Objective To evaluate the video-assisted thoracoscopic surgery(VATS) in the diagnosis and treatment of open thoracic traumas. Methods From July 2003 to July 2008,video-assisted thoracoscopic surgeries,including thoracic exploration,repair of the pulmonary laceration,parietal pericardium and diaphragm,hemostasis,evacuation of the clotted hemothorax,and mini-incision thoracotomy,were carried out in 64 selected patients with open thoracic traumas. Results Via VATS,all the 64 patients were diagnosed accurately: pulmonary laceration in 43(56 lesions),pericardiac rupture in 7(one of them showed right ventricular rupture),diaphragmatic rupture in 9(5 of them were complicated with spleen rupture,1 with hepatic rupture,and 1 with gastric rupture perforation),single intercostal vessel injury in 5,and combined intercoastal vessel injury in 3.The procedures involved VATS pulmonary laceration repair in 24(combined with thoracic wall hemostasis in 2),VATS combined mini-incision thoracotomy pulmonary laceration repair with Endo-GIA in 11(silk suture was employed in 6,and pulmonary wedge resection in 2).Through VATS procedure,hemostasis and repair were completed for pericardiac repair in 3,and diaphragmatic repair in 5.Thirteen cases were converted to open thoracic surgery.The duration of VATS procedure ranged from 32 to 124 minutes with a mean of 65.8 minutes.After the procedure,6 patients developed pneumothorax,4 showed mild subcutaneous emphysema,and 9 had slight hemoptysis in 1 to 12 days after the treatment.The patients were followed up for 2 to 60 months(mean,28.5 months).Chest X-ray performed during the period showed no pleural effusion,pneumothorax or other trauma-related complications.Conclusion VATS is effective for the diagnosis and treatment of open thoracic traumas with less surgical injuries and good outcomes.

OBJECTIVE:To analyse the situation of the drugs used in hospitals of Shanghai and to make objective evalua?tion.METHODS:To make a survey of the use of drugs in47hospitals of Shanghai in period2000～2002in respect to the sum of money of sales,main kinds,amount and clinical use of the drugs.RESULTS:The trend of total consumption increased in the past three years,however,the increasing rate declined.The antibiotics occupied the front10places in sequence of the sum of money of sales.The changes in proportion of domestic,joint venture made and imported drugs were not obvious.The gap in kinds of drug consumption was narrowed between domestic and world market,however,the difference in structure was still large.CONCLUSION:Hospital should pay attention to general trend of market of drugs and intensify rational use of drugs.

OBJECTIVE:To analyse the situation of use of antihistamine agents in hospitals of Shanghai and to make objective evaluation as reference for production,sale and consumption departments METHODS:To investigate the antihistamine agents used in 47 hospitals of Shanghai during the 1999～2001 period in respect to the kinds,dosage sum of money of consumption,DDDs,clinical evaluation and ARDs RESULTS & CONCLUSION:Consumption of antihistamine agents decreased in 2001,but kinds of drugs had no obvious change The commonly-used antihistamine agents were Cetirizine,Loratadine and Kitotifen Incidence of cardiotoxicity is very low,but we must take care of it

Visfatin was expressed in rat anti mouse islets,as well as in MIN6 cells. The visfatin expression was affected by various concentrations of environmental glucose (5.5 and 33.3 mmoL/L) and palmitate(0.5 mmol/L). As compared with low-level glucose medium (5.5 mmol/L, 1.0±0.11) , visfatin expression increased in media with high glucose and palmitate (1.32 ±0. 18, 1. 33±0. 15,1.72±0.27, all P<0. 05). The result suggests that visfatin seems to be involved in the regulation of insulin secretion.

Objective To continue following up the cohort members in Jiangsu province who were the largest subgroup in Chinese medical X-ray workers cohort subgroups on radiation carcinogenesis and analysis the cancer risk of medical X-ray workers which might be induced by chronic low-dose ionizing radiation between 1997 and 2011.Methods A retrospective cohort study was utilized to accumulate data.Epicure was applied to compute cumulative person years (with module of Datab) and relative risk (including 95％ CI) of malignant tumor on exposed group(with module of AMFIT) while the factors such as sex and attained-age were adjusted in the cohort members.Results The 7 708 follow-up members included 3 668 medical X-ray workers.The cumulative person-year in the cohort members was 94 651.2 (1997-2011) and its lost rate was 5.79％.During the follow-up period,441 cases had became cancer patients.The relative risk of all cancers was 1.44 (95％ CI:1.18-1.75),so was the solid cancers.Significant elevated risks of cancer were found on lung (RR =1.95,95％ CI:1.30-2.92),esophagus (RR =3.04,95％ CI:1.20-7.70),lymphoma(RR =2.24,95％ CI:0.67-7.48),leukemia(RR =1.57,95 ％ CI:0.33-7.39),throat (RR =2.47) and thyroid (RR =2.80,95 ％ CI:0.24-32.26) among medical X-ray workers.However,The RR of malignant tumors might not be associated with occupational exposure to ionizing radiation if we considered the lost factors (RR =1.2,95％ CI:0.94-1.46)Conclusions The RR of malignant tumors such as the cancer on lung,esophagus,thyroid among the medical X-ray workers in Jiangsu province were enhanced which might be associated with occupational exposure to ionizing radiation.

