Objective To explore the management practices of projects supported by National Natural Science Foundation in a large general hospital. Methods We carried out an overall analysis on the data of projects supported by National Natural Science Foundation of China from 2011 to 2016 in West China Hospital of Sichuan University. The characteristics of researchers who were granted the foundation were also studied. Results In the recent six years, there were 767 projects granted by the National Natural Science Foundation in the hospital, with an average of 127 projects a year. The Department of Medical Sciences was the top source of approval for the projects (690 items), and its granted projects covered all the categories set by the foundation committee. Most of the researchers who got the fund were between 25 and 40 years of age (501 projects). Researchers in charge of general projects were mainly professors with an age of (43.54±7.28) years old in average. Researchers in charge of Projects for Distinguished Young Scholars were mainly of medium-grade professional titles, and their average age was (32.01±3.05) years old. Moreover, among these young scholars, the age of male researchers [(31.27±2.23) years old] was significantly younger than that of female scholars [(32.90±3.62) years old](P<0.01). Conclusion It is more and more important for National Natural Science Foundation of China to study the accumulation of early research of young scholars and the leading role of the hospital in basic research, personnel training and discipline construction.
Objective To evaluate and compare the efficacy of anterior subcutaneous and submuscular transposition of the ulnar nerve in treating cubital tunnel syndrome. Methods From August 2006 to August 2008, 66 patients with cubital tunnel syndrome were treated with anterior subcutaneous transposition (subcutaneous group, 24 cases) and with anterior submuscular transposition (submuscular group, 42 cases). According to McGowan stages, all patients were at Stage2 or 3 entrapment neuropathy with paresthesia in the ring and small fingers. Respectively, 3 cases and 8 cases compl icated by interosseous muscle atrophy in subcutaneous group and in submuscular group. No significant difference was found in gender, age, duration of the disease, and compl ication between two groups (P lt; 0.05). The surgical features, distribution of Bishop rates, two-point discrimination test, muscular strength, and compl ications were recorded. Results The operation time was (28.4 ± 5.2) minutes in subcutaneous group and (43.8 ± 5.6) minutes in submuscular group, showing significant difference (P lt; 0.01). The incision length was (12.2 ± 2.5) cm in subcutaneous group and (13.6 ± 2.8) cm in submuscular group, showing significant difference (P lt; 0.05). All patients were followed up 1-3 years. According to Bishop scoring system, the results were excellent in 18 cases, good in 4 cases, and poor in 2 cases in subcutaneous group; excellent in 36 cases, good in 3 cases, and poor in 3 cases in submuscular group; and showing no significant difference between two groups (P gt; 0.05). At 6 months postoperatively, twopoint discrimination and grip strength were improved when compared with that of preoperation (P lt; 0.05), but there was no significant difference between two groups (P gt; 0.05). Pain and dysesthesia of the scar were noted in 1 patient of the subcutaneous group and 3 patients of the submuscular group. No infection or hematoma was found and no patient needed reoperation. Conclusion Both operative methods are effective alternative for treating cubital tunnel syndrome. The anterior ubcutaneous anterior transposition of the ulnar nerve has fewer traumas, and it is a better choice for some old patients.
ObjectiveIn order to provide a data base for fund project applicants and funding priorities, we would summarize the basic situation and key points of basic research in liver transplantation by analyzing the projects funded by the Natural Science Foundation of China (NSFC) in the field of liver transplantation.MethodsThrough the big data knowledge management and service platform of NSFC, internet-based science information system, and shared service network of NSFC, we searched the funding project information in the liver transplantation relevant field from 2010 to 2019, then analyzed the effectiveness of the Young Scientists Fund of NSFC in promoting young researchers and the research focus and development direction of funding projects.ResultsIn the latest 10 years, NSFC persistently and stably funded the basic research in the field of liver transplantation, with the total number of funding projects was 387, and the funding budget was 198.215 million yuan. The main types of funding projects were the General Program and the Youth Science Fund. There were 210 General Program project (54.3%) with an amount of 113.14 million yuan (57.1%), 127 Young Scientists Fund (32.8%) with an amount of 27.9 million yuan (14.1%), and 22 Fund for Less Developed Regions (5.7%) with an amount of 9.03 million yuan (4.6%). Sun Yat-sen University and Zhejiang University were far ahead of other supporting institutions in both the total number of projects undertaken and the amount of funds granted. The youth/surface ratio reached as high as 72.2% (13/18). The conversion rate of Young Scientists Fund to higher-level projects reached about 50%, which was significantly higher than the overall level of 24.7% (21/85) in the field of liver transplantation. The funding projects were mainly distributed in application code H0318 (liver regeneration, liver protection, liver failure, and artificial liver, 58, 15.0%), H0321 (organ transplantation of digestive system, 169, 43.7%), and H1006 (organ transplantation and transplantation immunity, 50, 12.9%). The main research fields were transplantation immunity and liver injury and liver protection. At the same time, projects such as graft function and complications of liver transplantation were also funded. There were few studies on the immune status of long-term survival in patients after liver transplantation and the mechanism on prevention of immunosuppressant-related diseases.ConclusionsThe NSFC has a great leading effect on the discipline development and talent cultivation of liver transplantation. However, there are still some problems in the discipline layout, such as the lack of attention to the mechanism of long-term graft function and chronic immune rejection.
