Combined with the development requirements of hospital medical disposable materials management and hospital information management,introduced a novel medical disposable materials management pattern which base on the enterprise resource planning chain supply systems.By optimizing purchasing procedure,inventory management,precision financial management,to realize the integrated management of the medical consumable materials affairs and financial affairs.

The incidence of pancreatic cancer has steadily risen in the past decades. Radical resection is still the best option for treatment of pancreatic cancer. Great progress has been achieved in pancreatic surgery;the mortality and morbidity have decreased dramatically, but long term survival after resection is still dismal. Standard pancreaticoduodenectomy is recommended now for pancreatic head cancer. Extended lymphadenectomy could not improve the prognosis of pancreatic cancer patients. Total pancreatectomy is suitable for some IPMNs patients, rather than a routine for pancreatic cancer patients. The current status and future of surgical treatment for pancreatic cancer will be summarized here.

[Objective] To analyze relations between alcoholic liver disease(ALD) and gut-liver axis, and the intervention effects of Linderae radix(LR) on both of them. [Methods] Research reports about ALD,gut-liver axisand LR on anti ALD at home and abroad in recent years were reviewed, and effects ofgut-liver axisin the occurrence and development of ALD and LR on ALD treatment were summarized. [Results] Recent studies show that there is an abnormalgut-liver axisin ALD,gut permeability and intestinal endotoxemia(IETM) induced by excessive alcohol consumption is one of the key pathogenic factors for the occurrence and development of ALD. Improving intestinal functions to alleviate IETM would be an efficient way to treat ALD. Linderae radix (LR) is a traditional Chinese medicine commonly used for Qi-regulating in clinic ,it possesses a good effect for gastrointestinal function regulation and as reported in recent researches,it has shown a good protective effect on ALD by improving the abnormal gut-liver axisand alleviating IETM. [Conclusions] The abnormalgut-liver axisinduced by excessive alcohol intake is the key factor for ALD formation and development. LR possesses a protective function on ALD viagut-liver axisimprovement.

Chromium ; toxicity ; DNA Methylation ; drug effects ; Epigenesis, Genetic ; Humans

OBJECTIVE: To evaluate the clinical effect of acellular dermal matrix (ADM) on the repair of different tissue defects in pharyngeal and laryngeal cancer. METHOD: Twenty-three cases of pharyngeal and laryngeal cancer were analyzed retrospectively, including 16 patients with pharyngeal cancer, and 7 patients with laryngeal cancer. After surgery, the patients appeared two types of tissue defects respectively: hypopharynx tissue defect and neck skin tissue defect. These defects were repaired with ADM, and the clinical effects were observed. RESULT: Sixteen cases of hypopharynx tissue defect and 7 cases of neck skin tissue defect were repaired with ADM. One case in hypopharynx tissue defect group and 2 cases in neck skin tissue defect group undergone pharyngeal fistula postoperatively. CONCLUSION The repair of tissue defects in pharyngeal and laryngeal cancer with ADM had some advantages, such as good histocompatibility, low immune rejection, wide material sources and simple method. There were some differences in clinical effects between hypopharynx cavity defect and neck skin tissue defects, so the emphasis of the need to pay attention to is different in the clinical.
Acellular Dermis ; Dermatologic Surgical Procedures ; Humans ; Hypopharynx ; surgery ; Laryngeal Neoplasms ; surgery ; Mucous Membrane ; surgery ; Neck ; surgery ; Otorhinolaryngologic Surgical Procedures ; Retrospective Studies

OBJECTIVE: To compare the clinical results between stapled and traditional suture closure total laryngectomy. METHOD: Fifty-three cases of laryngeal cancer with total laryngectomy were divided into 2 groups: 32 cases with traditional suture closure total laryngectomy (group A) and 21 cases with stapled total laryngectomy group (group B). Compare two groups in pharyngeal fistula, postoperative bleeding, dysphagia, and nasal regurgitation. RESULT: There was no difference of postoperative pharyngeal fistula between group A and B (P>0. 05). The incidence of dysphagia, nasal regurgitation, and postoperative bleeding in group B were 23. 8%, 14. 3% and 14. 3% respectively, which were obviously higher than that in group A (P<0. 05). CONCLUSION Stapled total laryngectomy has the advantages of reducing the operative time and simplifying the operation with some disadvantages such as higher standards of operation indications, higher incidence of dysphagia, higher nasal regurgitation, higher postoperative bleeding, and poor medical economic profit. Traditional suture closure total laryngectomy is recommended in clinical practice.
Deglutition Disorders ; Fistula ; pathology ; Humans ; Incidence ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Pharynx ; pathology ; Postoperative Complications ; Suture Techniques ; Sutures

