OBJECTIVE To understand the situation of hand hygiene in our hospital to explore effective measures for implementation.METHODS 258 medical personnel,were investigated for the hand-washing,before and after the implementation of the hands of our health system to compare the nosocomial infection rate.RESULTS The low rate 35.02%~49.42% of medical personnel washed their hands before the normal operation in and out the Ⅱ area.Hand-washing compliance rate was only 54.17%;and after the implementation of our health system in hand,nosocomial infection rate decreased 30%.CONCLUSIONS Washing hands is important to prevent nosocomial infection,Medical personnel generally do not have a strong sense and we should start and strengthen the supervision and improve the supporting facilities to ensure the compliance of medical staff.

Objective:To explore the counselor verbal response modes of psychic hot-line counseling and its characteristics.Methods:Through a qualitative study with category analysis method,8 pieces of audio recordings were collected,in each of which the entire duration was between 30 minutes to 50 minutes.And all of these record-ings were transcribed word by word.Meaningful 1202 pieces were deeply analyzed.Results:There were 5 core counselor verbal response types in hot-line counseling,greeting response,set-up response,listening response,follow-up response,and affecting response,all of which had 24 concept categories.All of the online counselors used the 5 types of verbal response.The listening response and follow-up response were the highest frequent types.Greeting response and set-up response were used mostly in the initial stage of counseling.Listening response,and follow-up response were used mostly in the stage of describing problem.Affecting response was sharply increased in the stage of analyzing problem.Greeting response and set-up response were used mostly in last stage of counseling.Conclu-sion:It suggests that there are 5 core counselor verbal response types and 24 concept categories in hot-line counse-ling.The listening response and follow-up response are the highest frequent types.Different types of verbal re-sponse modes used by counselor in different stages due to different intention.

To explore and identify the therapeutic components of traditional Chinese medicine (TCM) as a complex intervention through grounded theory, and the correlation and interaction within this model and the possible effects that they may have on the therapeutic effects of TCM.

Clinical trials play a critical role in medical research. However, only a few clinical trials conducted at present have been registered at various clinical trial registries. Clinical trial registration can prevent bias in these registered trials effectively and avoid unnecessary waste of resources due to meaningless repeats. Moreover, it will benefit the development of evidence-based medicine, and promote human welfare. Great attention has been paid to the importance and necessity of clinical trial registration. This review briefly introduced the definition, justification, contents, history, current status of clinical trial registration, and introduced the information regarding important international clinical trial registries in detail. Clinical trial registration should be developed toward a transparent, compulsory and comprehensive stage.

Objective To optimize the extracting process for Weiningsu Capsule.Methods With dry extract rate and naringin content as the inspection indicators,orthogonal test was used to investigate the influence of four extracting factors (water volume,extracting time,times of extracting and soak time of herbal) on the extracting process.Results The optimum extracting process was A3B2C2D3,i.e.the water volume being 10 times of the weight of medicinal material,extraction for two times and 1.5 hours each time,and soaking for 1.5 hours.Conclusion Optimization of extracting process for Weiningsu Capsule by orthogonal test is a simple,quick and accurate method.

Objective To compare the current therapeutic effects between endovenous radiofrequency treatment and conventional surgery for lower limb chronic venous insufficiency (CVI) ,and summarize operative skills and clinical value of endovenous radiofreq uency treatment on CVI .Methods Data of 45 limbs of 41 patients treated by endovenous radiofrequency treatment (endovenous ra-diofrequencytreatmentgroup)and20limbsof20patientsbytraditionalsurgery(traditionalsurgerygroup)wereanalyzedandcom-pared in terms of operation time ,postoperative pain ,postoperative hospitalized duration ,complications ,and one-year recurrence rate .Results Endovenous radiofrequency treatment group had less postoperative pain and shorter postoperarive hospitalized dura-tion than traditional surgery group(P<0 .05) .The operation time had no significant differences between two groups (P>0 .05) . The two groups had few complications and had no recurrence in one year .Conclusion As a minimally invasive treatment for vari-cose veins ,endovenous radiofrequency treatment has less trauma ,rapid recovery ,safe and effective ,and it is worthy to be recommen-ded .

