Burns ; pathology ; therapy ; Humans ; Prognosis ; Treatment Outcome ; Wound Healing

Objective To study the effect of small incision plus tubular stomach on serum vascular endothelial growth factor(VEGF) and quality of life in patients with esophageal cancer.Methods 78 patients with esophageal cancer were randomly divided into two groups,the control group (n =36 cases) and the observation group (n =42cases).The patients in the control group were treated through the conventional operation,while the patients in the observation group were treated through small incision plus tubular stomach.Serum VEGF and quality of life were detected.Results Qualities of life in both two groups were improved after operation and it in the observation group was higher than that in the control group (t =4.36,P ＜ 0.05).Serum VEGF in both two groups were decreased after operation (t =26.11,12.28,all P ＜ 0.01).It in the observation group was lower than that in the control group (t =14.94,P ＜ 0.05).Conclusion Small incision plus tubular stomach can significantly improve serum VEGF and quality of life in patients with esophageal cancer.

Through viewing the employee medical insurance system, problems were found as below: ( 1) The content of system did not match the name of “urban workers” and “basic medical insurance”. (2) In financing system, some business units and participated people had heavy burden; personal accounts shunt exceed 60% of the total health insurance fund and constituted a reverse subsidy;retirees did not assume the obligation of payment while they could obtain unjust enrichment through the personal accounts of the possible. (3) System inefficient and risky fund cost overruns. (4) Insurance coverage is low within the system. Recommendations: (1) To build a unified national basic medical insurance based on merger residents and new rural cooperative medical insurance. (2) Abolish workers’ medical insurance system, put urban workers into the universal basic medical insurance. ( 3) Introduce “medical expenses surtax”, establish supplementary medical aid fund or direct universal basic medical insurance fund. ( 4) To develop commercial health insurance and build a comprehensive health care system.

Objective:To study clinical diagnostic value combined detecting plasma cardiac troponin T (cTnT)and N terminal pro B type natriuretic peptide (NT-proBNP)in children With heart failure (HF).Methods:A total of 73 child HF patients from our hospital Were enrolled as HF group,and another 75 healthy children from Well child clin-ic Were regarded as healthy control group.Concentrations of cTnT and NT-proBNP,and left ventricular ejection fraction (LVEF)Were measured and compared betWeen tWo groups.Receiver operator characteristic curve (ROC) Was used to analyze diagnostic sensitivity and specificity combined detecting cTnT and NT-proBNP.Results:Com-pared With healthy control group,there Were significant increase in concentrations of NT-proBNP [(2486.7±87.5)pmol/L vs.(3573.8±98.2)pmol/L]and cTnT [(0.03±0.01)ng/ml vs.(0.35±0.09)ng/ml],and significant decrease in LVEF [(70.8±5.2)% vs.(42.6±3.8)%]in HF group,P <0.05 all;multivariate Logistic regression analysis indicated that NT-proBNP Was an independent relative factor for LVEF in HF children (OR=1.006,P = 0.012);When NT-proBNP value Was 3200 pmol/L and cTnT value Was 0.08 ng/ml,their sensitivity and specificity Were 89.5% and 85.7% respectively in combined diagnozing child HF,and the area under ROCWas 0.795.Conclusion: Combined detecting cardiac troponin T and N terminal pro B type natriuretic peptide possesses high clinical diagnostic value in children With heart failure.

Objective To explore the application value of laparoscopic surgery in type 2 diabetes patients with acute cholecystitis.Methods 50 type 2 diabetic patients with acute cholecystitis were chosen as the research objects,the patients were divided into the observation group and control group according to the method of treatment, 25 cases in each group.Strict control of blood glucose levels in patients before operation,the observation group treated by laparoscopy,the control group were treated with conventional open surgery.Recorded the operation time and hemor-rhage,postoperative abdominal drainage,anal exhaust time,patient ambulation time and hospitalization time and other indicators.The patients were followed up to record the postoperative infection,occurrence of complications such as postoperative inflammation.Results There was no statistically significant differences between the two groups in oper-ation time(t =1.02,P >0.05).In the observation group,the intraoperative blood loss was (41.2 ±8.3)mL,postop-erative drainage volume was (107.5 ±16.4)mL,which were significantly lower than those in the control group,and the anal exhaust time was (1.7 ±0.3)d,total hospitalization time was (7.1 ±1.7)d,which were significantly shorter than those of the control group,the differences were statistically significant(t =3.43,3.78,3.43,4.21,all P <0.05).The observation group the complications included wound infection 1 cases,the complication rate was 4.0%, while in the control group,the complications included bile leakage,reflux esophagitis,incision infection,fat liquefac-tion,pulmonary infection and incisional hernia,the overall complication rate was 24.0%,there was statistically signifi-cant difference in the complication rate between the two groups(χ2 =4.54,P <0.05).Conclusion The laparoscopic surgery in the treatment of type 2 diabetic patients with acute cholecystitis has exact effect,and the patients recovery time is short,the complication rate is low.

