Eighty-five elderly patients treated for the upper gastrointestinal bleeding(UGB)in our hospital between January 2000 and December 2002 were divided into death or survival group.Their clinical characteristics,risk factors,treatment and complications were retrospectively analyzed.Eighteen patients died of UGB within 30 days.Univariate analysis indicated that documented diabetes,cardiovascular disease,cerebrovascular disease,gastric ulcer,hemoglobin,arrhythmia,stomach cancer,multiple organ dysfunction syndrome(MODS),and shock were significantly associated with inhospital mortality within 30 days(P＜0.05 or P＜0.01).Stomach cancer,MODS,and shock entered into the Logistic regression model.These findings demonstrate that stomach cancer,MODS,and shock might be independent risk factors for short-term prognosis in elderly UGB patients.

With the silver wave struck,China has becone the only country entered the elderly population country with lower income.How to solve the pension dilemma faced by the large elderly population was an unprecedented severe problem that China must face in 21st Century.Through the field research,it led and eucowraged private funds enter the pension service market basde on the construction of mdeical suppotr integration legalsand regnlations.How to provide the diversirfication of the main body and expand the path,how to establish medical support integration pension service information network platform,how to implement the nursing statls' training mechanism for medical suppor integration and how to scientificallg integrate the service resonrces for medical support integration were analyzed.The existing problems of medical support integration service mode in Shenyang was analyzed to provide development suggestions and strategies so as to provide strategic thought for implementing medical support integration in Shenyang.

OBJECTIVE:To explore the development ofMedical support integrationservice mode under theHealthy China 2030development strategy. METHODS:The development experience ofMedical support integrationservice mode in developed countries like the United States,Australia,Japan,Germany and Sweden were summarized,and its enlightenment to China was ana-lyzed. RESULTS&CONCLUSIONS:In the United States,comprehensive services for the elderly was main project;Australia made full use of the third party platform to guarantee the reasonable operation of theMedical support integrationservice mode;Japa-nese health services for the elderly was taken by the combination of nursing insurance system with universal medical insurance sys-tem;Germany and Sweden encouragedHome careservice mode. Based on the advanced experience of foreign countries,com-bined with Chinese national conditions,ChineseMedical support integrationservice mode should adhere to the leading position of the government,introduce market competition mechanism,formulate strictMedical support integrationservices access stan-dards,and actively cultivate professional nursing staff,so as to achieve long-term development.

This paper presents a measurement which determines the CO2 concentrations in the patient's respiratory gases with G C during intravenous anesthesia.The method is simple, unexpensive, and its results are reliable. It is useful to detect the patients respiration, and to monitor oxygen supply after operation.

Objective:As a new strategic industry,health industry was related to the national economy and the livelihood of residents.To probe into the current situation and problems of health industry in Liaoning so as to provide reference for the sustainable development of health industry in Liaoning.Methods:Using the method of literature analysis and interview to explore the comparative advantages and the bottleneck factors of the development of health industry in Liaoning.Results:Liaoning Province medicinal resources were rich and unique,with strong industrial base and protruding industrial cluster advantage,which had leading enterprises significant demonstration effect.Meanwhile,the healthy development of the industry was the imbalanced in regional development,lack of industry standards,lack of R & D innovation,health industry talent scarcity etc.Conclusion:Combined with the actual situation and problems of the development of health industry in Liaoning,it put forward countermeasures and suggestions to provide strategic thinking for improving the development of the health industry in Liaoning.

Objective To improve the diagnosis and therapy level of the uterine intravenous eiomyomatosis, we reported one case involving the right heart and reviewed the relative literatures.Methods and results The patient is 38 years old, she was admitted to hospital with fever, abdominal pain and chest tightness for one week in July 2010. She had a total hysterectomy owing to hysteromyoma in 2003. In July 2010, because she wanted a baby with the method of surrogate pregnancy, so she was injected medicine to stimulate follicle growth in the USA. The medicine was Li ShenBao injection, the total of 12d daily 3 branch (dose not stated). Afterward she couldn't stand fever, abdominal distension and chest tightness, she returned to China for treatment. After she was hospitalized, for diagnosis she got many image examination done, such as B-scan, CT, MRI and PET/CT. Result All image examination found that a massive solid and cystic tumor in the abdominal and pelvic cavity, left kidney hydrocele, ascites, and tumor embolus in the right atrium, inferior caval vein, left renal vein, also bilateral iliac vein. The thoracic-abdominal surgery was carried out, massive tumor was removed, also the tumor embolus in the right atrium and inferior caval vein. The pathological diagnosis was uterine intravenous leiomyomatosis. Conclusion Uterine intravenous leiomyomatosis is a rare disease, involving to heart case is seldomness. In recent years, the case increasing could be related with the usage count of sex hormone in Assisted Reproductive Technology. The imaging examination can give a confident diagnosis, and the final diagnosis depend on pathology. For treatment, surgery is the first choice, and must be thorough to prevent recurrence.