BACKGROUND: There have been some prospective, randomized, controlled studies regarding the feasibility and safety of laparoscopic gastrectomy for gastric cancer, but controversy exists.OBJECTIVE: To systemically assess the feasibility and safety of laparoscopic gastrectomy for gastric cancer.METHODS: A computer-based online research of prospective, randomized, controlled studies addressing laparoscopic gastrectomy versus open gastrectomy published between January 1994 and December 2009 was performed in PubMed, Ovid Medline, Web of Knowledge, EMbase, Chinese Journal Full-text Database and Wanfang Database. Meta analysis of acquired data was performed through the use of RevMan 5.0 software. The inverse variance method was used to test the significance of continous data, while the Mantel-Haenszel method was used for dichotomous data. The chi-square test was used for evaluation of data heterogeneity. Homogenous data was calculated using the fixed effect model, and heterogeneous data was calculated using freedom model. Statistical data was expressed as 95% confidence interval. Funnel plot was used for sensitivity analysis to show potential publication bias.RESULTS AND CONCLUSION: Five papers that corresponded to inclusion criteria were included in this study. Among 326 cases included, 164 underwent laparoscopic gastrectomy and 162 received open gastrectomy. Meta analysis revealed that laparoscopic gastrectomy took longer operating time and removed fewer lymph nodes than open gastrectomy (both P ＜ 0.01), but for early-stage gastric cancer, laparoscopic gastrectomy was superior to open gastrectomy in terms of blood loss and hospital stay (P ＜ 0.01). But there was no significant difference in terms of time to resumption of oral intake, postoperative complications,postoperative morbidity rate, and tumor recurrence. Sensitive analysis demonstrated that publication bias existed in all indices to different extents with the exception of lymph node. The five papers adopted two different modes to remove lymph nodes, so subgroup analysis was also used. Results showed that for D1 lymph node dissection, laparoscopic gastrectomy took significantly reduced blood loss than open gastrectomy. All these findings indicate that laparoscopic gastrectomy for early stage gastric cancer is feasible and safe.

The article analyzed the system architecture design of the Shanghai municipal hospital clinical information sharing project, aiming to provide reference for system design of a regional medical information sharing system. This project is composed of the following: A universal medical card,hospital's internal information system, an inter-hospital network, a clinical information exchange and sharing platform, a data center, a decision support system and a public service portal. Key issues involved in the system design include the personal identity, the establishment of standards and specifications, the information sharing model, the information storage model, systems related to hospitals and personal privacy protection.

Objective To analysis the application value and the existing problems of sentinel lymph node biopsy in breast cancer surgery.Methods Pathological findings were retrospectively analysised in 100 female cases of breast cancer,who were diagnosed with early breast cancer and used blue dye in sentinel lymph node biopsy.Results Among 100 cases,92 cases were found SLNS,that the detected rate was 92％.Detected 217 sentinel lymph node,every case has 1 to 6 node,with the average of 2.4.Nintg-two cases were performed ALND.Among them,the SLNS negative detected 58 cases of ALN feminine,SLNS negative ALN detected positive 4 cases,30 cases of SLNS positive ALN positive detected.All of the patients did not appear allergic reaction.SLNB false positive rate of O,the false negative rate was 11.8％,sensitivity 88.3％,specific degree of 100％,the diagnostic coincidence rate was 95.7％.Conclusions Compared with the conventional axillary lymph node dissection,the sentinel lymph node biopsy has obvious advantages in early breast cancer surgery.For the cases of sentinel lymph node negative,there was no necessary to do the axillary lymph node dissection.

The earliest and the most common metastasis of hepatocellular carcinoma (HCC) occur in the intrahepatic portal venous system, which indicates its worst prognosis. In 28 HCC patients with intraportal tumor thrombus, we employed 2 procedures, ie. the transcatheter hepatic arterial embolization(THAE), transcatheter superior mesenteric or splenic arterial infusion (TSAI) and portal vein embolization (PVE) in 12 cases, and THAE alone in 16 cases. In the former group, tumor size reduced more than 50% in 8 cases (partial remission PR), in particular tumor thrombus disappeared in 3 and decreased in size in 8; whereas in the latter group, PR was achieved in 3 only, without change size of the intraportal tumor thrombus in all 16 cases (P