Objective Investigate the research capacity and key discipline construction of 9 public hospitals of Hangzhou health system in the past three years,provide suggestions based on survey findings.Methods The questionnaire designed include following information:construction of talent team in key disciplines of medicine,laboratory infrastructure investment,research projects approval and funding,papers and monographs,work efficiency and financial income,NSF funding projects and awards,and comparison of input and output.Results Key disciplines of medicine in Hangzhou health system has more than 1 200 scientific research personnel,18 provincial or municipal key disciplines,the laboratory equipment area was more than 9 000 me and total investment in lab facilities was more than 69 million RMB,the national,provincial and municipal funded project of medical key disciplines accounted for total hospital project were 71.7％,66.1％ and 53.66％.1 842 papers in total were published in the medical key (specialized) disciplines of municipal hospital.Conclusions Hangzhou health system has invested a lot of resources in medical science and technology,but is still insufficient,and there are few ways to promote the construction of talent team in key disciplines of medicine and not many leading disciplines in the country.This situation shows that the core competitiveness is not strong,and the innovation system and management mechanism need to be improved.

Objective To obtain Hangzhou residents' awareness, understanding, demands, and intentions of health examination and explore the factors influencing health examination. Methods Totally 1 183 residents (male: 542, female: 641, aged from15 to 80 years) were investigated by mean of questionnaire which included demographic characteristics, health status, medical behavior and awareness, the subjective reasons of unwilling to take health examination, the intention of choosing an institution, and the data of questionnaire were analyzed using single factor Chi-square test and conditional logistic regression analysis. Results Single factor Chi-square test showed that the factors affecting health examination participation which have statistical significances were as follows, gender (χ2=11.61,P=0.000), age (χ2=9.09, P=0.028), residence registration (χ2=44.16,P=0.000), marital status (χ2=8.96,P=0.03), educational backgroud (χ2=17.33,P=0.000), employment status (χ2=7.97,P=0.005), personal monthly income (χ2=22.82, P=0.000), having any kinds of health insurance (χ2=16.08,P=0.000), and the health examination fees paid by company (χ2=44.78,P=0.000). Conditional logistic regress analysis showed that the related fators which affecting the peoples participating rates of taking health examination are gender (P=0.003, OR=1.782), residence registration (P=0.000, OR=2.208), personal monthly income (P=0.009, OR=1.307), taking any kinds of insurance (P=0.004,OR=2.913)and the company organizing and paying for the healthy examination or not (P=0.000,OR=1.923). Conclusion The participation rates of taking health examination were affected by the factors such as male, younger than 45 years old, divorce, temporary residents, the jobless, low educational diploma and income, not having any insurance, taking the health examinaiton at their own expense and so on.

Objective:To investigate the relationship between Creactive protein(CRP)/albumin ratio (CAR) and lymph node metastasis of gastric cancer. Methods:A total of 96 cases of gastric cancer were included in the study. The clinical pathological stage and lymph node detection in patients with gastric cancer were analyzed, with the preoperative CAR as the dependent variable. Results:1) The pa-tients with preoperative CAR>0.04 has higher transfer rate and metastasis than the patients with preoperative CAR≤0.04, and the dif-ference was significant (P<0.05). The lymph node stage of patients with preoperative CAR>0.04 was significantly higher than that of the patients with preoperative CAR≤0.04, and the difference was significant (P<0.05). 2) The mean CAR of patients with Borrmann typesⅠ,Ⅱ,Ⅲ, andⅣgradually increased;with the progression of the pathological stage of gastric cancer, the mean value of CAR in-creased. 3) During the operation, the total number of lymph node dissections was high and the mean value of CAR before the opera-tion was high. Conclusion:The correlation between preoperative CAR and lymph node metastasis in patients with gastric cancer may reflect the degree of lymph node metastasis to a certain extent.

