The Workers' Hospital of Huangmian Group in our city, which succeeded in separating from the enterprise and becoming commercially oriented through reforming the property right system, has made some worthwhile attempts at transforming the property right system of enterprise-owned hospitals. The experience accumulated includes: commercialization of enterprise-owned hospitals through reforming the property right system is a must in adapting to the system of the socialist market economy and setting up the system of modern enterprises; it is also a must in the current reform of the health system; reform of the property right system of enterprise-owned hospitals gave strong impetus to the reform of operational mechanisms of personnel matters, distribution and management within the hospitals; appropriate policies are the key to ensuring the success of the reform; and hospitals with transformed ownership ought to maintain their original functions and continue to undertake such social tasks as medical treatment, prevention of diseases, healthcare and supervision of public hygiene.

BACKGROUND: Clinically, in patients undergoing hematopoietic stem cell transplantation (HSCT), human cytomegalovirus (HCMV) can be associated with delayed platelet engraftment, phenotypically abnormal peripheral blood leukocytes, and graft rejection, possibly through a direct viral effect on hematopoietic progenitor cells after HCMV infection. OBJECTIVE: To investigate the inhibitory effect of ganciclovir (GCV) on proliferation of colony forming unit (CFU) granulocyte-macrophage (CFU-GM), CFU-erythroid (CFU-E), CFU T-lymphocyte (CFU-TL), CFU-multipotential (CFU-Mix) and CFU-megakaryocyte (CFU-Mk) progenitor cells of cord blood (CB) and the protective effects on them. DESIGN: Contrast observational study.SETTING: Department of Molecular Biology, Affiliated Hospital of Luzhou Medical College.PARTICIPANTS: A total of 20 cord blood (CB) samples (with 10 mL for each sample) from fetal umbilical vein of normal term spontaneous delivery neonates were provided by the Department of Gynaecology and Obstetrics, Affiliated Hospital of Luzhou Medical College. All the patients were informed and agreed with the experiment.METHODS: The experiment was carried out in the Department of Molecular Biology, Affiliated Hospital of Luzhou Medical College from June 2004 to December 2006. Colony forming unit-assay was applied to observe the suppression effect of HCMV-AD169 strain on CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk of CB with the presence of GCV. The techniques of polymerase chain reaction (PCR) and fluorescence quantification PCR were used to demonstrate the existence of HCMV-AD169 DNA in the colony cells of cultured CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk. Normal progenitor cells culture system was regarded as blank control group; normal progenitor cells culture system with inactivated HCMV fluid as inactivated (IV) control group.MAIN OUTCOME MEASURES: ① The number and maintaining duration of colonies of cultured progenitor cells were counted by using a light inverted phase contrast microscope. ② The techniques of PCR and fluorescence quantification PCR were used to demonstrate the existence of HCMV-AD169 DNA in the colony cells of cultured progenitor cells.RESULTS: ① Number and lasting time of colonies: The numbers of CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk colonies in the HCMV infection group were significantly less than those in the blank control group (P < 0.01). The maintaining duration of colonies in the HCMV infection group was significantly shorter than that in the blank control group (P < 0.01). HCMV-DNA copies of colony cells of GCV group decreased significantly by using fluorescence quantification PCR compared with HCMV group (P < 0.01), while negative in blank control and inactivated control in CFU-MK and CFU-Mix. ② CFU Growth rate: The Growth rate of colonies was 37.4%, 74.2%, 40.1%, 67.4% and 38.9% of CFU-GM, CFU-E, CFU-TL, CFU-Mix and FU-MK, respectively. ③ CFU-HCMV-AD169 DNA: Fluorescence quantification PCR showed that nucleonic acid content of progenitor cells after GCV-affected HCMV infection was decreased as compared with that after HCMV infection (P < 0.01).CONCLUSION: The differentiation and proliferation of CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk are significantly inhibited after infected with CMV-AD169 strain. The growth of hematopoietic progenitor cell after HCMV-AD169 infection is promoted by GCV, which suggests that GCV has an effect of anti-HCMV in vitro.

