The necessity to carry out student-oriented teaching of Medical information retrieval and use course in medical postgraduate was analyzed according to its theory followed by an elaboration on its module setting, course management methods, course examination forms and teachers.

Objective To discuss the feasibility of laparoscopic renal surgery following kidney rupture.Methods Two patients with left kidney rupture were treated laparoscopiclly at our institution in the last 4 years. 1 operated 7 days after hemorrhage and another operated immediately. Both of them performed retroperitoneal laparoscopic nephrectomy. Results The operations succeeded, the operating time being 100～120 min, the blood loss 200～300 mL. There were no postoperative complications in all cases. Conclusion Laparuscopic exploration and extirpation offer a viable measure to treat kidney rupture.

Objective To calculate workload according to working day and holiday separately.Methods Functions of SQL in Oracle were used to separate working day and holiday.Results The method could accomplish holiday's workload statistics expediently.Conclusions Statistics of holiday's workload are becoming ordinary work,so the separated analysis for them has practical value.

OBJECTIVE To investigate the present situation of the nosocomial infection in our hospital in order to decrease the infection rate. METHODS A total of 40 554 patients were inspected from Oct 2004 to Sept 2005.There were 626 patients with nosocomial infection. RESULTS The nosocomial infection was 1.54%.Old patients were the main components.The longer they were in hosptial,the more risk of infection they had.Elder monitoring department and hematological department were the most common infected units.Respiratory tract was the most common infected site of the body.The entity of disease for the most infection was malignant tumor.Invasive treatment was one of the causes for the infection. CONCLUSIONS The infection rate of our hospital was relatively low.We should establish the system to control the infection.Use the advanced statistical software well be to aid the control and discover the anti-infection deficiency from the statistical view-point.

OBJECTIVE To summarize the infection cases and the factors causing site infection after operations,and investigate the measures to prevent and reduce exogenous incision infection.METHODS Discharged patients from Jan 1st,2003 to May 31st,2006 in our hospital were investigated for retrospective analysis on incision infection cases.RESULTS Totally 111 incision infection cases were reported from 54 286 cases.The nosocomial infection rate in this cohort was 0.21%(111/54 286),which was 33.44% of total surgical incision infection cases.CONCLUSIONS Incision infection is one of the most commonly encountered concomitant symptoms,it is as well the bottleneck for our hospital to reduce average stay length of surgical patients and patients′ hospitalization expenses,and to speed up turnover of beds.Incision infection rate is also an important criterion to evaluate the management quality and medical technology quality within and among hospitals.Effective measures should be taken to decrease incision infection rate and to resolve the problem that is difficult to hospitalize and expensive to treat.

BACKGROUND: von Willebrand factor (vWF) is only released from endothelial cells and platelets and is an in vivo and in vitro marker of endothelial injury in septic patients with acute lung injury (ALI). Interleukin-8 (IL-8), as a proinflammatory mediator causing recruitment of inflammatory cells, induces an increase in oxidant stress mediators and makes it as a key parameter for localized inflammation. However, it has not been well established whether the level of serum IL-8 is associated with the severity of lung injury and whether it is a prognosis marker for severe lung contusion. This study was to investigate the expression of plasma vWF and IL-8 and their association with the severity and outcomes of severe pulmonary contusion. METHODS: A total of 63 patients were divided into a severe pulmonary contusion with acute respiratory distress syndrome (ARDS) group and a non-ARDS group, or a survivor group and a non-survivor group, or an injury severity score (ISS) <20 group and an ISS ≥20 group. Another 20 healthy volunteers served as controls. The levels of plasma vWF and serum IL-8 were measured by enzyme-linked immunosorbent assay (ELISA) at 1, 3, 5 and 7 days after injury. The expression patterns of the plasma vWF and serum IL-8 were compared between different groups. RESULTS: The concentrations of plasma vWF and serum IL-8 were significantly increased in all severe pulmonary contusion patients at all time points in comparison with the control group. The concentrations of plasma vWF in patients with ARDS increased during the whole study period, but vWF in patients with non-ARDS increased gradually until day 5 and then decreased at day 7. The concentration of serum IL-8 showed a similar expression pattern in both groups, but the expression increased more significantly in the ARDS group than in the non-ARDS group. Interestingly, both plasma vWF and serum IL-8 levels steadily increased in the non-survivor group. Furthermore, the level of plasma vWF was higher in the ISS≥20 group than in the ISS<20 group. The level of serum IL-8 in the ISS≥20 group was consistently high, while that in the ISS<20 group peaked at day 3 and decreased at day 5. In addition, the level of plasma vWF was positively correlated with platelet count, but negatively correlated with oxygen index. The level of serum IL-8 was positively correlated with white blood cell count and ISS score, and inversely correlated with oxygen index. CONCLUSION: The elevated levels of plasma vWF and serum IL-8 in severe pulmonary contusion patients reflect the severity of pulmonary injury and patients outcomes, suggesting that the plasma vWF and serum IL-8 are sensitive markers for clinical evaluation of the severity of pulmonary injury and predication of patient prognosis.

OBJECTIVETo investigate the relationship between the second to the fourth digit ratio (2D:4D) and body mass index (BMI) in infertile men of the Han ethnic group in Ningxia.

METHODSUsing anthropometry, we calculated the mean ratio of 2D:4D and BMI of 197 infertile men and 148 normal healthy male controls, followed by analysis of their relationship.

