OBJECTIVE To develop the nosocomial infection information management subsystem,as a subsystem of the hospital information system,and to enhance the monitoring methods of hospital infections. It can monitor and provide necessary infection information for all administers of the hospitals. METHODS After collecting the data of hospital infections and analyzing the datum structure of the hospital information system,we developed the software of nosocomial infection information management subsystem using PowerBuilder9.0 and Oracle Database. RESULTS The subsystem could monitor infection of all inpatients,collect and analyze the data of infection examination,patients infected,usage of antibiotics and intervening operations,therefore,relieve information administers from collection works and make them focus on analysis,guidance and problem solutions. CONCLUSIONS As a part of the hospital information system,nosocomial infection information management subsystem can improve the effectivity and efficiency of hospital infection administers due to its accuracy,timeliness and wide coverage.

Objective To discuss the ventilatory catheter-assisted airway stenting under local anesthesia for airway stenosis.Methods From May 2008 to January 2013,25 consecutive patients with airway stenosis underwent the treatment of ventilatory catheter-assisted airway stenting under local anesthesia.The dyspnea score was grade Ⅱ in 3 patients,grade Ⅲ in 18 patients and grade Ⅳ in 4 patients.During the treatment,a 4 F VER catheter was placed into one of the main bronchi as a ventilatory catheter for oxygen supply in advance,the oxygen flow was set at 2 to 4 L/rmin according to the patients' condition,then the airway stenting was performed,after release of the stent,the ventilatory catheter was removed smoothly.Data on technical success,clinical outcome and follow-up were collected and analyzed respectively.The paired t test was performed to compare variables before and after tracheal stenting.Results Ventilatory catheter-assisted airway stenting under local anesthesia was technically successful in all patients.A total of 25 stents were placed in 25 patients.The stents included I-shaped stents (n=19) and Y-shaped stents (n=6).After the oxygen supply,the patients' SaO2 was increased to 94％ to 97％ rapidly.When the stent introducer sheaths were passing through the stenotic site,the SaO2 could be maintained at 92％ to 97％.The improvement of the respiratory difficulty was achieved in 100％ of our patients.The hypoxia symptom was relieved immediately after stents placement,the dyspnea score decreased to grade 0 in 2 patients,to grade Ⅰ in 19 patients and to grade Ⅱ in 4 patients.Respiratory rate and SaO2 improved from (30.0±2.1) times/min and (6.0±3.8)％ before stenting to (19.7±1.6) times/min (t=23.33,P＜0.01) and (93.0± 1.7)％ (t=23.50,P＜0.01) after stenting,respectively.Through the follow-up,3 patients suffered the stent-related complications after discharge,the complications included re-stenosis (n=2) and fracture(n=1).Conclusion Ventilatory catheter-assisted airway stenting under local anesthesia can be an effective,simple and safe method for airway stenosis.

Objective To explore the spiral computed tomography (CT) imaging feature of post-intubation tracheal stenosis (PITS) and to discuss its clinical significance. Methods The clinical data and CT imaging findings of 27 patients with PITS were retrospectively analyzed. The location, degree and shape of PITS were analyzed, and the imaging features were summarized. Based on the imaging features the etiology of PITS was suggested, and the role of imaging feature in assessing PITS condition and in planning clinical management was evaluated. Results A total of 35 tracheal strictures were detected in the 27 patients. The location of the strictures included trachea incision site (n=10), balloon level (n=5) and distal end of tube (n = 20). In all patients the degree of stenosis was > 30%. Localized stenosis was seen in 15 cases, which presented as “hourglass”or “girdle”shape. Segmental stenosis was found in 4 cases, which was characterized by a “ribbon” or “dumbbell” stricture on CT scans. Complex stenosis was found in 8 cases. With the help of imaging findings, all patients got timely, proper and individualized treatment. Conclusion PITS has typical imaging characteristics. Spiral CT scanning should be regarded as the imaging examination of first choice. Based on the different imaging characteristics, the relevant departments can evaluate patient’s condition and make individualized treatment plan. The imaging finding is very helpful for anesthesiologists and other clinicians in recognizing and in managing the post-intubation tracheal stenosis.

Objective To evaluate the therapeutic results of comprehensive interventional therapy for antiphospholipid syndrome (APS) complicated by deep vein thrombosis (DVT). Methods A total of 10 patients with APS complicated by DVT, who were encountered at authors’ hospital during the period from January 2001 to October 2013, were enrolled in this study. The patients included 3 males and 7 females with a mean age of 45 years (39-74 years). The patients were divided into pure anticoagulantion therapy (group A, n = 4) and catheter-based thrombolysis via the jugular vein combined with anticoagulantion therapy (group B, n = 6). The clinical data were retrospectively analyzed. After the treatment warfarin was orally administered in all patients for at least one year. Results There were no significant differences in general clinical characteristics between the two groups. Before the treatment, the circumference difference of the thighs was (5.55 ± 0.51) cm in group A and was (5.13 ± 0.45) cm in group B. After the treatment, the circumference difference of the thighs was (1.85 ± 0.31) cm in group A and was (0.95 ± 0.26) cm in group B. In both groups, the postoperative calf size was significantly reduced when compared with the preoperative one (both P < 0.01), which was more obvious in group B than in group A (P < 0.05). The detumescence rate in group B was significantly higher than that in group A, which was (81.7 ± 4.1)% vs (67.3 ± 3.6)%(P <0.01). The average hospitalization days of group B and group A were (13.83 ± 0.75) days and (20.75 ± 2.63) days respectively, and the difference was statistically significant (P < 0.05). In group A, clinical effective result was obtained in three patients and ineffective result in one patient, while in group B clinical cure was obtained in all patients. Conclusion In treating APS complicated by DVT, catheter-based thrombolysis via the jugular vein combined with anticoagulantion therapy is safe, effective and time-saving, while pure anticoagulation therapy has only limited efficacy.

