Objective:Through the analysis of the evaluation index system of the major rankings of universities and hospitals, this paper aims to provide a reference for the discipline construction of affiliated hospitals in universities.Methods:This paper comprehensively analyzes and compares the evaluation objectives and indicators of the five major rankings of universities and the three major rankings of hospitals in China and abroad.Results:Each main rankings have its own characteristics that both positive and with possible limitations.Conclusions:Hospital management departments can refer certain indicators in order to identify possible gaps of the hospital discipline development. Also, tailored corresponding measurements for discipline development can be developed in combination with real-needs.

Objective This paper aimed to discuss the construction strategy to promote research integrity in medical science from the perspective of hospital research administrators,and to provide theoretical basis for fulfilling the national strategic requirement of implementing "Scientific research integrity construction ".Methods Analyze and summarize the connotation,manifestations,causes and countermeasures of research integrity and research misconduct.Results The misconduct in medical scientific research occurred in various aspects,including scientific research projects,research papers,scientific achievements and other different stages.Behind reasons include weak sense of research integrity,lack of moral integrity education and training,improper academic evaluation system,lack of sound supervision,reward and punishment mechanism,etc.Conclusions A lot of strategies could adopted to promote the construction of research integrity and development of medical scientific research,for instance,strengthening scientific research integrity education,establishing a multi-dimensional evaluation system,improving the supervision,reward and punishment mechanism of scientific research integrity,as well as promote a better scientific research atmosphere.

Objective This article conducted the statistical analysis of SCI papers published during 2013-2017 at the first affiliated hospital of Sun Yat-sen university ,to understand the SCI paper outcomes as to provide reference for future policy making and research administration development .Methods We analyzed the SCI papers published by the First Affiliated Hos-pital of Sun Yat-sen University from 2013 to 2017 ."Article" and"Review" type SCI papers published by the hospital as the first completion unit were statistically analyzed from the aspects of quantity ,impact factors ,journals and discipline distribu-tion .Results A total of 2268 SCI papers were published in 5 years ,distributed in 1162 journals .The quantity and the average impact factor both increased year by year ,but mainly concentrated in traditional dominant disciplines .Conclusions The SCI papers were increasing annually since 2013 .However ,we still need to improve the quantity and quality of high-level articles ,to promote the development of disciplines ,to strengthen the construction of public experimental platforms ,to continue building talent teams ,to improve the reward and evaluation system ,and to further enhance the overall scientific research level of the hospital .

Objective To recognize the relationship between high cutantous artery branches and descending branch of lateral femoral circumflex artery artery,and to investigate the blood supply of anterolateral thigh flap in clinical.Methods Retrospective analysis 152 cases of anterolateral thigh flap from November,2003 to December,2016.It contains cutting with descending branchs in 99 cases,cutting with lateral branchs in 43 cases,the union of them in 8 cases and high cutantous artery branches in 2 cases.Results The flaps survival in 147 cases,cutting necrosis in 3 cases and partly necrosis in 2 cases.Descending and lateral branchs were both dominance neurovascular bundle of vastus lateralis muscle,independently or commonly dominate the skin of anterolateral thigh,occurrence rate was 33.5％.Conclusion The descending branch of lateral femoral circumflex artery include lateral branch,all of which are the neurovascular bundles,supply the anterolateral thigh muscle,and divid into some perforator branches crossing the musle to the anterolateral thigh skin subsequently,which constitute "the anatomical functional unit".High cutantous artery branche is the one of all of the branches,its origin lies hight and arise from lateral branch.

Objective To evaluate the outcomes of thumb reconstruction with dorsal thumb rotated single pedicel reverse island flap.Methods 49 thumb-tip defects cases with dorsal thumb rotated single pedicel reverse island flap were analyzed retrospectively.37 dorsal thumb reverse island flap were performed,and 12 ulnar-dorsal reverse island flaps were performed.Results The operation time was 40-60 minutes.The mean time was 45 minutes.All 49 cases survived completely.The color of the flaps was purple,and blisters in the surface of the flaps after 1-2 days in 2 cases.After took out stitches partly,the blisters were dried and crusted,the color of the flaps with better blood circulation was normal.The follow-up period was 3-24 months,all thumbs had satisfactory appearances and functions.The two-point discrimination was 6-9mm in flaps inosculated with nerve,that was 8-10 mm in flaps inosculated without nerve.The color,texture and elasticity of flaps were excellent,and the donor sites had not been defected.Conclusion Dorsal thumb rotated single pedicel reverse island flap is a reliable option to restore function as well as appearance,long vascular pedicle with skin strap,wide rotation angle,high rate of survival.It avoided damages to the well-known arteries and nerves.It is a relatively facile procedure that can be applied toward resurfacing thumb tip defects.

