Objective To investigate the clinical effect of the ultrasonic scalpel and electric knife in open thyroid surgery.Methods The clinical data of 182 patients underwent thyroid surgery were retrospectively analyzed.100 cases in the observation group were used the ultrasonic scalpel surgery and 82 patients in the control group were given electric knife surgery.The average surgical incision length,mean operative time,mean blood loss and postoperative complications were compared between the two groups.Results The average incision length of the observation group was (36.7 ± 6.1)mm,average time of thyroidectomy was (25.3 ± 5.1)min and blood loss was (14.2 ± 5.1)ml,which were significantly lower than those of the control group (P ＜ 0.05).The incidence rate of adverse reaction between the two groups had no significant difference(P ＞ 0.05).Conclusion Compared with electric knife,the use of ultrasonic scalpel in thyroid surgery can significantly reduce blood loss,shorten the operation time,the prognosis and clinical efficacy is good,it is worth to be further promoted in clinical.

Objective To study the clinical characteristics and therapeutic effect of the combination of intensive immunosuppression therapy with umbilical cord blood infusion in severe aplastic anemia (SAA) patients with infections.Methods A retrospective analysis of bacterial spectrum and treatment effect was performed for infections occurred in 27 SAA-Ⅰ patients who received antithymocyte globulin (ATG),cyclophosphamide (Cy) and cyclosporine A (CsA) followed by umbilical cord blood infusion.Results The prevalence of infections in 27 SAA-Ⅰ patients was 48.1％,among which 70 ％ were infected with bacteria (mostly gram-negative bacilli) and 30 ％ with fungal infection.Upper respiratory tract was the most common site,followed by the blood and lungs.The primary infections occurred at the median time of 9.5 d (-2-10 d)after the immunosuppressive therapy,and the initial infections of ANC were ＜ 0.2 ×109/L.Conclusion Combination of intensive immunosuppression and umbilical cord blood infusion is proven effective in treating SAA-Ⅰ.As a result,infection rate is low and can be controlled with sensitive antibiotics.

In the course of medical education for academic degree, reforming our teaching course by trying bilingualteaching in surgery to different students is an effective way to enhance the medical staff's English level and their abilityto use English. This article has summarized the experience of our bilingual teaching from the design, preparation andimplementation of the teaching.[

In this paper the basic feature of the participating teaching approach is elaborated,and the problems needing to be paid attention to in the process of its application and fulfillment are also discussed.

OBJECTIVE:To explore the risk factors for nosocomial infection of multidrug-resistant organism (MDRO) in ICU,and to provide reference for preventing and controlling MDRO in ICU. METHODS:In retrospective study,246 patients with nosocomial infection from ICU of Xi'an Aerospace General Hospital (hereinafter referred to asour hospital) during Jan. 2011-Dec. 2015 were selected and divided into non-MDRO infection group (140 cases) and MDRO infection group (106 cases). The detection and drug resistance of MDRO were analyzed in MDRO group. Univariate analysis and binary Logistic regression anal-ysis were used to explore risk factors for nosocomial infection of MDRO. RESULTS:During 2011-2015,435 strains of MDRO were isolated from 106 MDRO infection patients,in which Gram-negative bacteria accounted for 89.43%,showing severe drug re-sistance. Univariate analysis showed that the following 13 factors were related to nosocomial infection of MDRO,such as ICU ad-mission time,hypoproteinemia,acute cerebrovascular diseases,renal abnormalities,mechanical ventilation time,arterivenous cath-eterization time,urethral catheterization time,indwelling gastric tube time,type and time of using antibiotics,combined use of an-tibiotics,application of carbapenems and the third generation caphalosporins(P<0.05). Binary Logistic regression analysis showed that acute cerebrovascular diseases,type and time of using antibiotics were the independent risk factors for nosocomial infection of MDRO in ICU [odds ratios were 2.816,1.582,1.265,95%CI were (1.540,5.151),(1.085,2.306),(1.131,1.415)]. CONCLU-SIONS:Some prevention and control measures should be taken actively for high-risk MDRO infection patients in ICU to reduce the incidence of nosocomial infection of MDRO and improve the quality of health care.

Gastrointestinal bleeding in children is a potentially life threatening medical emergency requiring an appropriate diagnostic and therapeutic approach.The causes of hemorrhage are numerous and varies with age.The clinical presentation of gastrointestinal bleeding in children ranges from asymptomatic microcytic anemia to hypovolemic shock.Therefore,the primary focus in a child with gastrointestinal bleeding is rapid assessment,stabilization,and resuscitation followed by a diagnostic modalities.

