Objective To evaluate the application of intraoperative endoscopy during the emergency exploratory laparotomy in the patients with acute massive small intestinal bleeding.Methods Twenty-six patients with acute massive small intestinal bleeding were examined by intraoperative endoscopy during the emergency exploratory laparotomy and the clinical data were analyzed.Results The hemorrhagic reasons were clarified in 25 patients(96.2%) through the application of intraoperative endoscopy.Of the 25 patients,the results showed that 2 cases were with duodenal leiomyoma,1 case duodenal Dieulafoy' disease,5 cases small bowel leiomyoma,2 cases small bowel leiomyosarcoma,2 cases ileum lymphoma,3 cases ileum ulcer,4 cases small bowel cavernous hemangioma,5 cases small bowel arteriovenous dysmorphosis and 1 case pancreaticojejunostomy cut bleeding.The average examination time was 15 min and no complications related to intraoperative endoscopy occurred in all patients.Conclusion The application of intraoperative endoscopy,which may increase the detection rate,is efficient and safe during the emergency exploratory laparotomy in the patients with acute massive small intestinal bleeding.

Objective To explore the value of endoscopic duodenal feeding tube placement in severe coma patients with endotracheal tube by tracheostomy. Methods 28 patients, who suffered from severe coma with endotracheal tube by tracheostomy, received endoscopic duodenal feeding tube placement. Results Endoscopic duodenal feeding tube placement in all 28 patients was successful, and complications such as tube blocking or dropping occurred only in one patient. The average time of placing duodenal feeding tube was 16 min. Conclusion Endoscopic duodenal feeding tube placement was an effective, simple,convenient and safe way to set up enteral nutrition for severe coma patients with endotracheal tube by tracheostomy.

Objective To evaluate the efficacy and safety of contact endoscopic argon plasma coagulation(APC) for treating protuberant erosive gastritis. Methods 63 patients with protuberant erosive gastritis were randomly divided into groups A and group B, which were treated with non-contact and contact APC, respectively. The efficacy and safety were compared between the two groups. Results There was no significant difference between group A and group B in the efficacy and complication frequency. The curative rates in group A and B were 96.8% and 96.9%, respectively, and only 3 patients had abdominal pain or distension 1 to 3 days after operation, and disappeared within 3 to 7 days after treatment in each group. The numbers of ineffective operation in groups A and B were 284 and 96, respectively. The duration of operation in groups A and B was 11 min and 38 sec,7 min and 22 sec, respectivley. The numbers of accidental injury in group A and B were 137 and 58 times, respectively (all P

Objective To evaluate the impacts of comprehensive diabetes intervention to provide evidence for effective diabetic control in rural communities.Methods Diabetic patients from four communities at Wujin District of Changzhou City were selected.One hundred and seventy-three patients from two communities received comprehensive intervention,including medication therapy,diabetes education,and diet.exercise,and behavior instruction(intervention group);142 patients from the other two communities got medication therapy only (control group).All the participants were interviewed with structured questionnaire and phyrsical examination.The second epidemic investigation was conducted at 4 years to evaluate the effects of the intervention.Results At the end of the intervention,the awareness rates of normal fasting plasma glucose,major diabetes risk factors,healthy diet,and therapeutic strategies in the intervention group were 90.8%.74.6%,89.6%,and 59.5%,respectively,which were significantly higher than those in the control group (all P<0.05).For the intervention group,the rates of diet behavior or physical exercise change were 68.8% and 58.4%.respectively.which were much higher than those of the control group(all P<0.05).The average levels of systolic pressure,diastolic pressure,fasting plasma glucose,and total cholesterol were (130.6±10.4)mm Hg(1 mm Hg=0.133 kPa),(78.4±7.5)mm Hg,(6.2±3.1)mmol/L,and (4.5±0.9)mmol/L,respectively,in the intervention group,which were lower than those in the control group(all P<0.05).Conclusion Comprehensive intervention shows significant effects on rural community patients with diabetes.

OBJECTIVE:To improve the quality of ADR reports. METHODS:By using intensive hospital monitoring mode, ADR reports before and after the application of the system would be collected and factors as report quantity,type,time and quality of reports were analyzed statistically. RESULTS:It provided rapid reporting function after the implementotion of the system. Total quantity of reported ADR cases increased from 589 to 748,and the proportion of all the serious ADR reports increased from 62.8%to 11.76%. The score of repert quality increased from 93.64 to 98.36,the proportion of time-out reports increased from 94.05% to 97.33%,with statistical significance (P<0.05). CONCLUSIONS:Rapid reporting system of ADR in the hospital is beneficial to improve the efficiency and guarantee the quality of the reports. It also can expand the coverage of the monitoring network,and can lay the foundation for drug safety scientific evaluation and monitoring.