Objective To investigate the mechanism of sleeve gastrectomy combined with modified jejunoileal bypass (SG/MJIB) in improving the blood glucose of Goto-kakizaki (GK) rats.Methods According to the random meter method,the 28 GK rats were divided into 4 groups:sleeve gastrectomy with modified jejunoileal bypass (SG/MJIB),sleeve gastrectomy (SG),modified jejunoileal bypass (MJIB) and sham operation (SHAM).The changes of weight,food intake,fasting blood glucose,oral glucose tolerance test (OGTT),insulin tolerance test (ITT),plasma insulin and gastrointestinal hormonal (ghrelin and GLP-1) were monitored before and 16 weeks after surgery respectively.Results After surgery,the fasting blood glucose level in SG/MJIB group was obviously lower than that in SG,MJIB and SHAM groups (P＜0.05).From the 2nd week after surgery,OGTT of the SG/MJIB group was obviously improved compared to SG,MJIB,and SHAM groups (P＜0.02).In our post-op erative study,the insulin levels in SG/MJIB group were lower than those in SG,and SHAM groups (P＜0.05).Compared to MJIB and SHAM groups,ghrelin levels of SG/MJIB group were significantly decreased (P＜0.001),while GLP-1 levels of SG/MJIB group were higher than those of SG and SHAM groups (P＜0.01).Conclusions SG/ MJIB can improve insulin sensitivity and insulin secretion,and this effect is independent of the body weight and food intake.This study further validates that the gastrointestinal hormones play an important role in the pathogenesis and treatment mechanisms of type 2 diabetes mellitus.

Objective To explore the aging mechanisms of human adult adipose-derived stem cells (hADSCs) in vitro.Methods The hADSCs came from the production of normal patients with liposuction.The hADSCs were cultured in the 37℃ incubator and passed until the cells were senescent.The senescence-associated β-gal staining (SA-β-gal) and histone protein γH2AX staining were carried out in both young and old hADSCs.The quantitative real-time PCR (qRT-PCR) was conducted to check the difference of the transcription function of the young and old hADSCs.Results The cultured hADSCs would be the senescent cells when the PD number was more than 35.The aging cells became big and had large flat nuclei and much more lososomes in the cytoplasm.The SA-β-gal staining and γH2AX staining were mostly positive in the aging hADSCs (PD>35) compared with the self-renewing hADSCs (PD<20).The qRT-PCR results showed that the transcription levels of Nanog and Oct4 gene were very low in aging hADSCs compared with the self-renewing ones.Conclusions The hADSCs will be senescent (SEN) when cultured and passed in vitro for long time and the aging process is similar to that of stem cells in vivo.The aging model of hADSCs can be established by this method and will be very useful in the anti-aging drug, regeneration medicine, tissue engineering and stem cell therapy.

Objective To investigate the stimulating effect of exogenous hydrogen sulfide (H2S) on angiogenesis in glioblastoma (GBM). Methods Twenty adult Sprague-Dawley (SD) rats were randomly divided into two groups, glioma group (C6 glioma cell intracerebral implantation, n=10) and glioma-H2S group (C6 glioma cell intracerebral implantation and sodium hydrosulfide (NaHS) intraperitoneal injection, n=10). The tumor-bearing rat model was established by intracerebral injection of rat C6 glioma cells. After one week, normal saline was injected in glioma group and NaHS was injected in glio-ma-H2S group. Food and water were freely available during all phases of the experiment. After three weeks, rats were decapi-tated and brains were removed. HE staining was performed to show tumor structure and intratumoral angiogenesis. The immu-nohistochemical analysis was used to detect the expressions of CD34 and MMP-2, respectively. The microvessel density (MVD) in GBM was also measured. Results HE staining showed that the implanted tumors were predominantly spheroid with clear border and no capsule could be detected. The neovascular proliferations were observed in tumors. There were high-er expressions of CD34 and MMP-2 in glioma-H2S group. The value of MVD was significantly higher in glioma-H2S group than that of glioma group (P＜0.01). Conclusion Exogenous H2S serves as a stimulator of angiogenesis in the development of rat GBM, which may be related with the increased MMP-2 expression promoted by H2S.

