Objective To know the effects of electronic medical records(EMR) on the training quality of intern doctors' history-collecting and medical-records writing.Methods 195 students from Nantong University,Suzhou University and Xuzhou medical college were chosen as the subjects.For better effects,we divided the 195 students into two groups,81 students of Grade 2007 as the control group(hand-written medical record group) and 114 students of Grade 2008 as study group (electronic medical record group).The control group was arranged to complete EMR by transcribing the teacher's handwriting records into formal medical records after teachers' guidance and modification while the study group was arranged to write and directly modify the records on computer under the guidance of teachers and submit them for formal records.After the teaching,the medical record writing quality of two groups of interns was conducted centralized assessment to analyze the advantages and disadvantages of electronic medical records on the training of interns' collection and writing ability.SPSS 18.0 was used for statistical analysis,with count data using the number(percentage) and measurement data using mean +/-standard deviation.Measurement data of two groups of medical record writing scores were compared with t test,test level for α=0.05.Results The result of handwritten group was significantly better than EMR group(t=6.33,P＜0.001),which indicated training effectiveness of intern doctors' ability of writing medical record had digressive tendency on EMR group.Conclusion Negative effects of EMR are shown in intern doctors' history-collecting and medical-records writing.Cultivation quality of intern doctors' history-collecting and medical-records writing should be ensured by the combination of EMR and handwriting-medical training,the combination of daily inspection and key examination of medical record writing quality and establishment of feedback-rectification mechanism.

Objective:To establish a method for the determination of jasminoidin and paeoniflorin in Qiyitang Granules.Methods:The analytical column was a Agilent Eclipse XDB-C18 column(4.5?150mm,5?m).The mobile phase consisted of acetonitrile-0.1%H3PO4(12:88,V/V),flow rate was 1.0ml/min.The detection wavelength was 230 nm.Rusults:Jasminoidin and paeoniflorin were separated utterly and the linear correlation was good. The average recoveries of high,middle and low concentration of jasminoidin were 106.2%,97.5% and 98.1% respectively with RSD of 0.96%,1.23% and 1.62%(n=3)respectively.The average recoveries from paeoniflorin were 101.3%,99.5% and 98.2% respectively with RSD being 1.19%,1.33% and 1.58%(n=3),respectively. Conclusions:The method is simple,reproducible,accurate and reliable.It may be used for the quality control of this granules.

In this paper , the author analyzed the network media with three main characteristics of negative re-ports about doctor -patient dispute , from four aspects explains the network media in building a harmonious doctor-patient relationship in ethics responsibility: public opinion guide , social responsibility , self-discipline to bear the ethical responsibility and abide by relevant laws and regulations , accept the heteronomy , points out that the net-work media should strengthen self -discipline and self -reflection are scientific and objective , guide the netizens rational appeal , to assume the social ethical responsibility of building a harmonious doctor -patient relationship .

Objective To compare the clinical results of the intramedullary nails (Gamma nail and the proximal femoral nail) in treatment of intertrochanteric fractures of femur. Methods A review study was conducted on 116 intertrochanteric fractures of femur treated with the Gamma nail and 89 treated with PFN in our hospital between 2000 and 2003. Results In the Gamma nail group, the mean time for operation was 68.3(48 to 106)minutes,the mean blood loss during operation was 261(180 to 400)mL,the mean time for walking after operation was 5.0 (2.3 to 8.9)weeks and the mean time for bone union was 8.6(7.1 to 12.6)weeks. In the PFN group, the mean time for operation was 48.0(36 to 85)minutes, the mean blood loss during operation was 192(120 to 360)mL,the mean time for walking after operation was 5.3(2.5 to 8.1)weeks and the mean time for bone union was 8.8(6.9 to 12.1)weeks. There were significant differences in the mean time for operation and the mean blood loss between the 2 groups(P

