Objective To explore a simple and convenient method of small intestine double contrast examination:small intestine double contrast radiography with air-barium by non-tube fast.Methods 130 cases were randomly divided into study group(67) and control group(63).In study group,the enteric-coated capsules to be full of aerogenic powder,barium and cisapride were taken orally by the patients,while in control group,only barium was given orally,and metoclopramide injected by muscle,then the small intestinal air-barium double contrast examinations were performed.Results In the study group,the effect of examinations was satisfactory,ordinary and no effect in 53,12 and 2 cases respectively,and one patients fell because of swallowing difficulty,the total efficiency was 97.02% and the average examination time was(34.63?16.66) minute.In the control group,the effect of examinations was all ordinary and lasted time was(77.12?32.98) minute.These two methods were of remarkable difference in effect and lasted time in statistics(P

Objective To investigate the strategy of diagnosis and treatment for non-functional parathyroid cysts.Methods The clinical data of non-functional parathyroid cysts patients undergoing resection between Jan.1991 and Jan.2013 in Peking Union Medical College Hospital were retrospectively analyzed.Results Non-functional parathyroid cysts were confirmed by intra-operation exploration and post-operation pathology in 22 patients.Ultrasound scan revealed cervical cystic lesions in all patients before operations,and concomitant lesions in thyroid were found in 10 patients.The serum calcium and phosphate level were in normal range in all patients.Local excisions were performed in 11 cases for isolated cyst.Subtotal thyroidectomy were performed in 10 cases for concomitant nodular goiter or close anatomy association cyst and thyroid.Radical resection of thyroid and cervical lymph node dissection were performed in one patient for concomitant thyroid carcinoma.No operation related complications was recorded in these series.No relapse presented in these patients after more than 7 months of follow-up.Conclusion Non-functional parathyroid cysts should be considered in the differential diagnosis of cervical mass even though it rarely occurs.Surgical resection was one promising treatment for non-functional parathyroid cysts.

In an effort to overcome the inherent setbacks of private hospitals in the upcoming healthcare reform, and empower them to build people-benefit hospitals by learning the concept of scientific development, a business model is proposed. This model is designed based on analysis of their development characteristics and in combination of the business specifics, advocating a pool of the guidance force of people-benefit concept, the force of business integrity, that of differentiated competition, and that of self restraint.

Objective To explore the relation of stroke and metabolic syndrome (MS), and provide theoretical evidence for prevention of stroke and MS. Methods Five hundred stroke patients accompanied with MS were enrolled, and divided into different types according to the distribution of the components of metabolic syndrome and abnormal metabolic condition. The systolic blood pressure(SBP) ,diastolic blood pressure( DBP),fasting glycemia ( FPG ), triglycerides ( TG ), total cholesterol ( TC ), low density density lipoprotern-cholesterol (LDL-C), high density density lipoprotern-cholesterol (HDL-C)of each patient were detected and recorded. Results Among these stroke patients with MS, most patients were 60 - 69 years old ( 39.60% ), and there was no significant difference between two gender( P = 0. 545 ). Among each component of MS, hypertension was most related to MS;patients complicated with hypertension + hyperlipidemia + hyperglycemia were the most major proportion of stroke patients with MS(48. 00% ). Conclusion MS and its components are all risk factors for stroke,and the more complication the patients had,the more patients suffered from stroke with MS. Targeted interventions of different type of abnormal condition has important prevention effect on MS and stroke.

Nine hundred and forty nine general physicians in Beijing urban area received surgical skill assessment in 2008.The assessment results of five surgical skills (taking out stitches,changing dressings,skin suture,knot with gloves and wearing isolation gown) were analyzed with the relations of different gender,age,educational background,professional title,specialty,hospital grade,length of service and times of test taking.The average score of the total assessment was 71.The score was lower in the practitioners who were male,older than 50 years,higher educational background,lower professional tide,more than 2 times of test taking,and who were specialized in traditional Chinese medicine,ophthalmology and otorhinolaryngology and emergency medicine.Results suggest that the levels of surgical skills in general practitioners are generally low and periodical training is needed.

Objective To evaluate the effect of vagus nerve stimulation on the blood coagulation and fibrinolysis in endotoxemic rats.Methods Ninety-six male Sprague-Dawley rats,weighing 250-280 g,were equally and randomly divided into 4 groups using a random number table:normal saline group (S group) ; lipopolysaccharide (LPS) group; vagus nerve cutting group (VNC group) and vagus nerve stimulation group (VNS group).Endotoxemia was induced by LPS 10 mg/kg injected via the left femoral vein.In group S,normal saline 5 ml/kg was injected via the left femoral vein.In S and LPS groups,the bilateral vagus nerves were only isolated.The bilateral vagus nerves were isolated,ligated and cut immediately after LPS injection in VNC group.The distal end of the vagus nerve was stimulated with direct current (5 V,2 ms,1 Hz) continuously for 20 min starting from the end of LPS injection in group VNS.Six rats were sacrificed before LPS injection (T0) and at 2,4 and 6 h after LPS injection (T1-3) and arterial blood samples were taken for determination of the levels of plasma tumor necrosis factorα (TNF-α),antithrombin (AT),tissue-type plasminogen activator (tPA),plasminogen activator inhibitor type 1 (PAI-1) and D-Dimer.Results Compared with group S,the plasma TNF-α,tPA,PAI-1 and D-Dimer levels were significantly increased,and AT level was decreased after LPS injection in LPS and VNC groups (P ＜ 0.05).Compared with group LPS group,the plasma AT level was significantly decreased,and the plasma PAI-1 level was increased in group VNC,and the plasma TNFα,tPA,PAI-1 and D-Dimer levels were decreased,and the plasma AT level was increased in VNS group (P ＜ 0.05).Conclusion Electrical stimulation of the vagus nerve can improve the blood coagulation and fibinonlysis in endotoxemic rats,and activation of cholinergic anti-inflammatory pathway,inhibition of inflammatory responses and reduction of damage to vascular endothelial cells may be involved in the mechanism.

