This paper presents the experience of surgical treatment of 32 patients with esophageal stricture caused by corrosive burn. The modes of surgical treatment in this series included: instrumental dilatation in 11 cases, reconstruction with resection of strictured esophagus in 19 (pharyngogas-trostomy in 6, cervical esophagogastrostomy in 12 and colon interposition in 1) and reoperation for esophageal restenosis in 2, There was no operative morality. All patients were fol- lowed-up and 94% of them resumed their normal diet post-operatively. The author recommend that dilatation can be applied to patients with localized esophageal stricture or slight annular stricture, and should done early. Resection of the esophageal stricture and esophagal reconstruction can be used in patients with extensive or severe stricture. There are many ways to esophageal reconstruction. The optimal one should meet the following requirements: isoperistaltic segment without tension and rich in blood supply, it should be easy to perform and result in no restenosis.

AIM: To analyze the chemical composition and their relative contents of Fuyinjie Compound Huangsong Lotion. METHODS: A capillary column HP-5 MS was used. The column temperature was controlled by a program and the MS analysis was performed with EI and quadrupole mass analyzer. The chemical composition was identified by NIST98 searching and mass spectra comparing, and their relative contents were determined by using normalization method of chromatographic peak areas. RESULTS: There were 39 components found and 31 composed of more than 90% separated components were identified. CONCLUSION: The GC-MS is a simple, rapid and sensitive method for the chemical composition analysis of Fuyinjie Compound Huangsong Lotion.

On the basis of analysis of the current status and future tendency of development of the health services industry in Shanghai,the authors identified key problems and bottlenecks.Thus they made clear the target positioning and principles of the industry,and proposed the basic ideas and pattern of the industry in the 13 th five-year plan period,focusing on such fields as private and high-end healthcare services,traditional Chinese medicine services,public health services,commercial health insurance,and other related industries.In the end,corresponding supporting polices were proposed.

Objective To observe the effects of insulin caliper for blood glucose control on glycemic central tendency, fluctuation and incidence of hypoglycemia, etc., in emergent and critical patients to evaluate its application value.Methods A prospective single-blinded randomized parallel controlled intervention study was conducted. One hundred patients with severe hyperglycemia requiring treatment with insulin infusion admitted to emergency department and intensive care unit (ICU) of the First Hospital of Jiaxing from November 2015 to November 2017 were enrolled, and they were divided into the caliper group (used patented product insulin calipers for blood glucose control to adjust insulin dose for blood glucose control) and the conventional group (used paper-based insulin dose modification scheme to adjust insulin dose for blood glucose control) on average by random number table, 50 in each group. The gender, age, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), sequential organ failure assessment (SOFA), the principal diseases, main factors affecting blood glucose (hepatic and renal insufficiency, hypoglycemic drugs, glucocorticoids, mechanical ventilation, enteral nutrition, parenteral nutrition, intravenous glucose use, etc.), blood glucose levels at each time node (once every 2 hours after insulin use and once every 4 hours after 16-72 hours), glycemic coefficient of variance (CV), glycemic lability index (GLUGLI) and mean amplitude of glycemic excursion (GLUMAGE), insulin dose, incidence of hypoglycemia, proportion of achieving the glucose control target at each time point, the length of ICU stay and hospitalization cost per patient were recorded and compared between the two groups.Results After excluding those with incomplete data and withdraw in the midway, 92 patients were enrolled in the analysis finally,47 in caliper group and 45 in conventional group. There were no significant differences in the incidence of the gender, age, APACHEⅡ, SOFA, presence of infection at admission, previous diabetes history, glycosylated hemoglobin level, blood glucose at admission, proportion of patients after surgery, major diseases at admission and major factors affecting blood glucose between the two groups. A total of 1379 blood glucose measurements were obtained in the caliper group and 1332 blood glucose measurements were obtained in the conventional group. The glycemic measurements in caliper group were significantly lower than that in conventional group at each time point from 6-72 hours. Compared with conventional group, GLUGLI and GLUMAGE were significantly decreased in the caliper group [GLUGLI: 12.96 (8.73, 19.58) vs. 23.27 (13.07, 44.61), GLUMAGE (mmol/L): 0.66±0.22 vs. 0.87±0.28, bothP< 0.01]; there was a tendency towards decreasing incidence of hypoglycemia in the caliper group [8.51％ (4/47) vs. 15.56％ (7/45)], but no statistical difference was found (P > 0.05); the proportion of achieving the glucose control target was significantly increased in the caliper group [41.99％ (579/1379) vs. 27.18％ (362/1332),P < 0.01]. There were no significant differences in glycemic CV, insulin dose, proportion of hypoglycemic measurements in total measurements, and the length of ICU stay, the length of hospital stay, incidence of nosocomial infection, patient prognosis and cost between the two groups.Conclusion For emergent and critical patients, insulin caliper for blood glucose control presents favorable application value for achieving glucose control target, reducing glycemic fluctuation, and lowering the incidence of hypoglycemia.Clinical trial registration China clinical trial registration center, ChiCTR1800015024

