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Objective:To establish a supportive and effective management mode of scientific research project application, promote the capacity building of scientific research in the hospital.Methods:Retrospective analysis was conducted on the national and provincial scientific research projects of Xinhua Hospital Affiliated to Shanghai Jiaotong University Medical School from 2010 to 2019, and the practical effect of " point to point" management mode of scientific research project application was evaluated.Results:The funding rate of Xinhua Hospital, especially national scientific research projects and provincial talents projects, was greatly improved by adoption of the multi-dimensional " point to point" management mode of scientific research project application. The number of national scientific research projects increased from 34 (26.02 million) in 2010 to 72 (51.0851 million) in 2019.The number of provincial talents projects increased from 5 (1.05 million) in 2010 to 26 (6.5 million) in 2019.Conclusions:The " point to point" management mode of scientific research project application plays an important role in promoting the overall funding rate. Enhancement of comprehensive capacity of hospital scientific research can be achieved by further improvement of this management mode, early initiation and arrangement of funding application depending on the " close partner" entity, emphasizing scientific research talents cultivation.
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Objective To investigate the relationship between the trauma severity and the usage of antibacterial drugs and to provide reference for standard protocol of proper antibiotic use in wound care.Methods ICD-10 and AIS were used to set up the relationship and to analyze the use of antibiotics in patients with different trauma score.Results 25 035 trauma patients were enrolled in this study.Those patients were divided into five groups according to the AIS score with least severe as group 1 to most severe as group 5.The patient percentage in group 1 to 5 was 21.92％,67.73％,8.86％,0.97％ and 0.52％ respectively.The five most frequently used antibiotic classes are second generation cephalosporins,third generation cephalosporins,first generation cephalosporins,fluoroquinolones and penicillin/beta lactamase inhibitor combination, accounted for 29.69％,22.57％,20.33％,4.66％ and 4.47％ of total DDDs of antibacterial drugs.Individually, the top 10 antibiotics are cefuroxime (12.21％), cefazolin (8.31％), ceftriaxone (7.74％), cefathiamidine (7.34％), cefotiam (4.87％), ceftazidime (3.68％), amoxicillin/clavulanic acid (3.63％), levofloxacin (3.59％), cefoxitin (3.56％), flucloxacillin (3.52％);gentamicin (2.27％), ornidazole (2.00％) and cefoperazone/tazobactam (1.44％) were used most in their categories respectively.The variety and quantity of antibacterial drugs used for different trauma patients were different.Conclusion The trauma score based on ICD-AIS can reflect the severity of trauma.The use of antibiotics in patients with different trauma score can provide reference for the clinical applications of antibiotics in wound care.
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Objective To investigate the level of B7-H1 and its counter-receptor PD-1 expression in mDC and different subsets of T lymphocytes in HIV infected individuals in China and to analyze the correlation between the level of B7-H1/PD-1 and disease progression, and to demonstrate that PD-1/PD-L1-dependent inhibition is operating in HIV infected patients.Methods Percentage of B7-H1 and PD-1 expression in mDC, CD+4 T cells and CD+8 T cells from thirty-six untreated HIV infected patients and 20 health controls were selected and detected by flow-cytometry, its correlations with CD+4 T cell absolute counts and plasma viral loads were analyzed.Results The percentage of B7-H1 expression in mDC, CD+4 T cells and CD+8 T cells (mean 15.21, mean 20.63, mean 13.5)were higher than that of health controls (all P<0.05).The percentage of PD-1 expression in CD+4 T cells and CD+8 T cells (mean 17.91, mean 19.21)were higher than that of health controls (P<0.05, P<0.05). The level of B7-H1 and PD-1 expression were inversely correlated with CD+4 T-cell counts(mDC+B7-H1+:r=-0.647, P<0.01;CD+4B7-H1+:r=-0.489, P=0.002;CD+8B7-H1+:r=-0.372, P=0.026;CD+4PD-1+:r=-0.374, P=0.025;CD+8PD-1+:r=-0.455, P=0.005) and positively correlated with HIV viral load(mDC+B7-H1+:r=0.662, P<0.01;CD+4B7-H1+: r=0.426, P=0.01;CD+8B7-H1+:r=0.531, P=0.001;CD+4PD-1+:r=0.362, P=0.03;CD+8PD-1+:r=0.380, P=0.022).Conclusion The level of B7-H1 and PD-1 expression was associated with HIV disease progression, which provides a useful marker to define disease progression of HIV infection.
