With reformation and innovation in hospital management,hospital culture is playing a more important role than before in the development of hospitals.HEPA(Hospital Employee Assistance Program) is considered as the efficient means of enhancing hospital culture construction with "put the human fundamental" as its principal.This present article is going to introduce the origin,development and function of HEAP as well as the concept of hospital culture,indicating that HEAP may contribute to increment of employees' achievement,improvement of hospital management and enhancement of hospital culture construction.

Objective To investigate the value of detections of anti‐nuclear antibody (ANA) combined with anti‐cardiolipin anti‐body (ACA) ,anti‐sperm antibody (AsAb) and anti‐beta 2 glycoprotein I (β2 GPI) antibody in the diagnosis of female infertility dis‐ease .Methods A total of 187 female cases of infertility (infertility group) were detected serum ANA and AsAb by the indirect im‐munofluorescence assay ,and ACA andβ2 GPI antibody by the enzyme linked immunosorbent assay (ELISA) .ANA ,ACA ,AsAb andβ2 GPI antibody also were detected in 80 females cases of normal fertility (normal group) .Results Among 187 cases of female infer‐tility ,ANA positive rate was 18 .1% (34/187) and which in the normal group was 2 .5% (2/80) .The ACA positive rate was 22 .3%(43/187) in the infertility group and 5 .0% (4/80) in the normal group ;the AsAb positive rate was 18 .7% (35/187) in the infertil‐ity group and 3 .8% (3/80) in the normal group ;theβ2 GPI positive rate was 20 .3% (38/187) in the infertility group and 3 .8% (3/80) in the normal group;the differences between the two groups had statistical significance (P<0 .05) .Conclusion Infertility is closely correlated with the in vivo existence of ANA ,ACA ,AsAb andβ2 GPI antibody ,the joint detection is conducive to find the e‐tiology of infertility and improve the clinical diagnosis rate .

Objective To evaluate the values of gastrin‐releasing peptide (pro‐GRP) and neuronspecific enolase (NSE) in differ‐ential diagnosing of small cell lung cancer (SCLC) .Methods Serum samples from 120 SCLC patients ,130 non‐small cell lung canc‐er (NSCLC) ,80 Patients with benign lung disease and 90 healthy donors were collected to detect the level of pro‐GRP and NSE .All data were analyzed by SPSS13 .0 and then we analyzed the serum level and positive rates of the two tumor markers .ROC was gener‐ated by GraphPad Prism 5 .Results The expression level of pro‐GRP and NSE in SCLC group were significant higher than NSCLC group、benign lung disease group and healthy donors group (P<0 .05) .The positive rates of pro‐GRP in SCLC were higher than the other three groups (P<0 .05) .However ,there had no significant difference between SCLC group and NSCLC group in the posi‐tive rates of NSE(P>0 .05) .ROC area under curve of pro‐GRP ,NSE and both were 0 .890 ,0 .810 and 0 .915 ,separately .Conclusion The tumor biomarker of NSE could only identify of benign and malignant lung diseases ,but can not identify the type of lung canc‐er including SCLC and NSCLC ;Nonetheless the tumor biomarker of pro‐GRP could not only identify benign and malignant lung dis‐eases ,but also identify the pathological type of SCLC and NSCLC ;Combined determination of pro‐GRP and NSE had significant values for the differential diagnosis of SCLC .

Objective To analyze the features of cervical vertebra X-ray examination and transcranial Doppler (TCD) in children with cervical vertigo, and investigate the mechanism of the disease. Methods X-ray examination of cervical vertebra and TCD were performed on 80 children with cervical vertigo, and the features of the results were analyzed. Results The abnormal results of cervical X-ray examination mainly showed atlantoaxial joint or/and C2, C3 vertebral joint disorders, some of which combined with cervical instability, cervical curvaturestraightened and even reverse curvature, cervical scoliosis. The abnormal results of TCD showed the blood flow velocity in single or multiple branch of artery increased mainly, some of which decreased or became asymmetrial. Conclusion The cervical vertigo in children may result from various kinds of disorders of the atlas, axis or/and C2, C3 vertebrae.

Objective To observe the anatomy of the radial proper digital arteries and their dorsal vessels of index fingers, and the relative position and orientation of them were summarized. To explore the surgical method and clinical appilication of the stepladder advancement flap pedicled with the radial proper digital artery of index finger in the finger tip defects. Methods From June, 2013 to June, 2016, 6 hand specimens were injected into the brachial artery with red latex to carry out the microanatomy of the index finger’s radial proper digital arteries and their dorsal vessels. And 1 vascular cast of hand specimen were observed the origin, number and oriention of the artery and its dorsal vessel. Ten cases with soft tissue defects of index finger in finger tip, were repaired with stepladder advance-ment flap pedicled with the radial proper digital artery. The evaluations and analysis were made in survival rate and finger's function by the postoperative regular consultations. Results There were 2 (4 hands) or 3 (2 hands) dorsal vessels in the proximal, and 2(6 hands) in middle segments of the radial proper digital arteries of index fingers in 6 hand specimens respectively. While the vascular cast of hand specimen showed that 3 dorsal vessels in the proximal, and 2 in the middle segments of the radial proper digital artery. Ten patients were performed the operation. The blood flow after the surgery were good and all flaps survived well. Followed-up time was 10-14 months. The color, feeling, contour and texture of flaps was good. The function of flexion and extension of the finger was good too, and no defor-mity of the purlicue. The resolution of static two points was 5.5-9.0 mm, averaged of 7.2 mm. Conclusion The stepladder advancement flap pedicled with the radial proper digital artery of index finger can extend the donor site. It is safe, reliable and effective, providing a alternation for the repair of the soft tissue defects of the index finger tip.

