Objective To investigate clinical value of povidone -iodine disinfection for prevention of postpartum endometritis and abdominal incision infection in cesarean, to provide a reference for clinical treatment. Methods 160 cases of puerpera women were selected, all of them underwent uterine segment cesarean section. According to the digital table,they were divided into control group and observation group,80 cases in each group.In the observation group previous cesarean group remained untreated 30min before cesarean vaginal experiments 0.4%povidone-iodine for disinfection.The maternal postpartum endometritis incidence,abdominal incision infection rate, visual analogue scale,leukocyte index WBC,erythrocyte sedimentation rate index ( ESR) ,C-reactive protein ( CRP) were compared in the two groups.Results There were 32 cases of postoperative endometritis,12 cases (15.00%) occurred in the observation group, 20 cases ( 25.00%) occurred in the control group, the overall incidence of endometritis between the two groups had statistically significant difference (χ2 =5.945,P=0.025);endometritis 5cases (17.86%) premature rupture of membranes occurred in the observation group,the control group had 10 cases (31.25%),the difference was statistically significant (χ2 =6.565,P=0.009).Postpartum WBC,ESR,CRP in the observation group were significantly lower compared to the control group,the differences were statistically significant (t=5.045,P=0.007;t=7.945,P=0.001;t=8.676,P=0.000).In the observation group,postoperative abdominal incision infection rate was 3.75%,compared with the control group,there was no significant difference (χ2 =1.021, P=0.124).The VAS score of the observation group was (3.94 ±0.74),which was significantly lower than (6.25 ± 1.05) of the control group,the difference was statistically significant (t=6.331,P=0.010).Conclusion Previous cesarean vaginal povidone-iodine disinfection is effective in preventing postpartum endometritis,but can't help to low abdominal incision infection or improve wound healing.

The pathogenesis of post- infectious irritable bowel syndrome(PI-IBS)involves abnormal intestinal immune barrier, which possibly includes the pathological aspects: Intestinal and systemic changes in T lymphocyte; the change of inflammatory cytokines; a increase in intestinal mast cells and enterochromaffin cells and so on. Treatment by western medicine based largely on symptomatic treatment. TCM thinks that the fundamental organ of the irritable bowel syndrome is the liver. Emotional factors inducing liver dysfunction lead to the symptoms of irritable bowel syndrome. The pathogenesis of IBS is, the disorder of movement of qi in liver and spleen. Stagnation of liver-QI with deficiency of the spleen or disharmony between liver and spleen is the key pathogenesis of post-infectious irritable bowel syndrome. On this basis, in various stages of the disease, there may be a different pathogenesis. As a special type of IBS, the balance of vital qi and evil factors determine the disease progression of PI-IBS, in the treatment course also should not forget dispelling pathogenic factors while strengthening body resistance, tonifying deficiency and removing dampness。

The price adjustment in medical service system is a quite complex systematic engineering,this paper proposed the implement steps for the price adjustment in medical care system and correlative information technological support in Nanjing Jinling Hospital in details.The application results showed that the steps for the price adjustment in medical service system could insure the adjustment process steadyand effective,and it could also make the new price list software system and the whole information system run stably and reliably.

The development history of Chinese HIS is reviewed,the gap between domestic HIS and international one are compared from the scale of investment and the proportion of technical personnel,and the existing problems in domestic HIS are analyzed.It is suggested that the future tendencies of domestic HIS include the improvement of information standardization,more attention is paid to the construction of HIS,and the modern management should be taken as new objective,etc.[Chinese Medical Equipment Journal,2008,29(2):39-41]

Objective To make a safe and effective medicine therapeutic scheme correctly and quickly. Methods The data of previous cases and fuzzy knowledge gained through experience were stored in the database through digital techniques,in an effort to construct the knowledge database for rational clinical medicine administration. Then,the experience and optimized knowledge instructive to clinical drug use were selected through data mining techniques. Results The expert system based on clinical rational medicine administration over coronary heart disease was finally designed with instructive principles of rational clinical drug administration being proposed,which provided effective decision-making support for clinical diagnosis and treatment. Conclusion It is concluded that the system guarantees the knowledge preservation of clinical treatment,improves the correctness and rationality of clinical treatment,alleviates burdens on medical working staff and medical treatment cost,improves the medical efficiency and promotes the development of hospitals.

