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Scientific and reasonable management methods of research expenditure can promote the standardized and orderly development of research work and improve the fund use efficiency. A hospital analyzed the main problems in the management of such expenditure, and began to practice such management based on problems since 2019. By improving the internal control mechanism in terms of the system and process, the hospital took multiple measures to simplify the reimbursement formalities of researchers, dynamically manage the whole process of scientific research projects, and adopted the fund pool management method to allocate hospital′s supporting funds in batches. These measures effectively resolved the main problems and raised the efficiency of fund use.
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Objective To observe the safety and efficacy of regime that based on aqueous cytomegalovirus-DNA (CMV-DNA) load and IL-8 determination for therapeutic monitoring and local treatment cessation of cytomegalovirus retinitis (CMVR) patients after allogeneic hematopoietic stem cell transplantation (HSCT).Methods A prospective case series study.A total of 14 CMVR patients (22 eyes) after allogeneic HSCT diagnosed in Ophthalmology Department of Peking University People's Hospital between January 2016 and December 2018 were involved in this study.All patients were CMV-DNA seronegative at baseline and were treated with intravitreous injection of ganciclovir (IVG,3 mg in 0.05 ml) twice per week for 4 times in the induction stage and once a week in the maintenance stage.Aqueous humor sample was collected during the first time of IVG every week.CMV-DNA and the level of IL-8 were measured by real time quantitative PCR and ELISA,respectively.During follow-up,negative CMV-DNA (＜ 103/ml) or level of IL-8 ＜ 30 pg/ml in aqueous sample was set as local treatment cessation.Then patients were followed every 2 weeks for at least 6 months.BCVA,intraocular pressure and fundus examination were taken for each visit.The BCVA examination was performed using the international standard visual acuity chart,which was converted into logMAR visual acuity.BCVA and intraocular pressure at the baseline and the last follow-up were compared by the Student t matching test.Results Of the 14 CMVR patients (22 eyes) after allogeneic HSCT,8 patients (16 eyes) were bilateral,6 patients (6 eyes) were unilateral.At the baseline,the mean logMAR BCVA was 0.814 ± 0.563,the intraocular pressure was 17.2 ± 7.8 mmHg (1 mmHg=0.133 kPa),the mean aqueous CMV-DNA load was (3.43 ± 4.96)× 105/ml,the mean level of IL-8 was 518 ± 541 pg/ml.At cessation of local treatment,the median number of intravitreal injections was 5 times.Nine eyes showed negative CMV-DNA in aqueous humor,of which,7 eyes showed negative IL-8 in aqueous.CMV-DNA could still be detected in 13 eyes,while IL-8 was negative.Only one eye's retinal lesion was completely quiet.Six months after local treatment cessation,the mean logMAR B CVA was 0.812 ± 0.691,the intraocular pressure was 14.8± 5.4 mmHg;which was not significantly different from baseline (t=-0.107,1.517;P=0.916,0.137).Recurrence of CMVR happened in only 1 eye because of systemic EB virus infection.Retinal lesions progressively improved and became completely quiet in all the remaining 20 eyes.In 22 eyes,iatrogenic vitreous hemorrhage occurred due to low platelet count during treatment (＜ 30 × 109/ml) in 4 eyes.When the treatment was terminated for 6 months,the fundus of hematoma absorption was clearly visible.At the time of CMVR diagnosis,there were 2 eyes (9％) with posterior subcapsular opacity,which may be caused by systemic glucocorticoid therapy after allogeneic HSCT.Conclusion Aqueous CMV-DNA load and level of IL-8 could be used as quantitative variables for monitoring the therapeutic effect and determining time for local treatment cessation for CMVR after HSCT safely and efficiently.
