Objective To investigate the application of Vein Infrared Imaging instrument in the treatment of medical patients with difficulty of vein-detaining needle. Methods A total of 116 cases of patients with difficulty of vein-detaining needle were admitted to Peking Union Medical College Hospital International Medical Service Department from June 2015 to May 2016. These participants were divided into vein imaging and conventional puncture group by the punctures method, 58 cases in each group. Vein imaging group applied vein imaging device in the whole process of venous indwelling needle, including vascular assessment before operation, real-time imaging and confirmation, the control group used conventional technology in peripheral venous catheter. The success rate of vein-detaining needle, operation time, puncture tube material cost, the incidence rate of venous indwelling needle complications were compared between two groups of patients. Results One-time success rate of vein imaging group reached 72.4% (42/58), puncture success rate reached 93.1% (54/58), higher than in conventional puncture group, which was 48.3% (28/58), 67.2% (39/58),the difference between the two groups had statistical significance(χ2=7.061, 10.629,P<0.05). Conventional puncture group 's operation time was (8.4±4.2) min,and puncture tube material cost was(123.37±62.20)yuan;vein imaging group respectively were (3.5±1.2) min, (67.50±24.82) yuan, the difference between the two groups had statistical significance (t=5.410, 4.057, P<0.05). Conventional puncture group's rate of complications was 41.4%(24/58), and vein imaging group was 17.2%(10/58), the difference between the two groups had statistical significance (χ2=8.155,P=0.004). Conclusions Application of vein infrared imaging instrument is a practical, safe and rapid method of vein-detaining needle, which can improve the work efficiency of nurses, and have more advantages in the treatment of patients with difficulty of vein-detaining needle.

As an important component of hospital information system (HIS), outpatient information management system (OIMS) should be emphasized on during the process of hospital digitalization. This paper summarizes the main contents and functions of OIMS and discusses the most important sub-system of OIMS's, outpatient doctor workstation, on its case history, examination/Lab and prescription. The generalpurpose card system for outpatient service will be set up on the basis of computerized OIMS, and thus the problems of outpatient can be eliminated completely.

Objective To investigate the effect of autologous serum therapy in the treatment of three cases of exposure keratitis after general anesthesia.Method Autologous serum therapy was used to treat 3 cases of exposure keratitis,the curative effects assessed by the patients’complaints and observation of the ocular symptoms.Result All the patients reported eliminations of exposure keratitis and symptomatic relief.Conclusions The autologous serum therapy is effective for the treatment of exposure keratitis.The nursing strategies of keeping cornea moist,preventing infections,performing mental nursing and storing serum properly are critical for the enhanced curative effect.

Objective To explore the effect of flexible laser endotracheal intubation optical device (patent number 201520785723.7) on oral and maxillofacial intubation operations. Methods Forty-two patients with the oral and maxillofacial intubation optical device for general anesthesia were included in this study. The patients were from 16 to 73 years old and ASAⅠ-Ⅱ. Surface anesthesia was prepared for airway and nasal cavity. There were 27 patients whose mouth opening were smaller than 3 cm. After intravenous injection of midazolam 0.05 mg/kg and sufentanil 0.2μg/kg, reinforced endotracheal tube was inserted into throat 13-15 cm, then the probe shape to 120° and optical device were placed into the tube respectively, guided the tube according to the light spot in front of neck. There were 15 patients whose mouth opening were not smaller than 3 cm. The quick guidance optical device and larygoscope were adopted to help the intubation. After intravenous injection of midazolam 0.05 mg/kg, sufentanil 0.5 μg/kg, propofol 2 mg/kg, cisatracurium 0.2 mg/kg, the reinforced endotracheal tube was inserted into the oral cavity nasally, and completed intubation with laryngoscope. The success rate of intubation, time of intubation, the real-time blood pressure before and after intubation, heart rate and related complications were recorded before intubation and after intubation. Results In the 42 patients, 41 patients were successful for guidance intubation, and the success rate of intubation was about 97.6%. The average intubation time was(124.5±38.2) seconds. The shortest intubation time was 12 seconds and the longest was 276 seconds. During intubation, the increases of blood pressure and heart rate were in the normal range (<30%). Levels of SpO2 were maintained at 0.92-1.00. All the patients were without agitation. There were no serious complications such as hoarseness and pharyngalgia after operation.Conclusion The flexible laser endotracheal intubation optical device can be used quickly for oral and maxillofacial intubation, and the 45° bevel design for optical device can form two kinds of zones with bright light upward and downward. It is a new tool for nasal intubation that is more convenient for location of light guidance, and has high success rate and small stimulation.

