1.Design of laboratory information management system of hospital based on the Cloud Technology
China Medical Equipment 2016;(2):55-56,57
Objective:To propose the requirement of hospital development quality inspection information management system, develop solution, avoid cost enormous waste problem and realize the system on-line.Methods: Use the UML method to develop hospital equipment management information system, and completed a detailed description of its specific use case diagram, sequence diagram, class diagram.Results: Equipment operation rate increased by 10%, significantly shorten specimens control time of, the fault response time decreased from 10min to 1 min, quality control indexes increased to 16%.Conclusion: The UML-based LIS system improved the work efficiency of the equipment, received the satisfactory effect.
2.Effect of continuous positive airway pressure (CPAP) therapy on heart rhythm and blood pressure variability in primary hypertensive patients with obstructive sleep apnea/hypopnea syndrome (OSAHS)
Jianwei LUO ; Li ZENG ; Haibo XU
Chinese Journal of General Practitioners 2015;14(8):603-606
Objective To investigate the effect of continuous positive airway pressure therapy (CPAP) on heart rhythm and blood pressure variability in primary hypertensive patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods Ninety seven patients with OSAHS and primary hypertension were randomly divided into treatment group (n =49) and control group (n =48).Patients in control group receive antihypertensive medication only,while patients in treatment group received antihypertensive medication in combination with CPAP therapy for 4 weeks.The dynamic electrocardiogram (ESG) and ambulatory blood pressure for 24 h were measured before and after treatment in both groups.Results After CPAP treatment,the night index of standard deviation of the average NN intervals (SDANNniGHt) in treatment group was (89.0 ± 21.4) ms,while the day and night index of square root of the mean squared differences of successive NN intervals (rMSSDday and rMSSDnight) was (35.9 ± 17.2) ms and (45.7 ± 18.3) ms respectively.Compared with those before treatment,the index of SDANNnight was decreased and the indexes of rMSSDday and rMSSDnight were increased (P < 0.01).Compared with control group,the SDANNnight was decreased,and the rMSSDday and rMSSDnight were increased (P < 0.01,P < 0.05).After CPAP treatment,the night index of low-frequency power (LFnight) in treatment group was (15.3 ± 5.7) ms,which was lower than that before treatment,and the night index of high-frequency power (HFnigh) was (16.3-± 8.1)ms,which was higher than that before treatment (P < 0.01);the LFnight in treatment group was decreased and the HFnight was increased (P < 0.01).After CPAP treatment,the day and night indexes of systolic blood pressure (SBPday and SBPnight) and the night indexes of diastolic blood pressure (DBPnigh) t in treatment group were (136.1 ± 13.4) mmHg,(128.7 ± 9.8) mmHg (1 mmHg =0.133 kPa),and(83.7 ±7.2)mmHg respectivley,which were all lower than those in control group (P < 0.05 or P < 0.01).The incidences of morning peak blood pressure and non-dipper hypertension in control group were significantly higher than those in treatment group (P < 0.01).Conclusion CPAP therapy can effectively adjust the heart rate and blood pressure levels in patients with OSAHS and primary hypertension,especially in the night.
3.Effect of hand intrinsic muscle exercise on the postoperative recovery of fine movement in children with hand injury
Yuehua LIU ; Li ZENG ; Wenjie LUO
Modern Clinical Nursing 2013;(12):26-28
Objective To study the effect of hand intrinsic muscle exercise on postoperative recovery of fine movement in children with hand injury.Methods From January 2009 to December 2011,64 children with hand injury were randomly divided to exercise group and control group equally.Hand intrinsic muscle exercise and rehabilitative care were conducted in the exercise group while traditional rehabilitative therapies in control group.After 3-month therapy,MMDT(Minnesota Manual Dexterity Test)and PPT(Purdue Pegboard Test)were conducted to evaluate the functional recovery of hands.Result The results of MMDT and PPT were obviously better in the exercise group than in the control group(P<0.01).Conclusion Hand intrinsic muscle exercise may be effectively in promoting the recovery of fine movement in children with hand injury.
