Objective:The one-way communication between traditional LIS system and equipment has been unable to meet the needs of business development of medical laboratory in our hospital, we need to upgrade our equipment and to develop the bidirectional communication interface between LIS and equipment.Methods: Our hospital has invested a lot of money to upgrade previous One-way communication interface based on ASTM, the new instrument specifications conform to HL7 standard, and develop bidirectional transmission program based on HL7.Results: After the implementation of the bidirectional communication, testing equipment can automatically identify bar code to get the test request information, after the completion of the test instrument, the inspection unit can automatically send sample results to LIS.Conclusion: Bidirectional transmission improves the work efficiency, transmission based on HL7 is not only fast, but also conducive to the sharing of data between heterogeneous medical information systems, and it is a general tendency.

Objective To study the factors which affect the functional restoration of the elbow for adults with supracondylar or intercondylar fractures of the humerus treated with open reduction and internal fixation. Methods 22 patients with supracondylar or intercondylar fractures of the humerus were treated with open reduction and internal fixation from January, 1999 to December, 2004. They were followed up for an average of 30 months and complete clinical data were kept. The function of the elbow was evaluated with the Mayo elbow performance index. The relationship between the results and the factors —initial time of postoperative rehabilitation, fracture classification, operative approach and interval from injury to operation —were analyzed with cumulative logistic regression model of SAS software V8.2 (SAS institute, Cary, North Carolina). Results Of the 22 cases, 7 were excellent, 9 good, 5 fair and 1 poor. The excellent and good rates were 72.7%. And the odds ratio estimates of the 4 factors were 0.786, 0.299(B/A)0.221(C/A), 1.038, 0.197 respectively. Conclusions The initial time of postoperative rehabilitation, the fracture classification and the interval from injury to operation affect the functional restoration whereas the operative approach does not. Early operation, anatomical reduction, stable fixation and early rehabilitation will help improve the functional restoration.

Objective: To discuss the influence of comprehensive nursing intervention on patient’s oral mucositis with hematopoietic stem cell transplantation. Methods:One hundred and seventy four examples of patients with hematopoietic stem cell transplantation were equally and randomly divided into two groups, which are intervention group and control group. The usual care was given to the control group, while both the usual care and comprehensive nursing intervention were given to the intervention group. The comparative study of the occurrence and severity degree of oral mucositis in these two groups after one week pretreatment was conducted. Results:The occurrence rate of oral mucositis in intervention group and control group was 54.47%and 68.97%respectively. And there is no obvious significance of the occurrence rate before and after the intervention(x2=2.47, P>0.05). Nevertheless, the comprehensive nursing intervention could significantly lessen the severity of oral mucositis, and help to control the inflammation and promote healing. Conclusion:comprehensive nursing intervention could effectively reduce the occurrence degree of oral mucositis in the patients with hematopoietic stem cell transplantation.

Objective To analyze the detection rate of lung cancer during 2009-2013 in Shaoxing of Zhejiang province and its time trend. Methods The data of lung cancer in Shaoxing from 2009 to 2013 with a total coverage population of 21 970 825 person-year (male 10 993 657 person-year, female 10 977 168 person-year), was collected to calculate the detection rate, age adjusted detection rate, percentage change of incidence (PC), etc. The annual percentage change (APC) of incidence was estimated by linear regression based on the logarithm of the incidence rates observed. Results During 2009-2013, a total of 9 973 new cases were diagnosed as lung cancer with the sex ratio of male to female being 2.44∶1. The detection rate of lung cancer was 45.39/100 000 (male 64.35/100 000, female 26.41/100 000), age-standardized detection rate by Chinese standard population (ASR China) was 20.09/100 000 (male 28.37/100 000, female 11.66/100 000), age-standardized detection rate by world standard population (ASR world) was 27.26/100 000 (male 37.83/100 000, female 15.73/100 000). The cumulative rate and truncated rate of those aged 0-74 and 35-64 were 3.40% (male 4.80%, female 1.91%) and 39.90/100 000 (male 54.44/100 000, female 24.81/100 000). The detection rate of lung cancer increased from 34.29/100 000 in 2009 to 59.91/100 000 (APC=13.88%, P=0.006<0.05), among males the detection rate increased from 50.60/100 000 to 82.91/100 000 (APC=12.52%, P=0.011<0.05), and the female detection rate increased from 17.81/100 000 to 36.78/100 000 (APC=17.70%, P=0.005<0.05). In Shaoxing, the detection rate of lung cancer increased obviously among the residents over 45 years of age. For each age group except 15-and 20-, the male detection rate was higher than the female incidence. Conclusion The men who were 45 years and older were at a higher risk of lung cancer in Shaoxing. The detection rate of lung cancer increased year by year from 2009 to 2013 in Shaoxing, especially among women over 65 years of age.

