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 assess the violence risk levels of the community patients with severe mental illness and Analyze the associated factors.Methods A working group composed of psychiatrists,community police,FIMITIC staff,community physicians,neighborhood or village committee members was established.501 community patients with severe mental illness were evaluated with Violence Risk Assessment Scale by working group.While the data of the general demograpbic,medical history and violence history was investigated.Logistic regression analysis was used to explore the factors associated with violence.Results In 501 patients,risk levels of grade 0:124cases (24.8％),grade 1:165 cases (32.9％),grade 2:118 cases (23.5％),grade 3:59 cases (11.8％),grade 4:28 cases (5.6％) and grade 5:7 cases (1.4％).Logistic regression analysis showed four significant risk factors,which were schizophrenia (OR 4.139),no taking medicine (OR 6.883),unstable condition (OR 234.534) the number of previous violence(OR 3.457) (P ＜ 0.05).Logistic regression equation:Logit (severe violence) =-8.511 + 1.420 (schizophrenia) + 1.929 (no taking medicine) + 5.458 (unstable condition) +1.241 (the number of previous violence).Conclusion The results of violence risk assessment and risk factors have directive significance for management of community patients with severe mental illness.

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.

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.

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.

OBJECTIVE To explore the risk factors and countermeasures of burn wound infection.METHODS The data of burn patients in hospital from 2005 to 2007 were retrospectively analyzed.RESULTS From 341 burn patients 257 got infected and total infection rate was 75.4%.Investigation shows that the probability e of infection in 3 days was 12.9%,but the rate became 72.7% after 4 to 10 days.The bigger the wound area,the higher the possibility to got infected.The infection rate was 43.8% when BSA was smaller than 20.0%.When BSA was bigger than 41.0%,the rate was up to 88.0%.When BSA was bigger than 61.0%,the rate was 100.0%.Except that,antibiotics and standard medical performance were the important factors related to burn infection.CONCLUSIONS To strengthen the aseptic concept among medical staff,pay attention to the environment of hospital,and the sterilization of the materials,debridement and drainage in time,and rational usage of antibacterial drugs,are the effective countermeasures to reduce burn wound infection.

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:To compare the social adaptability of Chinese and Japanese children Method:306 preschool children in Xi'an and 215 Japanese children were sampled The research instrument was the Infant-Junior Middle School Social Adaptive Capacity Scale Result:In the six fields of social adaptability, Chinese children had lower scores than Japanese children, except for that of sports Conclusion:Chinese preschool children have lower social adaptive capacity, which may be due to the overprotective attitude of Chinese parents or grandparents

Objective To study the factors which affect the functional restoration of the elbow for adults with supracondylar or intercondylar fractures of the humerus treated with open reduction and internal fixation. Methods 22 patients with supracondylar or intercondylar fractures of the humerus were treated with open reduction and internal fixation from January, 1999 to December, 2004. They were followed up for an average of 30 months and complete clinical data were kept. The function of the elbow was evaluated with the Mayo elbow performance index. The relationship between the results and the factors —initial time of postoperative rehabilitation, fracture classification, operative approach and interval from injury to operation —were analyzed with cumulative logistic regression model of SAS software V8.2 (SAS institute, Cary, North Carolina). Results Of the 22 cases, 7 were excellent, 9 good, 5 fair and 1 poor. The excellent and good rates were 72.7%. And the odds ratio estimates of the 4 factors were 0.786, 0.299(B/A)0.221(C/A), 1.038, 0.197 respectively. Conclusions The initial time of postoperative rehabilitation, the fracture classification and the interval from injury to operation affect the functional restoration whereas the operative approach does not. Early operation, anatomical reduction, stable fixation and early rehabilitation will help improve the functional restoration.