Objective:To investigate the clinical and imaging features of basal ganglia germinoma in children and adolescents, so as to improve the accuracy of early diagnosis.Methods:The clinical symptoms and imaging findings of 10 cases of basal ganglia germinoma diagnosed by surgical examination or diagnostic radiotherapy in Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2010 to December 2019 were analyzed retrospectively.Results:There were 9 males and 1 female, aged from 5 to 15 years, with an average age of 9.7 years.There were 10 cases of limb weakness or mild hemiplegia, 1 case of headache and vomiting, and 1 case of extrapyramidal tract sign. There were 9 cases of computed tomography (CT) examination, 5 cases of high density, 4 cases of mixed density, and 3 cases of intrafocal calcification. 10 cases of routine magnetic resonance imaging (MRI) examination, MR T1-weighted imaging (T1WI): 5 cases of low signal, 3 cases of slightly low signal, 1 case of equal low signal, 1 case of equal slightly low signal; MR T2-weighted imaging (T2WI): 3 cases of high signal, 5 cases of slightly high signal, 2 cases of high and low mixed signal; T2 fluid attenuated inversion recovery (T2FLAIR): 1 case of low signal, 2 cases of slightly high signal, 1 case of iso-high signal, 5 cases of high signal, 1 case of high and low mixed signal; Diffusion weighted imaging (DWI): 2 cases of low signal, 1 case of equal signal, 1 case of equal slightly high signal, 4 cases of slightly high signal, 2 cases of high signal; 1 case of functional imaging susceptibility-weighted imaging (SWI): 1 case of low signal; 10 cases of MRI enhancement: 2 cases of no enhancement, 5 cases of mild enhancement, 3 cases of moderate/obvious enhancement, and the enhancement methods can be seen in spot, patch, mass and ring enhancement; Functional imaging magnetic resonance angiography (MRA) in 2 cases: 1 case had slender middle cerebral artery, fewer branch arteries than the opposite side, and 1 case showed no obvious abnormality; 2 cases of positron emission (PET)-CT: the metabolism of methionine (MET) on the affected side was significantly increased in 2 cases.Conclusions:Germinoma in the basal ganglia of children and adolescents are more common in men, with weakness or mild hemiplegia as the main symptom. The imaging findings have certain characteristics. Imaging findings combined with relevant clinical data can improve the accuracy of early diagnosis of germinoma in the basal ganglia.

Objective Promote the development of disciplines and enforce the construction and training of talent echelon through selection and assessment of discipline and academy leaders.Methods Conduct classified management on different disciplines and academy leaders concerning theirworking positions.The specific measurements include setting up selection and evaluation systems separately with different focuses,implementing dynamic management,establishing performance oriented mechanisms of promotion and demotion during the tenure period.Results The construction of talent echelon plays a significant role in capacity building of young talents,team building and development of all disciplines.Conclusions Systematic measurements could promote the development of disciplines and cultivation of reserved talents,including attaching importance on talent echelon establishment,defining suitable function of hospital,strengthening talent team building;establish a well-functioning talent management mechanism and effective incentive mechanisms.

The paper covered dominant models and organization of healthcare alliances in Xinjiang, illustrating the hospital group model, synergy development model, focused partnership support model, three-level integration model, and other business models.As described by the authors, healthcare alliances in Xinjiang, thanks to telemedicine, have achieved initial success by means of disciplines support, primary care human resources, new technologies and new service spreading, and promotion of appropriate medical techniques, in such aspects as regional medical cooperation, population benefits and medical resources sharing.

Objective:To explore leuncine-rich repeats and immunoglobulin-like domains protein 1 (LRIG1) expression in oral verrucous carcinoma(OVC) and its possible mechanism of tumor suppression.Methods:Paraffin specimens of OVC (n =15) and oral squamous cell carcinoma(OSCC,n =30) and corresponding adjacent normal tissues,and 15 normal mucosa tissues(NM) as control from injured patients were collected.The expression levels of LRIG1 and Bcl-2 were examined using immunohistochemical SP method.The correlation between the expression levels of LRIG1 and Bcl-2 was determined using two tailed Pearson's correlation.Results:LRIG1 was significantly lower in OVC tissue than that in NM tissue,but higher than in OSCC tissue.The expression levels of Bcl-2 in OVC were significantly higher than that in NM,but lower than in OSCC.The expression level of LRIG1 was negatively correlated with expression level of Bcl-2 in NM,OVC and OSCC tissue.Conclusion:LRIG1 may inhibit the expression of Bcl-2 and the development of OVC.

