Endometrial cancer (EC) is one of the most common gynecologic malignancy. Although the overall prognosis of EC patients is relatively good, patients with high-grade, recurrent, metastatic usually have a dismal prognosis. Lymph node status is one of the most important prognostic factors. However, for patients of early EC, whether lymphadenectomy must to be performed and its extent are still controversial. In this article, the indications of lymphadenectomy for early EC patients, the level of para-aortic lymph node dissection and the application of sentinel lymph node biopsy (SLNB) were reviewed respectively.

Adult ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; cytology ; Humans ; Macrophages ; pathology ; Male ; Middle Aged ; Pneumoconiosis ; pathology ; therapy

Objective:To understand the present situation of the grass-roots hospital patient satisfaction and influence factors after the implementation of new health care reform, and to put forward the rationalization proposals of improving degree of satisfaction. Methods:Conducted a questionnaire survey to 310 Grassroots hospital patients in Shandong province, and make data statistics and analysis. Results:After the implementation of new health care reform, satisfaction degree of medical services is relatively high in the mass, but there are also some problems. Through the investigation and analysis, the factors influencing patients satisfaction mainly include medical treatment cost, The doctor's technical level, the doctor's service attitude, diagnosis and treatment effect, The cost perform-ance of paying the medical costs and getting medical service price, The situation of meeting the work -up with medical equipment. Conclusion:From the perspective of new health care reform, the ascension of hospital patient satisfaction need to improve the level of basic hospital's medical technology, improve the medical service attitude, strengthen the management and control of medical expenses, and strengthen the government's financial investment.

OBJECTIVE To further improve the quality and promote implementation of(disinfection) and isolation(system), in order to reduce hospital infection.METHODS The quality control network is applied to perfect(disinfection) and isolation system and implemented the quality inspection according to standards to promote the(improvement) of management quality.RESULTS According to weak links existent in management to further(improve) the quality of work(analysis) and inspection that implemented,find out the course of implementing in(existent) weak link,improve and realize the disinfection and isolation system in practice.CONCLUSIONS The further improvement of quality in disinfection and isolation system implement is the best way to improve the(hospital) management of disinfection and isolation.

Objective To evaluate the difference of efficacy between continuous subcutaneous insulin infusion(CSII)and continuous intravenous insulin infusion(CVII)with human insulin in patients with diabetic ketoaciduria or ketoacidosis(DKA). Methods 120 patients with DKA were randomized into two groups,one was CSII group by a portable insulin pump(60 cases),the other was CVII group(60 cases).Results Both of CSII and CVII were effective in controlling blood glucose levels.CSII therapy provided better glycemic control(P

Objective:To understand the present situation of the grassroots medical personnel satisfaction during the implementation of new health care reform , and compared with the survey of 2011 , to further analysis the main factors of affecting the job satisfaction .Methods:Conducted a questionnaire survey to 326 employees of basic medi-cal institutions of Weifang city , Dongying city and Yantai city in Shandong Province , and study with the method of qualitative analysis and quantitative analysis .Results:The number of satisfied with the current basic medical work only is 5.2%, and the overall satisfaction rate is 38.04%.The overall satisfaction to compensation rate is 31.3%. The overall satisfaction to the relationship between doctors and patients is 36 .19%.The overall satisfaction to the hospital management system and performance appraisal is respectively 44 .17%and 40 .79%.Conclusions:Com-pared with the investigation results in 2011 , the overall satisfaction of the grassroots medical personnel has im-proved, but the overall satisfaction is not high .It puts forward constructive countermeasures: strengthen grass -roots hospital ability and talent building;strengthen the policy stability;improve the grassroots personnel′s reasona-ble salary;improve the occupation environment;protect the doctors′interests.

Medical ethics courses play a main channel role in the cultivation of applicable medical profession-als, who have both virtue and professional competence. To adapt to clinical medical education comprehensive re-form on the need for educating and training outstanding doctor and strengthen medical students′professional ethics and ethical practice ability, we must further optimize the medical ethics teaching reform:optimizing medical ethics education philosophy that to enhance the students′ability of ethical practice as the goal;optimizing implementation of the interactive case teaching that to strengthen the students′ethical thinking and decision-making skills as the basis;optimizing the channels and methods of research that to strengthen the students′ability of scientific research ethics as the promotion;optimizing evaluation method of medical ethics that to strengthen the formative assessment methods as the sudden breaking.

Objective To investigate the feasibility and efficacy of combined preoperative chemora- diation program followed by radical surgery in bulky early or moderate uterine cervical cancer.To determine the incidence and predictive value of rasidual disease in the radical hysterectomy specimens after CCR. Methods Thirty-five patients with uterine cervix carcinoma from January 2001 to September 2003 were treated with preoperative external beam radiotherapy to 3060 cGy in 4 weeks.Patients received concurrent continuous infusion cisplatin(20 mg/m~2)on day 1,8,15,22 of four weeks and 5-Fu(4 g)chemotherapy during the first four days and the last four days of the radiation course.Radical surgery was not performed until 4 weeks after the completion of the preoperative treatment.Results Clinical response was 85.71%,complete response,54.29 %;partial response,31.43 %.The analysis of the surgical specimens showed 19 patients had revealed residual disease and 16 patients had revealed no residual disease,the complete pathological response hed been 45.71%.Three-year survival rate was 87.14 % in 35 patients.Three-year survival rate of residual disease patients(76.32 %)was significantly lower than that of no residual disease(100.0 %)(P=0.0358). Three-year survival of cervical stromal invasion less than 1/2 and invasion extra stromal was 100.0 %, 41.67 % respectively(P=0.0109);three-year survival of lymph-vascular space involvement and no lymph- vascula space involvement was 0,85.29 %,respectively(P=0.0148).Conclusion Combined preoperative chemoradiation program followed by radical surgery in bulky early or moderate cervical cancer could reveal an effective efficacy with a tolerant complication.Residual disease is an independent and strong predictive factor.

