p38, p-JNK and p-ERK protein in lung tissues was up-regulated in KO-SEP group ( P<0.05). Conclusions:OTUD1 is involved in the endogenous protective mechanism against acute lung injury in septic mice, which may be related to the inhibition of TAK1-MAPK signaling pathway activation and decreased inflammatory responses.

Objective:To evaluate the role of tumor necrosis factor-alpha-induced protein-8 like-2(TIPE2) in sepsis-induced myocardial injury and the relationship with serine-threonine kinase(AKT)/glycogen synthase kinase-3β(GSK-3β)/β-catenin signaling pathway in mice.Methods:Sixteen male wild-type C57BL/6N mice and 16 TIPE2-gene knockout C57BL/6N mice, aged 6-8 weeks, with a body mass index of 20-25 g, were divided into 4 groups using a random number table method: wild-type+ sham operation group(group WT-sham), wild-type+ cecal ligation and perforation(CLP) group(group WT-CLP), TIPE2-gene knockout sham operation group(group KO-sham) and TIPE2-gene knockout CLP group(group KO-CLP), with 8 mice in each group. The model of myocardial injury induced by sepsis was developed by CLP in anesthetized animals. Blood samples from the inferior vena cava were collected at 24 h after surgery for determination of the concentrations of cardiac troponin I(cTnI) in serum by enzyme-linked immunosorbent assay. Then the mice were sacrificed and myocardial tissues were collected for determination of the pathological changes(by hematoxylin and eosin staining), expression of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and IL-6 mRNA(by quantitative polymerase chain reaction), and expression of TIPE2, phosphorylated AKT(p-AKT), phosphorylated GSK-3β(p-GSK-3β) and β-catenin(by Western blot).Results:Compared with the corresponding Sham groups, the serum cTnI concentration was significantly increased, the expression of TNF-α, IL-1β and IL-6 mRNA and expression of p-AKT, p-GSK-3β and β-catenin in myocardial tissues were up-regulated, the expression of TIPE2 was down-regulated( P<0.05), and the pathological changes of myocardium were found in corresponding CLP groups. Compared with group WT-CLP, the serum cTnI concentration was significantly increased, the expression of TNF-α, IL-1β and IL-6 mRNA and expression of p-AKT, p-GSK-3β and β-catenin in myocardial tissues were up-regulated, the expression of TIPE2 was down-regulated( P<0.05), and the pathological changes of myocardium were aggravated in group KO-CLP( P<0.05). Conclusions:TIPE2 reduces the myocardial injury probably through inhibiting the AKT/GSK-3β/β-catenin signaling pathway in septic mice.

Objective To observe the value of quantitative CT(QCT)abdominal body fat parameters combined with clinical-imaging model for predicting recurrent acute pancreatitis(RAP).Methods Data of 468 patients with acute pancreatitis(AP),including 207 cases of RAP(RAP group)and 261 cases of non-RAP(non-RAP group)were retrospectively analyzed.Clinical information,conventional CT manifestations and QCT parameters such as abdominal subcutaneous fat area(SFA),visceral fat area(VFA),total abdominal fat area(TFA),hepatic fat content and pancreatic fat content at the first visit were recorded or measured.Clinical characteristics,CT manifestations and QCT parameter values were compared between groups,and the independent factors for predicting RAP were selected with multivariate logistic regression analysis.Then a clinical-imaging model and a comprehensive model combining with QCT parameters were constructed,and their efficacies for predicting RAP were evaluated with receiver operating characteristic(ROC)curves,and the area under the curves(AUC)were calculated.Results Compared with non-RAP group,patients in RAP group were younger,had higher percentage of alcohol consumption,biliary stones and hyperlipidemia,as well as of distinct pancreatic margins on CT images,also higher VFA,TFA,liver fat content and pancreatic fat content(all P＜0.05).Alcohol consumption,hyperlipidemia,biliary stones,pancreatic margins and pancreatic fat content were all independent predictors of RAP,and the comprehensive model constructed based on these five had higher AUC(0.860)than clinical-imaging model constructed based on the previous 4 factors(0.701)and pancreatic fat content alone(0.770)(both P＜0.001).Conclusion QCT abdominal body fat parameters combined with clinical-imaging comprehensive model was effective for predicting the risk of RAP.