目的 了解社区人群对脑卒中危险因素及症状的知晓现状。 方法 随机抽样调查1 208名居民及112名医务人员的人口学特征、对危险因素及预警信号的知晓现状及其影响因素、信息来源及需求情况。 结果 90.1%、100.0%的居民及医务人员可辨识高血压是卒中的危险因素，而社区居民及医务人员对年龄、糖尿病、吸烟等危险因素的认识比例分别为65.0% 和85.0%，且对危险因素的控制策略缺乏了解。87.4%、100.0%社区居民及医务人员将一侧肢体的活动障碍作为卒中的第一大预警信号，其次为头晕、步态不稳、头痛、言语困难、视物模糊。卒中知识得分的单因素及多因素分析示：大学文化、已婚且在职的居民及高学历的医务人员对卒中信息的了解程度高。卒中信息的获取途径依次为电视、社区医生/讲堂、报纸、杂志、网络。 结论 西部城市社区人群卒中知识知晓率低，开展针对低学历医务者的卒中培训及低学历、独居及退休人员的居民讲堂是改善现状的必要途径。同时也为政府建立有效的院前早期识别及快速转诊技术提供了依据。Objective To assess the baseline knowledge of risk factors and warning signs of cerebral apoplexy in communities. Methods A total of 1 208 inhabitants and 112 medical personnel were selected by systematic sampling. The questionnaire included social-demographic data, knowledge of cerebral apoplexy risk and warning signs and influencing factors, the sources and requirement of information about cerebral apoplexy. Results Hypertension was a risk factor in 90.1% of residents and 100.0% of medical personnel. Age, diabetes and smoking were identified as the risk factor in 65.0% of medical personnel and 85.0% of residents. Medical therapy of risk factors was insufficient. The most common warning signs of cerebral apoplexy was hemiplegia, the following were vertigo, ataxia, headache, aphasia and double vision. Stepwise multiple regression analyses showed that residents who had higher educational background, spousal, workers and community worker with higher educational background had higher knowledge scores of cerebral apoplexy. The main sources of information about cerebral apoplexy were television, doctors, newspaper, magazine and network. Conclusions At present, the urban community residents in west China are lacking in knowledge about cerebral apoplexy. Going forward, targeted educational residents and medical workers should be directed at those who was highly educated, living alone, and retired. It is also provide a theoretical basis for establishing a prehospital identification and transfer treatment system based on community in developing countries.
ObjectiveTo summarize the management principle and clinical suggestions of the osteotomy gap of opening wedge high tibial osteotomy (OWHTO).MethodsThe related literature of the osteotomy gap of OWHTO in recent years was reviewed, summarized, and analyzed.ResultsDelayed union and non-union of the osteotomy gap are main complications of OWHTO. Tomofix plate, as locking steel plate, has the characteristics of angular stability and can better maintain the stability of the osteotomy gap, promote bone healing, and avoid loss of correction. There are some treatment options for the osteotomy gap site, such as, without bone, autologous bone graft, allogeneic bone graft, bone substitute materials graft, and augment factor graft to enhance bone healing. When the osteotomy gap is less than 10 mm, it achieves a good outcome without bone graft. For the obesity, lateral hinge fracture, large osteotomy gap, or correction angle more than 10°, the bone graft should be considered. In cases whose osteotomy gap is nonunion or delayed union, the autologous bone graft is still the gold standard. When the osteotomy gap repaired with the allogeneic bone graft, it is better to choose fragmented cancellous or wedge-shaped cancellous bone, combining with the locking plate technology, also can achieve better bone union. The bone substitute material of calcium-phosphorus is used in the osteotomy gap, which has the characteristics of excellent bone conduction, good biocompatibility, and resorption, combining with the locking plate technology, which can also achieve better bone union in the osteotomy gap. The augment factors enhance the bone healing of the osteotomy gap of OWHTO is still questionable. The bone union of the osteotomy gap is also related to the size of the osteotomy gap and whether the lateral hinge is broken or not.ConclusionNo matter what type of materials for the osteotomy gap, OWHTO can improve the function and relieve pain for knee osteoarthritis. More randomized controlled trials are needed to provide evidence for clinical decision to determine which treatment option is better for the osteotomy gap of OWHTO.