BACKGROUND: When the dynamic equilibrium between oxidation system and anti-oxidation system in the body is upset, the overly produced active oxygen-derived free radicals will attack the target organs, thus resulting in the damage to organs and big molecules, and then diseases. Total anti-oxidation capacity (T-AOC), superoxide dismutase (SOD), and nitric oxide synthase (NOS) activity are the majorindexes for the defense system of the body, and their status is closely related to diseases. OBJECTIVE:To explore the level of T-AOC, SOD and NOS in serum,and find out its relationship with lifestyle. DESIGN:Single sample investigation. SETTING:Department of Health Laboratory Technology, College of Public Health of Harbin Medical University. PARTICIPANTS:Totally 531 residents of Bin County aged 20 to 70years were recruited between September 2000 and May2001. MATERIALS:The reagents kits of T-AOC, SOD and NOS were manufactured by Nanjing Jiancheng Bio-engineering Institute. METHODS:The investigators surveyed the residents with the same questionnaire. Questionnaire was made and the investigators were trained in advance. The questionnaire was filled in item by item as required. Questionnaire items consisted of the general situation, financial status, dietary habit, hobby, status of health care, and mental factor. Finally 95 investigation indexes were completed. The activity of serum T-AOC, SOD and NOS of the 531 residents in Bin County was determined, respectively, with reagent kits produced by Nanjing Jiancheng Bio-engineering Institute. The lifestyle factors were analyzed by multivariate stepwise regression analysis,and informed consent was obtained from the participants. MAIN OUTCOME MEASURFS:① Serum T-AOC, SOD and NOS in the participants; ② lifestyle factors affecting T-AOC, SOD and NOS.RFSULTS:According to actual analysis, the 531 participants entered the results analysis. T-AOC was measured in 489 participants, SOD in 525participants, and NOS in 531 participants. ① Indexes of the participants:T-AOC of the males was obviously higher than that of the females [(20.01±7.21), (15.25±6.22) kU/L, P ＜ 0.05]. SOD of the males was slightly lower than that of the females while NOS of the males was slightly higher than that of the females, but there was no significant difference. ②Multivariate stepwise regression analysis showed that risk factors related to T-AOC were gender difference (OR=2.188), educational level (OR=1.859),and the presence of rheumatism, respectively (OR =1.142). SOD-related risk factors were educational level (OR=1.584), years of spirit drinking (OR =1.048), presence of nephritis (OR=1.093), and irradiation (OR=1.770);frequency of tea drinking was a beneficial factor (OR=0.800). NOS-related risk factors were the average amount of cigarette smoking (OR=1.194) and the times of weekly spirit drinking (OR=1.368). However, the beneficial factor that affected serum NOS was the frequency of weekly mutton eating (OR=0.458) CONCLUSION:This experiment revealed that the ability to clean free radical in the 531 subjects was good and that it was better in males than in females. The increased educational level and presence of rheumatism can decrease T-AOC. Drinking, smoking and irradiation decrease SOD activity while the frequency of tea drinking and mutton eating are beneficial factors.

Objective To analyze related factors for pacemaker pocket infection in elderly patients after implantation of permanent pacemakers and to provide a theoretical basis for preventing pacemaker pocket infection.Methods Pacemaker pocket infection and related factors were analyzed for 412 patients who received implantation of permanent pacemakers from Apr.2010 to Jun.2013 in the Department of Cardiology.Results With 5 cases of pacemaker pocket infection,the rate of infection was 1.2％.The infected patients were older than the uninfected patients [(74.5±4.2) years vs.(60.3±6.6) years,t=4.781,P＜0.01].The rate of infection was higher in patients who had undergone operations twice or more than in patients who had undergone one operation [10.0％ (3/300) vs.0.5％ (2/382),x2=10.583,P＜0.01].The rate of infection was higher in patients with the operation lasting 2 hours or longer than in patients with the operation time shorter than 2 hours [(3.8％ (4/106) vs.0.3％ (1/306),x2=7.802,P＜0.01].The rate of infection was higher in patients with pocket hematoma than in patients without pocket hematoma [16.7％ (3/18) vs.0.5％(2/394),x2=37.492,P＜0.01].Independent risk factors for pacemaker pocket infection included pocket hematoma (OR=6.193),number of operations≥2 (OR=2.594),operating time≥2 hours (OR=2.265) and age of 75 years or older (OR =2.193).Conclusions Pocket infection after implantation of permanent pacemakers is related to pocket hematoma,number of operations,operating time and age.