Objective To investigate indications of video-assisted thoracoscopic surgery in the treatment of esophageal carcinoma.Methods Video-assisted thoracoscopic surgery was performed in 11 patients with esophageal carcinorma from January 2005 to November 2005.The tumors were located at the upper segment in 2 patients,middle segment in 8 patients,and lower segment in 1 patient.The TNM staging results showed T_1N_0M_0 in 1 patient,T_2N_0M_0 in 2 patients,T_2N_1M_0 in 1 patient,and T_3N_0M_0 in 7 patients.Under thoracoscopy via thoracic and cervical incisions,the esophagus and tumor were disconnected and the intrathoracic lymph nodes were cleared through the right thorax.Then a median incision was made at the epigastrium.Through the incision the stomach was disconnected and intraabdominal lymph nodes were removed.Afterwards,esophagectomy and gastroesophagostomy were performed by way of the cervical incision.Results The operation time was 220~300 min(mean,265 min).The operative blood loss was 150~400 ml(mean,240 ml).The number of removed lymph nodes was 4~10(mean,6.4).The drainage tube was taken out at 2~3 days after operation,with a drainage volume of 200~500 ml(mean,350 ml).One patient developed a temporary left recurrent laryngeal nerve palsy that disappeared at 3 months after operation.Follow-up checkups for 4~15 months(mean,8 months) in the 11 patients showed no recurrence or metastasis of tumor.Conclusions Video-assisted thoracoscopic surgery can be adopted in patients with esophageal carcinoma at stage Ⅰ or Ⅱ,

Objective To explore the change of the red blood cell(RBC) immunoadhensive function in children with asthma and the effect of glucocorticoid on RBC immunoadhensive function.Methods The rosette rate of RBC-C3b receptor(RBC-C3bRR) and rosette rate of RBC-Immunocomplex(RBC-ICR) were measured by using yeast rosette method in 42 children with asthma,20 healthy children(control group),and 28 asthmatic children in remission period were measured also by the same methods after one month and six months of glucocorticoid inhalation therapy.Results The levels of RBC-C3bRR were lower in asthma group than that in remission group and control group(P0 05).Conclusions RBC immunoadhensive function has shown significant decrease in asthmatic children;and it may be improved by using glucocorticoid inhalation therapy in asthmatic children at remission period.

Objective To study the effect of cisplatin on the hepatocellular carcinoma HepG2 cells by Atomic Force Microscopy (AFM), then analysis the changes of ultrastructural in HepG2 cells during apoptosis induced by cisplatin at nanoscale level. Methods HepG2 cells were treated with cisplatin for 24h and 48h. The ultrastructural change of cell surface was detected by AFM , the inhibitory rate and apoptotic rate of cell were examined by MTT and fow cytometry. Results AFM images showed that with the prolongation of cisplatin-inducing, the deformation change of HepG2 cells varying degree. The cells appeared larger pore size of cell membrane, the value of cell membrane particle sizes, Rp-v, Ra, Rq and Meant Ht were significant increased. The inhibitory rate and apoptotic rate were significant increased. Conclusions Cisplatin induced shrinkage in cell morphology, pore formation and roughness increasing in cell membrane, thereby inducing apoptosis in HepG2 cells.

Objective To assess the impact factors of surgical site infection(SSI) in the department of general surgery,the improve the quality of the target of monitoring,provide clinical theoretical basis for reducing the incidence of SSI.Methods In 2015,920 patients who underwent general surgery was took in the targeted monitoring of SSI.SPSS19.0 software was used to analyzing the data.Results The infection rate was 4.35％;Surgical site infection rate was rising,with the increase of NNIS.17 pathogens were isolated,including 11 Escherichia colis which was the most.The incidence of the SSI was 2.40％ between two groups in the patients who underwent the elective surgeries 10.85％,in the patients who underwent emergency surgery.there was significant difference between two groups(x2 =27.997,P＜0.05).The type Ⅱ surgical incision was smain type in the department of general surgery,the incidence of the typeⅡ surgical incision was 2.27％,the incidence of the typeⅢ surgical incision was 21.90％,no SSI occurred in the type Ⅰ surgical incision;SSI incidence of surgery time which was more than 3 h was 7.27％,less than 3 h was 3.71 ％,there was significant difference between two groups(x2 =4.136,P＜0.05);the SSI incidence of the incision length ≥10 cm was 13.11 ％,less than 10 cm was 1.82％,the difference was statistically significant (x2=48.966,P＜0.05).Conclusion NNIS score,wound type,type of surgery,duration of surgery may become the risk factors SSI.