Objective To investigate the value of quantitative CT(QCT)parameters related to abdominal and dorsal fat content for predicting early postoperative complications of esophageal cancer.Methods A total of 184 patients who underwent radical esophageal cancer surgery were retrospectively collected and divided into complication group(n=76)and control group(n=108)according to whether early postoperation complication(within 30 days after surgery)occurred or not.QCT was used to obtain parameters related to abdominal and dorsal fat content,including visceral fat area(VFA),subcutaneous fat area(SFA),VFA/SFA and the degree of muscle fat infiltration(MFI)of posterior vertebral muscles based on L3 central-level CT images.Univariate analysis and multivariate logistic regression were used to analyze clinical and pathological data as well as QCT parameters related to abdominal and dorsal fat content to screen independent risk factors for early postoperative complications of esophageal cancer.Then receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each independent risk factor alone and their combination for predicting early postoperative complications of esophageal cancer.Results VFA/SFA and MFI degree of posterior vertebral muscles were both independent risk factors for early postoperative complications of esophageal cancer(OR=5.121,1.110,both P＜0.05).The AUC of VFA/SFA and MFI degree of posterior vertebral muscle was 0.81 and 0.77,respectively,while of their combination was 0.84.Conclusion QCT parameters related to abdominal and dorsal fat content could be used to effectively predict early complications of esophageal cancer after surgery.

ObjectiveTo observe the clinical effect of Yiqi Liangxue Shengji Formula （益气凉血生肌方， YLSF） on recurrence of angina pectoris and quality of life at eight weeks after perecutaneous coronary intervention （PCI）. MethodsEighty-two coronary artery disease （CAD） patients with qi deficiency and blood stasis and binding of stasis and heat syndrome who had underwent PCI were randomly divided into two groups with 41 patients each in the treatment group and the control group. Based on conventional western medicine after PCI， patients in the treatment group orally took YLSF granules while those in the control group were administered with placebo， one dose daily for 8 weeks. The recurrence rate of angina pectoris and readmission rate within eight weeks after PCI were recorded. Before and after treatment， total traditional Chinese medicine （TCM） syndrome score， Seattle Angina Questionnaire （SAQ） scores （physical limitation， angina stability， angina frequency， treatment satisfaction and disease perception）， and the SF-36 scores for quality of life （physical and mental health） were evaluated. The adverse reactions during medication in both groups were recorded. ResultsWithin eight weeks after PCI， the recurrence rate of angina pectoris in the treatment group （4/41， 9.76%） was significantly lower than that in the control group （11/41， 26.83%， P＜0.05）. The readmission rate in the treatment group was 2.44% （1/41）， while that in the control group was 12.20% （5/41）， with no significantly statistical difference （P＞0.05）. After treatment， total TCM syndrome score significantly decreased in both groups， while in terms of quality of life， the SAQ scores on domains of angina stability， angina frequency and disease perception as well as SF-36 total scores， physical health and mental health scores significantly increased （P＜0.05 or P＜0.01）. Compared between the two groups， total TCM syndrome score was significantly lower in the treatment group than the control group （P＜0.01）， while no significant differences were found in SAQ scores and SF-36 total， physical and mental health scores （P＞0.05）. No adverse reactions occurred in both groups during the treatment period. ConclusionYLSF can reduce the recurrence rate of angina pectoris within eight weeks after PCI for coronary artery disease， and can improve the TCM syndrome score， and have sound safety， with comparable effect to that of placebo in improving postoperative short-term quality of life.

Objective:To investigate the application value of intraoperative motor nerve monitoring in cervical neurogenic tumor surgery.Methods:The efficacy of intraoperative neuromonitoring (IONM) was analyzed retrospectively in 18 patients, including 6 males and 12 females, aged from 15 to 74 years, treated in Affiliated Drum Tower Hospital, Medical School of Nanjing University from June 2019 to September 2022 who underwent total cystectomy of cervical neurogenic tumors under intraoperative nerve monitoring.Results:All 18 patients had complete tumor removal, including 8 patients with tumors from the vagus nerve and 10 patients with tumors from the brachial plexus nerve. Postoperative nerve functions were normal in patients with tumors from brachial plexus nerve, and incomplete vocal cord paralysis occurred in 2 patients with tumors from vagus vagus nerve. The total incidence of motor nerve injury was 11.1% (2/18). All patients were followed up for 6 to 45 months, with no tumor recurrence.Conclusion:Intraoperative neuromonitoring has significant values in surgery of cervical neurogenic tumors, which is helpful to remove completely the tumors on the basis of protecting the nerve functions to the maximum extent.

Mitochondria are the main site of energy metabolism in cardiomyocytes， and at the same time mediate apoptosis and immune response， so mitochondrial dysfunction is closely related to the development of heart failure. Combined with the pathogenesis of mitochondrial dysfunction and heart failure， it is proposed that the mitochondrial function is similar to "sweat pore - collaterals - zang and fu organs"， according to which the treatment of heart failure is based on the theory of "sweat pore - collaterals - zang and fu organs". It is believed that the core mechanism of heart failure is qi deficiency， and qi deficiency leads to the weakness of the sweat pore opening and closing， or even the sweat pore closure， then resulting in qi deficiency and blood stasis， collaterals stagnation fail to flourish， and qi， blood， and body fluids can not infiltrate and nourish zang-fu organs， so that the heart fail to be nourished， and the disease will develop. The treatment should be based on the method of boosting qi and opening sweat pore， using acridity to unblock the collaterals， and invigorating blood and draining water， with medicinal of boosting qi， invigorating blood， and draining water as treatment.