Objective: To understand cognitive behavioral responses of college students in Guangxi at the early stage of COVID-19 regarding, and to provide a basis for schools and government to formulate relevant strategies and measures. Methods: An anonymous questionnaire survey was conducted among 69 783 students recruited online from 28 colleges and universities in Guangxi Province, regarding psychological response under public health emergencies. Results: Significant associated were found between the total score of COVID-19 knowledge score and factors scores of optimism, fear, avoidance, help and combat in cognitive behavioral response (r=0.15, -0.01, -0.06, -0.03, 0.28, P<0.05). Gender factors had an impact on all the five factors (Z=-13.67, -2.05, -13.31, -7.15, -24.34, P<0.05). Students with higher education levels and medical students had higher score in optimism and lower score in avoidance.Students with limited activities (β=0.38, 0.38, 0.42, P<0.05) and living in a community with infected cases score higher in factor including fear,escape and turning for help (β=0.14, 0.06, 0.15,P<0.05).optimism was negatively associated with fear among students living in a community with infected cases(β=-0.10,P<0.05). Conclusion Relevant departments need to strengthen science popularization and education, further improve students’ awareness of the epidemic, take scientific prevention and control measures, guide positive cognition, shape positive behavior, strengthen mental health education, and make preparations for the orderly resumption of school after the epidemic.

Objective To explore the awakening probabilistic prediction models of coma patients with traumatic brain injury on admission and six months after treatment,and develop and apply the software of the models.Methods Clinical data of 190 coma patients with traumatic brain injury,admitted to our hospital from September 2010 to October 2012,were analyzed retrospectively.Potential predictive factors at admission and after awakening were analyzed by binary Logistic regression analysis; based on these factors,the awakening probabilistic prediction models of coma patients with traumatic brain injury were established; C++ language was used to write the computer software that could predict the awakening probability of 103 patients with traumatic brain injury.Results Multinomial Logistic regression analysis showed that 6 factors,including age,pupillary light reflex,movement Glasgow coma scale (mGCS) scores,morphology changes of mesencephalon surrounding cisterna,eye opening time after treatment,and percentages of ischemic brain volume in CT images,were independent factors to predict the awakening probability of coma patients with traumatic brain injury.Model A and B owned high performance (C statistics of models:0.955 and 0.975; accept rate of models:90.5％ and 94.0％).The established software based on models was easy to use with reliable results (the accept rate of 103 patients were 87.3％ and 93.2％).Conclusion The established models can timely and accurately predict the awakening probability of coma patients with traumatic brain injury; the software named sober probabilistic prediction for coma patients with traumatic brain injury can help in decision-making in clinics.

Objective To study the method of calculating the supplement amount of sodium for the severe head injury patients suffered cerebral salt wasting syndrome (CSWS).Methods Fifty-six patients with CSWS after severe head injury,admitted to our hospital from March 2008 to February 2013,were chosen and randomly divided into two groups:group A (n=28),using the traditional formula to calculate the amount of sodium supplement,and group B (n=28),using our new formula to calculate the amount of sodium supplement.The sodium levels and intracranial pressure after intravenous administration were monitored and compared for 7 days.All the patients were followed up for 6 months,and their prognosis by Glasgow outcome scale (GOS) scores and the corrected time of hyponatremia were compared between the two groups.Results The hyponatremia of the two groups were corrected after treatment.The serum sodium level of group B was higher than that of group A 3,4,5,6 and 7 d after sodium supplement (P＜0.05); the intracranial pressure of group B was lower than that of group A 4,5,6and 7 d after sodium supplement (P＜0.05).Group B needed shorten time in correcting the hyponatremia and had higher good prognosis rate as compared with group A(P＜0.05).Conclusion The new sodium supplement formula in treating the severe head injury patients suffered CSCW is safe and effected,which can improve the prognosis of these patients.

Objective:To identify the risk factors of clinically relevant pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) for Vater′s ampullary carcinoma.Methods:The clinical data of 93 Vater's ampullary carcinoma patients who had undergone PD in Nanjing Drum Tower Hospital from January 2018 to December 2020 was retrospectively analyzed. According to the occurrence of CR-POPF, all patients were divided into the CR-POPF group and no CR-POPF group. Univariate analysis and multivariate analysis by logistic regression model were performed for perioperative risk factors of CR-POPF to identify the independent risk factors for CR-POPF after PD for Vater's ampullary carcinoma.Results:44 patients developed CR-POPF and the rate of CR-POPF was 47.3%(44/93). The most frequently detected microorganisms from abdominal drain fluid after operation were Klebsiella pneumoniae (25.8%), Enterococcus faecalis (19.4%), Enterobacter cloacae (11.8%) and Enterococcus faecium (10.7%). The results of univariate analysis showed that operation time, C-reactive protein (CRP) on postoperative day (POD)1, Klebsiella pneumoniae, Enterococcus faecalis and Enterococcus faecium in the abdominal drainage were statistically different between the two groups (all P value <0.05). Multivariate analysis revealed that CRP on POD1 ( OR 1.029, 95% CI 1.003-1.055, P=0.026), Klebsiella pneumoniae( OR 8.671, 95% CI 2.366-31.772, P=0.001), Enterococcus faecalis( OR 10.497, 95% CI 2.306-41.776, P=0.002) and Enterococcus faecium ( OR 22.580, 95% CI 2.303-221.403, P=0.007) in the abdominal drainage were independent risk factors for the development of CR-POPF after PD for Vater′s ampullary carcinoma. Conclusions:CRP on POD1, Klebsiella pneumoniae, Enterococcus faecalis and Enterococcus faecium in the drain samples were independent risk factors for the development of CR-POPF after PD for Vater′s ampullary carcinoma.