Marked by the Third Plenary Session of the Eleventh Central Committee of the CPC, Shanghai health care started a journey of reform and opening up as with other sectors. This essay reviews various stages Shanghai health care experienced and the achievements for the last 30 years since reform and opening up, and analyzes the challenges Shanghai health care faces currently. On this basis, the essay summaries the experiences and lessons learned from Shanghai health care reform and development.

Objective To ensure the safety of oral administration at night among elderly inpatients. Methods By the purposive sampling method, a total of 165 clinical nurses and 274 elderly patients were selected as sample. Elderly patients received nocturnal tracking and 165 nurses underwent survey questionnaire, that investigate risk factors for night safety of oral-administration. Results For circumstances of night oral medicine administration among 165 nurses, the rate of medicine inspection was highest (90. 9%), while the implementation rate of putting medicine into mouth was lowest (33. 3%). Drug regimen and administration time of elderly patients had positive correlation with the implantation level of putting medicine in the mouth by nurses (r=0.407, 0. 335;P < 0. 05). The compliance and posture of medication administration had positive correlation with medicine knowledge education to patients by nurses (r=0. 380, 0. 429;P<0. 05), and the adverse reactions of patients was positively correlated with nurses observed after taking the drug (r=0. 464,P<0. 05). Conclusions We should focus on guiding elderly patients to take medicine correctly and compliance of medicine order, and carry out the training of comprehensive drug knowledge for nurses to decrease the risks of night medicine administration.

OBJECTIVE: To present the surgical outcomes of advanced epithelial ovarian cancer (AEOC) since the implementation of a personalized approach and to validate multiple predictive models for R0 resection. METHODS: Personalized strategies included: 1) Non-invasive model: preoperative clinico-radiological assessment according to Suidan criteria with a predictive score for all individuals. Patients with a score 0–2 were recommended for primary debulking surgery (PDS, group A), or otherwise were counseled on the choices of PDS, neoadjuvant chemotherapy (NAC, group B) or staging laparoscopy (S-LPS). 2) Minimally invasive model: S-LPS with a predictive index value (PIV) according to Fagotti. Individuals with a PIV < 8 underwent PDS (group C) or otherwise received NAC (group D). Intraoperative assessment (with Eisenkop, peritoneal cancer index [PCI], and Aletti scores) and surgical results were prospectively collected. RESULTS: Between September 2015 and August 2017, 161 pathologically confirmed epithelial ovarian cancer patients were included. A total of 52 (32.3%) patients had a predictive score of 0–2, and 109 (67.7%) patients had a score ≥ 3. Among these individuals, 41 (25.5%) patients received S-LPS. Finally, 110 (68.3%) patients underwent PDS (A+C), and 51 (31.7%) patients received NAC (B+D). The R0 resection rates in PDS and NAC patients were 56.4% and 60.8%, respectively. The area under the curve (AUC) of Suidan criteria was 0.548 for group (A+C). The AUC of Fagotti score was 0.702 for group C. The AUC of Eisenkop, PCI, and Aletti scores were 0.808, 0.797, and 0.524, respectively. CONCLUSION: The Suidan criteria were not effective in these AEOC patients. S-LPS was helpful in decision-making for PDS and should be endorsed in the future.
Area Under Curve ; Cohort Studies* ; Drug Therapy ; Humans ; Laparoscopy ; Ovarian Neoplasms* ; Prospective Studies* ; Research Design ; Triage*

