Objective To find out about the current situation of the development of medical record management in Jiangxi Province. Methods Questionnaires were distributed to 182 medical record management workers in 98 hospitals of Jiangxi Province. Results Medical record management has witnessed slow development and the management contingent is characterized by low educational level, low professional titles, a rather limited number of years of work experience and numerical dominance of women. Conclusion That leaders in some hospitals fail to pay enough attention to medical record management and medical record management organizations have not been properly set up constitutes the chief cause of the slow development of the medical record management specialty in Jiangxi Province.

The liver is the most common site of colorectal cancer metastasis(CRLM). The importance of how to treat CRLM has attracted attention from doctors world wide and specific academic organization and expect consensus has been established. Relative principals of treatment of CRLM also developed in China, for example, guideline of diagnosis and treatment of colorectal cancer liver metastasis(draft) and standard for diagnosis and treatment of colorectal cancer, which were established in 2008 and 2010, respectively. However, we found that the Chinese doctors still understand these treatment policies inadequately, and easily produce deviation on the treatment progress. Based on the problems of current CRLM treatment, we have some thoughts or suggestions as follows: (1)Promoting the core conception of CRLM treatment actively: surgery is the only method to achieve possible cure of the CRLM. (2) Evaluating the status of new adjuvant chemotherapy for CRLM dialectically. (3)Paying attention to multi-disciplinary team(MDT): MDT is the scientific treatment foundation of CRLM. (4)Changing the treatment conception of primary tumor of CRLM: radical resection of primary tumor is essential for the resectable CRLM.(5)Emphasizing the surgical treatment of CRLM combined with lung metastasis. (6)Do not neglect the safety of patients, when we emphasize the surgery is the optimal treatment of CRLM. These guides of treatment of CRLM will improve the outcomes of CRLM around the world, but we still need pay attention to above mentioned points in order to insure the standardization and scientification of CRLM therapy.
China ; Colorectal Neoplasms ; pathology ; therapy ; Combined Modality Therapy ; Humans ; Liver Neoplasms ; secondary ; therapy

Objective To investigate the relationship between the ankle-brachial index (ABI)and the extent of coronary artery stenosis and the left ventricular function in elderly patients with coronary heart disease (CHD)with metabolism syndrome (MS). Methods A total of 140 patients with coronary artery disease was study subjects. In which, 66 cases complicated MS (MS group), 74 cases without MS (non MS group). ABI and the left ventricular function was examined in an patients. Results ABI was 0.90±0.32 in MS group, and 1.03±0.26 in non MS group, there was significant difference between two groups(P=0.015). Compared with non MS group, significant lower ratio of ABI in MS group [43.9%(29/66) vs 27.0%(20/74)] (P=0.038); whereas much more 3-vessel disease in ABI≤0.9 patients compared with those of ABI > 0.9 patients [86.3%(25/29) vs 37.8%(14/37) ], significant lower of the left ventricular function in ABI≤0.9 patients compared with those of ABI >0.9 patients (P<0.05). Conclusion There is more severe of coronary artery stenosis in ABI≤0.9 patients for CHD with MS, more attention should be payed to CHD patients combined with MS.

Objective To realize the interface of medical insurance system of Hefei with HIS system. Methods According to the requirements of HIS interior data structure and the networking invocation rules of the medical insurance interface functions dynamic databases provided by Hefei social insurance center, the charging program of No.1 Military Medical Project was modified greatly. Results The call of link library was carried out according to the number, type and returned value of the parameters. Conclusion Modification of the interface of the medical insurance not only makes convenience of patients, increases the serving level of the hospital, but also makes the management of patients standardized, and perfects the information system of the hospital.

Objective To study the application of continuous infusion of remifentanil combined with propofol with different velocity du-ring induction of general anesthesia in elderly patients. Methods Sixty elderly patients were divided into 4 groups randomly(n=15) and given remifentanil with continuous infusion rate of 0.1,0.15,0.2 and 0.3 ?g?kg-1?min-1,respectively.After given midazolam and propofol,remifentanil infusion started with different velocity.Three minutes later,vecuronium was given and intubation performed 2 min later.After that,propofol infusion rate was adjusted according to the changes of blood pressure and kept at 4 mg?kg-1?h-1 5 min before incision.Blood pressure(BP),heart rate(HR),intubation score(following Grant's method) and all side effects and adjuvant drugs used were recorded. Results Grant scores in all patients were less than 8.Atropine and ephedrine were given more in large dose groups and with decreasing of usage of propofol.HR decreased markedly in 0.3 ?g?kg-1?min-1 group after remifentanil began(P