Objective To assess the value of color Doppler ultrasonogarphy in the diagnosis of subacute thyroiditis (SAT). Methods Sixty-eight patients of SAT and 30 patients with thyroid papillary carcinoma were included, and their imaging features were retrospectively reviewed. Results All the patients with SAT had either focal or diffuse hypoechogenicity of the thyroid lobes with rich blood supplying in the diseased region, among them 52 patients (76.47%, 52/68) had tenderness on palpation. Diffuse and focal lesions were found in 40 (58.82%, 40/68) and 28 patients (41.18%, 28/68). The boundary and shape of focal lesions had no diagnostic characteristics compared with those of thyroid papillary carcinoma. Punctate calcification and resistance index (RI) in the nodule were significant different between the SAT and thyroid papillary carcinoma (P＜0.05). Conclusion Color Doppler ultrasonography can display the features of SAT and is an effective method for the diagnosis of SAT.

Objective To explore the diagnosis rate.pathology types and positive rate of cancer cell in spu-tum of early central pulmonary carcinoma in three obstructive signs on chest X ray screened by fiberbromchoscope.Methods 326 cases of three obstructive signs with high risk of lung cancer were screened for central pulmonarycarcinoma by spiral CT.biopsy by fiberbronchoscope and cytological examination of sputum.Results 32 patients were diagnosed with central pulmonary carcinoma,with morbidity of 9.8%.In these patients,21 were confirmed with obstructive pneumonia(65.6%),7 with obstructive atelectasis(21.9%),4 with obstructive emphysema(12.5%);In terms of pathology type,16 cases were defined as squamous cell carcinoma(50.0%),9 as small cell carcinoma(28.1%).3 were as large cell carcinoma(9.4%).2 were as adenocarcinoma(6.3%),1 as admosquamous carci-noma(3.1%),1 as bronchial gland carcinoma(3.1%);cancer cell could be found in sputum of 5 patients of 32 cases,among them,it was found in 3 of 21 patients with obstructive pneumonia(14.3%),1 in 7 patients with ob-structive atelectasis(14.3%),1 in 4 patients with obstructive emphysema(25.0%).Conclusion The prevelance of early central pulmonary carcinoma in three obstructive signs on chest X-ray is 9.815%,in which squamous carci-noma and small-cell carcinoma are common in pathology type.Screening can increase the detection rate of early pul-monary carcinoma.

Objective To explore the impact of healthcare-associated septicemia (HAS)on hospitalization expense as well as length of hospital stay,so as to optimize the allocation of healthcare resources,and provide scientific basis for reducing the economic burden caused by septicemia.Methods Hospitalized patients with confirmed HAS in a tertiary first-class teaching hospital between June 1 ,2012 and May 31 ,2015 were investigated retrospectively,con-trol group was set up in a 1 :1 ratio,hospitalization expense and length of hospital stay between two groups were compared.Results A total of 285 cases and 285 controls were enrolled in the study,the median of hospitalization expense in case group was higher than control group (￥19 718.39 vs ￥9 289.04,P <0.05);the median of length of hospital stay in case group was longer than control group (14.89 days vs 9.22 days,P <0.05).The disease bur-den caused by septicemia in different age groups and departments were different.The improvement rate of case group was lower than control group (76.49% [218/285 ]vs 83.51 % [238/285 ],χ2 = 2.562,P = 0.009 ). Conclusion As the common blood stream infection in hospitalized patients,septicemia not only increased the ex-pense of diagnosis and treatment,but also affected turnover rate of hospital bed.Rapid and effective diagnosis and treatment is significant o prevent and control septicemia.

Onodera prognostic nutrition index (OPNI) is a simple and effective parameter. It is calculated by serum albumin level and peripheral blood lymphocyte count. Initially, OPNI is used to assess preoperative nutritional status and surgical risk. In recent years, researchers have found that OPNI is related to the prognosis of many tumors. Simple and accurate prognosis evaluation can help to select treatment methods for digestive system malignant tumors, determine the best pre-operative treatment time and operation time, and improve the survival rate of patients with diges-tive system malignant tumors. The authors review the related literatures at home and abroad, and summarize the research advances in the prognostic value of OPNI for malignant tumors of digestive systems.