目的:观察脂微球前列腺素E1联合氯沙坦对糖尿病肾病(DN)患者24 h蛋白尿和肾功能的影响。方法:63例2型糖尿病肾病患者随机分为对照组和治疗组,两组患者均给予适量运动、饮食控制、降糖、降脂等常规治疗,对照组在常规治疗基础上给予氯沙坦治疗,而治疗组则同时给予脂微球前列腺素E1和氯沙坦,疗程共12周,分别观察治疗前后两组患者空腹血糖、肾功能及24 h尿蛋白的变化。结果:治疗12周后,两组患者空腹血糖控制良好,治疗组患者肾功能较治疗前明显改善(Plt;005),且尿白蛋白排泄率较对照组明显下降,分别为（32212±5021） mL/min和（27657±3812） mL/min,两者间的差异具有显著性意义。结论:脂微球前列腺素E1联合氯沙坦能明显改善糖尿病肾病患者肾脏功能,减少24 h尿蛋白。
Objective To explore the evaluation index and appointment mechanism of healthy professional titles. Methods We collected the data of people evaluated and appointed as advanced professional titles, and the evaluation and appointment documents in West China Hospital. We analyzed the evaluation index and appointment mechanism. Results A total of 400 people gained senior title promotion. The evaluation indexes focused on academic degrees, papers, research projects, patents, as well as awards and honors. The research achievements reduced of 80% people who had gained senior titles. Conclusion Current evaluation indexes prefer to inflexible index and ignore flexible index. The appointment mechanism lacks outcome evaluation, and the professional title will not be eliminated once appointed. In the future, we should improve the evaluation index and appointment mechanism focusing on the specific characteristics of healthy professional titles.
In response to the opportunities and challenges faced by large comprehensive public hospitals in the new era, West China Hospital of Sichuan University has summarized a set of plans for various positions in public hospitals through 18 years of exploration, and provides a reference basis for the position setting of public hospitals.
目的 根据MRI颈脊髓信号异常平面决定椎板切除减压范围，观察侧块螺钉固定结合不同范围全椎板切除减压治疗在颈脊髓损伤的临床疗效。 方法 2008年9月-2011年12月收治颈脊髓损伤患者16例。其中男10例，女6例，高处坠落伤5例，车祸11例，MRI显示脊髓损伤信号改变波及2个节段3例，3个节段9例，4个节段4例，椎间盘损伤变性12例，椎间盘轻度突出4例，均诊断为颈脊髓损伤伴高位截瘫，均行后路手术治疗。根据手术方式将16位患者分为观察组（9例）及对照组（7例），均采用后路侧块螺钉固定结合全椎板切除减压治疗，观察组减压范围以MRI提示颈脊髓信号异常为中心，对照组减压范围均为颈3～颈7。比较两组治疗前后的ASIA评分改变。 结果 16例患者均得到随访，随访10～48个月，平均17个月，脊髓神经恢复功能按照ASIA运动评分，平均增长值：对照组（42.75 ± 12.56）高于观察组（20.52 ± 11.60），差异有统计学意义（P＜0.05）。观察组患者ASIA分级分布：术前A级4例，B级4例，C级1例，末次家庭随访时A级4例，B级3例，C级2例；对照组术前A级3例，B级3例，C级1例，末次家庭随访时A级2例，B级1例，C级2例，D级2例，对照组ASIA分级术前与术后比较，差异有统计学意义（P＜0.05）；观察组ASIA分级术前与术后比较，差异无统计学意义（P＞0.05）；比较两组ASIA分级改善率，对照组明显优于观察组（P＜0.05）。 结论 根据MRI提示的颈脊髓信号异常平面决定侧块螺钉固定及颈椎板切除范围治疗颈脊髓损伤疗效不佳，减压范围扩大至颈3-颈7疗效较好。
The continuing medical education system of West China Hospital of Sichuan University is based on whole life cycle. We actively promote the continuing education, systematize and institutionalize the top-level design, and adopting flexible and diverse training methods. It is of great significance for a staff's entire career to continuously improve professional accomplishment, specialized knowledge and working skills, to adapt to the development of medical science and technology and the reform of health service, and to drive hospital innovation and high-quality development, so as to eventually achieve the goal of "double first-class" construction.
The construction of high-level talent teams is the core of building up high-level universities and hospitals, and it is an important reference index for the ranking of universities and academic disciplines. The first-class medical talent teams is an essential requirement for comprehensive hospitals to be ranked as "Double First-Class". Based on the practice of construction of high-level medical talents in West China Hospital of Sichuan University, this paper introduces the optimal appoaches in this regard.
A new human resource management system in West China Hospital of Sichuan University has been constructed to inspire work enthusiasm and innovation of the front-line medical staffs, strengthen the cohesion of the hospital, better service for patients, and promote high-quality development of the hospital. This paper introduced it and provided references for related researches.