Objective Through analyzing and summarizing the experiences and reflections during the construction of regional medical scientific research alliance,to explore the ultimate goal and ideal model of such work.Methods Literature review,as well as working experience summary and analysis.Results The purpose of setting up regional medical scientific research alliance lies in shared regional medical scientific research data information,using the two-way transformation model of laboratory and clinical research to support the medical service of primary health care in local hospitals,at the same time,promoting the construction and development of regional medical alliance.The ideal model is to make good use of the regional clini cal scientific research data sharing platform and related information sharing platform to promote the collaborative development of regional medical scientific research.Conclusions The ultimate goal of collaborative development of scientific research is to establish "an information map of regional scientific research resources",the map can be used for scientific research project cooperation,resource allocation,integration of scientific research forces and training of talent echelon,thereby comprehensively improve the regional research capacity.

Objective To analyze the clinical features of paracentral acute middle maculopathy(PAMM).Methods A retrospective series case observation was carried out.Clinical data of 11 eyes from 11 patients with PAMM were included in this study from January 2016 to December 2017 in Henan Eye Hospital.All of the patients received general information inquiry,regular ophthalmic examination,color fundus photography,fundus infrared imaging (IR),spectral-domain optical coherence tomography (SD-OCT),OCT angiography (OCTA),fundus fluorescence angiography(FFA),visual field examination and multifocal electroretinography.Results The ages of the patients ranged from 50 to 71 years old,with the average age of 60 years old.There were 9 males and 2 females,including hypertension in 3 patients,hypertension carotid atherosclerotic plaque in 1 patientd,diabetes with carotid stenosis in 2 patients,hypertension with diabetes in 2 patients,only carotid atherosclerotic plaque in 2 patients and chest trauma in 1 patient.The symptoms of PAMM were central or paracentral scotoma within 1 week.The best corrected visual acuity(BCVA) of the patients ranged from 0.6 to 1.0.All of the patients had central or paracentral scotoma or decrease of visual sensitivities.Mf-ERG showed that amplitude density of P1 waves was reduced in 8 eyes.With subtle-white lesion was seen in fundus of 8 eyes and no obvious symptom in 3 eyes.IR imaging demonstrated hypo-reflection in paracentral macula area in all eyes,and their FFA imaging seemed normal.SD-OCT scanning across lesion area revealed hyper-reflection in inner nuclear layer (INL).OCTA demonstrated perfusion deficit in deep capillary plexuses(DCP).After treatment,there was no improvement in BCVA for all the eyes but scotomas were lessened.Conclusions PAMM easily occurs in older males with systemic diseases.PAMM lesson is a occult paramacular middle layer of retinopathy.The combination examination of morphological and functional methods is avaiable for diagnosis.

Objective From the perspective of the application of Beijing Tongzhou district science and technology project,we can grasp the present situation,existing problems and opportunities of the hospital.Methods Taking the information of the application declared by Beijing Luhe Hospital in 2017 as the research object,using the Excel,statistical analysis of the applicants'age,professional title,degree and departments distribution;summing up the common problems of the expert feedback.Results The study found that the 144 subjects participated in the declaration had been laying particular stress on each of the five areas,including:research category,applicants‘ age,professional title,degree and department.Conclusions Based on the data of the application,we have made a preliminary discussion about the overall planning and management measures of the future hospital scientific research.

Objective To investigate the diagnosis and treatment of adult Hirschsprung disease. Methods The clinical data of 10 patients with adult Hirschsprung disease from August 2011 to August 2017 in the Department of General Surgery of the First Affiliated Hospital of Soochow University were retrospectively analyzed. Results Among the 10 patients, 4 cases were male, and 6 cases were female, with age 21 to 65 years old, and body mass index 16.77 to 25.73 kg/m2. The patients were diagnosed with Hirschsprung disease by postoperative pathological examination. All patients had difficult defecation medical history. Barium enema examination in 3 patients before operation showed obvious narrow segment, migrating segment and dilatation segment. Four cases received emergency surgical operation, and 6 cases received selective surgical operation. Complications included intestinal obstruction in 3 cases, incisions infection in 2 cases, and incision rupture in 1 case. Conclusions Adult Hirschsprung disease is difficult to be diagnosed, and the aspect of medical history, barium enema examination, surgical findings and pathological examination has to be combined. The surgery way of AHD is diverse and ought to be individual. Laparoscopic surgery with small trauma and quick recovery has great development space.

Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.

Objective: To identify the time window during which the mammalian target of rapamycin complex 1 (mTORC1) signaling pathway plays a key role in telogen-to-anagen transition of hair follicles, and to explore whether the pathway specifically promotes the proliferation of hair follicle stem cells (HFSCs) . Methods: Totally, 36 newborn ICR mice were randomly and equally divided into 3 groups: RAPA-P19 group intraperitoneally injected with 5 mg·kg^-1·d^-1 sirolimus on days 19-24 after birth, RAPA-P21 group intraperitoneally injected with 5 mg·kg^-1·d^-1 sirolimus on days 21-24 after birth, and control group intraperitoneally injected with the same volume of solvent on days 19-24 after birth. Four mice were sacrificed in each group on days 22, 23 and 24 separately. Skin tissues were resected from the back, and hematoxylin-eosin staining of the skin tissues were performed followed by observation of hair follicle morphology to evaluate whether murine hair follicles progressed into the anagen phase on day 24. Immunofluorescence costaining was conducted to determine the expression and localization of mTORC1 downstream molecular marker pS6 and cell proliferation marker Ki67 on days 22 and 23. Results: On day 24, hematoxylin-eosin staining showed anagen hair follicles in the control group and RAPA-P21 group, but telogen hair follicles in the RAPA-P19 group. On days 22 and 23, immunofluorescence costaining revealed positive staining for both pS6 and Ki67 in HFSCs in the control group, negative staining for both pS6 and Ki67 in the RAPA-P19 group, negative staining for pS6 and positive staining for Ki67 in the RAPA-P21 group. On day 23, epidermal cells and sebaceous gland cells in the upper hair follicle bulge were stained positively for Ki67 in all the 3 groups. Conclusion mTORC1 signaling specifically promotes the proliferation of HFSCs during telogen-to-anagen transition, but not affects proliferation of other cells in hair follicles.

