10.3969/j.issn.2095-4344.2013.25.019

Objective To explore hospital information system for solving the quality control problem of information collection and strengthening the hospital administration.Methods The factors affecting the information quality of the whole hospital information were analyzed.The control principle from "point" to "surface" was used to work out the quality control plan based on medical information,financial information and medicine information.Results The quality control plan was made according to the current hospital information flow.Conclusion The quality of hospital information collection in every link directly affects the information quality.Strengthening the quality control of information collection guarantees the administration quality of whole hospital information.

Objective To determine the detection rate of duodenal papilla and the diagnostic rate of small bowel diseases by capsule endoscopy(CE)and its possible influencing factors.Methods A total of 369 cases with suspected small bowel disease who had undergone CE were retrospectively reviewed. The de- tection rate of duodenal papilla and that of small bowel disease were calculated respectively. The detection rate of duodenal papilla in another 369 patients having received gastroscopy was also counted in order to findout the miss detection rate of forward-viewing endoscopy. The CE findings were reviewed at the rate of 1 im-age and 15 images per second by hand-motion respectively. The detection rate of duodenal papilla was calcu-lated,and the number of frames showing duodenal papilla was counted. Differences of detection rate of duo-denal papilla were also analyzed by different age and gender groups. In addition,the potential difference in detection rate of duodenal papilla between different bowel preparations before CE of two different reviewing approaches was also investigated respectively. Results The miss detection rate of duodenal papilla with for-ward-viewing gastroscopy was 22. 0%. The detection rate of duodenal papilla reviewed at the rate of 1 image by hand-motion,where less frames were needed to visualize duodenal papilla(3. 7vs7. 0),was significantly higher than that at the rate of 15 images per second(32. 2%vs13. 6%,P=0. 001). The diagnostic rate of small bowel diseases was also significantly higher than that of duodenal papilla by CE(67. 2%vs32. 2%,P=0. 000). Age and gender were not significantly correlated with the detection rate of duodenal papilla. No significant correlation was found between various kinds of bowel preparation before CE at different viewing rate and the detection rate of duodenal papilla. Conclusion It iS relatively difficult to identify duodenal pa- pilla by CE,as they are peculiarly positioned in anatomy,so the detection of duodenal papilla does not nec- essarily represent the detection rate of small bowel diseases. The major factors that influencing the detection of duodenal papilla by CE include local anatomy,viewing rate and technical limitations of CE.

OBJECTIVE To investigate the present situation of the nosocomial infection in our hospital in order to decrease the infection rate. METHODS A total of 40 554 patients were inspected from Oct 2004 to Sept 2005.There were 626 patients with nosocomial infection. RESULTS The nosocomial infection was 1.54%.Old patients were the main components.The longer they were in hosptial,the more risk of infection they had.Elder monitoring department and hematological department were the most common infected units.Respiratory tract was the most common infected site of the body.The entity of disease for the most infection was malignant tumor.Invasive treatment was one of the causes for the infection. CONCLUSIONS The infection rate of our hospital was relatively low.We should establish the system to control the infection.Use the advanced statistical software well be to aid the control and discover the anti-infection deficiency from the statistical view-point.

OBJECTIVE To summarize the infection cases and the factors causing site infection after operations,and investigate the measures to prevent and reduce exogenous incision infection.METHODS Discharged patients from Jan 1st,2003 to May 31st,2006 in our hospital were investigated for retrospective analysis on incision infection cases.RESULTS Totally 111 incision infection cases were reported from 54 286 cases.The nosocomial infection rate in this cohort was 0.21%(111/54 286),which was 33.44% of total surgical incision infection cases.CONCLUSIONS Incision infection is one of the most commonly encountered concomitant symptoms,it is as well the bottleneck for our hospital to reduce average stay length of surgical patients and patients′ hospitalization expenses,and to speed up turnover of beds.Incision infection rate is also an important criterion to evaluate the management quality and medical technology quality within and among hospitals.Effective measures should be taken to decrease incision infection rate and to resolve the problem that is difficult to hospitalize and expensive to treat.

Objective To calculate workload according to working day and holiday separately.Methods Functions of SQL in Oracle were used to separate working day and holiday.Results The method could accomplish holiday's workload statistics expediently.Conclusions Statistics of holiday's workload are becoming ordinary work,so the separated analysis for them has practical value.

AlM:To investigate biological measurement parameters of anterior segment in acute angle- closure glaucoma ( AACG) .METHODS:Forty-six eyes of 46 patients with AACG and 52 eyes of 52 patients with shallow anterior chamber and 50 eyes of 50 normal individuals were examined. The parameters of anterior segment including chamber crowd rate (CCR), lens thickness (LT), lens position (LP) and anterior chamber depth ( ACD ) were measured by A-ultrasound according to different ages in each group. The data were performed statistical analysis in three groups.RESULTS: ln each age range group (≥50 ~ 59 years old, ≥60 ~ 69 years old, ≥70 years old ) , statistically significant differences in three groups ( AACG, shallow anterior chamber group and the controls ) were found in CCR, LT, LP, ACD (P<0. 01). There were statistically significant differences only in CCR (P<0. 01) but not in LT, LP and ACD ( P > 0. 05 ) between AACG and shallow anterior chamber group in each age range group.CONCLUSlON: CCR can be used as the index of evaluating crowding state of anterior segment in AACG patients and the sensitivity is better than LT and LP.