Objective· To investigate the prospective value of early postoperative PI-APD in children with hydronephrosis.Methods· Data of children with hydronephrosis who underwent pyeloplasty in Xinhua Hospital,Shanghai Jiao Tong University School of Medicine between Jan 2012 to Nov 2015 was collected.PI-APD was divided into 3 categories (≤ 19％,19％＜PI-APD＜40％ and ≥ 40％).The relationship between PI-APD value and the degree of renal function (DRF) and dilation recovery after surgery was analyzed.Results· There were 360 children with hydronephrosis.The median follow-up was 20 months.The PI-APD value (3 months after pyeloplasty) was positively correlated with the degree of DRF recovery (r=0.631,P=0.000).Five patients received redo-pyeloplasty.PI-APD of all these patients was ＜19％.Conclusion· PI-APD is a new feasible ultrasound parameter in pyeloplasty followup.PI-APD ≥ 40％ at the first post-operative visit predicts pyeloplasty success.PI-APD ≤ 19％ indicates close follow-up after operation.PI-APD can also help select children at high risk for repeat intervention after pyeloplasty.

In recent years, public hospitals have been facing pressure from the reform of medical insurance payment methods. It is urgent to strengthen the operation and management of public hospitals. In June 2022, a tertiary public hospital utilized hospital intelligent agents to carry out refined cost management practices for medical service charging projects, sorted out medical service charging projects, designed management paths, and calculated project costs. The hospital conducted refined management on the cost of medical service charging items from three control dimensions of project unit cost with manpower, equipment and consumables, and two comparative directions with horizontal and vertical. The refined cost management practice not only pointted out the direction for global refinement cost control within the hospital, but also reduced the proportion of hospital consumption, which provided reference for improving the level of refined operation and management of public hospital hospitals.

Objective:To analyze the cost of diagnosis-intervention packet(DIP) in a certain hospital in 2021 based on hospital intelligent agents, so as to provide feasible ideas for refined management of DIP costs.Methods:On the basis of the construction of the hospital intelligent agent platform and the results of project cost accounting in the early stage, a total of 60 187 cases and 4 860 DIP diseases in the hospital in 2021 were selected as the research objects. The project superposition method was applied to calculate the unit cost of all DIP diseases in the hospital. Based on the results of DIP cost accounting, the ideas and methods of fine management of DIP costs were explored from the perspectives of DIP disease classification, management of all hospital diseases and medical insurance diseases, vertical and horizontal comparative analysis of DIP costs, and management of medical insurance cases and non medical insurance cases under the same DIP disease category.Results:Twenty-two advantageous DIP disease types, 67 key disease types, 1 590 potential disease types, and 3 181 disadvantageous disease types were identified. Introducing medical income as an intermediate indicator facilitated the classification of DIP disease types under medical insurance, 1 072 advantageous disease types, 917 key disease types, 458 potential disease types, and 815 disadvantageous disease types in medical insurance were identified. Through refined accounting, it was found that the average cost of non medical insurance cases under the same DIP disease category was generally higher than that of medical insurance cases, and there were differences in DIP costs at different levels during different time periods.Conclusions:By determining and analyzing the advantages and disadvantages of disease types in the entire hospital, common problems of disease types under the same category can be identified, and targeted control measures can be proposed. By analyzing the two dimensions of medical insurance surplus and medical surplus, the advantages and disadvantages of medical insurance diseases can be quickly determined, providing a lever for the control of medical insurance diseases. The horizontal and vertical comparative analysis of DIP costs, as well as the analysis of medical insurance cases and non medical insurance cases under the same DIP disease category, can provide feasible methods for hospitals to manage DIP costs at multiple levels and dimensions.

BACKGROUND:Bibliometrics and visual analyses based on thematic literature are particularly important for understanding the foundation and frontiers of postmenopausal osteoporosis research. OBJECTIVE:To perform bibliometric,citation,and visualization analyses of highly cited SCI papers in postmenopausal osteoporosis research over the last 20 years. METHODS:The top 100 highly cited papers on postmenopausal osteoporosis published between 2003 and 2022 included in SCI-EXPANDED catalog of the Web of Science database were obtained for bibliometric measure and visual analysis using CiteSpace software. RESULTS AND CONCLUSION:The top 100 highly cited papers have a total of 67 377 citations in the Web of Science Core Collection,with an annual average of 49.17 citations per paper.Postmenopausal osteoporosis research primarily involves medical,engineering,biological,and multidisciplinary fields.The subcategories are dominated by endocrinology and metabolism,and medicine:internal medicine.Stable and close cooperative network relationships have been formed globally.United States,University of California System,Cummings,and Steven R are the country,research institution,and author,respectively,with the most highly-cited publications.The frontiers of postmenopausal osteoporosis research mainly include calcium and vitamin D supplementation and fracture risk,clinical studies of bisphosphonates in the treatment of postmenopausal osteoporosis,atypical femur fracture,clinical studies of new drugs and sequential treatment of postmenopausal osteoporosis,predictors of fracture risk,mid-and long-term follow-up of osteoporotic vertebral compression fractures,genetic polymorphisms and hereditary factors,formulation and updating of clinical practice guidelines for postmenopausal osteoporosis.Large cohort studies,high-quality randomized controlled trials,systematic reviews,meta-analyses,and clinical practice guidelines are the great engines that drive the development of clinical research in postmenopausal osteoporosis.We should make efforts in the above areas to improve China's international influence in the field of osteoporosis.

