The paper analyzes the deficiencies of the traditional Hospital Information System (HIS),establishes the hospital data mining and analysis platform,introduces the platform architecture,builds the data mining models themed by analysis of hospital leaders,supervision and management of antibacterial drugs,analysis of hospital quality,analysis of single disease,expenditure control by medical insurance,etc.,and puts forward the smart solutions to improve the service tevel of hospitals on the basis of above.

OBJECTIVE To explore the methods and effects of endoscopic nasal structure reshaping for treatment of chronic rhinosinusitis(CRS). METHODS One hundred and twenty-three cases of CRS patients with abnormal anatomy in nasal cavity and sinus were treated by the Messerklinger approach. At the same time varieties of anatomical abnormalities were corrected,including:①submucous resection of nasal septum,②submusous middle turbinate resection,③submusous inferior turbinate resection,④Uncinate process resection ⑤deal with frontal recess and its adjacent cells. RESULTS All patients were followedup for 1 to 2 years. One hundred and six cases were successful,14 satisfied and 3 inefficient. The rate of full recovery was 97.56%. CONCLUSION Reshaping nasal structure during endoscopic surgery is a method worth recommendation for structural rhinitis.

Objective To investigate the correlation between level Ⅱ cervical lymph node metastasis (CLNM) and thyroid disease background,tumor size,location,and local lymph node metastasis in patients with papillary thyroid carcinoma (PTC).Methods A thyroid cancer database was established using Access database software.62 patients with PTC undergoing neck dissection in the 1st Department of Head and Neck surgery of Sichuan Cancer Hospital from Aug.2013 to Mar.2014 were retrospectively reviewed in terms of their sex,age,thyroid disease background,number of nodules,tumor size,location,and CLNM.Results 30 out of 62 patients had level Ⅱ cervical lymph node metastasis (Ⅱa:27 cases,Ⅱb:6 cases).13 out of 23 patients without history of other thyroid disease had level Ⅱ CLNM,9 out of 17 patients with Hashimoto's thyroiditis had level Ⅱ CLNM,3 out of 18 patients concomitant with nodular goiter had level Ⅱ CLNM and 2 patients concomitant with hyperthyroidism and having received radioactive iodine 131 treatments had level Ⅱ CLNM.Among patients with level Ⅱ CLNM,2 patients had tumors ＜10 mm,17 patients had tumors between 10 mm and 40 mm,and 4 patients had tumors ＞40 mm.Most of the tumors (11/17) with level Ⅱ CLNM were located in the upper polar of the thyroid,while the rest were located in the middle (12/23) and lower (3/12) region of thyroid.Conclusions Level Ⅱ CLNM is a common feature of thyroid carcinoma.It has been well accepted that level Ⅱ cervical lymph node should be dissected when extracapsular invasion or CLNM to level Ⅲ or Ⅳ occurs.In addition to traditional risk stratification,level Ⅰ CLNM is correlated with tumor size,location,and thyroid disease background.Therefore,close attention should be paid to level Ⅱ cervical lymph node when tumors are located in the upper polar of thyroid and individualized treatment should be chosen for each patient.

Objective To discuss the preventive strategy of complications in reoperation of differentiated thyroid carcinoma (DTC).Method Clinical data of 114 patients with DTC who needed reoperation because of recurrence or inadequate operation were reviewed retrospectively.The reoperations included total thyroidectomy for 101 cases,lobectomy for 13 cases,central compartment neck dissection for 94 cases,and lateral neck dissec tion for 65 cases.Results 8 cases (8.77％) suffered from temporary RLN injury,one patient (0.88％) has permanent nerve palsy.Nerve dysfunction recovered after reoperation in 4 cases who had suffered from recurrent laryngeal nerve palsy in previous operations.Transient hypoparathyroidism occured in 10 patients (8.77％),and per manent hypoparathyroidism happened to 2 patients (1.75％).Conclusion For patients undergoing reoperation,detailed preoperative examination,proper operative approach,meticulous dissection on the thyroid capsule,visual identification of RLN followed anatomic landmark and intraoperative nerve monitoring (IONM) are key factors to reduce complications in reoperation of DTC.

OBJECTIVE To investigate the efficacy and feasibility of endoscopic surgery to manage the tumors involving naso-ethmoidal complex and anterior skull base.METHODS 19 cases of tumors involving nasal cavity,ethmoid sinus and anterior skull base were summarized retrospectively, including 3 cases of ethmoidal squamous carcinoma, 3 cases of esthesioneuroblastoma,3 cases of melanoma,1 case of plasmocytoma,2 cases of ethmoidal adenocarcinoma,4 cases of adenoid cystic carcinoma,2 cases of meningioma.RESULTS Tumors were totally removed in 18 cases and subtotally removed in 1 case,all the cases were followed up for 1 to 3 years.Of the 3 cases of melanoma,1 case died of brain metastases 1 year after surgery,1 case recurred 8 months after surgery,1 case of adenoid cystic carcinoma recurred 17 months after surgery.No recurrence were found in the rest 16 cases during 1-3 years of following-up.CONCLUSION Endoscopic surgery is a effective method for malignant tumors localized in nasal cavity and ethmoid sinus and benign anterior skull base tumors involving nasal cavity and sinuses.Indication must be carefully selected for malignant tumors and postoperative radiotherapy should be advised.