Objective To evaluate the treatment of acute cholecystitis patients through laparoscopic cholecystectomy (LC). Methods 387 cases of acute cholecystitis patients who underwent LC were studied retrospectively . Results Of the 387 cases, there were 359 cases of calculus incarcerated cholecystitis , 152 cases of cholecystitis with acute inflammatory symptoms for 72 h or more, 10 cases were converted to Laparotomy (2.6%).The operations lasted for 30~200 min(63.09 ±26.62 min on average),with blood loss about 10~500 mL(51.41 ±32.41 mL on average),and drainage was adopted in 183 cases.No complications developed fol-lowing the surgeries in 3 to 24 months, indicating a 100% cure rate. Conclusion If with good command of rules and techniques during LC operations , It is both safe and feasible to treat acute cholecystitis patients through LC operations .

Objective To develop the system of computer information processing for radiotherapy. Methods Visual Foxpro 5.0 was used to program the system through the model of client-server machine. SQL-server was used as the database-server.Results The main function of this system was management of the case data for radiotherapy and make plans for radiotherapy. Conclusion This system operates steadily with the data safe and reliable. It can be used extensively in clinical practice.

Objective: To explore the mechanism of moxibustion for rheumatoid arthritis (RA) by observing the metabolite changes in urine using liquid chromatography-mass spectrometry (LC-MS)-based metabolomic analysis. Methods: Twenty-four rats were randomly divided into a control group, a model group, and a moxibustion group. Rats in the model and moxibustion groups were established as collagen-induced arthritis (CIA) models. The control and model groups did not receive any intervention; rats in the moxibustion group received moxibustion at Shenshu (BL23) and Zusanli (ST36). After three weeks of intervention, ankle joint, serum, and urine samples were collected for pathological examinations and metabolomic tests. Results: After moxibustion treatment, the CIA rats showed increased body mass, reduced swelling of the hind paws and arthritis score, decreased serum cytokine levels, and improved histopathological evaluation of the ankle joint. Twenty-four significantly altered metabolites were found, mainly involved in alanine metabolism, taurine and hypotaurine metabolism, tricarboxylic acid cycle, phenylalanine metabolism, tyrosine metabolism, and primary bile acid biosynthesis. These metabolites may serve as potential biomarkers for RA. Conclusion: Moxibustion can effectively resist inflammation in CIA rats. The potential biomarkers and the abnormal metabolic pathways of RA can be identified by LC-MS-based metabolomics. Metabolomics may be an effective way to explain the mechanism of moxibustion in treating RA.

With the transformation of medical model, nursing humanities has gradually become the core of nursing practice, and the reform and construction of nursing humanities curriculum system has become one of the urgent problems to be solved in the reform of nursing education. This paper summarized the research progress of the construction of nursing humanities curriculum system at home and abroad, including curriculum setting, teaching strategies and methods, assessment forms, teacher competence and so on. It is hoped that it will be of reference value to the future construction of medical-teaching synergy of nursing humanities curriculum and the integration model of colleges and universities.

Objective:To investigate the clinical manifestations, risk factors and outcomes of patients with acute cingulate cortex (CC) infarction.Methods:Patients with acute CC infarction admitted to the Department of Neurology, the First Affiliated Hospital of Nanjing Medical University from December 2019 to April 2022 were enrolled retrospectively. According to the location of infarction, they were divided into anterior cingulate cortex (ACC) infarction group and posterior cingulate cortex (PCC) infarction group. The clinical manifestations, stroke risk factors, imaging examination and National Institutes of Health Stroke Scale (NIHSS) score of the patients were analyzed. At one month after onset, the modified Rankin Scale was used to evaluate the short-term outcome.Results:A total of 21 patients with acute CC infarction were enrolled, including 12 males (57.14%), aged 67.14±12.36 years (range, 45-89 years). There were 16 patients (76.19%) with ACC infarction, including 13 (81.25%) unilateral CC infarction. The clinical manifestations were mainly apathy, decreased concentration, and executive dysfunction. There were 5 patients (23.81%) with PCC infarction, all with unilateral onset, mainly manifested as memory loss and visual space disorder. Among the 21 patients, 18 (85.71%) had ≥2 vascular risk factors, and 13 patients (61.90%) had ≥3 vascular risk factors, of which hypertension was most common (90.48%); 19 (90.48%) were caused by atherosclerosis, and 2 (9.52%) were caused by cardiogenic embolism. After treatment, the symptoms of both groups were improved significantly, and there was statistical difference in the NIHSS score before and after treatment ( Z=4.07, P<0.01). During the follow-up, 16 patients (76.19%) had a good outcome, 5 (23.81%) had a poor outcome and no death occurred. Conclusions:ACC and PCC infarction mainly showed different forms of cognitive impairment. If the diagnosis and treatment are timely, the overall outcome of CC infarction is good.