Objective To analyze the etiological characteristics of human Brucella strains isolated, and to improve the precision in control and prevention of brucellosis. Methods In 2016, blood samples were collected from patients in Jingyuan County Gansu Province, and tested via the Rose-Bengal Plate Agglutination Test (RBPT) and the tube agglutination test methods,and serological positive blood samples were inoculated to bidirectional blood culture bottle for culturing, and further identified by traditional biological classification method and the Brucella abortus, Brucella melitensis, Brucella ovis, and Brucella suis species-specific PCR (AMOS-PCR). Multiple-locus variable number tandem repeat sequence analysis (MLVA) -16 was used to detect molecular typing and do cluster analysis. Results The isolated strain was identified by the traditional biological classification method, bacteria could grow in thionine and reddened dye, A and M factors agglutination tests were positive, Bk2phage treatment of bacterial strain cracking, but Tb, Wb phages were not cracked. AMOS-PCR amplification result showed a 731 bp band, which was a strain of Brucella melitensis. The results of MLVA-16 showed that there was a difference in the number of repeats on some Variaable Number of Tandem Repeat(VNTR)sites of the isolated strain. Clustering analysis showed that, the isolated strain was clusted into the same clade with the clustering of Brucella melitensis type 3 from GS-201605 in Gansu. And the clustering was similar compared with that of Zhejiang, Guangdong, Fujian and Yunnan. Conclusion Human brucellosis is a inputting transmission in Gansu Province, there is a genetic variation of genotype 3 sheep Brucella between Gansu Province and other domestic provinces.

Objective: To investigate the effect of LncRNA OIP5-AS1 on radiosensitivity of non-small cell lung cancer (NSCLC) cells and its mechanism. Methods: The radiation-resistant cell A549R was established by using A549 cells irradiated by X-ray 6Gy in 5 fractions. The expression levels of OIP5-AS1 and miR-34c-5p in A549 and A549R cells were detected by qRT-PCR. OIP5-AS1 inhibitor or miR-34c-5p mimetic was transfected into A549R cells, or OIP5-AS1 overexpression plasmid was transfected into A549 cells. Cell apoptosis was detected by flow cytometry. Cell radiosensitivity was analyzed by colony formation assay. The expression levels of p-Chk2 and p-ATM proteins were measured by Western blot. Dual luciferase assay was adopted to verify the relationship between OIP5-AS1 and miR-34c-5p. Results: Compared with A549 cells, the expression of OIP5-AS1 was significantly up-regulated in A549R cells (1.97±0.11 vs.1.01±0.05, P<0.05), whereas the expression of miR-34c-5p was remarkably down-regulated (0.43±0.02 vs.1.02±0.06, P<0.05). The expression levels of p-Chk2 and p-ATM proteins in A549R cells in the silencing OIP5-AS1+ 6Gy group were significantly lower (0.43±0.03 vs.1.39±0.15, 0.51±0.0 5 vs.1.21± 0.11, both P<0.05), whereas the apoptotic rate was significantly higher than those in the silencing control+ 6Gy group [(13.29±1.25)% vs. (28.47±2.31)%, P<0.05)]. The expression levels of p-Chk2 and p-ATM proteins in A549 cells in overexpressing OIP5-AS1+ 6Gy group were significantly higher than those in overexpression control+ 6Gy group (1.23±0.13 vs.0.75±0.06, 1.08±0.11 vs.0.59±0.04, both P<0.05). Inhibiting miR-34c-5p expression reversed the effect of silencing OIP5-AS1 on survival fraction of A549R cells (SER=1.42). OIP5-AS1 negatively regulated the expression of miR-34c-5p. Conclusion Silencing OIP5-AS1 enhances the radiosensitivity of radiation-resistant A549 cells by up-regulating the expression of miR-34c-5p, providing a potential target for radiotherapy of NSCLC cells.