RESULTSThe BMI was correlated positively with the 2D:4D ratio of the left hand in the infertile men (P < 0.05) and in the patients with a higher 2D:4D ratio of the left hand (P < 0.05), but negatively with the 2D:4D ratio of the righ/left (Dr-1) (left: P < 0.01; Dr-l: P < 0.05). The mean 2D: 4D ratio and BMI were both lower in the normal control than in the infertile men, with statistically significant differences in BMI (P < 0.05) and the 2D:4D ratio of the left hand (P < 0.05).

CONCLUSIONThere is a correlation between the 2D:4D ratio and BMI in infertile men.

Objective: To analyze the epidemiological characteristics of notifiable infectious diseases reported in Zhejiang Province in 2020 for prevention and control. Methods: Data of notifiable infectious diseases reported in Zhejiang Province in 2020 were extracted from China Information System for Disease Control and Prevention. The incidence and death of notifiable infectious diseases were analyzed and compared with the averages from 2015 to 2019; then the characteristics of some key diseases such as coronavirus disease 2019 ( COVID-19 ), influenza and other infectious diarrhea were summarized. Results: Totally 487 271 cases of 30 kinds of infectious diseases were reported. The incidence and mortality rate was 832.94/100 000 and 0.615 4/100 000, which were 7.05% and 14.60% lower than the average value of 2015-2019.The weekly morbidity of Class A and Class B infectious diseases fluctuated between 1.24/100 000 and 3.68/100 000, and hit the bottom in the sixth to eighth week. The morbidity of Class C infectious diseases was 154.19/100 000 in the first week, then dropped to 4.83/100 000 in the second to sixth week and maintained at a low level. High morbidity of infectious diseases were reported in Hangzhou ( 1 412.62/100 000 ), Jinhua ( 960.35/100 000 ) and Ningbo ( 921.25/100 000 ). The morbidity of class C infectious diseases in Hangzhou was 1 248.80/100 000, which was far higher than that of other ten prefecture-level cities. The diseases with high reported morbidity were influenza (438.45/100 000), other infectious diarrhea (140.29/100 000 ), hand-foot-and-mouth disease ( 99.64/100 000 ), pulmonary tuberculosis ( 41.92/100 000 ), syphilis (41.37/100 000) and viral hepatitis ( 30.48/100 000 ). More deaths were reported in AIDS and pulmonary tuberculosis, and the mortality were 0.482 1/100 000 and 0.116 2/100 000. A total of 1 306 confirmed cases, 302 asymptomatic infections and 1 death of COVID-19 were reported. Conclusion In 2020, the incidence rate of notifiable infectious diseases in Zhejiang decreased compared with the average value of 2015-2019. Pulmonary tuberculosis, syphilis and hepatitis B still have high morbidity, and the COVID-19 epidemic spread widely. The morbidity of some respiratory infectious diseases and imported infectious diseases have dropped significantly compared with previous years.

Objective:To summarize the clinical characteristics and surgical treatment experience of pregnant women with acute Stanford type A aortic dissection.Methods:From January 2005 to December 2018, a total of 12 patients with acute Stanford type A aortic dissection were treated in Zhongshan Hospital affiliated to Fudan University. Two patients died of sudden aortic dissection rupture during emergency CTA examination. The other 10 patients underwent surgical treatment, the age was 22-40 years[mean(30.7±5.8) years], the pregnancy was 15-39 weeks[mean(28.8±6.5) weeks], two cases in the second trimester of pregnancy, seven cases in the third trimester of pregnancy and one case in puerperium. Among them, seven cases were Marfan syndrome, one case was bicuspid aortic valve malformation, two cases were complicated with pregnancy hypertension.Results:One case died during perioperative period and died of rupture of abdominal aortic dissection in twelfth day after operation. One fetus was diagnosed as stillborn before operation. Before December 2013, six patients underwent surgeries, the mean cardiopulmonary bypass time was(96.8±16.5)min, aortic occlusion time was(70.8±19.3)min, intensive care unit time was(3.4±2.3) days, ventilator-assisted mechanical ventilation time was(21.6±15.6)h. After January 2014, four patients underwent surgeries, the mean cardiopulmonary bypass time was(202.3±6.4)min, the aortic cross-blocking time was(137.5±10.3)min, circulatory arrest time was(27.3±8.8)min, intensive care unit time was(12.0±5.7) days, and the ventilator-assisted mechanical ventilation time was(40.3±24.4)h. The postoperative complications included tracheotomy in two cases, hemodialysis in one case, poor wound healing in one case. One patient who had been treated with Bentall was followed up to sixth year and died of progressive rupture of descending arch dissection. One patient was followed up to seventh year after Bentall surgery, redo Bentall and Sun’s procedure were performed because of artificial valve infection, and was discharged uneventful. No adverse cardiovascular events occurred in other patients.Conclusion:Surgical treatment should be actively considered in pregnancy complicated with acute Stanford type A aortic dissection. Multi-disciplinary team cooperation can effectively improve the safety and effect of operation.

OBJECTIVE To study the methods and curative effects of reconstruction of oropharyngeal defects after resection of tonsillar cancer. METHODS Nineteen patients with tonsillar cancer underwent operation. The choice of surgical procedure was decided on the size of the lesions. The tumor was resected through the hyoid approach and mandibular swing approach. Surgical defects were repaired immediately with tongue flap, temporalis myofascial flap, pectoralis major myocutaneous flap. RESULTS The functions of respiration, chewing, deglutition, and speech were restored satisfied in all patients. Partial necrosis of the pectoralis major myocutaneous flap occurred in one patient, and mild difficulty of open mouth in 3 patients after repaired with temporalis myofascial flap. CONCLUSION Choosing what is optimum from multiple feasible surgical methods is prerequisite for better oropharyngeal function and quality of life in patients with tonsillar cancer.