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Objective:To investigate the independent risk factors of deep venous thrombosis (DVT) in patients with spinal cord injury (SCI) treated with limb blood circulation pump.Methods:From January 2016 to December 2018, 300 patients of thoracolumbar spine fractures with SCI were collected in the department of spinal surgery of Shaoxing Central Hospital.The patients received blood circulation pump to prevent DVT after operation, 48 patients with DVT were classified as DVT group, and the remaining 252 patients were classified as non-DVT group.The basic information (sex, age, height, weight, etc.), body mass index (BMI), chronic disease status (diabetes, hypertension, coronary heart disease, etc.), smoking history, combined lower extremity fracture, SCI classification, operation time, intraoperative blood loss were collected.The differences of above indicators between the DVT group and the non-DVT group were analyzed.The factors with statistical differences were substituted into logistic regression analysis to identify independent risk factors for DVT in patients with SCI who were treated with blood circulation pump.Results:The proportion of elderly patients (≥60 years old) in the DVT group was higher than that in the non-DVT group (79.17% vs.57.14%, χ 2=8.196, P=0.004), and the proportion of obese patients (BMI≥25kg/m 2) in the DVT group was higher than that in the non-DVT group(77.08% vs.56.35%, χ 2=7.203, P=0.007), the proportion of patients with diabetes in the DVT group was higher than that in the non-DVT group (68.75% vs.10.71%, χ 2=84.877, P=0.000), the proportion of smokers in the DVT group was higher than that in the non-DVT group(81.25% vs.49.21%, χ 2=16.685, P=0.000), the proportion of patients with lower extremity fractures in the DVT group was higher than that in the non-DVT group (41.67% vs.7.14%, χ 2=43.443, P=0.000), and the proportion of patients with complete injury in the DVT group was higher than that in the non-DVT group (45.83% vs.15.08%, χ 2=23.834, P=0.000). Logistic regression analysis showed that diabetes, smoking history and lower extremity fractures were independent risk factors for DVT in SCI patients with limb blood circulation pump (O r=1.138, 1.356, 1.548, P=0.003, 0.007, 0.014). Conclusion:The independent risk factors for DVT in SCI patients when using blood circulation pump may include diabetes, smoking history and lower extremity fractures.
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Zinc levels are high in pancreatic β-cells, and zinc is involved in the synthesis, processing and secretion of insulin in these cells. However, precisely how cellular zinc homeostasis is regulated in pancreatic β-cells is poorly understood. By screening the expression of 14 Slc39a metal importer family member genes, we found that the zinc transporter Slc39a5 is significantly down-regulated in pancreatic β-cells in diabetic db/db mice, obese ob/ob mice and high-fat diet-fed mice. Moreover, β-cell-specific Slc39a5 knockout mice have impaired insulin secretion. In addition, Slc39a5-deficient pancreatic islets have reduced glucose tolerance accompanied by reduced expression of Pgc-1α and its downstream target gene Glut2. The down-regulation of Glut2 in Slc39a5-deficient islets was rescued using agonists of Sirt1, Pgc-1α and Ppar-γ. At the mechanistic level, we found that Slc39a5-mediated zinc influx induces Glut2 expression via Sirt1-mediated Pgc-1α activation. These findings suggest that Slc39a5 may serve as a possible therapeutic target for diabetes-related conditions.
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Acute promyelocytic leukemia (APL) was considered to be the most rapidly fatal leukemia,because of serve clinical manifestation,high rate of early death and the low cure rate.APL has achieved great success due to the application of ATRA and ATO.Although the complete remission rate is about 90％,the relapse rate has been reported to be as high as 15％-30％.So reducing the recurrence and improving long-time survival have become the focus of the study.Choosing the reasonable treatment after remission is very important.The post remission therapy usually include consolidation therapy and maintenance therapy,but the optimal strategy has been controversy.Therefore,this artical will review the literature of APL in consolidation therapy.
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The Internet Public Opinion Monitoring and Early Warning System for medical and health industry was designed and implemented due to the frequent occurrence of Internet public opinion, which has all-directional data collecting and analyzing functions, including big data collection, near duplicate detection, spam filtration, key public opinion early warning, region identification and tendency analysis, and can thus provide evidence for relevant departments to take effective measures for the control of Internet public opinion.
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PET/CT is often used in the management of patients with lymphoma ,and have been recom-mended for the staging and response assessment in diffuse large B -cell lymphoma and Hodgkin ,slymphoma .Al-though follicular lymphoma is almost always 18 F-fluorodeoxyglucose avid ,PET/CT is not routinely used in the clinical practice of follicular lymphoma .But there is a growing body of literature supporting the use of PET /CT in follicular lymphoma.Therefore,on the application of PET/CT in follicular lymphoma ,we review the recent litera-tures in this paper .