Objective To investigate the organ protective effects and the timing of continuous blood purification (CBP) in the treatment of severe sepsis. Methods A double-blind randomized controlled trial was conducted. Seventy-four patients with severe sepsis aged between 35 years and 80 years with acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) scores over 20 admitted to Department of Critical Care Medicine of the First Hospital of Wuhan from January 2013 to January 2015 were enrolled. They were divided into control group (n = 37) and treatment group (n = 37) by random number table method. All patients in these two groups received conventional therapy following the guidelines for management of severe sepsis in 2012. In addition the patients in treatment group received continuous veno-venous hemofiltration (CVVH). The critical score, liver and kidney function indexes, etc., levels of pro-inflammatory cytokines in plasma and ultra filtrate before and 24, 48, and 72 hours after treatment, and the clinical picture 2 weeks after treatment in two groups were observed. Results APACHE Ⅱ scores, multiple organ dysfunction syndrome (MODS) scores, Murray scores of acute lung injury, and systemic inflammatory response syndrome (SIRS) scores of the patients of the above two groups were gradually declined after the treatment. The levels of white blood cell count (WBC), procalcitonin (PCT), lactate (Lac), tumor necrosis factor-α (TNF-α), interleukins (IL-6 and IL-8), and endotoxin gradually lowered. Levels of blood urea nitrogen (BUN), serum creatinine (SCr), alanine transaminase (ALT) and the oxygenation index (PaO2/FiO2) showed a tendency of lowering. There were statistically significant differences in scores of critical illness, WBC, PCT, Lac, pro-inflammatory cytokine, liver and kidney function indexes, etc. between treatment group and control group 48 hours after treatment (APACHE Ⅱ score: 15.5±4.7 vs. 20.3±5.3, MODS score: 4.6±1.4 vs. 7.3±2.2, Murray score: 1.4±0.5 vs. 1.7±0.6, SIRS score: 2.9±0.8 vs. 3.7±1.0, WBC (×109/L): 1.1±0.5 vs. 1.6±0.5, PCT (μg/L): 26.7±12.0 vs. 32.4±14.1, Lac (mmol/L): 7.6±2.2 vs. 9.3±2.8, TNF-α (μg/L): 96.3±17.4 vs. 153.4±24.2, IL-6 (μg/L): 146.8±20.6 vs. 213.8±29.2, IL-8 (μg/L): 287.1±43.6 vs. 354.5±56.2, endotoxin (kEU/L): 1.4±0.5 vs. 2.6±0.8, BUN (mmol/L): 8.7±3.6 vs. 18.5±6.4, SCr (μmol/L): 143±39 vs. 197±42, ALT (U/L): 141±27 vs. 183±34, PaO2/FiO2 (mmHg, 1 mmHg = 0.133 kPa): 150.3±45.4 vs. 124.7±32.1, all P < 0.05], and the difference was significant up to 72 hours. In the treatment group, TNF-α, IL-6, IL-8, and endotoxin could be decreased in the filtrate 24 hours and 48 hours after treatment and they correlated with the lowering tendency of their plasma levels. Compared with the control group, CVVH based on conventional treatment of severe sepsis could significantly reduce the incidence of MODS (10.8% vs. 29.7%, χ2 = 4.423, P = 0.038) and mortality (5.4% vs. 13.5%, χ2 = 4.674, P = 0.032), and remarkably shortened the duration of mechanical ventilation (days: 3.1±0.6 vs. 5.3±1.7, t = 2.103, P = 0.045), and the length of intensive care unit (ICU) stay (days: 8.5±1.7 vs. 13.2±2.4, t = 2.245, P = 0.042). Conclusion Early CBP can decrease the level of pro-inflammatory cytokines, prevent MODS, and remarkably improve the prognosis of patients with severe sepsis.

Flavonoids is one of the biggest families of the plant-derived secondary metabolites with structural diversity. Until now, over 10 000 kinds of flavonoids with distinct structures have been purified and identified from plants, and some of them possess a range of important pharmacological effects, such as anticancer, anti-inflammatory and so on. So far, a number of genes and enzymes responsible for the biosynthesis of flavonoids have been reported, especially, a great of progress has been achieved in the synthetic biology of flavonoids in the recent years. Herein, based upon a brief introduction on the biosynthesis of flavonoids, this review summarizes the research advances in synthetic biology of flavonoids in the past two decades (2001-2021), highlighting the cell factories construction of the representative flavonoids. And, a brief discussion and prospects of the relevant metabolic bottlenecks and optimizing strategies are proposed.

ObjectiveTo investigate the long-term (＞1 year) rebleeding rate after capsule endoscopy (CE)-guided intervention in patients with obscure gastrointestinal bleeding (OGIB) and to identify the risk factors of rebleeding.MethodsA total of 307 consecutive patients who underwent CE for OGIB in our hospital from June 2002 to October 2010 were enrolled.Follow-up data were obtained by reviewing medical records,CE database and contacting the patients or their relatives by telephone.We evaluated the rebleeding rates and analyzed risk factors predictive of rebleeding by means of COX ratio hazard model.ResultsThe medium follow-up was 52 months (range13-112 months).Significant lesions were found in 202 patients (65.8％).The overall rebleeding rate after interventional therapy induced by CE findings was 28.0％ (86/307).CE positive patients had higher rebleeding rate than CE negative patients (37.6％ vs 9.5％,log-rank test,P=0.000),while specific therapy could prevent rebleeding,compared with nonspecific therapy (32.9％ vs 23.0％,P=0.042).95.3％ (82/86) rebleeding occurred within 24 months after CE.Multivariate analysis performed by using COX proportional hazards model showed that age over 50 years,CE positive findings,lowest hemoglobin (Hb) level 3 months before CE ≤7 g/dl,receiving nonspecific therapy after CE,hypertension,administration of anticoagulants,antiplatelet medicine or NSAIDs after CE were six risk factors associated with rebleeding.Conclusion Clinicians should be aware of these risk factors for OGIB rebleeding,which can reduce the occurrence of rebleeding and improve OGIB patients' prognosis.Those high risk OGIB patients should be followed up for at least 24 months after CE.