Objective To analyze the factors influencing the total cost of hospitalization after internal fixation of intertrochanteric fracture.Methods Enrolled in this study were 142 patients with intertrochanteric fracture who had been treated at our department between March 2013 and August 2014.They were 54 men and 88 women,aged from 24 to 95 years (average 69.8 years).Intramedullary fixation was adopted in 135 cases while extramedullary fixation in 7.By AO classification,32 cases were type A 1,75 type A2 and 35 type A3.We analyzed their demographic data,fracture-associated factors,bleeding-associated factors and surgery-associated factors.For univariate analysis,the independent sample t test was performed between 2 groups.One-Way ANOVA analysis was performed among several groups.For multivariate analysis,multivariate linear regression analysis was performed.P ＜ 0.05 was regarded as statistically significant.Results The independent sample test revealed that the total cost of hospitalization for those with preoperative deep venous thrombosis (6.9 ± 1.0 × 105 (￥)) was significantly higher than for those without (5.0 ± 0.8 × 105 (￥)) and the total cost for those undergoing intramedullary fixation (5.5 ± 1.2 × 105 (￥)) was significantly higher than for those undergoing extramedullary fixation (4.4 ±0.7 × 105 (￥)) (P ＜ 0.05).The multiple linear regression analyses showed that preoperative deep venous thrombosis (t =11.750,P ＜ 0.001),perioperative transfusion (t =2.803,P =0.006),hospital stay (t =5.949,P ＜ 0.001) and intraoperative blood loss (t =2.885,P =0.005) were the independent factors influencing the total cost of hospitalization.Conclusions Preoperative deep venous thrombosis,perioperative transfusion,intraoperative blood loss,and hospital stay may influence the total cost of hospitalization for patients undergoing internal fixation of intertrochanteric fracture.More attention should be paid to control of the total cost of hospitalization in addition to ensuring the perioperative life safety.

Adopting the theory of group fairness strategy put forward by Lawrence Kohlberg,an integrity education aimed at medical students is carried out on the basis of class,with teachers,family members and social individuals as cooperators.The integrity education could be promoted by setting up an independent nature,and educational idea of selective moral personality.It puts the core content of impartial democratic participation into effect,takes the morality sense of responsibility education as basis,constructs a democratic participation atmosphere,and emphasizes the significance of daily life during the integrity education in order to promote the cultivation of integrity quality of medical students.

Inflammatory bowel disease (IBD) is a chronic intestinal inflammatory disease with unknown etiology,including ulcerative colitis (UC) and Crohn’s disease (CD).At present,as the global incidence of inflammatory bowel disease is increasing year by year,the role of the intestinal micro ecology in disease evolution has attracted more and more attention,and as an important part of gut microbes system,the intestinal fungus'changes and effects in disease states are unclear.This paper reviews on the intestinal fungus in the occurrence,development of inflammatory bowel disease from the composition and distribution of the intestinal fungus and its relationship with the gut bacteria,and the immune reaction.

Objective:To analyze and compare the dose monitoring and control systems of two types of medical linear accelerator systematically from the view of mechanical and electrical engineering, and establish the method of the quality assurance of the dosimetry system and the solution in the routine maintenance.Methods: To systematically compare and analyze the system of dose monitoring and control for two types of linear accelerators (Precise Elekta and C-series of Varian Medical Systems) from twofold aspects that included machine physics and electric engineering of medical linear accelerators.Results:The monitoring system that took ionization chamber as center was established between connotation of machine physics and concrete realization of electromechanical engineering, and explained the difference and similarity between open type and sealed type of ionization chamber, and the theory that Precise series needn't be serviced by PFN.Conclusion: Based on the analysis of ionization chambers structure of medical linear accelerators on the principle of quality assurance system, proposed dosimetric testing and adjustment method, and provide reference for the establishment of quality assurance system and technical procedures of the maintenance engineering.

OBJECTIVE:To promote the sound development of clinical pharmacy.METHODS:The practice and signifi?cance of the clinical pharmacy of our hospital were analyzed and evaluated so as to put forward methods for further development of clinical pharmacy.RESULTS&CONCLUSION:Providing the clinical pharmaceutical services is the general trends and the prospect for which is promising.