Objective To explore the effect of sequential therapy of transcatheter arterial chemoembolization (TACE) followed by percutaneous microwave coagulation therapy (PMCT) in treating early-stage primary hepatocellular carcinoma (PHC), and to analyze the factors that may affect the prognosis. Methods During the period from Jan. 2011 to Apr. 2014, a total of 66 patients with early-stage PHC were admitted to authors’ hospital. TACE was carried out in all patients, which was followed by PMCT in 5 -7 days. All patients were followed up regularly. CT, MR, ultrasonography, AFP, liver function and other related laboratory tests were performed. Kaplan-Meier estimation was used for the analysis of disease-free survival time. The high-risk factors were analyzed by Chi-square test. Multivariate analysis was conducted by using logistic analysis method. Results After TACE the serum levels of ALT, TBIL and DBIL were increased significantly when compared with preoperative ones (P< 0.01). After sequential PMCT the serum levels of AST, ALT and DBIL were increased significantly when compared with preoperative ones (P< 0.01). When compared with TACE, after sequential PMCT the serum level of AST was increased (P< 0.01), while serum levels of TBIL and DBIL were decreased (P< 0.01). Compared with TACE and preoperative data, the post-PMCT AFP level was decreased (P < 0.01). During the follow-up period one patient died. The 3-year cumulative survival rate was 98.5%. Recurrence was seen in 19 cases. The one-year, 2-year and 3-year disease-free cumulative survival rate was 70.3%, 50.8% and 41.6% respectively. Univariate and multivariate analysis indicated that the risk factors of recurrence in early-stage PHC included AFP ≥ 100 μg/L, viral load≥103 copies/ml and irregularity of tumor border (P<0.05). Conclusion Sequential therapy of TACE followed by PMCT is an ideal treatment for early-stage PHC, sequential PMCT after TACE does not affect liver recovery process. AFP ≥ 100 μg/L, viral load ≥ 103 copies/ml and irregularity of tumor border are the risk factors of recurrence.

Objective Through the research and analysis of guangdong medical college affiliated hospital orthopaedic hospitalized patients with a diagnosis of osteoporosis in Zhanjiang,this paper provide theoretical basis for the prevention of osteoporosis frac-ture.Methods The elderly aged over 40 years old,living in this area for a long time.Data was collected from August 2012 to Feb-ruary 2014,hospitalized patients in guangdong medical college affiliated hospital were diagnosed with osteoporosis.Contents include general situation survey,medical examination,venous blood tests and bone mineral density testing.Results Fracture group average age is older than the non fracture group;the fracture group lumbar spine bone mineral density(LSBMD)and femoral neck bone min-eral density(FNBMD)T value and Z value and serum calcium group is greater than the fracture and the differences were statistically significant(P <0.05).Fracture group in gender divided into two groups for comparison,in which women older than men,and the difference was statistically significant(P <0.05),male LSBMD T and Z values and FNBMD T value is greater than the female and the difference was statistically significant(P <0.05).According to the 10 year age group,Each age group compared with the frac-ture number and non fracture number,in the age group of 70-80 fracture number were the most;All age groups in LSBMD,FNB-MD,serum calcium(Ca)and VitD compared,non fracture group is most higher than that of fracture group.The influence factors of the fractures for non conditional Logistic regression analysis,age,LSBMD,FNBMD T value increased were risk factors for fracture, VitD,FNBMD,LSBMD T value increased were protective factors of fracture.Conclusion Need as soon as possible to prevent osteo-porosis,especially before the age of 40,try to improve the peak bone density,to prevent the occurrence of osteoporosis in the future.

Objective To evaluate the safety and efficacy of Viabahn covered stent in treatment of hepatic artery pseudoaneurysm (HAPA) caused by surgery.Methods Clinical data of 7 patients with postoperative massive intra-abdominal hemorrhage and diagnosed as HAPA with emergency angiography were collected from November 2015 to May 2016.All the patients underwent Viabahn covered stent implantation.Perioperative and postoperative clinical data of the patients were recorded,and with 1-month follow-up.Results All the 7 cases were diagnosed as extrahepatic HAPA and successfully completed Viabahn covered stent procedure,and curative rate was up to 100％.One case experienced transient vasospasm in the hepatic artery proximal to the stent.All the patients repeated hepatic artery CT angiography scans one week after surgery,with no evidence of bleeding.With 1-month follow-up,all the patients were in stable conditions.Conclusion Viabahn covered stent is minimally invasive,simple and effective interventional approach for HAPA.