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Objective To investigate the value of perfusion CT in the evaluation of neoadjuvant chemotherapy in locally advanced squamous cell carcinoma.Methods Sixty-seven patients with Ib2-IIb squamous cell carcinoma of the cervix underwent CT perfusion imaging before neoadjuvant chemotherapy to measure blood flow (BF),blood volume (BV),peak time (MTT),permeability sur-face (PMB),perfusion time to peak (TTP)and MIP(HU);and underwent routine enhancement CT after the two course of neoadju-vant chemotherapy treatment to measure tumor size,and evaluate the therapeutic effect.Results Among 67 patients,48 patents were effective (2 completely remission and 46 partial remission),and 1 9 patients were ineffective (1 5 stable and 4 progressed),with the overall response rate of 71.6%.The differences of PMB and BV value between effective and ineffective group were statistically significant before neoadjuvant chemotherapy (P 0.05).The BV and PMB value were relatively higher in the patients with effective chemotherapy.Conclusion CT perfusion imaging could measure the BV and PMB value of the tumor before neoadju-vant chemotherapy to provide the basis for treatment selection.
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PurposeThe bone flare phenomena has been well described on bone scintigraphy for efficacy monitoring up to now, but our knowledge has been rarely described on MSCT, the phenomena may be erroneously classiifed as disease progression. This article intends to evaluate the existence and CT features of bone flare phenomena of metastatic bone disease in lung cancer patients treated with ibandronate, to raise awareness of this phenomenon.Materials and Methods The clinical and image data of 45 patients with bone metastases of lung cancer were retrospectively analyzed prior to treatment and 3, 6 months after treatment, the change of CT value and CT features 3 months after treatment between bone flare phenomena group, progressive disease group 1 and progressive disease group 2 were compared.Results The incidence of bone flare phenomena was 6.7% (3/45). 3 months after treatment, CT value of the bone flare phenomena group and progressive disease group 1 changed when compared with before treatment, the differences were statistically signiifcant (t=-5.787 and-2.788,P0.05) of CT value in the progressive disease group 2 after 3 months' treatment. After 3 months' treatment, the bone flare phenomena group mostly appeared as osteogenic sclerosis of osteolytic lesions, while the cases of progressive disease group mostly appeared as new periosteal reaction of the lesion, or osteogenic/mixed lesion combined with osteolytic damages, the difference between the two groups was statistically signiifcant (χ2=10.139, 8.041 and 4.154,P0.05).Conclusion In patients treated with ibandronate, when there is therapeutic effect evaluation standard of bone metastases (disease progression) and clinical comprehensive curative effect evaluation standard (effective) discordance at 3 months after treatment, it can be interpreted as bone flare phenomena, and the change of CT features contributes to the differential diagnosis of bone flare phenomena with progressive disease.
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Background Idiopathic macular epiretinal membrane (IMEM) combined with age-related cataract (ARC)is a common eye disease and the primary managing approach is the combination of phacoemulsification,intraocular lens (IOL) implantation and vitrectomy.However,whether the ocular length measured by IOL Master is accurate for the calculation of IOL refraction in the eye with IMEM remains unclear.Objective The aim of this study was to evaluate the refractive outcomes of combination surgery of phacoemulsification,IOL implantation and vitrectomy in IMEM eyes.Methods A prospective cohort study was designed.Forty-two eyes of 42 patients with IMEM combined with ARC (IMEM+ARC group) were enrolled in Peking University People's Hospital and the combination of phacoemulsification,IOL implantation and vitrectomy was performed from September 2010 to August 2011,and 47 eyes of 47 patients with ARC were included for the phacoemulsification combined with IOL implantation in the corresponding period (ARC group) under the approval of Ethic Committee of Peking University People's Hospital and informed consent of the patients.Ocular length and corneal curvature were measured using IOL Master,and the expected IOL diopter was calculated with SRK-T formula.Regular eye examination and medical optometry were performed 1 month and 3 months after operation to obtain the actual diopter and the refractive error.The outcomes were compared between the two groups.The correlations of refractive error with change of fovea thickness were evaluated after operation in the IMEM+ARC group.Results There were no statistically significant differences in the age,ocular length and corneal curvature between the two groups before operation (P =0.863,0.704,0.770).The visual acuity was improved 3 months after operation in comparison with before operation in both groups (P=0.001,0.000).The negative diopters were obviously higher 1 month and 3 months after operation than those before operation in both groups (all at P＜0.001),but no significant difference was seen between the IMEM+ ARC group and ARC group (Fgroup =0.417,P =0.520).The diopter deviations 1 month and 3 months after operation were (-0.727±0.666)D and (-0.628±0.627)D in the IMEM+ARC group,and those in the ARC group were (-0.664±0.644) D and (-0.642±0.550) D,showing insignificant differences between the two groups (Fgroup =0.036,P =0.849 ; Ftime =1.523,P =0.221).In IMEM + ARC group,the macular fovea thickness was (474.89 ± 135.76)μm in preoperation,and the shift values of macular fovea thickness were (-83.84 ±91.12)μm and (-158.53±113.03) μm in postoperative 1 month and 3 months.No positive correlations were presented between the diopter deviations and change of fovea thickness 1 month and 3 months after operation in the IMEM+ARC group (r=0.200,P =0.229 ; r =0.065,P =0.698).Conclusions Myopia shift after operation is similar in the IMEM combined with ARC patients to the only ARC patients,suggesting that the ocular length and corneal curvature measured by IOL Master is not affected by epiretinal membrane.
