Objective To explore the clinical efficacy of tirofiban in treatment of patients with high-risk non-ST-segment elevation of acute coronary syndrome (NSTE ACS),in order to improve the level of treatment effect. Methods 90 cases with high-risk NSTE ACS from January 2011 to April 2013 were randomly divided into control group and observation group. The control group were received treatments of conventional aspirin,clopidogrel, anticoagulation,coronary angiography (CAG)and percutaneous coronary intervention (PCI),while the observation group were added tirofiban therapy an the basis of control group. After the treatment,the differences of cardiovascular adverse events,thrombolysis in myocardial infarction (TIMI)flow grade and complications in both two group were observed and compared. Results There were significant differences in major adverse cardiovascular events in the distal vascular blockage,surgery without reflux,recurrent angina and myocardial infarction and post-PCI TIMI flow grade 2 and 3 (P<0.05),but not in bleeding complications,TIMI flow grade 0 and 1 before and after PCI treatment. Conclusion Tirofiban is safe and effective in treatment of high-risk NSTE ACS in interventional procedures. It can improve TIMI flow, increase tissue perfusion and reduce postoperative complications.

Objective To evaluate the efficacy of testosterone supplementation for partial androgen deficiency in middle-aged men. Methods This prospective,double-blind,placebo-controlled,randomized clinical trial was conducted in our hospital.A total of 179 patients (mean age,41.8 years) were randomly divided into study group (n=136) and control group (n=43).The 136 patients in study group received andriol (80 mg,twice a day) for 3 months;while the 43 patients in control group received no special treatment.The changes of partial androgen deficiency in aging male (PADAM) scores,serum total testosterone (TT),free-T (fT) and relevant sexual hormone levels were assessed before and after treatment. Results In study group the PADAM scores at 1 and 3 months after treatment were significantly improved compare with those before treatment (P0.05). Conclusions Partial androgen deficiency in middle-aged men is clinically exist and testosterone supplementation for this condition is safe and effective.

BACKGROUND:Diabetes mel itus can give rise to bone metabolic disorders in patients, resulting in the occurrence of osteoporosis and low traumatic fractures. However, the pathogenesis mechanism remains unclear. OBJECTIVE:To review the current research progress in the bone metabolic disorders resulting from diabetes mel itus, and to provide theoretical basis of the prevention and treatment of diabetic osteopathy. METHODS:A computer-based online search was conducted in Pubmed database (http://www.ncbi.nlm.nih.gov/pubmed/) from January 2000 to December 2013. Articles focusing on diabetes mel itus regulating bone metabolism were col ected using the key words of“diabetes mel itus;bone”in English. High-quality relevant studies were included, while repetitions and unidirectional studies were excluded.
RESULTS AND CONCLUSION:A total of 6 979 articles were obtained initial y, and after screening procedures 58 literatures were selectively included in this review. Although type 1 and type 2 diabetes mel itus exert different effects on the bone mineral density, they ultimately result in osteoporosis and low traumatic fractures. It is widely believed that the pathogenesis may be that high glucose breaks the balance between bone formation and bone absorption, so that bone absorption is greater than bone formation. The number of the osteoclasts is increased, while the cytokines of promoting osteogenesis are restrained. As a consequence, those result in low bone mineral density, brittle bone and high incidence of fracture.

ISO9000 quality management system (ISO9000QMS) emphasize on the customer-oriented, managers' leadership and all staff's joining, adopt the process method and system management, spread the taking facts as a basis to make decision and improve consistently, and establish win-win relation with the suppliers. So, the digital hospital can adopt the ISO9000QMS. In order to establish the ISO9000QMS, the digital hospital should: (1) Design integrally, including analyzing the operation procedure, clarifying the job duties, setting up the spreading team and setting the quality policy and objectives: (2) Learning the ISO9000 quality standards; (3) Drawing up the documents, including the quality manual, program files and operation guiding files; (4) Training according the documents; (5) Executing the quality standard, including the service quality auditing, quality record auditing and quality system auditing; (6) Improving continually. With the establishment of ISO900QMS, the digital hospital can appraise more accurately, analyze quality matters statistically and avoid the interference of artificial factors.
Hospital Administration/legislation & jurisprudence ; Hospital Administration/*standards ; Hospitals, Public/legislation & jurisprudence ; Hospitals, Public/*standards ; Management Audit/*standards ; Quality Assurance, Health Care/*organization & administration ; Quality Control ; Total Quality Management/methods ; Total Quality Management/*standards

The health check up flow of digital hospital can be consulted with the assembly line of industry factory. Because they have the following same features: highly specialized workstation, closeness and continuance, rhythm, balanced production, continuous production. The essential prerequisites are as the follows: The inspecting items and methods should be stable; advanced product mix and stable production design; standardized raw material, consumption, procedure, inspection method; there are lots of request for health inspection; the customers move at the least unit; the space arrangement should be reasonable; the time arrangement should be proportion. With the computer net, the digital inspection can achieves the raw material controlling accurately. The basis of check up line concerns about equipment, net and software, data collection, and personnel. The group technology is used in the health inspection flow design of the digital hospital in the field of items customers and zone redivided. The digital assembly linemic health inspect has the following stages: member registering, notice, check in, arrange order, time control, report, feedback and analysis. The assembly linemic has following advantages: increasing the productivity, the space utility, satisfaction of customer, fund returning, lowering the cost and ensuring the quality.
Computer Communication Networks ; *Delivery of Health Care ; *Hospital Administration/economics ; *Hospital Information Systems/organization & administration ; Preventive Health Services/economics ; Preventive Health Services/organization & administration