Objective To explore the medical insurance quota payment of dialysis treatment for outpatients with end-stage renal disease in Chengdu from following aspects, evaluation indexes and reasonable amount, so as to provide scientific basis for the payment of single disease. Methods A questionnaire survey was conducted to collect the cost information of patients, and to formulate the assignment of evaluation indexes according to the therapeutic principles and statistical results; Delphi method was adopted to determine the assignment and the standard of quota payment. Results A total of 17 dialysis organizations approved by Chengdu municipal medical insurance were involved in this study. Of 700 questionnaires distributed, 686 were retrieved. After excluding 26 questionnaires for incomplete filling and incorrect treatment information, a total of 660 questionnaires were included actually, accounted for 94.28% of all informants. The results of survey showed that, the hemodialysis treatment rate accounted for 84% (555/660) of all informants, while the peritoneal dialysis treatment rate accounted for 16% (105/660). By assessing the project assignment of outpatient dialysis treatment, the minimum annual payment of hemodialysis was RMB 118 242.75 yuan, while that of peritoneal dialysis was RMB 96 498.00 yuan. Conclusion The quota payment of outpatient dialysis shows b evidence after adopting the treatment project assignment. The grading quota payment of outpatient dialysis enables the medical insurance fund to be more reasonably used.
Objective To seek the best evidence on communication between physicians and patients so as to improve the physician-patient relationship in China. Methods We used the key words ‘physician-patient relationship’ and ‘communication’ to identify related systematic reviews and meta-analyses, and then evaluated them with the Overview Quality Assessment Questionnaire (OQAQ) checklist. Results Seventeen studies were included for final evaluation. According to the OQAQ checklist, the score range of the study quality was 3 to 9. 41.29% (7/17) of the included studies scored 7 to 9, 23.5% (4/17) scored 6, and 35.3% (6/17) scored 3 to 5. Factors influencing physician-patient communication primarily included communication targets, time, contents, and approaches. Conclusion There are not enough studies on physician-patient communication in China. We need to identify the problems affecting communication behavior, encourage patients to express their preferences, choose appropriate training strategies, and make timely evaluation so as to better satisfy the needs of patients and physicians.
ObjectiveTo establish an efficient method of isolating and culturing high activity and high purity of Schwann cells, and to identify the cells at the levels of transcription and translation. MethodsThe sciatic nerves harvested from a 4-week-old Sprague Dawley rat were digested in the collagenase I for 15 minutes after dissecting, and then the explants were planted in culture flask directly. The cells were cultured and passaged in vitro, the growth state and morphological changes of the cells were observed under inverted phase contrast microscope. MTT assay was used to test the proliferation of cells and the cells growth curve was drawn. RT-PCR and immunohistochemistry staining were used to detect S100 and glial fibrillary acidic protein (GFAP) at the levels of transcription and translation, respectively. The purity of cells was caculated under microscope. ResultsAfter the digestion of collagenase I, fibroblast-like cells appeared around explants within 24 hours, with slender cell body and weak refraction. After tissues were transferred to another culture flask, a large number of dipolar or tripolar cells were seen after 48 hours, with slender ecphyma, plump cell body, and b refraction, and the cells formed colonies within 72 hours. The cells were covered with the bottom of culture flask within 48-72 hours after passaging at a ratio of 1∶2, and spiral colonies appeared. Cells showed vigorous growth and full cytoplasm after many passages. MTT assay results showed that the cells at passage 3 entered the logarithmic growth phase on the 3rd day, reached the plateau phase on the 7th day with cell proliferation, and the growth curve was “S” shape. RT-PCR results showed that the cells expressed S100 gene and GFAP gene, and immunohistochemistry staining showed that most of the cells were positively stained, indicating that the majority of cells expressing S100 protein and GFAP protein. The purity of Schwann cells was 98.37% ± 0.30%. ConclusionHigh activity and high purity of Schwann cells can be acquired rapidly by single-enzyme digestion and explant-culture method.