Objective To evaluated the risk factors of urethral recurrence ( UR) following radical cystectomy ( RC) in patients with bladder urothelial carcinoma.Methods The clinical data of 350 male patients who underwent RC between January 2005 and January 2013 were retrospectively analyzed.The mean age was 63 years (rang 46-76) years.176 cases had the history of non-muscle-invasive bladder cancer.15 cases were were found the tumor invasion into the prostatic urethral.The way of urinary diversion after RC included 172 cases were orthotopic neobladder, 90 cases were cutaneous diversion and 88 cases were ileal couduitin.331 cases underwent preoperation intravesical instillation.36 cases underwent systemic chemotherapy after operation.148 cases were found the multiple tumor lesions, which was more than 2 sites. The pathological stage was more than T2 satge in 189 cases.And 177 cases were diagnosed as high-grade urothelial carcinoma.Multivariate Cox regression analyses were used to evaluate the risk factors associated with the UR.Results There were 350 cases in this study, UR was observed in 28 cases ( 8%).On multivariate Cox regression analyses, previous history of NMIBC (HR=15.205,95%CI 3.718-62.180,P<0.001), prostate urethral involvement(HR=5.233,95%CI 1.106-24.754,P=0.037) and Non-orthotopic neobladder(HR=6.656,95%CI 1.840-24.077,P=0.004)which the operation of cutaneous diversion and ileal couduit , were independent risk factors of UR following RC.Intravesical instillation before operation ( HR =0.470, 95%CI 0.010-0.217, P <0.001 ) was the protective factor of the UR.Conclusions Previous history of NMIBC, prostatic urethral involvement and Non-orthotopic neobladder were independent risk factors of UR.Intravesical instillation before operation was protective factor of UR.Urethrectomy for patients with high risk factors and intravesical instillation before operation were important.

Objective To investigate the risk factors for postoperative pulmonary complications (PPCs) in colorectal cancer patients.Methods From January 2014 to June 2016,risk factors for postoperative pulmonary complications in colorectal cancer patients were analyzed retrospectively.The data was analyzed by individual elcment,then the statistically significant factors were analyzed by logistic regression analysis.Results Forty-one out of 352 had PPCs,the incidence rate was 11.6％.The incidence of PPCs was significantly increased in patients with age over 65,a history of smoking,the combined chronic obstructive pulmonary disease (COPD),body mass index (BMI) over 25 kg/m2,operation time (3 h) or longer and preoperative neoadjuvant chemotherapy (P ＜ 0.05) with single factor analysis.In the six kinds of risk factors,age over 65,body mass index (BMI) over 25 kg/m2,COPD and operation time (3 h) or longer wcre the independent risk factors for multiple factors analysis (P ＜ 0.05).Conclusion For elderly patients with colorectal cancer,especially with a history of COPD or obesity,if the operation time was long,more attention should be paid for the happen of PPCs.

Objective: To investigate the relationship between rs4373814 polymorphisms of calcium channel (CACNB2) gene and the susceptibility of essential hypertension (EH) occurrence in Han population at northeastern area of China. Methods: A case-control study in Han population at northeastern of China was carried out and the research included 1998 participants as 2 groups: EH group,n=1006 patients treated in our hospital, and Control group,n=992 subjects with normal blood pressure from physical examination. The rs4373814 polymorphisms were examined by Snapshot technique and the statistical analysis was performed by SPSS 19.0 software. Results: The rs4373814 risk allele C frequency of CACNB2 gene was signiifcantly different between EH group and Control group,P=0.039, OR=1.068, 95% CI (1.004-1.137). Logistic regression analysis showed that with adjusted gender, age, BMI, smoking, drinking, in dominant model, the genotype rs4373814 carring CC + GC/GG obviously increased the risk of EH occurrence,P=0.037, OR=1.260, 95% CI (1.013-1.567). Conclusion: The rs4373814 polymorphisms of CACNB2 gene are related to the susceptibility of EH occurrence in Han population at northeastern area of China.