Objective:The one-way communication between traditional LIS system and equipment has been unable to meet the needs of business development of medical laboratory in our hospital, we need to upgrade our equipment and to develop the bidirectional communication interface between LIS and equipment.Methods: Our hospital has invested a lot of money to upgrade previous One-way communication interface based on ASTM, the new instrument specifications conform to HL7 standard, and develop bidirectional transmission program based on HL7.Results: After the implementation of the bidirectional communication, testing equipment can automatically identify bar code to get the test request information, after the completion of the test instrument, the inspection unit can automatically send sample results to LIS.Conclusion: Bidirectional transmission improves the work efficiency, transmission based on HL7 is not only fast, but also conducive to the sharing of data between heterogeneous medical information systems, and it is a general tendency.

Objective To dynamically observe the expressions of Toll like-receptor 2 (TLR-2),TLR-4 and inflammatory cytokine IL-1 beta and TNF alpha,and analyze the correlation between TLR-2,TLR-4 and inflammatory response on rat cornea alkali burn.Methods Forty SPF healthy SD rats were excluded the anterior segment disease,the right eye was set as burn experiment and the left eye as normal control,Ⅲ level corneal alkali burn model was established with concentration of 1 mol · L-1 NaOH(At the establishment and after the establishment of the model,the inconsistent degree of corneal bums,the corneal perforation and hyphema in rats,etc.,were removed,and finally randomly selected 32 eligible rats),then were randomly grouped into 3 days,7 days,14 days and 21 days group,8 eyes in each group.The rats were observed and photographed anterior segment of each group,evaluated the corneal inflammation index,then removed the eyeball of the rats in the corresponding time points.The eyeballs were made into pathological tissue section and stained with HE method.The number of inflammatory cells in the cornea was calculated,and the expression of TLR-2,TLR-4,IL-1 beta and TNF alpha was detected in the rat cornea with method of Western blot protein detection at the same time.The differences of each group were analyzed,and the correlation was assessed between TLRs and inflammatory factor.Results There were the expressions of TLR-2,TLR-4,IL-1 beta and TNF alpha in the normal rat cornea,and its expressions were gradually increased after alkali burn,reached the peak at the 7 days,then decreased gradually,the difference of each group (the 3 day,the 7 day,the 14 day,the 21 day) was statistically significant (all P ＜ 0.05).The expressions of TLR-2 and IL-1 beta (r =0.986,P ＜ 0.05),TNF alpha (r =0.986,P ＜ 0.05) were positive correlated.The expressions of TLR-4 and IL-1 beta(r =0.975,P ＜ 0.05),TNF alpha (r =0.990,P ＜0.05) were positive correlated.Conclusion TLRs participates and may start immune inflammatory response after corneal alkali burn,mediates the production of inflammatory cytokine.

Targeted agents for advanced colorectal cancer mainly include inhibitors of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR).Studies show that bevacizumab and cetuximab can improve the prognosis of advanced colorectal cancer patients,but there is slight difference in the choice of chemotherapy regimens when combined with them.Bevacizumab and cetuximab can improve the overall survival of K-ras wild-type colorectal cancer patients similarly.The emergence of new targeted drugs such as aflibercept,regorafenib provides more choices for the targeted therapy of advanced colorectal cancer patients.

Melatonin has a significant inhibitory effect on various cancers,especially on breast cancer.In estrogen receptor (ER)-positive human breast cancer,anti-cancer effects ofmelatonin on breast cancer cells and transplanted tumors mainly achieve by suppressing ER mRNA expression and ER transcriptional activity via the MT1 receptor.In addition,melatonin regulates the transactivation of other members of the nuclear receptor super-family,estrogen metabolizing enzymes,and the expression of related genes.Furthermore,melatonin also suppresses tumor aerobic metabolism,critical cell-signaling pathways relevant to cell proliferation,survival,metastasis,and drug resistance.Melatonin demonstrates both cytostatic and cytotoxic activity in breast cancer cells that appears to be cell-type specific.Studies on animal and human models indicate that disruption of the circadian nocturnal melatonin signal promotes the growth,metabolism,and signaling of human breast cancer,resulting in invalid hormone therapy and chemotherapeutic resistance in breast tumors.