Objective To explore the efficacy of peroneus brevis tendon transfer and peroneal tendofascial flap for repairing achilles tendon and overlying skin defect.Methods From April,2004 to May,2015,5 cases of achilles tendon and overlying skin defect were treated with peroneus brevis tendon transfer and peroneal tendofascial flap.In these cases,the length of the achilles tendon defect was from 3.0 cm to 8.0 cm,and the size of skin defect ranged from 2.0 cm × 3.0 cm to 3.0 cm × 5.0 cm.Using peroneus brevis tendon to reconstruct achilles tendon defect,and covered with peroneal tendofascial flap,and then skin graft.One of them combined with the gastrocnemius tendon V-Y advancement to promote the reconstruction of achilles tendon longer defect.The patients were followed-up regularly,and evaluated by the American Society of Ankle Arrhythmia (AOFAS) ankle-hindfoot scoring system.ResultsAll operations were successful and the grafted skin survived.All cases were followed-up from 6 months to 10 years with an average of 5.2 years.At the time of last followed-up,all wounds healed well without re-infection and ulceration.Not foot varus deformity and the strongth was back to the level before the injury.AOFAS ankle-hindfoot score was increased from (50.44 ± 12.05)(preoperative) to (90.02 ± 6.55)(the last follow-up) (P＜0.05).Conclusion There were some advantages in the method of the treatment of achilles tendon and overlying skin defect by using peroneus brevis tendon transfer and peroneal tendofascial flap,such as easy to cut,small damage to the donor area,and no significant deformity to the receptor area,etc.It is a good way to repair achilles tendon and overlying skin defects.

Objective To explore the effect of using smart products (including smart phones, computers and other electronic products),as well as having hobbies on their cognitive function in pension agency elderly people,and analyze if there is certain protective effect on cognitive function by using smart products and having hobbies.So as to reduce the risk of mild cognitive impairment in the future. Methods By convenience sampling, 160 residents living in the nursing home of suzhou city (mean age 60 or higher) were selected, and demographic data were collected by using a homemade questionnaire, their cognitive function was investigated by using the Montreal Cognitive Assessment Scale. Results Single factor analysis showed that the score of the elderly who often use smart products in every cognitive field and overall cognitive function were superior to those who could not use smart products,the difference was statistically significant(t=-4.47--2.15,all P<0.05).The scores of the elderly with hobbies were higher in the overall cognitive function and the other six areas except the orientation, than those who had no hobby,and the differences were statistically significant(t=-6.80--1.81,all P<0.05).After adjusting for age,gender,body mass index(BMI),cultural level,often using smart products in total cognitive function in the elderly(t=4.842,P<0.01)and executive function(t=4.008,P<0.01),attention(t=3.045,P=0.003), abstract(t=2.135,P=0.034),delayed recall(t=3.759,P<0.01),the directional(t=2.866,P=0.005)of the five areas showed significant correlation. The total cognitive function of the elderly with hobbies (t=3.496, P = 0.001) and the visual spatial execution function (t=3.316, P = 0.001), naming (t=3.241, P =0.001), abstract (t=2.643, P = 0.009), and delayed recall (t=2.073, P= 0.04) were all significantly correlated.Conclusions Often using smart products and having certain hobbies are protective factors of cognitive function,build corresponding intervention plans for the future,by cultivating the elderly hobby, guiding the elderly using intelligent products and other measures to achieve successful aging, slow the cognitive decline,thus reducing the risk of mild cognitive impairment.

