Objective:To study the effectiveness of Loop electrosurgical excision procedure (LEEP) in the diagnosis and management of cervical intraepithelial neoplasia(CIN). Methods: 155 patients with CIN were diagnosed by cervical biopsy under colposcopy. All cases were treated with LEEP and the operative time, bleeding volume, cervical biopsy results before and after LEEP were evaluated, and the effects and cervical regeneration were followed up. Results: The mean operative time of LEEP was 6. 8 minutes. The mean bleeding volume was 9.6m1. Pathological diagnosis of CINI CIN Ⅱ CIN Ⅲ after LEEP were positively correlated to directed biopsy by colposcopy. The correlation coefficient was 0.785 ( P < 0.01). The cure rate of LEEP was 98.6%. Among the 151 cases, 134 (88. 7%) were satisfactory cervical regeneration. Conclusions: LEEP is one of the effective and safe methods for the diagnosis and treatment of CIN.

Objective:To observe the therapeutic effect of Xiaoshui Formula Ⅱ on malignant ascites.Methods:60 cases of malignant ascites were randomly divided into a treatment group and a control group.The treatment group was treated with external application of Xiaoshui Formula Ⅱ and the control group with intraperitoneal injection of DDP.The therapeutic effect of Xiaoshui Formula Ⅱ was observed.Results:The total effective rate of ascites resolution was 87.1% in the treatment group and 58.6% in the control group.There were significant differences in improvement of clinical symptoms,Karnofsky score and correlative indexes between the two groups.Conclusion:Xiaoshui Formula Ⅱ has better therapeutic effect than intraperitoncal injection of DDP,with no side effect.

Objective To explore the similarities and differences in endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus (BE). Methods Three hundred and seventy-one cases with BE were divided into elderly group (n=254) and nonelderly group (n=117). The detection rate, endoscopic findings and pathological changes were assessed. Results The detection rate of BE was 2.9% in the elderly, and 0. 9% in the non-elderly(χ2 =127.8, P＜0.01). The 112 cases (44.1%) of the elderly had reflux symptoms, and so did 87cases (66.7%) of the non-elderly (χ2 =55.9, P＜0.01). The detection rate of BE in the two groups was increased year by year from 2004 to 2008. The detection rate of ring pattern was significantly higher in elderly group than in non-elderly group (28.7% vs. 10.3%, χ2=14.5, P＜0.01). Nonelderly patients had higher rate of island pattern than elderly patients (59.5% vs. 71.7%, χ2=4.7,P＜0.05). There were significant differences in the rate of specialized intestinal metaplasia between elderly and non-elderly patients (42.1% vs. 27.4%, χ2=6.9, P＜0.01). The difference in low and medium grade intraepithelial neoplasm between the two groups had statistical significance (21.3% vs.11.1%, χ2=4.9, P＜0.05). There were two cases with adenocarcinoma in elderly group, but no case was found in non-elderly group. The detection rate of H. pylori was comparable between elderly group and non-elderly group (35.5% vs. 40.9%, χ2=0.40, P＞0.05). Conclusions The elderly patients have the 3.2 times higher detection rate of BE than non-elderly patients. The detection rates of specialized intestinal metaplasia and intraepithelial neoplasm are higher in elderly group than in nonelderly group.

Objective:To evaluate the efficacy of chemotherapy for advanced biliary tract carcinoma and the factors that influence sur-vival. Methods:A total of 91 cases of advanced biliary tract carcinoma from January 2010 to April 2015 were enrolled in our study. The patients' characteristics, chemotherapy regimens, and effects were analyzed. Results:We enrolled 56 males and 35 females with a me-dian age of 57 years. A total of 90 patients were assessable for their responses to first-line chemotherapy. A total of 69 patients re-ceived the GP regimen, whereas 21 patients received some other regimens. The disease control rate (DCR), median progression free survival (mPFS), and median overall survival (mOS) were 68.1%versus 52.4%, 5.10 months versus 2.50 months (P=0.025), and 13.00 months versus 7.20 months, respectively. Only 31 patients received S-1 based regimens, and 12 patients received some other regi-mens as second-line chemotherapy. The DCR, median PFS, and median OS showed no statistical differences. Only four patients re-ceived S-1 based regimen plus bevacizumab as second-line chemotherapy (median PFS 5.3 months;median OS 7 months). Hematologi-call toxicity was the most common side effect in the first-line GP regimen. The side effects of the S-1 based chemotherapy regimen was relatively less. Conclusion:The GP regimen is an effective first-line chemotherapy for advanced biliary tract carcinoma, whereas S-1 ap-pears as an effective second-line chemotherapy drug. Bevacizumab-based regimens may be effective and require further validation.

Objective To evaluate the effects on catheter related blood stream infection by different dressing frequency of peripherally inserted central catheter(PICC)with neonates. Methods A systematic review of randomized controlled trials (RCTs) from databases, Data were searched about the transparent dressing replacement frequency for neonatal PICC catheterization. The meta-analysis was performed by using RevMan 5.2 software. Results Nine RCTs were included in a total of 1 730 patients. Meta analysis showed that there was no significant difference in the incidence of PICC puncture dressing, catheter-related infections (including puncture port infection, catheter-related blood flow infection, catheter bacterial colonization) at every 3, 5, and 7 days (P> 0.05). Conclusion the dressing of PICC catheter are replaced will not increase the incidence of catheter-related infections within 7 days, throughout the more appropriate frequency of dressing replacement is once every 7 days.

Objective To construct and apply an intelligent follow-up information system for patients with cancer pain,providing references for improving the efficiency of hospital follow-up and promoting pain management of patients at home.Methods The intelligent discharge follow-up system for patients with cancer pain includes 2 platforms,namely a patient self-report platform and an administrator operation platform.The administrator operation platform consists of 5 modules,namely the workbench module,the follow-up plan module,the follow-up results module,the health education module and the data statistics module.In January 2022,the system was officially put into clinical application.The use of the system was analyzed,and patients'completion rate,medication compliance,incidence of moderate and severe pain and satisfaction with pain control were compared before(from January 2020 to December 2021)and after(from January 2022 to November 2023)the application of the system.Results At present,this system has been applied in 95 cancer-related wards of our hospital.From January 2022 to November 2023,the number of people who should be followed up was 4 248,and the number of people who actually completed the follow-up was 4 127;the rate of follow-up completion was 97.2%;the rate of timely completion of the follow-up was 94.9%;the rate of automatic follow-up by the system was 40.1%;the rate of patient abnormality report was 31.9%;the rate of timely treatment of patient abnormality report was 89.1%.After the application of the system,the completion rate of pain follow-up was increased,and the difference was statistically significant(P<0.001).After the application of the system,the medication compliance rate of patients with cancer pain increased from 86.9%to 91.0%;the incidence of moderate and severe pain decreased from 6.8%to 5.2%;the satisfaction with pain control increased from 81.0%to 83.5%(P<0.05).Conclusion The intelligent discharge follow-up system for patients with cancer pain can effectively improve the discharge follow-up efficiency and promote the management of patients with cancer pain at home.