Varicose veins is the main clinical manifestations of the chronic venous insufficiency.TIPP transilluminated powered phlebectomy,a new minimally invasive surgery,received much attention while surgical techniques aimed at treating varicose vein were constantly updated.In this article,TIPP in the varicose vein surgery is reviewed from its history,operating techniques and advantages,and TIPP's future is being prospected.

OBJECTIVE:To provide reference for drug production,parchase and use in local governments,health care depart-ment,hospitals,manufacturers and sales enterprises,etc. METHODS:By consumption sum sorting method,the information of 14 categories and key types in 34 hospitals from Chongqing area during 2012-2014 were analyzed statistically such as sales,produc-tion manufacturers. RESULTS:The consumption sum of 34 hospitals from Chongqing area increased by 15%-17% during 2012-2014. The consumption sum and proportion of anti-infective drugs showed a downward trend,decreasing by 3.28%. Those of respi-ratory system drugs and anti-tumor drugs had the largest increase,with increasing rate of 79.01% and 69.39%,respectively. Do-mestic drugs accounted for about 73% market share,and sales of imported drugs increased more than domestic and joint-stock drugs,increasing by 40.17%. Among 6 Chongqing pharmaceutical manufacturers on the top 100 consumption sum shortlist,total consumption sum of 3 manufacturers had increased;the consumption sum of top 10 foreign pharmaceutical manufactures increased year by year. CONCLUSIONS:The consumption sum of drugs is increasing in Chongqing area. Anti-infective drugs accounted for less than 16%,which is the achievements of clinical application of antibiotics special rectification activities for 3 years. Both respi-ratory system disease and malignant tumor have high incidence in Chongqing area. Domestic drugs still are main types in hospital. Foreign manufacturers develop well in China,but Chongqing pharmaceutical manufacturers show unsatisfactory development pros-pect.

Objective To explore the differences in disease location,pathological feature,disease severity,extraintestinal manifestations and drug treatment between inflammatory bowel disease (IBD) patients with comorbid autoimmune disease (AD) and simple IBD patients.Methods From January 2009 to December 2014,the clinical data of 54 IBD patients with comorbid AD and at the same period 74 simple hospitalized IBD patients were retrospectively analyzed.According to IBD type and whether combined with AD,patients were divided into Crohn's disease (CD)+AD group (n=16),CD group (n=26),ulcerative colitis (UC)+AD group (n=38) and UC group (n=48).Chi square test was performed to compare the differences in disease severity,location,extraintestinal manifestations and drug treatment between IBD patients with and without AD.Results There was no statistically significant difference in location among four groups (all P＞0.05).The most common concomitant AD of IBD was rheumatoid arthritis (20.4％,11/54) and ankylosing spondylitis (13.0％,7/54).The proportion of mild active patients of CD+ AD group was lower than that of CD group (2/16 vs 53.8％ (14/26),x2 =7.180,P=0.007),while the proportion of severe active patients was significantly higher that of CD group (6/16 vs 0,x2 =8.519,P=0.004).There was no statistically significant difference in moderate active patients between the two groups (P=0.808).Main type of patients of UC+ AD group (76.3 ％,29/38) and UC group (68.8 ％,33/48) were moderate active patients.There was no statistically significant difference in disease stage and location (all P＞0.05).The incidence of extraintestinal manifestations of IBD+AD group (55.6 ％,30/ 54) was significantly higher than that of IBD group (9.5 ％,7/74,x2 =32.279,P＜0.01),and the main manifestation was arthritis (37.0％ (20/54) vs 5.4％ (4/74),x2=20.504,P＜0.01).The rate of glucocorticoid and immunosuppressant application in IBD+AD group was higher than that of IBD group (40.7％ (22/54) vs 17.6％(13/74),x2 =8.438,P=0.004;20.4％(11/54) vs 0,x2=14.000,P＜ 0.01).Conclusions The condition of patients with IBD and comorbid AD is more severe,and the incidence of extraintestinal manifestations is higher.Early treated with glucocorticoid and immunosuppressant could effectively achieve remission.