OBJECTIVE To establish a chromatography-mass spectrometry method for simultanenous detection of 3 genotoxic impurities in pantoprazole sodium. METHODS The chromatographic column was octadecylsilane bonded silica gel as filler (Kromasil 100-5, 4.6 mm×25 cm, 5 μm or equivalent column), acetonitrile-0.01 mol·L−1 ammonium acetate(35∶65) as mobile phase, flow rate 0.9 mL·min−1, column temperature 25 ℃; positiveion detection mode, scanning range: 150−450 Da, dryer temperature 350 ℃, dry gas flow rate 10 L·min−1, atomization gas pressure 50 psig, capillary voltage 4 000 V, fragmentation voltage 175 V, cone hole voltage 65 V. The time for entering the mass spectrometry was set to 0−3.5 minutes to waste, 3.5 minutes to retain the main peak-0.5 minutes to MS, and 0.5 minutes to end to waste. RESULTS The concentration of genotoxic impurity 1 had a good linear relationship with peak area between 9.04−27.13 ng·mL−1(r=0.998), the concentration of genotoxic impurity 2 had a good linear relationship with peak area between 8.92−26.75 ng·mL−1(r=0.999), and the concentration of intermediate II had a good linear relationship with peak area between 7.78−23.34 ng·mL−1(r=0.990); the quantitative limit of genotoxic impurity 1 was 9.0430 ng·mL−1, and the detection limit was 0.9043 ng·mL−1; the quantitative limit of genotoxic impurity 2 was 8.9174 ng·mL−1, and the detection limit was 2.9725 ng·mL−1; the quantitative limit of intermediate II was 7.7792 ng·mL−1, and the detection limit was 0.7779 ng·mL−1; the recovery rate of 3 genotoxic impurities ranges from 92.3%−107.0%, with an RSD of 2.0%−7.9%. No three impurities were detected in pantoprazole sodium. CONCLUSION This method can accurately and quantitatively determine three genotoxic impurities of pantoprazole sodium raw material: genotoxic impurity 1, genotoxic impurity 2, and intermediate II. The method has strong specificity, high sensitivity, simple and rapid experimental operation, and can be used for the determination of the above three genotoxic impurities in pantoprazole sodium.

Objective: To investigate the effect of cephalosporin sequential therapy on acute mesenteric lymphadenitis caused by bacterial infection. Methods: From December 2015 to December 2018, 66 patients with acute mesenteric lymphadenitis caused by bacterial infection in Shaoxing Central Hospital were randomly selected.The control group(33 cases) received intravenous infusion of cefuroxime.The observation group(33 cases) was treated with intravenous infusion of cefuroxime, after the abdominal pain disappeared and the peripheral blood cell count returned to normal, the cefuroxime axetil tablet was given orally.The clinical efficacy of the two groups was evaluated, and the treatment costs and adverse reactions of the two groups were counted. Results: The total effective rate of the observation group was 96.97%(32/33), compared with 90.91%(30/33) of the control group, the difference was not statistically significant(χ²=1.26, P=0.53). The total cost of treatment in the observation group was (326.85±51.88)CNY, which was lower than that of the control group[(576.82±72.17)CNY], the difference was statistically significant(t=16.15, P=0.00). There were no significant adverse reactions in the two groups during treatment periods. Conclusion Sequential therapy with cefuroxime and venous infusion of cefuroxime for the treatment of acute mesenteric lymphadenitis in children with bacterial infection is safe, but sequential therapy is less expensive and therefore recommended.