Objective To analyze the detection rate of thyroid cancer from 2009 to 2013 in Shaoxing of Zhejiang province and its time trend.Methods The data of thvroid cancer in Shaoxing from 2009 to 2013 was collected to calculate the detection rate,age adjusted detection rate and percentage change of incidence,and the annual percentage change (APC) of incidence was estimated by linear regression based on the logarithm of the incidence rates observed.Results lDuring 2009-2013,a total of 3 290 new cases were diagnosed as thyroid cancer with the sex ratio of male to female being 1 ∶ 3.69.The detection rate of thyroid cancer was 14.98/100 000 (male 6.39/100 000,female 23.59/100 000),with age-standardized detection rate by Chinese standard population (ASR China)9.13/100 000(male 3.94/100 000,female 14.31/100 000),and age-standardized detection rate by world standard population(ASR worll) 10.39/100 000(male 4.47/100 000,female 16.32/100 000).The detection rate of thyroid cancer increased from 7.26/100 000 in 2009 to 27.26/100 000 (APC =39.65％,P＜0.05),with the detection rate among males increasing from 2.42/100 000 to 12.65/100 000(APC =48.44％,P＜0.05),and the detection rate among female increasing from 12.15/100 000 to 41.96/100 000(APC =37.58c％,P＜0.05).In Shaoxing,most of the new thyroid cancer cases were from 25 to 59 years old,and the highest incidence happened in the group of 50-54 years.For each age group,the detection rate in female was almost over two-folls higher than the incidence in male.Conclusion The detection rate of thyroid cancer was increased year by year from 2009 to 2013 in Shaoxing,especially among the young and middle-aged women.The corresponding measures must be taken to control the risk factors of thyroid cancer.

Objective To observe the outcome of the implementation of personalized enteral nutrition of severe acute pancreatitis patients. Methods 24 patients with severe acute pancreatitis admitted from June 1, 2013 to March 31, 2014 were divided into experimental group and control group according to the random number table method. Control group calculated the energy supply according to the basic energy expend formula while experimental group according to the actual enery expend formula. Hemoglobin, albumin, C-reactive protein, serum and urine amylase, complication rate, hospitalization time and cost changes were compared. Results 7 days after enteral nutrition, hemoglobin content and albumin content of experimental group were higher than those of control group [(130.50±17.60) g/L vs.(126.33±23.96) g/L, t=-4.231, P<0.05; (40.88±4.66) g/L vs.(36.29±3.45) g/L, t=-2.263, P<0.05]. And C-reactive protein of experimental group were lower than that of control group [(47.62±9.89) mg/L vs.(58.22±11.23) mg/L, t=3.618, P<0.05]. Hospitalization time and cost of experimental group were lower than those of control group [(22.50±5.85) d vs.(16.75±6.47) d, t=12.272, P<0.01; (36 364.76±2 162.08) yuan vs.(14 143.44±3 921.78) yuan, t=9.421, P<0.01]. Conclusions The implementation of personalized enteral nutrition is more hepful for the physiological requirements of individual patients, and not affect the pancreatic secretion. At the same time, inflammatory mediators can be reduced and also reduce the economic burden of patients and society.

Objective To analyze the incidence of malignant tumor in Shaoxing of Zhejiang Province in 2012.Methods Descriptive analysis was carried out based on our chronic disease monitoring information management system.Age-standardized incidence was calculated according to Chinese standard population in 1982 and the Segi's world population.Results The crude incidence of malignant tumor was 291.34/100 000,age-standardized rate by Chinese standard population (ASR China) and by world population was 137.29/100 000 or 176.72/100 000,respectively.The cumulative rate of the 0-74 years old group was 20.27％ and the cut rate of the 35-64 years old group was 301.49/100 000.Male crude incidence of cancer and ASR China were 330.46/100 000 and 149.28/100 000,respectively; for female,the figure was 251.93/ 100 000 and 124.79/100 000,respectively.The crude incidence and ASR China were 364.85/100 000 and 171.77/100 000 in urban area residents,and 277.86/100 000 and 130.93/100 000 for those living in rural areas.Age-specific incidence of the 0-29 years old group remained low,although the incidence was increased after 30 years old and reached the peak in the 80-84 years old group.The most common malignancy were lung cancer,gastric cancer,colorectal cancer,liver cancer,breast cancer,thyroid cancer,esophageal cancer,pancreatic cancer,cervical cancer and leukemia (76.77％).Conclusions Lung cancer,gastrointestinal cancer and female reproductive system cancer were most common malignancy in Shaoxing of Zhejiang Province in 2012.The incidence of thyroid cancer,leukemia and brain tumor is significantly increased over the past few years,which may need effective control and prevention strategies.