Objective To analyze the pulse-field gel electrophoresis (PFGE) patterns and antibiotic resistance of Salmonella enteritidisstrains isolated in Longyan city in order to provide reference for effective control, clinical diagnosis and treatment of outbreaks of food-borne diseases.Methods Seventy-seven Salmonella enteritidis strains isolated from food poisoning cases, livestock and poultry meat samples collected for food safety risk monitoring and sporadic cases in 2014 and 2016 were analyzed by PFGE.Antibiotic susceptibility testing was carried out to determine the minimum inhibitory concentrations (MIC) of 16 common antibiotics to 57 strains.Results Seventeen PFGE types were identified among the 77 Salmonella strains including three predominant types (P4, P6 and P8) and were grouped into three major pulsotypes (Cluster1-3) at 90% similarity level.The predominant types causing outbreaks of Salmonella enteritidis infection were P8, P6, P4 and P14, which were responsible for five cases of food poisoning.These isolated strains were highly resistant to nalidixic acid (93%), followed by resistance towards ampicillin (74%) and streptomycin (54%).Forty-one strains were resistant to three or more antibiotics (71.93%).Conclusion The PFGE types of Salmonella enteritidis strains isolated in Longyan city exhibit polymorphism and are clustered into three major pulsotypes.PFGE molecular typing can provide early-warning of sporadic outbreaks and help to identify the sources of infections in Salmonella enteritidis-related food poisoning.Attentions should be paid to multidrug resistant Salmonella enteritidis.Surveillance for multidrug resistant strains and usage of antibiotics should be strengthened.

BACKGROUND: Models concerning tumor external environment mainly concentrated on laboratory two-dimensional culture and in vitro animal experiment, which lack of three-dimensional stereo.OBJECTIVE: To establish in vitro bone metastasis stereo models of human prostate carcinoma, and to investigate the effect of stem cells on proliferation rate and clustering size of prostate carcinoma cells. METHODS: Bone marrow mesenchymal stem cells (BMMSCs) were extracted from 2 clean grade SD rats. Alginate was used to simulate medullary microenvironment, where prostate carcinoma cells and BMMSCs were co-culturedd. Growth of the cells in the three-dimensional model was observed through microscope and histological sections. The carcinoma cells were transfected with green fluorescent protein. The proliferation of monoclonal cells clustering was observed under light microscope and fluorescence microscope. RESULTS AND CONCLUSION: In the co-culture group, the clustering speed, clustering amount and tumor formation rate were greater that those of the control group. The monoclonal cells clustering was formed at 7.75 days and 6.00 days in the control and co-culture groups, respectively, with cell counts of (95.13±11.63) and (112.53±14.67) after 10 days. The formation rate of fluorescent cell clones was (77.10±6.85)% in the control group and (64.55±6.21)% in the co-culture group, the difference had significance. The results suggested that: the alginate microenvironment is conductive to proliferation and clustering of prostate carcinoma cells and BMMSCs.

BACKGROUND:Deep vein thrombosis after hip replacement has a high incidence rate. Moreover, deep vein thrombosis can induce pulmonary embolism that can endanger patients’ life and dysfunction of distant deep vein. The appearance of deep vein thrombosis is a great obstacle for the gradual y increased hip replacement.
OBJECTIVE:To observe the occurrence of deep vein thrombosis of lower limb after total hip replacement in elderly patients, and to screen the risk factors for the occurrence of deep vein thrombosis of lower limbs.
METHODS:Clinical data of 128 elderly patients with hip replacement were analyzed retrospectively. Al patients were examined with color Doppler ultrasound in double lower limbs at 1 day before replacement and 7 days after replacement. Multifactor unconditional logistic analysis was conducted on clinical related factors and the formation of lower limb deep vein thrombosis.
RESULTS AND CONCLUSION:At 7 days after the operation, 16 patients affected deep vein thrombosis of lower limb. The factors for deep vein thrombosis contained female, general anesthesia, bilateral hip replacement and the application of bone cement (P<0.05). The risk for deep vein thrombosis after total hip replacement significantly increased in elderly patients aged over 70 years. Multifactor unconditional logistic analysis exhibited that the multiple risks of sex, obesity and the use of bone cement in elderly patients with deep vein thrombosis increased to 11.398, 3.109 and 8.925. The patients with a blood type O at the age of over 70 years experienced a decreased risk for deep vein thrombosis after total hip replacement. The occurrence of deep vein thrombosis decreased to 0.186 times after replacement. Blood type O could be considered as a protective factor for the occurrence of deep vein thrombosis.