Coronary Sinus ; abnormalities ; Humans ; Male ; Middle Aged ; Subclavian Vein ; Vena Cava, Superior

We are reporting in this article some analyzed data obtained from inspection and related information on current situations medical devices in use. Some ideas and suggestions are also proposed here on how to systematically and legally inspecting and monitoring medical devices in use.
Equipment Safety ; Materials Management, Hospital

According to the safety protection of laser, discusses the basis and method of classification were discussed the classify of fractional photothermolysis Laser was tested and analyzed.
Lasers ; classification

Objective To compare surgical gastrojejunostomy and endoscopic stenting in palliation of malignant gastric outlet obstruction.Methods This retrospective study investigated patients treated for malignant gastric outlet obstruction from January 2007 to January 2014 in the first affiliated hospital of Nanjing Medical University.Endoscopic stenting was placed in 29 patients and surgical gastrojejunostomy was performed in 42 patients.The outcomes assessed included diet scores,time to diet,length of hospital stay,treatments fees and complications.Results Both endoscopic stenting and surgical gastrojejunostomy can relieve patients' syndrome with significant higher GOOSS score compared with that before treatment (P ＜0.05),but score improves faster in stenting group.Clinical success for endoscopic stenting and surgical gastrojejunostomy was 96.6％ and 92.9％ respectively,and technical success was 100％ for both of them.Endoscopic stenting group was found to have lower early complication rate(3.4％ VS 23.8％,P ＜0.05),higher late complication rate(24.1％ VS 6.9％,P ＜0.05),less time to diet,hospital stay and treatment fees(all P value ＜ 0.05)than surgical gastrojejunostomy group.The major complication after endoscopic stenting is re-obstruction while it is infection and leak of anastomotic site for surgical group.There were no significant differences in complication between two groups (27.6％ VS 11.9％,P ＞ 0.05).Conclusion Both endoscopic stenting and surgical gastrojejunostomy can relieve patients' syndrome effectively and safely,but endoscopic stenting improves GOOSS scores more rapid with less time to diet,less early complication rate and easy-dealing late complications,also it needs less hospital stay and fees.It's a better choice for patients with less survival expectation.

Objective To explore the method of clinical application and the final result of the com- pound flap of distally based of saphenous nerve-great saphenous vein nutritional vessels.Methods Basing on the anatomic basis that the nutrient vessels of saphenous nerve-great saphenous vein have the same deriva- tion as the branches of the muscle,bone and skin.Eight cases of the tissue defects of ankles and feet were re- paired by the flap.Results Seven cases were survived completely except the distal partly necrosis in one case.The calcaneal defects of one case were repaired by the iliac graft after two weeks of the operation.Follow up from 3 monthes to one year,the texture,appearance and function of the multiflap were good.Conclusion The compound flap of distally based of saphenous nerve-great saphenous vein nutritional vessels has the ad- vantages as follow:the reliable blood supply,avoidance of sacrificing the major arteries,reconstruction of sen- sation and simply procedure.Besides,the defects of soft tissue and bone can be repaired on one operation.

Objective To analyze the associations between particulate air pollution (PM10,PM25) and stroke daily attack or mortality. Methods Meta-analysis method was used to polysynthetically analyze 16 quantitative studies about the associations between particulate air pollution and stroke daily attack or mortality. The relative odds ratio(OR) of stroke attack or mortality associated with per 10 μg/m3 increase of particulate matter concentration was used as effective value,taking a sensitivity analysis for the results. Results A 10 μg/m3 increase in PM10was associated with a 1.09% (95%CI: 0.10%-2.08% ) increase in stroke daily attack (OR=1.011,95%CI: 1.001-1.021)and 0.70% (95%CI: 0.60%-0.80% ) increase in stroke daily mortality (OR= 1.007, 95%CI: 1.006-1.008). The results of sensitivity analysis supported above results. As for PM2.5 OR appeared to be 1.001 (95%CI: 0.992-1.010) with a 10 μg/m3 increase in stroke daily attack and 1.052 (95%CI:0.958-1.154) for daily mortality. Conclusion There are positive associations between PM10 and stroke daily attack and mortality, increase of PM25 was not associated with stroke attack and mortality.

Objective : To explore the reform of the operating mechanism of centers for disease control and prevention ( CDCs ) in the new era, and to put forward recommendations. Methods : We collected the financial investment and staffing of CDCs in Zhejiang Province from 2018 to 2020 through China Disease Prevention and Control Information System and Zhejiang Health Statistical Yearbook. We conducted a questionnaire survey among 620 staffs selected by convenience sampling, and a qualitative interview among 40 leaders and experts from CDCs and general hospitals in Zhejiang Province. Results : By the year 2020, there were 105 CDCs in Zhejiang Province, including 1 province-level, 11 prefecture-level, 90 county-level and 3 development zone-level ones. The revenues were mainly from financial subsidy and business incomes, which were over expenditures. There were 7 008 posts in CDCs, with a staffing allocation ratio of 1.29/10 000. Among the reform measures of operation mechanism of CDCs, the flexible communication between clinicians and public health doctors was highly approved (90.03%); among the reform measures of enhancing the integration of prevention and treatment, further clarifying the public health functions of hospitals and ensuring financial compensation was highly approved (74.01%). Conclusion We should further stimulate the endogenous power and vitality of CDCs, strengthen the construction of talent team, promote the active integration of hospitals and CDCs, and improve public health level.