Objective To observe the expressions of DNA methyltransferases (DNMTs) 1,3a and 3b in retinoblastoma (RB).Methods Sixty-two RB samples and six normal retinas were studied,including 17 poorly differentiated and 45 well differentiated samples; 16 invasive and 46 non-invasive samples.The expressions of DNMT1,3a,and 3b,and Ki-67 were detected using immunohistochemical analysis.Brown staining of nuclei was considered to represent the positive stain for DNMT1,3a and 3b,and ki-67,blue staining as negative.The level of high expression of nuclear staining was,positive cells in DNMT1≥65 ％,in DNMT3a≥60％ and in DNMT3b≥40％.The correlations of DNMT1,3a and 3b expression in RB samples,and MIB-1 labeling index were analyzed.Results Viewed under the light microscope,negative expressions of DNMT1,3a and 3b were demonstrated in normal retinas,however,positive expression was observed in RB samples,with 100％ in DNMT1,98％ in DNMT3a and 92％ in DNMT3b.Comparing well differentiated RB samples with poorly differentiated samples,significant differences were found in high expression of DNMT1 (x2 =12.57,P＜0.05) and DNMT3a (x2 =10.54,P＜0.05) ; also in the positive cells of DNMT1 (U=179,P＜0.05) and DNMT3a (U=198,P＜0.05).No significant difference was found comparing high expression (x2=1.5,P＞0.05) and positive cells (U=307,P＞0.05) of DNMT3b.When comparing invasive tumor tissues with non-invasive tumors,significant differences were shown between high expression (x2 =4.72,P＜0.05) and positive cells comparing DNMT1 (U=236,P＜0.05).No significant difference was shown in high expression (x2=3.53,0.84; P＞0.05) in DNMT3a and DNMT3b,or in comparison with positive cells (U=338,257; P＞0.05).The expression of DNMTs was positively correlated with the MIB-1 labeling index in RB tissues (R2=0.554,0.376,0.219; P＜0.05).Conclusion There are high expressions of DNMT1,3a,and 3b in RB.

Objective To observe the expression and relationship of high-mobility group A(HMGA) 1,HMGA2,MIB-1 labeling index (LI) and let-7 in retinoblastoma (RB).Methods Forty-four RB samples were studied,including 11 poorly differentiated samples,33 well-differentiated samples; eight invasive and 36 non-invasive samples.The expression of HMGA1,HMGA2 and MIB-1 LI in RB were analyzed by immunohistochemitry.The HMGA1,HMGA2 were scored on a scale of 0 to high expression.0: no expression ; low: 1％ - 10 ％ ; medium: 11 ％ - 50 ％ ; high: ＞50 ％.The MIB LI were scored on a scale of 0to high expression.O: no expression;low: 1％ - 40％;high: ＞ 40％.Semiquantitative reverse transcription-polymerase chain reaction was used to assay the let-7 expression level: ≥ 80％ showed no significantly decreased expression; 60％ - 79％ showed medium decrease in expression; ＜ 60％ highly decreased in expression.Results In 44 RB samples,there were 14 cases with no HMGA1 expression (32％),11 cases with low expression (25％),10 cases with medium expression (23％),and nine cases with high expression (20％).Expression level of HMGA1 was significantly higher in poorly differentiated RB than in well-differentiated RB (x2 =11.3,P＜0.01) ; however,no statistically significant difference was found between invasive tumors and noninvasive tumors (x2 -5.9,P＞0.05).There were 11 cases with no HMGA2 expression (25％),11 cases with low expression-(25％),nine cases with medium expression (20％),and 13 cases with high expression (30％).Expression level of HMGA2 was significantly higher in poorly differentiated and invasive RB than in well differentiated and noninvasive RB respectively (x2=20.9,8.7; P＜0.05).There were 4 cases with no MIB-1 LI expression (9％),18 cases with low expression (41％),and 22 cases with high expression (50％).Expression level of MIB1 LI was significantly higher in poorly differentiated RB than in well-differentiated RB (t=5.2,P＜0.05).Higher expression of MIB-1 LI was found in invasive tumors than in noninvasive tumors,with no significant difference (t=-1.1,P＞0.05).Twenty seven cases had no significantly decreased expression of let-7 (61％).There were eight cases with medium decreased expression (18％) and nine cases with highly decreased expression (21％).Correlation analyses revealed that MIB1 LI expression significantly correlated with HMGA1and HMGA2 proteins (r=0.327,0.602; P＜0.05).A significantly inverse correlation existed between let-7 expression and HMGA1,HMGA2 proteins and MIB-1LI respectively (r=-0.247,-0.310,-0.392; P＜0.05).Conclusions Overexpression of HMGA1,HMGA2 and MIB-1 LI and down regulation of let-7 were demonstrated in RB.Supplying let-7 to RB cells can possibly inhibit HMGA1 and HMGA2 expression.

Objective To investigate the satisfaction degree of family members of children patients with the quality of nursing by follow-up analysis using telephone.Methods We used the high quality nursing questionnaire as the follow-up investigation.311 parents of the discharged pediatric patients were enrolled in this study,and answered the questionnaire within 1 ～2 weeks after their children were discharged from hospital.Meanwhile,we collected specific comments through asking questions by telephone.Then we analyzed and summarized the results by the content analysis.Results We found the total satisfaction rate was 96.65％ and there were three levels after qualitative analysis on the specific recommendations:evaluation of the hospital system,evaluation of professional knowledge and skills of the medical workers,evaluation of the attitude of the medical workers.Conclusions The parents of pediatric patients are satisfied with the high quality nursing which has pediatric features.However,what the parents focused on had already beyond the scope of the high quality nursing itself.We should expand the concept of quality service to every aspect of the hospital work,in order to meet the needs of the parents of pediatric patients in the department of pediatrics.