Objective: To investigate the effect of tetramethylpyrazine (TMP), a major active component in Chinese medicine Ligusticum chuanxiong, on metastasis of breast cancer cell line MDA-MB-435S in vitro, and its possible mechanism. Methods: MDA-MB-435S cells were cultured under hypoxic condition, which could trigger malignant metastatic potential of tumor cells in vitro. Thus, the concentration of TMP which could not affect the proliferaion of hypoxic MDA-MB-435S cells was determined by MTT assay. The morphology of MDA-MB-435S cells treated with TMP under hypoxic condition was observed by immunofluorescence. The capacities of invasion and migration of hypoxic MDA-MB-435S cells were determined by Transwell chamber and Wound healing assays, respectively. The expressions of hypoxia-inducible factor-1α (HIF-1α)-mediated metastasis-related proteins, such as vascular endothelial growth factor-A (VECF-A), lysyl oxidase-1 (LOX-1), Snail and Slug, were detected by Western blotting. Results: TMP could significantly change the morphology and inhibit the metastasis of MDA-MB-435S cells cultured under hypoxic condition, improve the morphology of the cells, reduce the number of stress fibers of F-actin, and inhibit the capacities of invasion and migration of the cells in vitro. Moreover, TMP reduced the expression levels of HIF-1α-mediated metastasis-related target proteins VECF-A, LOX-l, Snail and Slug proteins through decreasing the expression of HIF-lα under hypoxic condition, which resulted in the inhibition of metastasis of MDA-MB-435S cells. Conclusion: These findings indicate that TMP can inhibit the metastasis of breast cancer MDA-MB-435S cells by reducing the expressions of HIF-la and the metastasis-related target proteins in vitro. Therefore, TMP may be an effective agent to prevent hypoxia-induced metastasis of breast cancer.

Objective To study the effects of large dose anisodamine (654-2) combined with ulinastain on severe acute pancreatitis (SAP).Methods 100 healthy adult SD rats which were fasted 12 hours before experiment and were allowed drinking water freely,were divided to 5 groups randomly (random number):normal control group,SAPgroup,SAP + Ulinastain group,SAP + Anisodamine group,SAP +Ulinastain + Anisodamine,there were 20 rats in every group.To observe the levels of diastase,phospholipase A2 (PLA2) and endotoxin and pathology of rats in every group.Another cohort of 60 SD rats were divided into 3 groups:SAP group,SAP + Ulinastain group,SAP + Ulinastain + large dose Anisodamine group,survival periods were observed.Results The levels of diastase,PLA2 and endotoxin in SAP rats were higher than those in 3 SAP with treatment groups (P ＜ 0.05).The histopathological changes were most severe in SAP group.All of 3 markers in 3 SAP with treatment groups decreased obviously,and anisodamine alone was effective to treat SAP,but the effect of UTI + 654-2 was better than UTI or 654-2 alone,and histopathological changes were mild in this group treated with UTI + 654-2.Conclusions Anisodamine could effectively relax the Oddi sphincter thereby decreasing the hydrostatic pressure inside the bile duct and pancreatic duct.Ulinastain is a kind of proteinase inhibitor suppressing many kinds of enzymes and in tern to stabilize lysosomal membrane and inhibit the release of lysosomal enzyme.Combination of the large dose Anisodamine with Ulinastain could inhibit the overexpression of inflammationarv factors in SAP,thereby lessening the severity of viscera injury.

Adult ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; adverse effects ; Humans ; Tachycardia, Reciprocating ; etiology ; Tachycardia, Ventricular ; etiology

Objective To establish an epidemic dynamics model of the transmission and prevention strategies of rotavirus infection in hospital.Methods Rotavirus SEIR model based on different isolation measures was constructed using epidemic dynamics method, the effectiveness of isolation measures was evaluated.Results Supposing that all patients were isolated, isolation measures were taken on the 3rd day of transmission, there were 4.3 cases of infection on the 5th day of transmission, peaked on the 7th day(n=6.4), until the 14th day of transmission, the number of infected persons fell to 3.4 cases.If isolation measures were taken on the 2nd day of transmission, the infected persons reached 4.0 on the 6th day, and reduced to 3.2 cases on the 8th day.If isolation measures were taken on the 1st day of transmission, the infected persons reached 2.4 at most, healthcare-associated infection would not occur.Early isolation can effectively prevent the outbreak of rotavirus infection, the later the isolation, the more the infection occurs and the longer the outbreak lasts.Conclusion Rotavirus infection can easily break out in hospital, early discovery and early isolation of rotavirus infected child is the effective measure to avoid rotavirus infection outbreak in hospital.

Objective To explore the clinical efficacy of endoscopic transgastric or transpapillary drainage in treatment of pancreatic pseudocyst. Methods 100 patients with pancreatic pseudocyst from March 2014 to March 2015, 80 cases were underwent endoscopic ultrasound-guided transgastric and the other 20 cases were underwent transpapillary drainage. The treatment effect and complications were recorded. Results The success rate was 95.00 %, and cysts completely disappeared in 84.00 % of the patients. Among all the patients there are 10 cases occurred intraoperative bleeding, 3 cases occurred stent clogging or migration and 7 cases occurred infection, the overall incidence of complications was 20.00 %. Conclusion Endoscopic transgastric or transpapillary drainage in treatment of pancreatic pseudocysts has better clinical curative effect, and can also reduce the occurrence of complications, which is worth popularizing clinically.