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Information Services ; Information Systems ; standards ; Public Health ; statistics & numerical data ; Public Health Informatics

Objective To evaluate the effect of infiltration anesthesia at Calot's triangle on postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.Methods One hundred and forty patients,aged 18-64 yr,with 18 kg/m2 ≤ body mass index ≤ 31 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic cholecystectomy,were randomly divided into 2 groups (n =70 each):control group (group A) and infiltration anesthesia at Calot's triangle group (group B).In group B,1％ ropivacaine 10 ml was injected into Calot's triangle before dissection of the gallbladder,while the equal volume of normal saline was injected into Calot's triangle in group A.The patients in both groups received patient-controlled intravenous analgesia (PCIA) for 48 h starting from 10 min before the end of surgery.The VAS score was maintained below 4 during PCIA.When VAS score ≥ 4,lasting for more than 30 min,tramadol 1.5 mg/kg was injected intravenously.The consumption of physic liquor for PCIA,and requirement for tramadol were recorded.The incidence of puncture-related damage to Calot's triangle and local anesthetic intoxication and adverse effects such as nausea and vomiting within 48 h after surgery were also recorded.The first postoperative flatus time was recorded.Results Compared with group A,the consumption of physic liquor for PCIA,requirement for tramadol,and consumption of tramadol were significantly reduced,and no significant change was found in the incidence of nausea and vomiting and the first postoperative flatus time in group B.No puncture-related damage to Calot's triangle occurred in A and B groups.There was no local anesthetic intoxication in group B.Conclusion Infiltration anesthesia at Calot's triangle can optimize postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.

Objective To observe the changes of red blood cell distribution width, mean platelet volume and cardiac troponin I in patients with Acute Coronary Syndromes, and to evaluate the value for early diagnosis by using ROC curve. Methods 191 patients with ACS and 206 patients with the chest pain syndromes non-ACS were selected in this study. Electrocardiogram,blood routine,creatinine, LDL-C and cardiac troponin I were determined within six hours after hospitalized,meanwhile the feature of ROC curves was observed. Results There was no significant difference between ACS group and non-ACS group about red blood cell, hemoglobin, platelet,creatinine and LDL-C［(3.82±0.57)×1012/L,(101.3±3.3)g/L,195（98.6-334.8）×109/L,69（45-120）μmol/L,(2.95±0.85)mg/dl vs (3.89±0.50）×1012/L,(103.5±3.7)g/L,201（135.2-346.9）×109/L,71（49-100）μmol/L,(2.82±0.75)mg/dL］ (P＞ 0. 05). Red blood cell distribution width, mean platelet volume and the cardiac troponin I in ACS group［13.70(12.00-15.20)%,9.4（7.42-12.31）fL,(5.63±1.39)μg/L］ were significantly higher than that of non-ACS group［12.60（11.20-13.83）%,8.2（6.24-10.97）fL,(0.04.±0.01)μg/L］ (P＜0.01) .The area under ROC curves of red blood cell distribution width,mean platelet volume and cardiac troponin I were 73.5%, 78.8%, 98.1% respectively, while the best cut-off value was 13.15%, 12.45 fL, 0.06 μg/L respectively. Conclusions The combination using of red blood cell distribution width andmean platelet volume and cardiac troponin I and other conventional cardiac markers might be served as early diagnosis marker for the ACS patients admitted to emergency departments.

Objective To discover the role of interleukin-18(IL-18) and CD_(54) in congestive heart failure(CHF),and evaluate the diagnostic value of IL-18 and CD_(54) in CHF.Methods Blood samples were collected from 52 children with CHF,included 18 cases in classⅡ,17 cases in class Ⅲand 17 cases in class Ⅳ.Fifteen healthy children were normal control group.The levels of IL-18 was(detec-)ted by ELISA method and the expression of CD_(54) was examined by flow cytometry.Results The levels of IL-18 and CD_(54) in CHF were significantly higher than those of control subjects(P0.05),but the levels were respectively significantly higher than that of control subjects(P

Objective:To investigate the diagnostic value of serum GP73 combined with Dickkopf-1 and AFP in hepatocellular carcinoma.Methods:117 cases of hepatocellular carcinoma in our hospital were collected as hepatocellular carcinoma group,80 patients with hepatitis B virus as the hepatitis group,and randomly selected 80 healthy subjects as the control group from September 2014 to September 2016.The serums GP73,Dickkopf-1,AFP level of every group were detected by the enzyme-linked immunosorbent assay (ELISA),and the relationship between the GP73,Dickkopf-1,AFP between clinicopathological features were analyzed,the diagnostic value of GP73,Dickkopf-1 and AFP in hepatocellular carcinoma were analyzed.Results:The serums GP73,Dickkopf-1,AFP level of hepatocellular carcinoma group were higher than those of hepatitis group,control group,and the serum AFP level of hepatitis group was higher than that of control group,the difference was statistically significant (P＜0.05).The GP73,Dickkopf-1,AFP in patients with classification B～C were higher than those in classification A among the Child Pugh classification,the difference was statistically significant (P＜0.05).No statistical significance on difference of GP73,Dickkopf-1,AFP between different differentiation,tumor size,number of tumors was found (P＞0.05).The sensitivity,specificity,positice predictive value,negative predictive value,and accuracy of GP73+Dickkopf-1+AFP in the diagnosis of hepatocellular carcinoma were higher than those of GP73,Dickkopf-1,AFP respectively,the difference was statistically significant (P＜0.05).Conclusion:Serums GP73,Dickkopf-1,AFP in patients with hepatocellular carcinoma have high expression levels,combined with the three indicators can obviously improve the diagnostic value of hepatocellular carcinoma,which has clinically important reference value.