Objective To observe the efficacy of atorvastatin and irbesartan in the treatment of early diabetic nephropathy and the influence on serum cystatin C and adiponectin,thus to improve clinical outcomes.Methods 80 patients with early diabetic nephropathy met the inclusion criteria were randomly divided into observation group (40 cases)and control group(40 cases).All patients were given conventional diabetes comprehensive intervention, the control group then was given irbesartan 150mg/d,qd,the observation group was given atorvastatin on the basis of control group,20mg/d,qd,both two groups were treated for 12 weeks.The FBG,HbA1c,renal function indication (Scr,BUN,UAER),lipid parameters indication(TC,TG),cystatin C,adiponectin were detected.DBP,SBP were detected by 24h ambulatory blood pressure.Results The DBP,SBP,Scr,BUN,UAER,TC,TG,cystatin C,adiponec-tin of the observation group after treatment were lower than before treatment(P <0.05 or P <0.01).The BUN,TC, TG of the control group had no significant changes before and after treatment (P >0.05).The DBP,SBP,Scr,BUN, UAER,TC,TG,cystatin C,adiponectin of the observation group after treatment were lower than the control group (P <0.05 or P <0.01).Conclusion Atorvastatin combined with irbesartan can effectively control blood pressure, has overall improvement in glucose and lipid metabolism,effectively reduce adiponectin,inhibit glomerular dysfunc-tion,improve kidney function,it is a good method for prevention and treatment of early diabetic nephropathy.

Objective To investigate the occupational musculoskeletal injury of nurses in a thirdgrade and A-level general hospital in Zhengzhou,and analyze the relationship between occupational musculoskeletal injury and presenteeism.Methods 460 nurses were surveyed with questionnaires by convenience sampling,including nurses' demographic data,Nordic Standardized Questionnaires and Work Limitations Questionnaire.Results The annual incidence rate of OMSI in nursing staff was 82.38％.The parts of body which had high annual incidence rate of nurses' OMSI were lower back,neck and shoulder.The rates of presenteeism for no OMSI,one part OMSI and two or more parts OMSI were 35.14％,52.60％ and 59.68％.The scores of work efficiency decrease were (2.02±1.26),(4.67±2.53),(7.31±3.42).Conclusions Nurses' occupational musculoskeletal injury can result in presenteeism.The more serious occupational musculoskeletal injury is,the higher incidence rate of presenteeism,the more critical the presenteeism is.

Objective:To investigate the clinicopathlogical significance of the CyclinE,p21WAF1/CIP1 and p53 expression in laryngeal carcinogenesis.Method:The expression of CyclinE,p21WAF1/CIP1 and p53 was examined by using immunohistochemical method in normal epithlia (20),dysplastic epithlia (40) and laryngeal cancers (60).Result:①In normal epithlium,dysplastic squamous epithlium and in squamous cell carcinoma of the larynx,the positive immunostaining rate of CyclinE protein was 5.0%(1/20),20.0%(8/40) and 45.0%(27/60) respectively (P＜0.001),and p21WAF1/CIP1 protein was 95.0%(19/20)，75.0%(30/40) and 63.3%(38/60) respectively (P＜0.01),while the rate of p53 was 0,30.0%(12/40) and 61.7%(37/60)(P＜0.001) respectively.②p21WAF1/CIP1 positive expression in highly、moderately and poorly differtiated carcinomas were 76.2%(16/21)、66.5%(19/29) and 30.0%(3/10) respectively (P＜0.05),p21WAF1/CIP1 protein expression was significantly associated with tumour cell differentiation.③The positive expression of CyclinE closely related with the positive expression of p53 (P＜0.05).No correlation was found between p21WAF1/CIP1 expression and p53 expression.Conclusion:①CyclinE and p53 could be an early molecular event in the carcinogenesis of larynx.②p21WAF1/CIP1 expression is associated with tumour cell differentiation.③The mutual mechenism of cell cycle regulators (CyclinE、p21WAF1/CIP1 and p53) play an important role in the laryngeal carcinoma.