Ameloblastoma ; pathology ; Bone Neoplasms ; classification ; genetics ; pathology ; Chondromatosis ; pathology ; Chondrosarcoma ; classification ; pathology ; Enchondromatosis ; pathology ; Humans ; Osteosarcoma ; classification ; pathology ; Sarcoma, Ewing ; pathology ; Societies, Medical ; United States ; World Health Organization

Objective To explore the nutritional status of vitamin D among healthy adults lived in Fuling district of Chongqing .Methods A total of 718 healthy adults aged 23-90 years old undergoing the physical examination in the physical ex‐amination center of our hospital from March 2012 to December 2013 were selected and divided into the 23-44 years old group and the ≥45 years old group .The tandem mass spectrometer was adopted to detect the level of serum 25(OH) vitamin D for evaluating the nutritional status of vitamin D .Results The proportions of lack ,insufficiency ,normal and excess of vitamin D in the 23 -44 years old group were 80 .79% ,19 .21% ,0% and 0% respectively ;which in the ≥45 years old group were 77 .91% ,18 .20% ,3 . 89% and 0% respectively .The average level of serum 25(OH) vitamin D in 23-44 years old group was lower than that in the ≥45 years old group ,the difference was statistically significant (P=0 .002 ,t=1 .98) .In these two groups ,the difference in serum 25 (OH) vitamin D level between males and females had no statistical significance (P>0 .05) .Conclusion The healthy adults in Ful‐ing district are lack of vitamin D in different degrees .

Objective To evaluate the effect of community nurse training in peripherally inserted central catheter (PICC) on community nursing quality of tumour patients with indwelled PICC during the intermission of chemotherapy.Methods A prospective study was performed with a total of 220 patients with esophageal or lung cancer enrolled from September 2011 to March 2013 in the Department of Cardiothoracic Surgery,the First Affiliated Hospital of Chongqing Medical University.The 220 patients included 174 males (79.1％) and 46 females (20.9％),at the age of (61.1 ±9.0) years.With the start of community nurse training as the cut-off line,the patients were divided into pre-training group (n =119) and post-training group (n =101).PICC-related complications and patient satisfaction were compared between the 2 groups.Results The overall PICC-related complication rate was 20.9％ (46/220) during community nursing,including,in the order of declining incidence,infection (7.2％,16/220),and venous thrombosis (4.5％,10/220),catheter occlusion (3.6％,8/220),catheter dropping (2.7％,6/220),and leaking/damage (2.7％,6/220).The total complication rate and incidence of infection in the post-training group were both significantly lower than those in the pre-training group (14.9％ vs.26.1％,P =0.047 ; 3.0％ vs.10.9％,P =0.035),and patient satisfaction (including satisfaction for answers to questions about PICC,feelings about PICC indwelling and PICC position,and overall satisfaction) was significantly higher than in the pre-training group (P =0.003,P =0.011,P =0.001).Conclusion Community nurse training programmes have positive effects on improving PICC-related nursing and patient satisfaction in cancer patients with PICC indwelling during intermissions of chemotherapy.

During the fetal-neonatal transition, the body must undergo many important physiological changes to adapt the extrauterine environment. After birth, the blood and energy supply through placenta is stopped with clamping of the umbilical cord and, meanwhile, the pulmonary ventilation function is established when exposure to the air, which results in a series of changes in the respiratory, circulatory and endocrine systems and energy metabolisms, etc. The physiological transition can be relfected in heart rate, blood pressure, oxygen saturation, temperature, and other physiological indicators. The changes of these indicators can be used as references for prevention, diagnosis and treatment of neonatal diseases. This review provides an overview of physiological changes and implications in the lung function, circulatory and endocrine systems, and energy metabolism during the transition at birth as well as intervention measures for abnormal fetal-neonatal transition.

Anemia is one of the most common disease in premature infants,it not only affects growth and development,but also have long-term impact on the future movement,cognition,learning ability and behavioral development,and most of mental harms nor reversible even though after iron supplementation.So,supplementation with intravenous iron will be a good approach to prevent and treatment with anemia for oral iron supplementations invalid or intolerant infants.Currently,safety and start time for iron supplementation in preterm infants remains controversial.This review focuses on the efficacy and safety of intravenous iron for prevent and treatment of iron deficiency anemia in preterm infants.