Objective To improve the efficiency of blood collection in hemodialysis patients by inventing and applying new blood collection needles.Methods One hundred and eighty cases of hemodialysis patients were randomly divided into control group 1(CG1),control group 2(CG2),experimental group(EG). Comparison of the three groups in time of blood collection,the number of operation that had the risk of acupuncture injury and the number of the blood samples that had been contaminated. Results There were statistically significant difference (P<0.05)in three groups.The number of times of blood collection in the number of operations that had the risk of acupuncture injury,and the number of the blood sample that had been contaminated. CG1 had the longest blood collection time(12.55 min),EG had the shortest blood collection time(5.09 min);the risk of acupuncture injury was the highest in CG2 and the lowest in the EG.The number of contamination of blood samples and the amount of inaccurate sample in CG1 were the highest,and the lowest in the EG. Conclusions The working efficiency of transfer type anti-acupuncture needle(TTAN)during blood sample collection in hemodialysis patients is signifi-cantly better than that of traditional blood collection method,and it is helpful to reduce the risk of acupuncture injury and the risk of contamination in blood samples,which is worthy of promotion.

Objective To determine the incidence and clinical features of headache after carotid endarterectomy (CEA).Methods A retrospective analysis was made on the data of patients undergoing CEA in the Department of Vascular Surgery,Peking Union Medical College Hospital from Jan 2014 to Jan 2015.There were 119 males and 24 females,including 97 cases of symptomatic carotid stenosis and 110 cases of severe carotid stenosis.Results The incidence of newly emergent headache after surgery was 44％ (63/143).The earliest time of headache was 30 minutes after surgery and the latest was 6 days after surgery.95％ of headache occurred within 48 hours after surgery (60/63).79.4％ (50/63) of the headache lay ipsilaterally with CEA,and bilateral headache accounted for 20.6％ (13/63).Severe headache accounted for 4.8％ (3/63),all were ipsilaterally frontal and temporal headache,complicating central nervous system symptoms.Conclusions After CEA headache is a common clinical symptom.Most were mild to moderate and unilateral,which can be relieved spontaneously.Cerebral hemodynamics need to be further examined to differentiate the different pathological states of severe headache on the operative side after CEA because of the high risk of developing hyperperfusion syndrome or cerebral infarction.History of TIA or stroke is the risk factor of post-CEA headache.

Objective To achieve the hospital's scientific research objectives during the 13th five-year plan period,we designed to know about the potential NSFC application capacity and existed problems in our hospital.Methods Using "Questionnaire Star" network investigation platform to design questionnaire and conduct data analysis.Results Respondents are divided into two groups,one was who intend to apply in next three years while the other would not.it is found that there are obvious differences between the publication of SCI,as well as the previous research project application and conducting experiences.Conclusions In order to improve the rate of NSFC application,the hospital scientific management workers can consider doing the following:Improve the number of SCI papers published from the perspective of helping to encourage and forcing pressure.Strive for financial support from all parties and build a central experimental platform to create conditions for basic experiments for clinical medical workers.Regular and in time training for NSFC application.Some pressure when necessary to promote the extension of low-level study.Pay more attention to the incentives of research performance at the department level.

Objective To investigate the effect of Calcium Dobesilate Capsules in the treatment of diabetic retinopathy ( DR ) and its effect on hemorheology, vascular endothelial function and thrombin.Methods According to the random number table the 80 cases of DR patients admitted in our hospital from September 2014 to August 2016 were divided into observation group and control group, 40 cases in each group, two groups of patients were treated with conventional therapy, the observation group was treated with Calcium Dobesilate capsules.Two groups of treatment were three months.Compared of the therapeutic effects, the before and after treatment changes of visual acuity, hemorheology, vascular endothelial function and thrombin index.Results The total efficiency of the observation group 92.50% was higher than the control group 72.50% (P<0.05);After treatment, two groups visual acuity increased, and the observation group after treatment higher than the control group (P<0.05); Plasma viscosity, whole blood viscosity at high shear and low shear whole blood viscosity, erythrocyte aggregation index in two groups were decreased, and observation group lower than the control group (P<0.05);Plasma NO and ET-1 levels in two groups were reduce, and observation lower than the control group after treatment (P<0.05); After treatment, two groups PT, TT and APTT increased, and observation group PT, TT and APTT higher than the control group (P<0.05) .There were no obvious adverse reactions in the two groups during the treatment period.Conclusion The effect of calcium dobesilate capsules in the treatment of patients with DR is obvious, and it can improve hemorheology.