Objective To understand the schedule and effectiveness of water-improving defluoridation projects comprehensively of control of fluorosis in drinking-water-borne endemic fluorosis areas in Shandong Province,and to provide a scientific basis for making strategies for prevention and control of the disease.Methods In accordance with the requirements of Shandong Provincial Survey Scheme for Implementation of Prevention and Control Measures of Endemic Fluorosis,the progress of water-improving defluoridation projects was investigated in Shandong Province.The types of water source,scale and operating conditions for water-improving defluoridation projects in 17 cities of the province were investigated.Water fluoride contents of the normal operating projects were detected by F-ion selective electrode.Results ① By the end of 2012,a total of 3 539 water-improving defluoridation projects were built that covered 9 856 fluorosis villages,113 counties,17 cities in the province,and the water-improving rate was 91.01％ (9 856/10 830).The type of water source of water-improving project was mainly groundwater,accounted for 93.78％ (3 319/3 539) of the total projects.As for the scale of the water-improving projects,small centralized water supply projects were the main projects,accounted for 92.96％(3 290/3 539) of the total projects.\)Of all the water-improving defluoridation projects,normal operating projects accounted for 89.12％(3 154/3 539),intermittent and scrapped projects accounted for 3.25％(115/3 539) and 7.63％ (270/3 539),respectively.③Among normal operating projects,the number of projects with water fluoride content ≤ 1.20 mg/L was 1 925,accounted for 72.40％(1 925/2 659).The number of projects with water fluoride content ＞ 1.20 mg/L was 734,accounted for 27.60％ (734/2 659); among them water fluoride contents between 2.01-4.00 mg/L and ＞ 4.00 mg/L were 233 and 65,respectively,and the highest water fluoride value was 9.71 mg/L.Conclusions The progress of water-improving projects in some cities (counties) of Shandong Province is still slow.Some of the water-improving projects can not be operated normally or have been scrapped,and water fluoride content has exceeded the standard seriously.So the prevention and control measures need to be further strengthened,funding should be increased,and the operating conditions and water quality of the water-improving defluoridation projects in Shandong need to be further improved.

Objective To understand the status quo of the illness situation and the implementation of prevention and control measures on Kashin-Beck disease( KBD ) in Shandong Province , and provide a scientific basis for assessment and acceptance of the work on eliminating KBD. Methods In accordance with the requirements of the national “Implementation Scheme for Endemic Disease Control in 2012” and the “Shandong Provincial Technical Scheme for KBD Control in 2012”. In four towns of Qingzhou, three epidemic villages were selected as the surveying villages in each town in order to understand the implementation of measures for prevention and control of KBD; information such as population of investigating villages, per capita income, farming, food and the implementation of control measures,etc were included. In each investigating village, 7 - 12 years old children were selected to receive clinical and X-ray examination. When fewer than 50 people in a investigating village , one additional endemic village was included near the investigating village , and all children aged 7 to 12 of the village were checked. The number of cases of clinical degree Ⅰ, Ⅱ, Ⅲand the detection rates, X-ray positive detection rate, the number of cases of metaphysis, epiphysis, distal end of phalanx, carpal bone, triad and the detection rates were calculated, respectively. Clinical and X-ray diagnosis were based on “The Diagnostic Criteria of Kaschin-Beck disease”(WS/T 207-2010). Results A total of 14 epidemic villages were selected to survey in four towns of Qingzhou. In the recent three years in the epidemic areas, measures of supplying Se had not been implemented;measures of resettlement and off-site education had not been implemented either. In the epidemic areas , the main crops were wheat and corn; the staple food was flour which accounted for more than 80%, and the foreign food bought accounted for only 11%. The areas of returning farmland to forest (grass) accounted for 0.32%(36/11 151) of the original arable land, and the areas of replanting economic crops accounted for 1.17%(131/11 151) of the original farmland. A total of 536 children aged 7 to 12 were examined by clinical and X-rays. Patient of KBD was not detected clinically. Six positive patients with metaphyseal changes of KBD were detected by X-rays, and the average X-ray detection rate was 1.12%(6/536). Patients with abnormal epiphysis, distal end of phalanx and carpal bone were not detected by X-rays. Conclusions KBD in Shandong Province has been effectively controlled. Since the cause of KBD is still unknown, it is necessary to build a sustainable long-term control mechanism of KBD;further improve the monitoring system and dynamic monitoring work still need to be strengthened.