Objective To discuss the relationship between recovery of anatomical integrity and functional outcome in elderly patients with distal radius fractures by comparing the effects of open reduction and closed reduction. Methods The cl inical data were retrospectively analyzed from 78 elderly patients with distal radius fractures treating with nonoperation andoperation from February 2005 to March 2009. Thirty-seven patients underwent closed reduction and spl intlet fixation or cast appl ication (non-operation group), and forty-one patients underwent open reduction and internal fixation (operation group). In non-operation group, there were 15 males and 22 females with an average age of 73 years (60-83 years). According to the AO classification system for fracture, there were 8 cases of type A2, 7 cases of type A3, 7 cases of type B1, 4 cases of type B2, 2 cases of type B3, 4 cases of type C1, 2 cases of type C2, and 3 cases of type C3. The time from injury to admission was between 30 minutes and 3 days with a mean time of 1 day. In operation group, there were 18 males and 23 females with an average age of 71 years (62-80 years). According to the AO classification system for fracture, there were 5 cases of type A2, 7 cases of type A3, 7 cases of type B1, 6 cases of type B2, 3 cases of type B3, 4 cases of type C1, 5 cases of type C2, and 4 cases of type C3. The time from injury to admission was between 30 minutes and 7 days with a mean time of 1 day. There were no significant differences (P gt; 0.05) in sex, age, disease course and fracture classification between two groups. Results All incisions obtained heal ing by first intention after operation in operation group. All patients were followed up for 9-36 months (20 months on average). Fracture heal ing was achieved within 8 to 15 weeks, with an average of 11 weeks. There were no significant differences (P gt; 0.05) in fracture heal ing time between non-operation group [(10.8 ± 2.0) weeks] and operation group [(11.7 ± 2.5) weeks]. At last follow-up, thepalmar tilt angle was (5.6 ± 2.0)° and (8.6 ± 3.0)°, the radial incl ination angle was (19.1 ± 4.9)° and (21.8 ± 2.0)°, and the radial length was (8.3 ± 1.3) mm and (10.4 ± 1.4) mm in non-operation group and operation group, respectively; showing significant differences (P lt; 0.05) between two groups. According to the Gartland-Werley score, the results were excellent in 9 cases, good in 21 cases, fair in 5 cases, and poor in 2 cases in non-operation group, the excellent and good rate was 81.1%; in operation group, the results were excellent in 13 cases, good in 25 cases, fair in 2 cases, and poor in 1 case, the excellent and good rate was 92.7%, showing no significant difference (P gt; 0.05) between two groups. There were no significant differences (P gt; 0.05) in flexion and extension activity of wrist, radioulnar partial activity, pronation-supination activity, grip and pinch strength between two groups. Conclusion Open reduction and closed reduction can achieve satisfactory functional outcomes, but closed reduction was inferior to open reduction in anatomic reduction for treating distal radius fractures in elderly patients.
ObjectiveTo investigate the value of diffusion weighted imaging (DWI) combined with three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) in evaluating metastatic lymph nodes secondary to hilar cholangiocarcinoma. MethodsFrom July 2009 to March 2011, DWI examination was performed in 37 patients with hilar cholangiocarcinoma, which was compared with 3D-VIBE sequences. The morphological characteristics and distribution were analyzed for metastatic and nonmetastatic lymph nodes. Signal intensity (SI) was measured on DWI images and apparent diffusion coefficient (ADC) was calculated for each lymph node. The SI of lymph nodes (SILN） and liver (SIliver) were also measured and the ratio of SI was calculated. The ADC and the ratio of SI were compared between metastatic and nonmetastatic lymph nodes. ResultsThere were fifty-nine groups of lymph nodes in 37 patients with hilar cholangiocarcinoma, fifty-one groups were revealed in both DWI and 3D-VIBE sequences, and eight groups were only demonstrated in one sequence (P=0.070). The short diameters were (1.05±0.42) cm and (0.78±0.22) cm on 3D-VIBE images for metastatic and nonmetastatic lymph nodes, respectively (P=0.030). The ADC value in metastatic lymph nodes was (1.64±0.3)×10-3 mm2/s, which was significantly lower than that in nonmetastatic lymph nodes 〔(2.28±0.79)×10-3 mm2/s〕 on DWI images (P=0.033). There were no significant differences in SILN/SIliver between metastatic and nonmetastatic lymph nodes on images of portal venous phase and 3 min delayed contrast-enhanced phase. ConclusionsDifferences of ADC and short diameter can provide valuable information to differentiate metastatic lymph nodes with nonmetastatic lymph nodes. When combined with 3D-VIBE sequence, DWI is more effective in evaluating metastatic lymph nodes secondary to hilar cholangiocarcinoma.