Objective:To explore the clinical efficacy of reconstructing the calcaneocuboid and calcaneonavicular ligaments with the autologous semitendinosus for chronic bifurcate ligament injury.Methods:A retrospective study was conducted to analyze the clinical data of 12 patients with chronic bifurcate ligament injury who had been treated by anatomical reconstruction with the autologous semitendinosus from March 2018 to January 2021 at Department of Foot and Ankle Surgery, The Fourth Hospital of Wuhan. There were 4 males and 8 females with an age of (41.4±9.6) years. Seven left and 5 right feet were affected; the time from injury to surgery was (9.3±4.3) months. The surgical efficacy was evaluated based on anteroposterior and lateral imaging assessments of foot weight-bearing at 6 months postoperation, comparison of the visual analogue scale (VAS) pain scores for foot weight-bearing walking and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scores between preoperation and the last follow-up, stress test for stability of the transverse tarsal joint, recovery of movement, and occurrence of complications.Results:All patients were followed up for (18.4±4.0) months. Their sports activities were completely resumed after postoperative (6.8±3.9) months. Primary wound healing was achieved in all patients. One patient suffered from cutaneous nerve lesion and skin numbness, the symptoms of which disappeared after conservative treatment. Double harmonic curves were observed on the anteroposterior and lateral imaging films of foot weight-bearing in all patients. The spaces in the calcaneocuboid and the calcaneonavicular joints were normal, the articular positions were matched, and the calcaneocuboid joint was stable without recurrence or worsening of displacement. The VAS decreased significantly from preoperative 6.5 (5.6, 7.0) to 0.0 (0.0, 1.0) at the last follow-up, and the AOFAS mid-foot score increased significantly from preoperative (55.6±8.8) points to (92.3±2.6) points at the last follow-up ( P<0.05). The stress test for the stability of the transverse tarsal joint showed joint stability. Conclusion:Reconstruction of the calcaneocuboid and calcaneonavicular ligaments using the autologous semitendinosus is an alternative treatment for patients with chronic bifurcate ligament injury, because it can restore the stability of the bifurcate ligament and obviously improve the foot and ankle functions with limited postoperative complications.

Objective:To construct a biospecimen bank of patient derived organoids (PDOs) from pancreatic cancer tissues and to explore the feasibility of PDOs drug sensitivity assay technology to guide chemotherapy drug selection for pancreatic cancer.Methods:Pancreatic cancer tissue specimens obtained after surgical resection and puncture biopsy from Mar 2020 to Dec 2022 at Drum Tower Hospital, Nanjing University School of Medicine were collected. Pancreatic cancer PDOs were cultured in vitro and histologically identified; PDOs were treated with gemcitabine, Nab-paclitaxel, fluorouracil, Oxaliplatin, and Irinotecan and cell viability was measured to analyze the correlation between PDOs drug sensitivity and the actual clinical treatment response.Results:The PDOs can reproduce the pathological features of corresponding tumor tissues; the sensitivity of different PDOs to the same chemotherapeutic drug is significantly different; The sensitivity of PDOs was highly consistent with the actual treatment effect of the corresponding patients 75.76% (25/33); organoid organ-based susceptibility testing had predictive value for the treatment response of patients (AUC=0.733, 95% CI: 0.546-0.919, P<0.05). Conclusion:A biobank of pancreatic cancer PDOs was successfully constructed, and the drug susceptibility test results were significantly correlated with the actual medication response of patients, suggesting that the drug susceptibility test technology based on PDOs has the potential to guide individualized chemotherapy for pancreatic cancer.