WJ multipurpose guided puncture outfit in interventional ultrasound was developed.Guided puncture with this outfit was performed on 203 cases of various diseases.All 274 punctures were saccessful The study shows hat this guided puncture outfit can be set on various linear probes,fit-ted into puncture,biolpsy or catheter needles.It can actively adjust the puncture angle,precisely forecast,fix and calibrate the puncture angle and depth,perlorm guided puncture in real time etc.It is notnecessary to set line and tabulate the puncture angle.The outfit is easy and rapid to handle and also is reliable with high success rate

Objective:Study on the clinical application and analysis of structured electronic medical records in our hospital in last.Methods: Discharged patients data selected from July 2012 to June 2014, using statistical methods for data processing, 8000 case files were divided into two groups: Group A and Group B.Results: After comparing the two groups of two groups of data, and ultimately disease coding accuracy rate 94.88%, fill in the correct rate increased 88.38%, missing rate decreased 4.63%, two groups had no significant difference data; The quality of writing the doctor increased gradually, the error rate tends to be stable, structured clinical application to control.Conclusion: Sequential specification writing medical doctor, scientific analysis of medical record information, the clinical application of structured electronic medical records the error rate is reduced in the operation, improve the accuracy, more standardized, accurate, standardized.

Objective To explore the influence of uncertainty in illness in compliance of respiratory function exer-cise and rehabilitation after surgery in patients with coronary artery bypass graft (CABG) surgery. Methods Mishel uncer-tainty in illness scale and compliance of respiratory function exercise scale were used to collect data in 108 patients with CABG. The correlation of the uncertainty in illness and compliance of respiratory function exercise was analyzed. Patients were divided into three groups (high score, medium score and low score groups) according to the detection of uncertainty in illness. Values of compliance of respiratory function exercise, postoperative care time, postoperative ventilation time, postop-erative hospital stay duration, 6-min walking test (6MWD) and left ventricular ejection fraction (LVEF) were compared be-tween three groups. Results The uncertainty in illness was in medium level (95.51±9.48) in patients with CABG surgery, which was negatively correlated with compliance of respiratory function exercise (r=-0.926, P<0.01). The postoperative venti-lation time and postoperative care time were less in low score group than those of medium score group and high score group. The compliance of respiratory function exercise, 6-min walking test and postoperative LVEF were better in low score group than those of medium score group and high score group. Conclusion Medical personnel should take targeted interventions to reduce the uncertainty in illness in patients, enhance the compliance of respiratory function exercise, reduce the postopera-tive complications and promote early recovery of patients.

Objective To investigate the management of prevention and control of catheter-related bloodstream in-fection (CRBSI)in intensive care units (ICUs)of tertiary hospitals in a city,and explore stategies.Methods Data about CRBSI prevention and control as well as quality management were collected and surveyed by self-developed questionnaires.Results Of ICUs in 8 hospitals,the incidence of CRBSI was 4.81 ‰,case infection rate was 5.02‰.6 (75.00%)hospitals had standard operating instruction for the prevention and control of CRBSI, 2 (25.00%)hospitals had maintenance record on central venous catheter,and 2(25.00%)hospitals implemented maximum sterile barrier and catheterization combination strategy,none hospital adopted anti-infective dressing and chlorhexidine bathing.Conclusion There are many problems in the standard operating instruction and implementa-tion of measures for the prevention and control of CRBSI in ICUs of tertiary hospitals in this city,which needs to be improved.

Health appropriate technologies are applied nationwide in our country and have produced good results. But the informatization of health appropriate technologies lags behind and is still at a preliminary stage.As the network of Zhejiang basic health appropriate technologies has been estabished,this paper discusses some issues related with the informatization of health appropriate technologies.

Objective To understand the fairness of health resources of endemic diseases institutions in Henan Province,to provide evidence for endemic allocation of health resources for the government.Methods Health-related data resources in endemic disease prevention and control institutions were collected in Henan Province,including personnel,business space area,the value of equipment,and health funding,etc.The percentages of population distribution and geographical distribution of health resources were calculated; Lorenz curves of demographic fairness and geographic fairness were drawn.According to Lorenz curve (Gini coefficients of the population and the geographical distribution were calculated based on Lorenz curve),Gini coefficients were used to evaluate the fairness of the endemic disease prevention institutions for health resource allocation.Results As can be seen from Lorenz curve,the population fairness of endemic disease prevention and health personnel was the best,but the number of senior officers was less and the total value of equipment owned was low.The geographical fairness of all the indicators of health resources was poorer,and geographic fairness among senior officers was the worst.The Gini coefficient of health technical personnel,senior personnel,undergraduate or above personnel,value of equipments,area of business room and health funding allocation determined by the population distribution was less than 0.4.The health resources were relatively fair and reasonable according to the distribution of population.The Gini coefficients of all the indicators determined by the distribution of geography were higher than those determined by the distribution of population.Furthermore,the geographic Gini coefficient of senior personnel was above 0.4 which was in the vigilance state.Conclusions The equality of health resources determined by population distribution in the institutions for endemic diseases control in Henan is superior to those determined by geographic distribution.The allocations of health resources of endemic diseases control in different areas are unbalanced.