Objective: To explore the anatomy and clinical application of stepladder V-Y advanced flaps based on the lateral calcaneal artery perforator. Methods: Twenty-four lower extremities from 12 adult cadavers were dissected to investigate the perforators emerging along the lateral edge of the achilles tendon, in terms of amount and distribution, relative to the tip of the lateral malleolus. Based on the anatomical findings, stepladder V-Y advanced flaps, based on the perforator(s) of the lateral calcaneal artery (LCA) or the peroneal artery (PA), were used for reconstruction of lower-posterior heel defects in 22 cases. Results: Twenty-four lower extremities from 12 adult cadavers were successfully dissected. The peroneal artery continued to be the lateral calcaneal artery at the level of (6.0±1.4) cm above the tip of the lateral malleolus. Both of them have the perforators distributed to the skin in the achilles tendon area. In the space from the tip of the lateral malleolus to 8.0 cm and above, a total of 71 perforators with diameter larger than 0.5 mm were found in all extremities. Among them, 9%(7/71) were originated from peroneal artery, and 91%(64/71) were the lateral calcaneal artery. In the 22 cases of clinical application, the pedicle of flaps were used, based on the perforator of lateral calcaneal artery and (or) peroneal artery. The size of flaps ranged from 3.5 cm×9.0 cm to 5.0 cm×10.0 cm.There were 3 cases of skin necrosis at the tip of the flap, which were healed after dressing change. The other flaps had completely survived, and the wound healed in the first stage. Follow-up last for 8-24 months after operation. All patients had well recovery of ankle flexion, extension and appearance. They were able to weight-bearing walk, with natural gait. The texture and sensation of the flaps were similar to that of the surrounding skin. There were few obvious scar or contracture deformity. The functional recovery was satisfied. Conclusions The blood supply in the achilles tendon region is mainly from the lateral calcaneal artery, and partly from the peroneal artery. Stepladder V-Y advanced flap based on the lateral calcaneal artery perforator can be used with reliable blood supply and sensation reconstruction, which is a good choice to repair small to medial wounds in heel area.

【Objective】 To evaluate the effect of adding platelet GPⅡb/Ⅲa receptor inhibitor (A adjuvant) into the Batroxobin cup (A cup) on the accuracy of the thromboelastogram (TEG) platelet aggregation function test using the functional fibrinogen (function fiber cup) test results as a standard. 【Methods】 From December 2019 to May 2020, 100 (persons) whole blood samples were collected from patients who visited the Department of Neurology, Department of Cardiology, Department of General Affairs and Department of Rehabilitation of our hospital for TEG platelet aggregation function test, and the blood standard samples were divided into MA <25 mm group (n=50) and MA≥25 mm group (n=50) according to the A-cup blood clot intensity (MA) value (mm) measured by TEG, the two groups were subdivided into A cup group (n=50, respectively), A auxiliary group (adding A auxiliary in A cup) (n=50, respectively), and functional fiber cup group (n=50, respectively), each subgroup was tested once again. The linear correlation, platelet inhibition and the consistency of drug efficacy interpretation results in platelet Adenosine diphosphate (ADP) and Arachidonic acid (AA) pathway respectively between the three subgroups were compared. 【Results】 (1) In the MA<25mm group, the inhibition rates of ADP and AA pathway in platelet of A cup, A adjuvant and functional fibrin cup subgroups were (32.00±17.44) % vs (30.19±17.44) % vs (30.07±16.18) %, (24.3±33.53) % vs (22.53±30.9) % vs (22.37±31.2) %, respectively (R² were all>0.975); (2) In the MA≥25 mm group, the inhibition rates of ADP and AA pathway in platelet of A cup, A adjuvant and functional fibrin cup subgroups were (34.34±33.59) % vs (18.45±24.42) % vs (18.01±24.33) %, (23.19±39.33) % vs (8.48±21.75) % vs (8.31±21.7) % ( R² between the A cup group and the A adjuvant group were all<0.8, and R2 between the A adjuvant group and the functional fibrinogen cup group were all >0.975); (3)Take the test result of the functional fibrinogen cup as the standard, the correct rates of ADP and AA pathway drug efficacy interpretation were 82% (41/50) vs 100% (50/50) and 84% (42/50) vs 100% (50/50) respectively (P<0.05) between the A-cup group and the A adjuvant group, while the interpretation results of drug efficacy of the two pathway were consistent between the A adjuvant group and the functional fibrin cup group (P>0.05). 【Conclusion】 Adding A adjuvant to TEG platelet aggregation function test can effectively inhibit non-specifically activated platelets in the A cup in the detection of platelet aggregation function, truly reflect the function of fibrinogen and improve the accuracy of platelet inhibition rate.