This paper is based upon a certain hospital's Mobile Clinical Information System. It discusses the design of the system in detail from three aspects: its function, its framework and the selection of its software and hardware. Finally some discussions are made for its improvement and perfection. PDA (personal digital assistant), clinical information, wireless network
Hospital Information Systems ; Microcomputers ; Software Design

Objective To investigate symptom characteristics and their their prevalence in terminally ill patients with ovarian carcinoma.Methods A retrospective study was carried out based on clinical data of 98 terminally ill patients with ovarian carcinoma who died in our hospital during January 1995 to December 2004.Fifteen most common symptoms were analyzed with a focus on the followings:symptom incidence,survival time after symptom occurrence,regularity of symptom cluster,and common causes of death.Fifteen symptoms were:pain,cachexia,pleural effusion and ascites,dyspnea,fever,intestinal obstruction,renal failure,bone marrow depression,lung infection,hemorrhage,deep venous thrombosis (DVT),intestinal or pancreatic fistula,mycotic infection,jaundice and emergency conditions.Results (1)The most prevalent symptom was pleural effusion and ascites(63%),followed by pain(60%), cachexia(59%),dyspnea(52%)and intestinal obstruction(49 %).(2)The symptom which lasted longest survival time was mycotic infection(77 days),followed by intestinal or pancreatic fistula(75 days), intestinal obstruction(67 days),pain(60 days)and eachexia(60 days).Symptoms such as bone marrow depression,renal failure,dyspnea and emergency conditions were comparatively critical associated with shorter survival times(14,13,12,7 days,respectively).(3)Terminal symptoms occurred typically in clusters,with 4.9?1.5 symptoms per case.Of 98 cases,84 cases(86%)had 4 or more symptoms,with the median survival time of 63 days from the last day of anti-cancer therapy,and a slow death process.The remaining 14 cases(14%)with 3 or fewer symptoms survived only 25 days,of which 10 cases(71%)died of emergency diseases.The survival time for two groups was significantly different(P

0.37).Meanwhile a good correlation (Y=0.99X-0.18,r=0.987) was obtained. Though Westergren method correlated preferably with MICROTEST 1 (Y=0.86X+1.27,r=0.906),there was a markedly different (t=3.174,P=0.001).At last different references values were collected, according to sex and age.Male,32.5 mm/1 h(60 years old);Female, 34.03 mm/1 h(50 years old).Conclusions MICROTEST 1 correlated preferably with Westergren method.The examination by MICROTEST 1 needs small quantity of sample and fewer time.Furthermore,it has good repeatability and stability.The factors such as temperature and Hct have little influence on the results.The result suggested that it is suitable to apply MICROTEST 1 to large- scale clinical laboratory or other labs.But the reference value of ESR was influenced by age,which should be considered in clinical usage.

Fourteen psychrotrophic bacteria were isolated from swamp soil collected in Ruoergai plateau wetland,and their generation time and degrading ability of livestock wastewater CODcr was determined.The results showed that the generation time was within 4.9 h to 11.6 h.Based on the generation time,9 psychro-trophic strains(NLJ1,NLJ6,NLJ7,NLJ9,NLJ10,NLJ11,NLJ12,NLJ13 and NLJ14),whose generation time was within 4.9 h to 5.6 h,were chosen to treat livestock wastewater.The results suggested that these 9 strains had different CODcr disposal ability when treating livestock wastewater singly at 6?C for 6 h,and strains NLJ6,NLJ7,NLJ9,NLJ10,NLJ11 and NLJ13 had good ability to degrade livestock wastewater,the CODcr degrading rate was about 60%~70%,hence,they were used as high efficient strains;However,the CODcr degrading rate of the other strains was less than 50%.After inoculating mixture culture of these six strains into the distilled livestock wastewater,after 6 h's treating,the CODcr degrading rate reached to 85.42%.Furthermore,activated sludge collected from Yaan,Dujiangyan and Chengdu were inoculated by the mixture culture of those six strains,and used to treat livestock wastewater for 6 h.The results showed that the average CODcr degrading rate was 81.67%,76.32% and 70.56%,respectively;Variance analysis showed that there was no significant differentiation between each treatment,which revealed that those six psychrotrophic strains had good adaptability to different source of activated sludge.