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Objective To analyze the effects of flexible ureteroscopic Holmium laser lithotripsy on renal function in the treatmen of renal calculi. Methods From October 2010 to March 2012,41 cases of solitary renal calculi (24 males and 17 females) were treated with flexible ureteroscopic Holmium laser lithotripsy ( FURL).Patient's mean age was 51.9 ± 15.9 years ( range from 31 to 88 years).Locations of renal calculi detected by image study were 22 cases in middle and upper calyx,9 cases in lower calyx,10 case in renal pelvis.The mean size of calculi was 16.9 ±6.0 mm (range from 10 to 28 mm).Blood samples (2 h pre-operatively,and then 2 h,12 h,24 h,48 h,72 h post-operatively) were collected and serum NGAL,serum Cys-C were tested Results The measured levels of pre-operative NGAL and Cys-C were 3.5 ± 0.6μg/L,501.7±121.3 μg/L,and levels of post-operative NGAL at 2 h,12 h,24 h,48 h and 72 h were 4.2±0.8 μg/L,5.0±1.0 μg/L,4.9±1.4 μg/L,4.3± 1.1 μg/L and 3.8 ±0.1 μg/L,while the according levels of Cys-C were ( 516.4 ± 126.2 ) μg/L,( 723.8 ± 134.8 ) μg/L,( 770.4 ± 162.8 ) μg/L,(671.7 ± 138.3 ) μg/L and 574.0 ± 116.7 μg/L.Serum NGAL began to increase 2 hours after operation (P ＜0.05,and reached the peak in 12 hours,it began to decline 12 hours after surgery,but it was still higher at 72 hours than pre-operative level (P ＜ 0.05.Serum Cys-C showed no obvious ascent 2 hours after operation in FURL group ( P ＞ 0.05 ),but increased obviously 12 hours after operation and lowered down after the peak that occurred 24 hours after surgery.Serum Cys-C still remain above the baseline 72 hours after operation (P ＜0.05). Conclusions Flexible ureteroscope lithotripsy can cause reversible damage to renal function after surgery.
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The paper introduces the system design of internet platform in novelty assessment and selective dissemination of informa-tion of medical science and technology project in Zhejiang province, including the exploitation of environment , processing of novelty as-sessment and selective dissemination of information as well as main function design. This system has noticeable advantages, such as com-prehensive functions, multiple participation, transparent service process, which could finish the relevant work on the internet, improve the quality of information service and enhance the efficiency.
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Objective To evaluate the inflammatory response in the airway of healthy rats following exposure to motor vehicle exhaust. Methods Sixty healthy SD rats(30 males and 30 females,aged 6 weeks) were randomly divided into 6 groups. The rats in the exposed groups were placed by the main traffic road and those in the control group were placed in the normal laboratory environment. The bronchoalveolar lavage fluid(BALF) was analyzed on the 14th,30th and 90th day of exposure .WBC,NO,TNF-?,and IL-8 in BALF of the rats in each group were tested. Results The NO content [(9.75?4.78) ?mol/L] in BALF of the rats in the group exposed for 30 days was obviously higher than that in the control group [(4.40?1.45) ?mol/L],but there was no any obvious difference between the two groups in terms of the content of TNF-? and IL-8 in BALF. Conclusion This study demonstrates that exposure to vehicle exhaust can induce inflammatory response in healthy rats,the on-the-spot experiment on animal exposure can be used to observe early respiratory tract inflammation and 30 days of exposure is the sensitive period for the change of the inflammatory indicators.
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Objective To evaluate the relationship between Helicobacter pylori antigen in saliva and the activity of gastritis and like intestinal metaplasia(IM)or atypical hyperplasia(AH).Methods From June 2004 to June 2005 Helicobacter pylori antigen were detected in saliva of 246 persons by enzyme-linked immunosorbent assay(ELISA),and the Hp-positive rates in saliva in patients with different gastritis were compared.Results The Hp-positive rate in saliva in patients with active chronic gastritis was 74.29%(26/35),which was significantly higher(P