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 know the principles of the transformations of the spatial directions in the view of the 0~ sinus endoscope and to simulate the space in endoscope using SkechUp software. METHODS The ideal model of the nasal cavity was designed and observed by the 0?rod-lens telescope. The space of the model in the endoscope was simulated using SkechUp.The principles of the transformations of the spatial directions were observed,which consisted of the lateral horizontal line (Lhn,n=0-6),the lateral vertical line (Lvn,n=0-9),the top horizontal line (Thn, n=0-9) and the lateral angle line (LAL).The location of the horizon was observed.RESULTS If the elevation angle (between the endoscope and bottom of nasal cavity) of the endoscope entering the model was unchanged and the distance of the endoscope entering the model was increased gradually,the positions of Lhn,Lvn and Thn in the visual field of the endoscope were replaced by Lh (n+1),Lv (n+1) and Th (n+1) respectively.The positions of Lhn,Lvn and Thn had repeatable characteristics.One horizontal plane in the space can become a horizon in the view and the location of the horizon in the view was invariable.If the distance of the endoscope entering the model was unchanged,the endoscope was moved to produce15?,30?,45?,60?elevation angle gradually,the positions of LAL (15?,30?,45?,60?) had the symmetry and repetition and the position of the horizon in the view was variable.CONCLUSION The directions of Lh and Lv and the locations of the horizon in the view of the 0?endoscope are correlative with the elevation angle of the endoscope,not pertinent to the distance of the endoscope coming into the nasal cavity.The directions of the space in the visual field of the endoscope have the symmetry and repeatable characteristics.Simulating the space in the visual field of the endoscope using SkechUp software provides the bases for the operation.

Objective To evaluate the diagnostic evaluation of isotropic scanning and Lung Care soft- ware in solitary pulmonary nodules,and to improve the diagnostic accuracy.Methods 52 patients suffered from SPN were included in our study.Two experts in CT analyzed the films.First,they read the axial images and made diagnosis.Then isotropic scanning and lung care software approaches were used on 16 spiral CT and another analysis were made again.The results were compared with pathological diagnosis respectively. Results Spiculated sign,lobulated sign,vessel convergence were found more on isotropic scanning approach, that had significant difference with axial images analysis(P

0.05).The adverse reaction rate was 14.0% (7 case) in the treated group and 15.6%(7 cases) in the controlled group. There was no significance difference between the two groups (P=0.83). But the adverse reactions were more tolerable in LEF group than in MTX group. Conclusion This study suggests that LEF is an effective and more safe drug for active rheumatoid arthritis in our country.

Objective To observe the therapeutic effects and assess the feasibility of radiofrequency thermo- coagulation denervation(TRD)mediated by digital subtraction angiography(DSA)for patients with lumbar facet joint syndrome(LFJS).Methods Eighty LFJS patients were randomly divided into two groups:a denervated group(groupⅠ)and a control group (groupⅡ).The lumbar facet joints of the patients in groupⅠwere treated with TRD,while those in groupⅡhad their lumbar facet joint cavities injected with the mixture of 1 mg betamethasone and 1 ml lidocaine.All patients were assessed using the Visual Analog Scale(VAS)before treatment and 30 rain,1 d, 1 w,1 m and 6 m after.Schober values were measured at 1 w,1 m and 6 m after treatment.The therapeutic effects and side effects were assessed at 6 m after treatment.Results VAS scores in groupsⅠandⅡat 30 min,1 d,1 w and 1 m after treatment were remarkably lower than before treatment.In addition,those in groupⅠ6m after treatment were also significantly lower(P＜0.01).Compared with those in the groupⅡ,VAS scores in groupⅠwere signifi- cantly decreased at 1 m and 6 m after treatment(P＜0.05 and P＜0.01,respectively).The schober values in groupⅠat 1 m and 6m were obviously increased in comparison with those in groupⅡ,while the therapeutic effects in groupⅠat 6m after treatment were better than those in groupⅡ(P＜0.01).There were no side effects,such as injuries to the nerve roots or dysfunctional dermal sensation,in either group.Conclusion TRD,mediated by DSA,has ther- apeutic effects on LFJS.Such treatment is safe,convenient,and gives long-term pain relief.

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 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.