Objective:To investigate the current status of hospitalized neonatal death of different gestational ages in Shaanxi Province.Methods:All neonatal deaths in six hospitals in Shaanxi Province from 2016 to 2020 were retrospectively analyzed, and the differences in perinatal complications, the causes of death, and the age at death were compared using Chi-square (or Fisher's exact ) test. Results:(1) Totally, 220 488 neonates were delivered in the obstetric department of the six hospitals during the study period; 71 782 out of them were admitted to the neonatal department. While 424 neonatal death was reported, giving the total hospitalized neonates mortality rate of 5.5‰ (394/71 782), which included 152 deaths of transferred patients ( n=9 103, 16.7‰), 226 premature (53.3%), 196 term (46.2%), and two post-term infants (0.5%). (2) Among mothers of dead neonates, 73.6% were found to have at least one perinatal complication. The most common one was fetal distress (146 cases, 34.4%), followed by gestational diabetes mellitus (113 cases, 26.7%), amniotic fluid abnormalities ( n=73, 17.2%), maternal infectious diseases ( n=71, 16.8%), and hypertensive disorders in pregnancy (HDP) ( n=52, 12.3%). The lower the gestational age, the higher the proportion of multiple pregnancies and assisted reproduction technology applied (Fisher exact test, P<0.05). On the contrary, the higher the gestational age, the higher the cesarean section rate ( χ 2=26.69, P<0.001). HDP was more likely to occur in the gestational age of 28-31 +6 and 32-34 +6 weeks ( χ 2=37.16, P<0.001), and amniotic fluid abnormalities were more likely to occur in those over 37 weeks ( χ 2=27.47, P<0.001). (3) The five leading causes of neonatal death were neonatal respiratory distress syndrome (NRDS, n=100, 23.6%), neonatal asphyxia ( n=88, 20.8%), maternal infectious diseases ( n=80, 18.9%), and birth defects ( n=54, 12.7%), and pulmonary hemorrhage ( n=22, 5.2%). The first three causes of death in term and post-term infants were neonatal asphyxia ( n=65, 32.8%), birth defects ( n=42, 21.2%), and infectious diseases ( n=26, 13.1%). NRDS ( n=83, 36.7%), infectious diseases ( n=54, 23.9%), and neonatal asphyxia ( n=23, 10.2%) were the three leading causes of death of premature babies. (4) Out of the 326 (76.9%) neonatal deaths within seven days after birth, 162 (38.2%) died within 24 h after birth and 164 cases (38.7%) between one to seven days after birth. Conclusions:Most neonatal deaths occurred among preterm ones and within seven days after birth, whose mothers suffered perinatal complications. The causes of neonatal death vary among different gestational age groups.

OBJECTIVETo study the safety and feasibility of fast track surgery (FTS) in the promotion of postoperative recovery for gastric cancer patients undergoing gastrectomy.

METHODSFrom January to December in 2013, 71 gastric cancer patients were prospectively enrolled and randomized into the FTS group and the control group. Patient in the FTS group received FTS management and those in the control group received routine management. The postoperative recovery and stress were compared between the two groups.

RESULTSFTS was associated with shorter time to bowel function return [(67.8±19.7) h vs. (90.0±20.6) h, P<0.01], shorter hospital stay [(13.5±3.0) d vs. (17.8±7.3) d, P=0.01], lower hospital cost [(23.8±3.7) thousand Yuan vs. (27.8±6.1) thousand Yuan, P<0.05], and less stress response (lower pain score, WBC count, C-reactive protein, all P<0.01). The postoperative complications including ileus, infection, anastomotic leakage were similar (all P>0.05).

CONCLUSIONFast track surgery decreases postoperative stress response and promotes recovery.

Aged ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Perioperative Care ; Postoperative Complications ; prevention & control ; Prospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo investigate the better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction adenocarcinoma.

METHODSA total of 153 cases of early gastroesophageal junction adenocarcinoma who were planned to receive radical proximal gastrectomy from January 2003 to December 2011 were prospectively enrolled and randomly divided into two groups by table of random number according to methods of digestive tract reconstruction, including 3S anastomosis group (80 cases, 3S jejunal interposition) and traditional anastomosis group (73 cases, esophageal remnant gastric posterior wall anastomosis). Postoperative complications, operative time, mortality, nutritional parameters and postoperative quality of life were compared between these two groups.

RESULTSThere were no significant differences between two groups in postoperative complications, operative time and mortality (all P>0.05). 3S anastomosis group was better in nutritional parameters than traditional group six months after operation (P<0.05). As compared to traditional group, incidence of reflux esophagitis decreased [20.0%(16/80) vs. 46.6%(34/73), P<0.01] and gastric emptying time prolonged obviously [(160.8±8.1) min vs. (61.1±10.8) min, P<0.01] in 3S anastomosis group 18 months after operation. Postoperative QLQ-C30 rating scale revealed quality of life was significantly higher in 3S anastomosis group as compared to traditional group.

CONCLUSIONJejunal interposition is a better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction carcinoma.

Adenocarcinoma ; surgery ; Anastomosis, Surgical ; methods ; Digestive System Surgical Procedures ; Esophageal Neoplasms ; surgery ; Esophagogastric Junction ; pathology ; Gastrectomy ; methods ; Humans ; Jejunum ; pathology ; Operative Time ; Postoperative Complications ; Postoperative Period ; Quality of Life ; Reconstructive Surgical Procedures ; methods ; Stomach Neoplasms ; pathology