Objective To observe the effect of acute hypervolemic hemodilution (AHH) with two kinds of hydroxyethyl starches including Voluven and HES on the renal function of emergency surgery patients with brain injury.Methods This study involved 54 brain injury patients treated with emergency surgery,who were randomly divided into Voluven group ( AHH130 group),HES group ( AHH200 group) and Ringer's lactate group (LR group),with 18 patients in each group.All the patients were managed with inhalation anesthesia.ECG,MAP,CVP and SpO2 were observed in operation.The blood urea nitrogen (BUN),urine creatinine ( BCr,UCr),urinary albumin (ALB) and urinary α1-microglobulin ( α1-MG) were detected before AHH ( T0 ),at the end of operation ( T1 ),at 4 hours ( T2 ),day 1 ( T3 ),day 2 (T4) and day 3 (T5) after operation.The creatinine clearance (CCr) and fractional sodium clearance (FSC) were calculated and the urine output,fluid replacement,blood loss and blood transfusion recorded.Results The HR,CVP and MAP in the three groups were within the normal range of variation at all time points,with statistical difference for comparison between groups and within group ( P ＞ 0.05 ).There was no significant difference in urine output and blood loss,while the intraoperative fluid volume and blood transfusion in the AHH130 group and the AHH200 group were significantly less than those in the LR group (P ＜ 0.01 ).There was no statistical difference in aspects of BUN,BCr and urinary ALB at each time point between and within the three groups ( P ＞ 0.05 ).After treatment with AHH,the urinary α1-MG level in the AHH130 group and AHH200 group was significantly increased ( P ＜0.01 ),which was decreased at T5 but was still higher than that at T0 ( P ＜ 0.01 ),and was higher than that in the LR group at all time points (P＜0.05).After treatment with AHH,CCr was decreased in the AHH130 group and AHH200 group,which reached the lowest level at T2,with statistical difference compared with the levd at T0 ( P ＜0.01 ).Then,CCr was recovered to normal at T5.FSC in the three groups after AHH treatment was increased slightly and the most significantly at T2,which was not statistically different compared with that at T0 ( P ＞ 0.05) and FSC was not statistically different between and within groups at other time points (P ＞0.05).All the values about the renal function in all the groups changed within the normal range at each time point.Conclusions AHH with Voluven or HAES is a feasible and safe blood conservation measure that can significantly reduce the allogeneic blood transfusion but exert insignificant effect on renal function of the brain injury patients with normal renal function before emergency surgery.

Objective To compare the in-hospital and follow-up clinical results of percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG)in patients of left ventricular dysfunction with coronary artery disease.Methods 147 patients with left ventricular dysfunction were divided into PCI group(n=60)and CABG group(n=87).Clinical,angiographic and revascularization data were collected for analysis.Patients were by SPSS 13.0 software.P value of less than 0.05 was considered statistically significant.Results In-hospital MACCE rates and mortality ofthe two groups were comparable[(6.7%vs 9.2%,P＞0.05)and(1.7%vs 8.0%,P＞0.05)].Multivariate Logistic regression analysis indicated that in-hospital MACCE risk of the two groups were similar(OR≥3.03,95%CI 0.27～34.48,P＞0.05).22-month follow-up showed no signficance in MACCE rates (16.0%vs 13.8%,P＞0.05)and in repeated revaseularization rates(8.O%vs 1.7%,P＞0.05)between the two groups.Multivariate Cox regression analysis indicated that follow-up MACCE risk of the two groups were comparable (HR≥1.35,95%C/0.44～4.13,P＞0.05).Conclusion In coronary artery disease patients with left ventricular dysfunction,PCI and CABG have similar in-hospital and long-tem MACCE rates.Long-terra effect of PCI would be further increased with the wide use of drug-eluting stents.