Objective To explore the clinical effiicacy and effect on cytokines of invigorating the kidney and activating blood fomula on treating osteoarthritis patients in the pattern of kidney deficiency. Methods 113 patients with knee osteoarthritis were randomly divided into two groups including 56 cases of treatment group and 57 cases of control group, which were treated by invigorating the kidney and activating blood fomula and combinaton of Celecoxib and Glucosamine respectively. The clinical effiicacy of two groups were investigated by Womac osteoarthritis index and the average severity of OA index. The changes of serum inflammatory cytokines TNF-? and IL-6 were detected by ELISA. Results The total efficiency of the treatment group was 89.3% and better than the control group (P 0.05) compared with control group. The serum TNF-?, IL-6 levels of treatment group significantly decreased after treatment in treatment group (P

0.05). Conclusions Radical TUVBT can be selected as surgical treatment for muscle-invasive bladder cancer cases,especially for those who are older and weak,and not medically fit for radical cystectomy or those who refuse the open surgery.

Objective To investigate the expressions of the CD13 in gastric cancer and the relationships between it and the patients' prognosis.Methods The expressions of CD13 were detected by immunohistochemical (SP method) in 104 cases of gastric cancer and 16 cases of normal gastric mucosa.Results The expressions of CD13 in 104 cases of gastric carcinoma and 16 cases of normal gastric mucosa show positive rate were 74％ (77/104) and 0％,respectively.The expressions of CD13 in gastric cancer were higher than in normal gastric mucosa and the difference was statistically significant (P ＜ 0.01).The expressions of CD13 in gastric cancer were not relative to patients' age,gender,and lymph node metastasis (P ＞ 0.05),but to be correlative with tumor sizes,clinical stage,degree of differentiation,and patients' 5-year survival rate (P ＜ 0.05).Conclusions The abnormal expression of CD13 in the gastric cancer may be correlative with the occurrence and development of gastric cancer,which can be an important indicator to evaluate the degree of malignance,guide treatment and assess uncertain prognosis of gastric cancer.

Objective To investigate the risk factors for recurrence after surgery for biliary pancreatitis.Methods A total of 284 patients with biliary pancreatitis who were treated in The Fourth Hospital of PLA from January 2008 to December 2014 were followed up,and the risk factors for postoperative recurrence were analyzed.The chi-square test was used for categorical data,and the unconditional logistic regression model was used for multivariate analysis.Results The follow-up period ranged from 6 to 27 months (mean 36.4 ± 8.4 months).Of all patients,27 experienced recurrence,and the recurrence rate was 9.51％.The univariate analysis showed that postoperative recurrence was associated with a family history of gallstone disease,high-fat diet,sand-like stones,intrahepatic bile duct stones,biliopancreatic duct opening stenosis,and diverticulum around the ampullar region (x2 =8.721,5.979,8.641,15.996,33.833,and 27.203,all P ＜0.05).The multivariate logistic analysis showed that high-fat diet (OR =2.296,P =0.012),biliopancreatic duct opening stenosis (OR =2.280,P =0.007),and diverticulum around the ampullar region (OR =2.522,P =0.009) were independent risk factors for recurrence after surgery for biliary pancreatitis.Conclusion Biliary pancreatitis patients with high-fat diet,biliopancreatic duct opening stenosis,or diverticulum around the ampullar region tend to experience recurrence after surgery.Intervention and close follow-up should be performed for these patients to prevent recurrence.

International Standard for Medical Laboratories Accreditation demanded monitoring the quality of the total testing process (TFP).Recently, the errors in the analysis phase had been effectively controlled, while the errors in pre-and post-analytical phases still remained comparably high, and became the major factors influencing the TTP quality.Thus, monitoring and improving the quality of the extraanalytical phases became the major challenge.Monitoring the TTP quality required the laboratory staff to extend the quality management to the influential elements outside the laboratory.In addition, it also prompted the organizers of external quality assessment (EQA) in China to provide a quality assurance program for extra-analytical phases.The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) had developed a model of quality indicators.The Q-Probes and Q-Tracks programs of the College of American Pathologists provided a good practice of monitoring and improving quality for the extraanalytical phases.Based on the related international guidelines, the QIs system was established for quality management and control in clinical laboratory, so as to manage EQA of extra-analytical phases.

Coronary Disease ; Humans ; Smoking