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Objective To evaluate the clinical value and the early therapeutic efficacy of hysteromyomas treated with the radiofrequency ablation (RFA) by two-dimensional contrast-enhanced ultrasound(2D-CEUS) and three-dimensional contrast-enhanced ultrasound(3D-CEUS). Methods A total of 90 patients with 150 hysteromyomas were treated with RFA, including 138 intramural myomas and 12 submucous myomas (in which 5 had micr-pedicles). 2D-CEUS and 3D-CEUS were performed within one day before and after RFA treatment, respectively. The blood supply of focal zone(FZ) was observed by 2D-CEUS and 3D-CEUS. The volume of hysteromyomas and the coagulation necrosis range were measured by 3D-CEUS. The average necrotic rates of hysteromyoma were calculated. Results The 5 submucous myomas with micr-pedicles were removed completely after the RFA treatment. The 2D-CEUS appearances of other 145 hysteromyomas were diverse after the RFA treatment, in which 137 FZs had no contrast infusion,indicating complete ablation, 8 FZs appeared peripheral linear or small flaky enhancement, considering incomplete treatment. The 3D-CEUS performances were variant too, in which 132 FZs vascular network displayed as a "cavity", indicating complete tumor necrosis, the other 7 FZs appeared "branch shape" low enhancement and another 6 FZs showed nonuniform low enhancement, considering residual tumor tissue. The average necrotic rate of the 139 hysteromyomas was (97.1 ± 12. 9)% ,another 6 hysteromyomas was only (46. 4 ± 7. 0) %. Conclusions 3D-CEUS can display vascular structure and spatial relationship of the hysteromyomas, which can be used as the complement of 2D-CEUS. The combination of the two techniques can evaluate the earlier therapeutic efficacy of hysteromyomas by RFA more timely, intuitively and accurately.
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Objective To detect the alternation of the level of CTLA-4 expression in T cells and regulatory T cells, and to study the relationship between CTLA-4 expression in T cells and regulatory T cells and disease progression of HIV infected Chinese. Methods Fifty-eight untreated HIV-1 infected patients were enrolled and the level of CTLA-4 expression in T cells and regulatory T cells were detected by flowcytometry. CD4+T cell numbers, viral load, level of CD95, HLA-DR, CD38 expression on T cells were measured to study the relationship between the level of CTLA-4 expression and disease progression of HIV infected patients. Results We found that the level of CTLA-4 expression in CD4+T cells continuously increased in long term nonprogressors (LTNP), asymptomatic HIV infected patients (HIV) and AIDS patients (P<0.05). The level of CTLA-4 expression in CD4+T cells was significantly correlated with CD4+T cell counts, the frequency of CD8+ CD38+T cells, CD4+CD95+T cells and CD8+CD95+T cells (P<0.05). There had no difference in the level of CTLA-4 expression in CD8+T cells among all groups and neither did we find the relationship between the level of CTLA-4 expression on CD8+ T cells and the CD4 counts, viral load, activation or apoptosis of T cells. The level of CTLA-4 expression in regulatory T cells of LTNP group was significantly lower than that of HIV and AIDS group (P<0.05). The level of CTLA-4 expression in regulatory T cells was significantly correlated with CD4 counts, the frequency of CD4+HLA-DR+T cells and CD8+HLA-DR+T cells (P<0.05). Conclusion The level of CTLA-4 expression in CD4+T cells and regulatory T cells is correlated with disease progression and the level of the activation of immune system of HIV infected Chinese and may play a role in the immune balance in HIV infection.
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Objective To study the association of CD4+CD8+Foxp3+ regulatory T cells with the HIV long term non-progressors(LTNP) in China. Methods Seventy-four HIV-1 infected patients (LTNP group, HIV group and AIDS group)and 16 normal controls were enrolled and the frequency of CD4+CD25+Foxp3+ regulatory T cells were detected by flow cytometry. To study the correlation between CD4+CD25+Foxp3+ regulatory T cells and disease progression, the absolute CD4+ T cells, viral load, apoptosis and activation of T cells were also examined. Results The frequency of CD4+CD25+Foxp3+ regulatory T cells in LTNP group was significantly lower than that in HIV and AIDS group (P<0.05). The frequency of CD4+CD25+Foxp3+ regulatory T cells was inversely related to CD4+ T cells and closely related to viral load and CD38, CD95 expression on CD4, CD8+ T cells (P<0.05). Conclusion The frequency of CD4+CD25+Foxp3+ regulatory T cells of HIV infected LTNP is significantly lower than typical progressors, which indicates that alternation of regulatory T cells may play a protective role in LTNP.