Objective To analysis the progress in prevention and control of iodine deficiency disorders (IDD) in Dalian and to provide a scientific basis for further prevention and control of the disease.Methods From 2006 to 2010,5 or 9 townships were randomly sampled from each county in Dalian,4 villages were sampled from each selected townships and 15 or 8 households were sampled from each selected villages for collecting salt samples and salt iodine level was determined by direct titration method.Sixty daytime urine samples from pregnant women,breast feeding women,infants and young children were collected,respectively,every year to detect urinary iodine level.From 2007 to 2009,2 to 11 counties were sampled and from each selected county one school was sampled to collect 100 daytime urine samples of children aged 8-10 and iodine content was determined.From 2006 to 2009,2 to 5 counties were sampled,from each selected county 2 to 5 schools were sampled and 100 children aged 8 to 10 in each selected school were sampled to detect intelligence quotient level and the thyroid volume.Results From 2006 to 2010,16 012 copies of households' edible salt samples were monitored; the average iodine content was ranged 29.68-31.51 mg/kg,the rate of qualified iodized salt in household ranged from 97.24％ to 98.42％.A total of 1398 copies of urine samples of pregnant women,486 breast feeding women,473 infants and 502 young children were monitored,and the median value of urinary iodine was 129.3-189.6,114.6-190.6,148.5-298.5 and 144.4-187.3 μg/L,respectively.A total of 1657 urine samples were monitored,1264 intelligence quotient level and 1197 thyroid volume of school-age children were determined,the median urinary iodine,thyroid goiter rate and intelligence quotient level was 217.9-266.7 μg/L,0-3.29％ and 110.4-117.2 μg/L,respectively.Conclusions From 2006 to 2010,the city's households qualified iodized salt coverage rate has reached the national standard for elimination of iodine deficiency disorders.The iodine nutrition of key population and school-age children has reached adequate level,the thyroid goiter rate is less than 5％,and the level of intelligence quotient has increased every year.But the iodine nutrition of breast feeding women in 2009 and 2010,pregnant women in 2010 is inadequate,so iodine nutrition surveillance and health education in pregnant and breast feeding women need to be strengthened in the future.

Objective To summarize the anatomic variations of recurrent laryngeal nerve (RLN during thyroid surgery and to investigate the technical key points for identification and preservation of the nerve.Methods Clinical data of 1548 consecutive patients undergoing thyroid operation with intraoperative routine exposure of RLN from June 2010 to June 2012 was retrospectively analyzed.Results In this series,2620 RLNs at risk were clearly exposed and identified during a total of 1548 thyroid operations,wherein complete dissection was performed on 1886 nerves.Injury occurred in 11 of 2620 (0.42％) nerves.Through the analysis of all 2620 RLNs,conditional variations were found in 64 nerves.Of 1886 RLNs that were completely dissected,421 (22.3％)nerves presented with natural variations of six patterns,including morphological branching variation in 126 (6.68％) nerves,course and location variation in 124 (6.57％)nerves,variation in relationship with inferior thyroid artery (ITA)in 36 (1.91％)nerves,variation at the Berry ligament in 112 (5.94％) nerves,variation at the cricothyroid joint in 17 (0.80％) nerves,and 6 (0.32％)cases of non-recurrent laryngeal nerve (nRLN).Conclusions Variations in RLN found during thyroid surgery are of relatively high incidence,complex and diverse,which can be a potential reason of nerve injury due to visual misidentification.Thus,a thorough knowledge of the normal anatomy of RLN and its anatomic variations ensures a safe and effective thyroid surgery.

Objective To investigate and analyze the influencing factors of community nursing cognition and employment intention of higher vocational nursing students,and provide reference for higher vocational colleges to carry out community nursing education and employment guidance.Methods Using the stratified cluster sampling method,nursing students from different grades and different education levels were selected as the object of study and participate in the questionnaire survey.Results The nursing students from different grades,education levels and areas showed significant difference in community nursing and employment intention.Conclusions Higher vocational nursing colleges should strengthen the community nursing practice education and community employment guidance; improve the community nursing cognition and community employment intention of nursing students.

Objective To assess the influence of timing of tracheostomy performed on ICU patientswith mechanical ventilation support for long-term.Methods A retrospective study was carried out in 94 patients under mechanical ventilation support with tracheostomy from January 2012 to October 2014.The patients were divided into early stage group (group A) in which the tracheostomy was done within 7 days after endotracheal intubation and late stage group (group B) in which the tracheostomy was performed at above 7 days after endotracheal intubation.The differences in lengths of mechanical ventilation support (MVS),ICU stay,and hospital stay,incidence of ventilator-associated pneumonia (VAP) and mortality were compared between two groups using nonparametric statistics.Results Compared with group B,there were statistically significant reduction in duration of mechanical ventilation (7d vs.17 d;P ＜ 0.05),shorter length of ICU stay (10 d vs.19 d;P ＜ 0.05),and lower incidence of VAP (21.05％ vs.36.84％;P ＜ 0.05) in group A.There were no significant differences in hospital stay and mortality between two groups (P ＞0.05).There was a correlation between the duration of mechanical ventilation and timing of tracheostomy (R2 =0.680) and a correlation between the length of ICU stay and the timing of tracheostomy (R2 =0.662) was found.Conclusions Early tracheostomy has a significant positive impact on critically ill patients hospitalized in this ICU.These results support the tendency to balance the risk-benefit analysis in favor of early tracheostomy.

Runx2 is a transcription factor belongs to RUNXX family, and it is one of the important factors involved in expression and participation in regulation of mammary specific genes in the mammary gland. The overexpression is also as-sociated with certain characteristics of breast cancer. This article aims to summarize the recent progress of the role that Runx2 plays in breast cancer.