Objective Comparative study of gastric tube implantation at different times in patients with invasive mechanical ventilation. Methods Random sampling was used to divide 160 patients who were incubated with mechanical ventilation at the hospital into two groups,There were 80 patients in each group. Two groups of patients were routinely placed gastric tube by a stationary nurse.The observation group was treated with ordinary silica gel stomach tube at early stage(immediately)after trachea cannula, the control group still used the ordinary silica gel stomach tube after the trachea cannula late (24 hours later).The one-time successful rate,the total successful rate,the operation time and the result of the two Methods were observed in the two groups. Results The observation group Placing stomach tube one-time successful rate and the total successful rate was 75% (60/80), 97.5% (78/80), significantly higher than the control group 27.5%(22/80),72.5%(58/80),the difference was statistically significant(χ2=36.12, 19.61,P<0.01).The operation time of gastric tube in observation group was(1.49 ± 0.45)min,which was significantly lower than that of control group(3.07 ± 0.32)min,the difference was statistically significant (t=25.48,P<0.01).The observation group only heard gurgling not pumped to the gastric juice of 10 cases (12.50%), only smoke into the gastric juice does not hear the gurgling in 0 cases, both in 70 cases (87.50%),both in 0 cases,the control group were 37 cases(46.25%),0 cases,40 cases(50.00%),3 cases (3.75%). There were significant differences between the 2 groups in determining the success of gastric tube placement,and the difference was statistically significant(χ2=39.36,P<0.01). Conclusions After the trachea cannula,the ordinary silica gel gastric tube was placed in the early stage(immediately),which improved the successful rate of gastric tube placement in the mechanical ventilation patients, Shortened the operation time,improved the work efficiency and alleviated the patient's pain.

Objective To analyze the clinical value of low molecular heparin calcium combined with early rehabilitation intervention in the prevention of deep vein thrombosis after internal fixation of intertrochanteric fractures.Methods 100 patients with internal fixation for treatment of femoral intertrochanteric fracture from January 2014 and October 2015 were selected and randomly divided into two groups:the control group of 50 cases, treated with low molecular weight heparin low molecular weight heparin by abdominal subcutaneous injection of drug therapy and routine nursing intervention service, observation group of 50 cases, in the control group based on the use of early rehabilitation intervention.The incidence of deep venous thrombosis after operation in two groups was recorded, and the changes of platelet count and coagulation markers were observed before and after intervention in the two groups.Results The observation group of patients with postoperative deep venous thrombosis incidence rate of 4%, significantly lower than the control group 16%, the difference was statistically significant (P<0.05), the two groups after the intervention each time the platelet count was higher than that of before intervention, four weeks after the intervention, the observation group of platelet count (239.51 ±34.62) ×109/L, significantly higher than the control group (235.23 ±28.87) ×109/L, the difference was statistically significant (P<0.05), the two groups before the intervention of each marker concentration, the difference was not statistically significant, patients in the observation group after the intervention, the blood coagulation markers concentrations were significantly lower than before treatment, and were significantly lower than the control group after the intervention.The comparison between the two groups, the difference was statistically significant (P<0.05).There was no chest pain, chest tightness, dyspnea and other symptoms of pulmonary embolism in the two groups , and no adverse reactions were found.Conclusion The application of low molecular weight heparin calcium combined with early rehabilitation intervention can effectively reduce the incidence of deep venous thrombosis after intertrochanteric fracture fixation.

Objective To explore the standard clinical pathway and stratified cost insurance in patients with senile cataract operation. Methods Patients treatment by senile cataract phacoemulsification combined with IOL implantation were selected as research subjects by cluster sample from two hospitals from 2013 to 2014 . Patients were divided into different groups according to the year, chronic diseases, preoperative waiting time. The difference of hospitalization expenses and hospitalization time were compared. Different levels of hospital costs were established by CHAID decision tree used hospitalization cost as target variable. Results The waiting time for operation was 2 days, the total hospitalized time was 5 days and these can be used as reference time in clinical pathway. Patients uninsured or with long waiting time for operation had longer hospitalized time. Chronic disease, terms of payment and waiting time before operation were point factors that effect the hierarchical of decision tree. Conclusion The new standard of clinical path need to adjust constantly. Distinguish different patients condition and pay different clinical path costs.

Objective To preliminary understand the parenting stress of parents with cerebral palsy children,and analyze the source of parenting stress and its related influencing factors,in order to provide the basis for targeted and effective intervention and available social support.Methods Using the Parenting Stress Index Short Form,the Simple Coping Style Questionnaire and the Social Support Scale,80 parents of children with cerebral palsy were investigated.Results The mean score of parenting stress were (102.31 ± 18.79).Parents' parenting stress were associated with its education degree,employment status,family income,the number of children,the negative coping styles,emotional support,tools support,formal support and other related factors (P ＜ 0.05).Conclusions The parenting stress of parents with cerebral palsy children is severe.Enhancing cerebral palsy knowledge,encouraging active treatment and rehabilitation,increasing of social concern and support are the effective measures to reduce the parenting stress of parents with cerebral palsy children.

Objective: Through managing objectives in our hospital, promote the hospital management. Methods:Use expert advice method to establish the target assessment index system, with the weighted index method to calculate the final score. Results: According to the characteristics of the department, develop differentiated, personalized indicators; objective management system consists of 3 level indicators medical examination standard (680 points), scientific research and teaching standards (220 points), departmental management assessment criteria(100 points), and 45 secondary indicator of internal medicine, surgical 49 second-level indicators. Conclusion: Objective management is the starting point of the hospital and meticulous management, and implementation of objective management enhance the awareness of the collective participation of the medical staffs at all levels, so that the department changes from passive management to active management, and it enhances department execution and promotes the hospital science directly.

Bao-Xie-Ning (BXN), a traditional Chinese herbal medicine (CHM) formula composed of Fructus Evodiae, Flos Caryophylli and Cortex Cinnamomi, and used for the treatment of infant diarrheal illness, was subject to systematic assessment for its putative multiple pharmacodynamic effects and pharmacological antidiarrheal mechanisms.