In 2006, I was awarded a scholarship from Universiti Sains Malaysia for Fellowship training at Monash University (MU) for one year. The objective of the training programme was to develop knowledge and skills in several areas, including androgen deficiency, male infertility, prostate disease, testicular tumours, sexual dysfunction and sexually transmitted diseases. The training programme consisted of attachments with clinical specialists, completion of a course work module and a research project. After completion of the training programme, I believe that Primary Care Physicians (PCPs) will benefit from undertaking the training programme that I had completed. It will enable PCPs to assume leadership roles in this multidisciplinary area. The ability of PCPs in handling sexual and reproductive health issues in men will definitely be a more cost effective form of care for patients, particularly as the number of specialists is limited, and even more importantly, it will be satisfying for the patient and the physician.

Internally, there is internal quality self-evaluation by the higher education institutions, and externally, there are institutional accreditation and professional accreditation by accrediting agencies. About 80 accrediting agencies take charge of such kind of accreditation respectively. They are recognized by non-governmental Council for Higher Education Accreditation, or by US Department of Education, or by both. State quality reviews of higher education are reviews for state licensure which affect private institutions and reviews for accountability which primarily affect public institutions. A multi-level wide spectrum of higher education accreditation system of United States is so clearly analyzed. Additionally, variety of ranking of higher education institutions and programs are produced through statistical analysis of questionnaires fry different commercial publishers.

The existing higher educational systems in different countries of Europe are so complicated and diversified that they cause a lot of trouble when the economic process of integration is underway.Thus, the trend is towards reformation of the national educational systems.The main purpose of the reformation is to pursue convergence as well as internationalization. Three important conferences on the reformation have been held since 1998. The conclusions of the conferences are presented, and both analysis and synthesis of the reformation extending all over Europe are given. It is hoped that the European idea and practice of reformation will be an inspiration to and used for reference by the higher education in China as it will also move towards internationalization after the joining of WTO.

ObjectiveTo compare the advantages,disadvantages and clinical value of the improved loop the jejunum behalf of the stomach surgery and the P - type jejunum on behalf of stomach surgery.Methods56 patients with gastric cancer were divided into two groups by different ways of gastrectomy alimentary tract after gartrectomy.Patients in observation group( n =35 ) were given the modified loop jejunum on behalf of gastric surgery and patients in control group( n =31 ) received P-type jejunum on behalf of the stomach surgery.The clinical effects were compared between two groups.ResultsThere were no significant differences in surgical time and bleeding volume in 2 groups ( P ＞ 0.05 ).Emptying time [(61 ± 3 ) min] of observation group was longer than that of control group (37 ± 19) min]( t =3.03,P ＜ 0.05 ) ; Each food intake [( 308 ± 44 ) ml] in observation group was significiantly improved compared with control group [(262 ± 34) ml (t =2.55,P ＜ 0.05) ; The times of daily diet [(4.2 ± 1.2) times] in observation group was lower than that of control group [( 5.7 ± 2.3 )] ( t =2.46,P ＜ 0.05 ).The incidence of postoperative complications( 14.3％ ) of the observation group was significantly lower than the control group (42.9％) ( x2 =5.71,P ＜ 0.05).ConclusionOn the terms of 2 ways of digestive tract reconstruction,the improved loop the jejunum behalf of the stomach surgery is superior to the P-type jejunum on behalf of the stomach surgery,which can effectively improve the quality of life of patients and reduce the incidence of complications,but have no complex surgical procedures.

Objective To explore the work connotation development and establishment of working model for outpatient triage nurses.Methods 1000 outpatients were selected and randomly divided into the control group and the experimental group with 500 patients in each group.The control group selected doctors freely,while the experimental group let patients choose doctors after work connotation of triage nurses was developed.The application effect of two working models was compared.Results The rates of power satisfaction,anxiety,knowledge of re-visit and total satisfaction degree in the experimental group were higher than those in the control group.Conclusions The implementation of work connotation development for triage nurses can facilitate consultation outside the hospital and reservation for return visit,which is worthy of reference.