Objective To analyze the relationship between thyroid function and grades of diabetic nephropa-thy (DN).Methods One hundred and twenty patients with definite DN were classified into the four groups,and forty patients with non-DN diabetic was NDN group.Their serum albumin,blood hemoglobin,serum potassium,functional parameters of thyroid and dependability to DN were analyzed.Results The plasma albumin ofⅢ,Ⅳ and Ⅴ group were (41.3 ±3.6)g/L,(30.5 ±4.8)g/L and (28.3 ±5.9)g/L,which were lower than those of NDN group (F=11.36,P<0.05).24h urine protein ofⅢ,Ⅳ and Ⅴ were (0.48 ±0.29)g,(1.86 ±0.54)g and (1.69 ±0.67)g, which were higher than those of group NDN (F=7.12,P<0.05).Triiodothyronine(T3)ofⅢ,ⅣandⅤgroup were (0.98 ±0.38)nmol/L,(0.75 ±0.41)nmol/L and (0.60 ±0.28)nmol/L,which were lower than those of NDN group (F=7.64,P<0.05).Tetraiodothyronine(T4)of III,IV and V group were (6.06 ±1.76)nmol/L,(5.31 ±1.98)nmol/L and (4.65 ±1.87)nmol/L,which were lower than those of NDN group (F=6.83,P<0.05 ).Free Triiodothyronine (FT3)ofⅢ,Ⅳ and Ⅴ group were (4.37 ±2.12)pmol/L,(3.33 ±2.30)pmol/L and (2.91 ±1.82)pmol/L, which were lower than those of NDN group (F=7.14,P<0.05 ).Correlation analysis indicated that FT3 was an independent predictor for the severity of diabetic nephropathy.Conclusion In the patients with DN Ⅳ and Ⅴ,DN has attained a very severe status and the treatment of DN should be intensive.

Objective To investigate the expressions and the relationship of FEZ1 and p16 in cervical intraepithelial neoplasia (CIN).Methods The expressions of FEZ1 and p16 in 93 cases of CIN and 10 cases of normal cervical specimens were detected by immunohistochemistry.Results The positive expression rates of FEZ 1 were 90.0％ (9/10) of normal cervical specimens,67.9％ (19/28) of CIN I,36.0％ (9/25) of CIN Ⅱ,22.5％(9/40) of CIN Ⅲ.The positive expression rates of p16 were 10.0％(1/10) of normal cervical specimens,32.1％(9/28) of CIN I,76.0％(19/25) of CIN Ⅱ,92.5％(37/40) of CIN Ⅲ.There were significant differences in the positive expression rates of FEZ1 and p16 between CIN Ⅰ and CIN Ⅲ (P ＜ 0.01),there was no significant difference in the positive expression rates of FEZ1 and p16 between CIN Ⅱ and CIN Ⅲ.The expression of FEZ1 and p16 was negatively correlation in CIN (r =-0.712,P＜ 0.01).Conclusion The abnormal high expression of p16 and abnormal low expression of FEZ1 in CIN may be involved in the occurrence and development of CIN,detecting the expressions of the two indexes may be helpful for clinical diagnosis.

Objective:To identify the key genes related to rheumatoid arthritis (RA) by to the weighted gene co-expression network analysis (WGCNA) and experimental verification to find key genes related to RA.Methods:The microarray data of RA were downloaded from the Gene Expression Omnibus (GEO) database. Gene network was constructed, and the genes were classified into different modules using WGCNA. HUB genes in modules related to RA clinical symptoms were analyzed by gene ontology. Subsequently, different data sets of GEO were used to verify the expression profile and diagnostic capacity of the HUB gene [receiver operating characteristic curve (ROC)]. In addition, the expression of HUB gene in RA was verified by real time polymerase chain reaction (RT-PCR) and Western blot, and the relationship between key genes and disease activity score 28 joints (DAS28) was analyzed. Paired-sample t-test and Pearson's correlation analysis was used for statistical analysis. Results:A total of 5 413 differentially expressed genes were filtered. Weighted gene coexpression network was constructed and genes were classified into 23 modules. Among them, the black module is closely related to the clinical symptoms of RA, which contained 346 genes. Enrichment analysis and Kyoto encyclopedia of genes and genomes (KEGG) signal pathway analysis showed that it was to be enriched in the positive regulation of interleukin 6, interleukin 1 beta secretion, osteoclast differentiation, NOD-like receptor signaling pathway, T helper cell 17 (Th17) cell differentiation and many other pathways closely related to RA. Motile sperm domain-containing protein 2 (MOSPD2) was significantly correlated with clinical symptoms. It was highly expressed in blood monocytes and bone marrow monocytes ( t=2.238, P=0.032; t=3.153, P=0.006), and positively correlated with blood expression in RA joint synovial fluid ( r=0.683, P=0.03). ROC curve analysis determined that MOSPD2 could distinguish RA from the control group (the area under the curve was 0.855 and 0.726) respectively. RT-PCR and Western blotting results showed that MOSPD2 was up-regulated in RA patients ( t=-3.96, P=0.02). MOSPD2 expression levels in blood were positively correlated with DAS28 in RA patients ( r=0.884 6, P=0.046 2). Conclusion:MOSDP2 is closely related to the clinical symptoms of RA patients, and may be one of the targets for the diagnosis and treatment of RA.