Objective: To investigate the spatio-temporal clustering characteristics of influenza in Yinzhou District, Ningbo City, Zhejiang Province from 2017 to 2021, so as to provide insights into prevention and control of influenza. Methods Data of influenza in Yinzhou District from 2017 to 2021 were collected from the Chinese Disease Prevention and Control Information System. The software ArcGIS 10.8 was employed for spatial autocorrelation analysis, and SaTScan 10.1 was employed for spatio-temporal scanning to analyze the temporal and spatial clustering characteristics of influenza incidence in Yinzhou District. Methods: Data of influenza in Yinzhou District from 2017 to 2021 were collected from the Chinese Disease Prevention and Control Information System. The software ArcGIS 10.8 was employed for spatial autocorrelation analysis, and SaTScan 10.1 was employed for spatio-temporal scanning to analyze the temporal and spatial clustering characteristics of influenza incidence in Yinzhou District. Results: Totally 60 543 influenza cases were reported in Yinzhou District from 2017 to 2021, with an incidence of 0.76%. The incidence of influenza peaked in December 2019 (9.35%) and January 2020 (9.28%) during the period between 2017 and 2021. Spatial autocorrelation analysis showed that there was a positive spatial correlation of influenza incidence in Yinzhou District from 2018 to 2021 (all P<0.05), and a high clustering in 2019 and 2021. Zhonghe Street showed a low-high clustering from 2017 to 2020; Jiangshan Town showed a low-high clustering in 2017 and 2020, and a high-high clustering in 2019 and 2021; Shounan Street showed a high-high clustering from 2018 to 2020; Yunlong Street showed a high-high clustering in 2021. Spatio-temporal scanning analysis showed that the class Ⅰ clusters were located in the central region which centered in Dongqianhu Town, with aggregation time in August 2017, in the northwest region with aggregation time in December and January from 2018 to 2020, and in the west region with aggregation time in August 2021. Conclusion The incidence of influenza in Yinzhou District from 2017 to 2021 showed a spatio-temporal clustering in the northwestern region in winter and summer.

AIM:To study the diagnosis of hyperchloremic triple acid-base disorders (hyperchloremic TABD) and its mechanisms and to find out the cause of hyperchloremic TABD of the burn patients. METHODS:① 154 concomitant arterial blood gas and electrolyte panel of 113 burn patients were diagnosed by clinical approach. ② The plasma aldosterone concentrations of burn patients were tested by radioimmunoassay. RESULTS:9 cases of the 113 burn patients were hyperchloremic TABD. Their plasma aldosterone's values were significantly higher than that of the natural ( P

OBJECTIVE:To introduce the research and application of sentinel hospital pharmacovigilance system,and provide technical reference for hospital pharmacovigilance working in China. METHODS:A sentinel hospital pharmacovigilance system based on hospital information system was established,the architecture and functionality were introduced and its effects were ana-lyzed. RESULTS:The sentinel hospital pharmacovigilance system formed by hospital business information management platform and data center. Its main functions included drug data arrangement,the auxiliary reporting of ADR,active monitoring,pharmaco-vigilance information inquiry,monitoring and warning and statistical analysis,which successfully achieved the rapid reporting and active monitoring of hospital ADR. The system had applied in 20 sentinel hospitals,and the ADR reporting quantity was obviously increased after applying the system. Compared with 2015,ADR reporting in a sample sentinel hospital was increased 120.6％ since it used the system in early 2016. Besides,the system had improved the ADR reporting process,operation and input standard for the ADR reporter,shortened the reporting time and improved the efficiency of the reporting staff. CONCLUSIONS:The establish-ment and application of sentinel hospital pharmacovigilance system has greatly improved the hospital ADR monitoring management level,and it is of great significance to further strengthen the pharmaovigilance in China.

Objective : To analyze and verify the factors influencing the prediction model of suicidal ideation of burn patients in hospital based on international scale． Methods : The clinical data of 194 burn patients treated in hospi- tal were retrospectively analyzed．General data questionnaire，ISI，HAMD，HAMA，ASDS and BSHS-B were used to evaluate the influencing factors of suicidal ideation．According to the presence or absence of suicidal ideation， the patients were divided into the suicidal ideation group and the non-suicidal ideation group．The baseline data be- tween the groups were compared，univariate screening of meaningful variables was conducted，and multivariate Lo- gistic regression modeling was further conducted. ROC analysis evaluated model differentiation，and internal verifi- cation was conducted. Results : According to the baseline data analysis results，there were no statistically signifi- cant differences in age，BMI，years of education，smoking history，estimated percentage of burned area，head and neck burns，hip and perineal burns，and pain scores in the suicidal ideation group (21 /194) compared with the non-suicidal ideation group ( 173 /194) ．Gender (P = 0. 047) ，presence or absence of trunk burn (P = 0. 022) ， severity of burn ( moderate burn : P = 0. 002 ; severe burn : P = 0. 458 ; extremely severe burn : P = 0. 169) ，ISI score (P = 0. 001) ，HAMD score (P = 0. 001) ，HAMA score (P＜0. 001) ，ASDS score (P = 0. 003) ，BSHS-B score (P = 0. 011) had statistical significance．Multivariate Logistic regression analysis showed that the severity of burn (moderate burn : OR = 0. 103，P = 0. 009 ; severe burn : OR = 0. 351，P = 0. 223 ; extremely severe burn : OR = 0. 103，P = 0. 095) and HAMA score ( OR = 1. 136，P = 0. 007) were independent influencing factors for burn patients with suicidal ideation 。The Logistic regression prediction model was established by two independent influ- encing factors. ROC analysis results showed that the model had good differentiation ( AUC = 0. 880，95% CI : 0. 808 －0. 952 ，P ＜0. 001 ) and the internal verification accuracy was 79. 38%． Conclusion The prediction model built on the basis of two independent influencing factors，burn severity and HAMA score，has a good predic- tion accuracy，which is helpful for clinicians to intervene as soon as possible for burn patients with suicidal ideation in hospital，in order to reduce the incidence and enrich clinical psychological research.