Background Retinal hemorrhage in newborns is a common clinical finding,and serious retinal henorrhage resulting in poor prognosis.The factors affecting retinal henorrhage in newborns are unelucidated now.Identifying these factors is helpful for the early prevention and treatment.Objective This study was to explore the underlying maternal,obstetric,and neonatal clinical factors for degree of retinal hemorrhages in healthy full-term newborns.Methods A cross-sectional study was performed in the approval of Ethic Committee of Zhongshan City People's Hospital.A total of 1 311 full-term infants,with gestational age more than 37 weeks and Apgar ≥9 scores were included in this study.Infants with severe systemic diseases or any other eye diseases were excluded.Ocular fundus of the infants were examined with Ret Cam Ⅲ within 4 days of birth and were independently identified by 2 eye doctors.The newborns of retinal hemorrhage were divided into grade Ⅰ,Ⅱ and Ⅲ groups based on Egge criteria,and the infants without retinal hemarrhage served as the normal control group.Maternal,obstetric,neonatal parameters and general factors were analyzed and compared among different groups,and the risk factors that affected the newborns retinal hemorrhage were analyzed by logistic regression analysis.Results Retinal hemorrhage was seen in 28.30％ infants (371/1 311),and 152,116 and 103 infants were identified as grade Ⅰ,Ⅱ and Ⅲ,with the percentage of 11.59％,8.85％ and 7.86％,respectively.Among the factors that examined in the study,cord around fetal neck was the risk factor of aggravation of degree of retinal hemorrhage in newborns (OR =1.308,95％ CI:1.011-1.693,P =0.041).In the mode of delivery,spontaneous vaginal delivery appeared to be the positive factor of the incidence of retinal hemorrhage (OR=0.134,95％ CI:0.132-0.137,P＜0.001),but cesarean section was not a main risk factor.Conclusions Spontaneous vaginal delivery and cord around fetal neck are the potential risk factors for the aggravation of degree of retinal hemorrhage in full-term infants.Accordingly,infants with these risk factors should be paid more attention to prevent the progression of retinal hemorrhage.

Objective To investigate the relationship between apoptcsis, expressions of VEGF and clinicopathological characteris- tics, and prognosis in esophageal squamous cell carcinoma (ESCC). Methods Sixty-one surgical specimens of primary esophageal squa- mous cell carcinomas were examined for VEGF by immunohistochemical staining (S-P). Apoptcsis was determined by TUNEL (TdT media- ting dUTP-biotin nick end-labeling) method. Clinicopathologic features were examined by histopathology. The prognostic impacts of these pa- rameters were analyzed by univariate and survival analysis. Results AI and VEGF were well correlated with differentiation, TNM stage. Lower tumor differentiation and higher TNM stage were related to decreasing AI and VEGF. In addition, VEGF in the groups of invasion be- yond muscularis and lymph node metastasis is significant higher than that in invasion reaching muacularis and no lymph node metastasis (P <0.01). But there were no significant correlation between AI and invasion( P>0.05). The simple-factor analysis results showed that the decrease of AI, VEGF, lymph node metastases, lower tumor differentiation, and invasion reaching muscularis were related to decrease of sur- vival rate. However, multivariate Cox analysis demonstrated that only AI and VEGF were the significant prognostic factors. Conclusions Apoptosis and angiagenesis participate in ESCC and promote its growth. VEGF is related to angiogenesis of ESCC. The increase of VEGF may promote invasion and lymph node metastasis. AI and VEGF are significant prognostic factors in ESCC.

Purpose To explore the expression of Toll-like receptor 4 (TLR4), PI3K, AKT and NF-κB in cervical lesions, and to in-vestigate their association with human papillomavirus ( HPV) 16 infection. Methods Immunohistochemical SP staining was performed to detect the expression of TLR4, PI3K, AKT, NF-κB in paraffin-embedded cervical tissue specimens from Uighur women with chroni-cal cervicitis, cervical intraepithelial neoplasia ( CIN) and cervical squamous cell carcinoma ( CSCC) . The HPV 16 DNA was detected by PCR. Results The positive expression rates of TLR4, PI3K, AKT, NF-κB in chronical cervicitis, CIN and cervical cancer were 32. 0%, 59. 4%, 77. 8%, 28. 0%, 56. 3%, 73. 0%, 24. 0%, 56. 3%, 79. 4%, and 8. 0%, 48. 4%, 81. 0%, respectively. The expression of them was higher in cervicitis than in CIN and cevical cancer ( P<0. 05 ) . The positive expression rates of HPV 16 in three groups were 8. 0%, 48. 4% and 81. 0% (P<0. 05). The expression of TLR4, PI3K, NF-κB and HPV 16 was related to cervi-cal cancer differentiation (P<0. 05). PI3K and AKT were significantly correlated with FIGOs’ stages (P<0. 05). NF-κB was corre-lated with lymph node metastasis. The expression of TLR4 was significantly associated with HPV 16 infection in CIN and CSCC ( r=0. 303, P=0. 015, r=0. 633, P=0. 000), and correlation with PI3K in CIN and CSCC (r=0. 254, P=0. 045, r=0. 386, P=0. 003). PI3K was associated with AKT only in CSCC (r=0. 298, P=0. 018). Conclusions The expression of TLR4 can be up-regulated by HPV 16 infection. High expression of PI3K/AKT signal pathway mediated by TLR4 may play important roles in the devel-opment and progression of CIN and CSCC, and HPV 16 infection may be a trigger factor affecting the molecular signal pathway.

Objective To detect the PML-RARα fusion gene expression of APL patients with FISH and fluorescent quantitative PCR and discuss the sensitivity and specificity of two techniques. Methods The detection of the PML-RARα fusion gene expression of 75 APL patients with FISH and fluorescent quantitative PCR were carried out simultaneously. Results Eighty eight patients of primary and relapse or remission phases were examinated and total conformity rate was 96.59 %. Fourteen primary patients were detected and conformity rate was 100 %. Seventy four relapse or remission patients were detected and conformity rate was 95.95 %. Stem cell essays were detected for six times and conformity rate was 100 %. Conclusion The sensitivity of FISH and fluorescent quantitative PCR is identical for primary APL patients and FISH is more sensitive. But the sensitivity of FISH is weaker than that of fluorescent quantitative PCR for detection of residue disease.