Bile duct injury is a question that should be highly concerned. ll the time. In general surgery with the improvement of acknowledge to the serious results after bile duct is injured, many active and effective measures are taken, which make the incidence of bile duct injuries lower. Advancing medical technology and numerous clinical experiences contribute to great improvement in treatment methods and effects on patients who have suffered bile duct injuries. At the same time, There are many new questions should be confronted with. The current conditions of treatments of iatrogenic bile duct injuries are reviewed in this article.

Esophageal cancer is one of the tumors with high morbidity rates in China, and surgery remains to be the preferred treatment. However, certain complications such as anastomotic fistula, lung infection, respiratory failure, and circulatory failure occur after surgery. Postoperative enteral nutritional support could not only maintain and improve the nutritional status of the body but also re-duce complications and maintain normal immune function. This review focuses on the progress in postoperative enteral nutrition in pa-tients with esophageal cancer.

Objective To discover the basic principle of hospital operation and predict the hospital developing trends through analysis of massive data involved in the hospital information system(HIS),with a view of providing better services to patients.Methods The Oracle Warehouse Builder was used as technical platform of date warehouse building in the process of modeling the HIS by using relational database and modeling the data warehouse by using the star model of the multi-dimensional database models.Data Miner,a data mining tool,is also applied to analyze information in the hospital related to inpatient structure and mobility,expenses structure,medical workload and economic benefits.Results Support was provided to management and decision making in hospital.Conclusion Wide applications of data warehousing and data mining are observed in HIS,resulting in remarkable economic and management benefits.

Objective To explore the distribution and antimicrobial resistance of pathogens causing urinary tract infection(UTI)in patients with prostatic hyperplasia,and provide reference for clinical diagnosis and rational anti-microbial therapy.Methods Urine culture results of 171 patients with prostatic hyperplasia complicated with UTI from February 8,2012 to October 12,2013 were analyzed retrospectively.Results A total of 192 bacterial isolates were isolated from 171 patients,gram-negative bacteria accounted for 79.17%,37.50% of which were Escherichia coli (E.coli )strains,and 18.75% were Klebsiella pneumoniae (K .pneumoniae );gram-positive bacteria and Candida accounted for 18.23% and 2.60% respectively.Of E.coli and K .pneumoniae ,the proportion of extend-ed-spectrumβ-lactamase (ESBLs)strains were relatively higher,which was 72.77% and 63.89% respectively,re-sistant rates of ESBLs-producing E.coli to piperacillin.cefuroixme,ceftazidime,ceftriaxone,aztreonam,and levo-floxacin were all significantly higher than non-ESBLs strains,resistant rates of ESBLs-producing K .pneumoniae to piperacillin,cefoxitin,aztreonam,levofloxacin,and compound sulfamethoxazole were all significantly higher than non-ESBLs strains.Resistant rates of Pseudomonas aeruginosa to imipenem and meropenem were both 50.00%, susceptibility rates of Enterococcus to penicillins and aminoglycosides were both low,linezolid-and vancomycin-re-sistant strain was not found.Conclusion Organisms isolated from patients with UTI associated with prostatic hy-perplasia have high antimicrobial resistance,clinical therapy should be based on characteristics of bacterial distribu-tion and antimicrobial resistance.

Objective To compare the efficacy between ureteroscope with holmium laser lithotripsy (URS) and minimally invasive percutaneous nephrolithotomy (MPCNL) in oblique supine position for the proximal and middle ureteral calculi.Methods Ninety-six patients with proximal and middle ureteral calculi were divided into URS group (54 cases) and MPCNL group(42 cases) according to the treatment order.The operative duration,postoperative hospital stay,stone-free rate,intraoperative blood loss ＞ 400 ml rate,conversion to open surgery rate,complication rate including postoperative fever were observed,and stone composition was analyzed.Results The operative duration and postoperative hospital stay in URS group and MPCNL group were (55.3 ± 12.1),(49.6 ± 11.5) min and (1.7 ± 0.9),(4.4 ± 1.2) d,respectively,and there were significant differences (P ＜ 0.05 or ＜ 0.01).There were no significant differences in the stone-free rate,complication rate (Clavien degree Ⅱ),conversion to open surgery rate,intraoperative blood loss ＞ 400 ml rate,complication rate,postoperative fever rate (P ＞ 0.05).Stone composition analysis showed that the proportion of calcium oxalate stone was 51.0％(49/96).Conclusions URS and MPCNL in oblique supine position for the proximal and middle ureteral calculi are effective and safe therapeutic modalities.The operative duration of MPCNL in oblique supine position is shorter,and postoperative recovery of URS is fast.