Objective: The relationship between outdoor temperature and blood pressure (BP) has been inconclusive. We analyzed data from a prospective cohort study in northwestern China to investigate the effect of outdoor temperature on BP and effect modification by season. Methods: A total of 32,710 individuals who participated in both the baseline survey and the first follow-up in 2011-2015 were included in the study. A linear mixed-effect model and generalized additive mixed model (GAMM) were applied to estimate the association between outdoor temperature and BP after adjusting for confounding variables. Results: The mean differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between summer and winter were 3.5 mmHg and 2.75 mmHg, respectively. After adjusting for individual characteristics, meteorological factors and air pollutants, a significant increase in SBP and DBP was observed for lag 06 day and lag 04 day, a 0.28 mmHg (95% Conclusions This study demonstrated a significant negative association between outdoor temperature and BP in a high-altitude environment of northwest China. Moreover, BP showed a significant seasonal variation. The association between BP and temperature differed by season and individuals' demographic characteristics (age, gender, BMI), unhealthy behaviors (smoking and alcohol consumption), and chronic disease status (CVDs, hypertension, and diabetes).
Adult ; Blood Pressure/physiology* ; China/epidemiology* ; Environmental Exposure/statistics & numerical data* ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Seasons ; Temperature

Ohjective To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of sinusoidal obstruction syndrome (SOS) caused by gynura segetum.Methods The clinical data of 9 patients with SOS caused by gynura segetum (5 males and 4 females) who underwent TIPS were retrospectively analyzed from February 2017 to June 2018.The Child-Pugh scores were (9.5 ± 1.3) and the MELD scores were (12.5 ± 5.0).The success rates,complications and follow-up results were evaluated.Results TIPS was performed successfully in all the 9 patients.The portal venous pressure gradient dropped from (22.4 ± 2.7) mmHg to (10.4 ± 3.2) mmHg (P ＜ 0.05).There was no complication such as abdominal hemorrhage and biliary peritonitis.Nine patients were followed-up for 1 ～17months,mean 7.8 ± 6.0 months.One month after treatment,the Child-Pugh scores were (7.1 ± 1.8),compared with that of the preoperative scores,the difference was statistically significant (P ＜ 0.05).The MELD scores were (5.3 ± 4.6),compared with that of the preoperative scores,the difference was also statistically significant (P ＜ 0.05).At the end point of the follow-up,color Doppler ultrasound and portal CTA showed that the TIPS shunt was patent and hepatic congestion was relieved in all the 9 patients.All patients were alive.Conclusion TIPS was a safe and efficacious treatment for SOS caused by gynura segetum.

Objective:To study the risk factors of Budd-Chiari syndrome (BCS) associated with hepatocellular carcinoma in patients who underwent endovascular recanalization.Methods:The data of 340 patients with BCS who underwent endovascular recanalization at the Affiliated Hospital of Xuzhou Medical University between January 2015 and June 2021 were retrospectively collected. Using propensity score matching, a total of 57 patients (40 males and 17 females) were enrolled into this study, with the age of (50.4±8.7) years. Patients were divided into the hepatocellular carcinoma group ( n=19) and the control group ( n=38) according to whether occurrence of hepatocellular carcinoma after cardovascular recanalization. Preoperative indicators including gender, age, BCS type, and model for end-stage liver disease (MELD) score, and postoperative indicators including alpha fetoprotein, intrahepatic nodule formation, vascular restenosis, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were compared between the two groups after propensity score matching. Multivariate logistic regression analysis was used to analyze the risk factors of BCS associated with after endovascular recanalization in these patients. Results:There were no significant differences in gender, age, BCS type, MELD score and other preoperative data between the two groups (all P>0.05). The proportions of patients with postoperative alpha fetoprotein>9.0 μg/L, AST>40 U/L, ALT>50 U/L, intrahepatic nodules and vascular restenosis after endovascular treatment in the hepatocellular carcinoma group were significantly higher than those in the control group (all P<0.05). Multivariate analysis showed postoperative alpha fetoprotein >9.0 μg/L ( OR=46.778, 95% CI: 3.310-661.140), AST>40 U/L ( OR=36.307, 95% CI: 1.317-1 001.009), intrahepatic nodule formation ( OR=66.254, 95% CI: 4.225-1 038.974) and vascular restenosis ( OR=16.276, 95% CI: 1.712-154.773) to have an increased risk of being associated with hepatocellular carcinoma in these BCS patients (all P<0.05). Conclusion:Postoperative alpha fetoprotein>9.0 μg/L, AST>40 U/L, intrahepatic nodule formation and vascular restenosis were independent risk factors of BCS associated with hepatocellular carcinoma in patients who underwent endovascular recanalization.