Objective: To observe the ultrasound characteristics of galactostasis at various physiological stages, so as to improve the diagnosis of galactostasis. Methods: The ultrasound data of 56 patients with galactostasis were retrospectively analyzed and the ultrasound characteristics were summarized. The ultrasonic manifestations of different physiological stages were compared. Results: During the lactation period,there were extensive mammary duct ectasias and floating weak signals were found in the mammary duct during pure galactostasis; large non-responsive fluid areas exhibited formations of honeycomb-like multilocular fibrous septa; and these cavities ruptured with abscess when secondary infection occurred. During the later lactation period,the dilated galactophores became hypoechoic or anechoic,which,together with the dot-like echoes of residual breast milk or macular strong echoes, formed mixed signals of retention cysts. After menopause, the galactophores atrophy occurred; the accumulation of galactostasis desiccated into patches or powder, which caused thick hyperechoic dots or multiple hyperechoic streaks in the galactophores or parenchyma. Conclusion: Ultrasonic images of galactostasis vary with the physiological and pathological changes of the mammary glands, and are related to the duration of galactostasis, absorption, concentration and desiccation of lactation.

ObjectiveTo investigate the clinical features,early diagnosis and therapeutic methods of primary tumor of the duodenum.MethodsThe clinical data of 130 patients of primary tumor of the duodenum who were hospitalized in Peaking University Third Hospital from 1974 to 2010 were summarized.There were 30 cases of benign tumors and 100 cases of malignancy. ResultsMore than 90％ of primary tumors of the duodenum were located at the duodenal bulb and descendent part.59％ of malignant tumors were located in the area of duodenal papilla. The mean diameter of benign tumors was less than 2 cm compared with more than 3 cm in malignancies. Upper abdominal pain,jaundice,black stool,intestinal obstruction and abdominal mass were among the most common clinical manifestations. Jaudice was most common in papilla tumors,and intestinal obstruction and palpable abdominal mass often indicate advanced stage.Duodenofiberscopy combined with air barium double contrast radiography increase the diagnosis rate.Among the 30 benign cases,11 cases underwent simple tumor resection,14 cases received endoscopic tumor resection and 3 cases underwent pancreaticoduodenectomy.Resection rate and the 5-year survival rate was 100％. Of the 100 malignant cases,56 cases underwent standard pancreaticoduodenectomy,3 cases received pylorus preserving pancreaticoduodenectomy,9 cases underwent simple tumor resection and 12 cases received segmental duodenectomy.Resection rate was 84％.The 5-year survival rate was 46％ in 59 cases receiving Whipple's procedure.ConclusionsPrimary tumor of the duodenum lacks specific clinical features. Simple tumor resection and segmental duodenectomy can be done for benign cases, while pancreaticoduodenectomy is the therapy of choice for malignant cases.

A review of milestones of medical informationization in China,and a description of standardization,integration,intelligence,mobility and regionalization development.These points are aided by an analysis of hospital information platform,hospital operation management system,the technologies of big data and business intelligence,mobile health and regional health for the purpose of advancing medical informationization in China.

OBJECTIVE:To analyze the risk factors,pathogens and drug sensitivity test of ventilator-associated pneumonia (VAP) in ICU. METHODS:A case-control study was conducted to analyze the clinical data of 190 patients receiving mechanical ventilatory support in ICU. RESULTS:The incidence of VAP in our hospital was 48.4%;elderly patients(>65 years),duration of mechanical ventilation(>5 d),use of corticosteroids,antacid drugs,indwelling stomach tube,and combined use of antibiotics were the risk factors of VAP;among the 162 pathogens,39 were Gram-positive bacteria(24.07%),102 were Gram-negative bacte-ria (62.96%),21 were fungi (12.96%);multi-drug resistance existed in most pathogens. CONCLUSIONS:A variety of factors are closely associated with the incidence of VAP;the main pathogens of VAP are Gram-negative bacteria;the phenomenon of multi-drug resistance is common. Some measures are adopted to decrease the incidence of VAP,such as strengthen monitoring of el-derly patients,to improve their immunity;use hormonal drugs reasonably;shorten the course of mechanical ventilation as much as possible,and plan ventilator removal;elevate the head of the bed and clean the oral for patients receiving gastric canal implantation and enteral nutrition;clean hands in accordance with asepsis principle strictly,and use antibacterials reasonalbly.