4.Influencing factors of postoperation fast-track recovery in patients with thoracoscopic lobectomy
Ansu WANG ; Yu LI ; Li ZHANG ; Qian LUO ; Li ZENG
Chinese Journal of Practical Nursing 2016;32(13):965-969
Objective To explore influencing factors of postoperation fast-track recovery in patients with thoracoscopic lobectomy and provide support for the concept of fast track surgery in clinically application. Methods A total of 129 patients who underwent thoracoscopic lobectomy were selected and questionnaire were adopted for survey between January 2015 and September 2015. Univariate analysis and multivariable logistic regression analysis were used to screen influencing factors of postoperation fast-track recovery. Results Univariate analysis showed that the influnecing factors of postoperation fast-track recovery in patients with thoracoscopic lobectomy were closely related to the age, combined basic disease or not,smoking index,preoperative smoking cessation time,preoperative pulmonary function training or not,systematic health education or not,postoperative wound pain,early postoperative ambulation or not,postoperative chest exercises in time or not (t=2.880,χ2=0.219-33.224, P<0.01 or 0.05). Multivariable logistic regression analysis showed that systematic health education or not, postoperative wound pain,preoperative pulmonary function training or not,postoperative chest exercises in time or not,combined basic disease or not,smoking index,and quit smoking more than two weeks or not were the independent risk factors. Conclusions For the patients with thoracoscopic lobectomy, preoperative condition and postoperative condition in the early should be assessed in time. Controlling the pain effectively,giving reasonable guidance of preoperative pulmonary function exercise,strengthening the respiratory tract management,systematic health education,improving the ward environment,high quality of social support and other diversified services could accelerate the recovery of the postoperative patients.
5.Evaluation of MRI for axillary lymph node in breast cancer after neoadjuvant chemotherapy
Fu LI ; Jian ZENG ; Chunyan LI ; Ming LUO ; Zhen KONG
Tianjin Medical Journal 2016;44(1):94-97
Objective To explore and evaluate the clinical value of MRI for status of axillary lymph node after neoadju-vant chemotherapy (NAC) in patients with breast cancer. Methods Forty-four patients with 1ocally advanced breast cancer (LABC) were underwent NAC for four cycles. The longest diameter of axillary lymph node (ALN) measured by MRI scan. Val-ue of apparent diffusion coefficient (ADC) and their correlation were compared before NAC and four cycles after NAC. Re-sults of MRI and pathological data for ALN were compared between two groups of patients. Results All patients finished four cycles of NAC. The total response rate (CR+PR) was 72.7% (32/44), and the total non-response rate (SD+PD) was 27.3%(12/44). The longest diameter of ALN was significantly shortened in response group. The longest diameter was (1.37± 1.06) cm before NAC and (0.90±0.76) cm after NAC (P<0.01). The ADC value of the tumor was significantly increased in re-sponse group [(0.91±0.28) ×10-3 mm2/s before NAC and (1.01±0.32)×10-3 mm2/s after NAC, P<0.01)]. There was no signifi-cant correlation between ADC value change (△ADC) and the longest diameter change of ALN (△L, r=0.131, P=0.413). The sensitivity, specificity and Kappa value of ALN evaluation after NAC were 100%, 62.5%and 0.68 measured by MRI. Con-clusion The change of tumor longest diameter reflects the effect of chemotherapy directly. The tumor ADC value of MRI can not be used as an independent indicator of chemotherapy effect of ALN, eventhouth MRI was the sensitive index for eval-uating the status of axillary lymph node after neoadjuvant chemotherapy for breast cancer.
6.Diagnosis and treatment of pheochromocytoma:a fifty-year clinical experience
Dongliang PAN ; Hanzhong LI ; Ailun LUO ; Zhengpei ZENG ; Fang LI
Chinese Journal of Urology 2001;0(11):-
Objective To review and discuss the changes of diagnostic techniques and therapeutic modalities of pheochromocytoma during the past fifty years. Methods The clinical data of 362 patients (196 men and 166 women; age range,7-75 years;mean age,38 years) with pheochromocytoma from January 1955 to July 2004 were retrospectively analyzed.The disease course ranged from 20 d to 20 years with a mean of 3.9 years.According to the premedication,the past 50-year period was divided into 3 stages;and the diagnostic techniques,premedication, anesthetic skills,surgical procedures and perioperative death rate were compared among the 3 stages. Results There were 60 patients in the first stage (1955-1975) and their diagnoses were made on urine VMA and retroperitoneal air-contrast imaging.They had no premedication except for tranquilizers.The therapeutic modality was open surgery of resecting tumors under peridural anesthesia.The perioperative mortality was 8.3% (5/60).The second stage (1976-1994) included 105 patients and they were diagnosed mainly by 24-h urine catecholamine, ultrasonography and CT.Phenoxybenzamine was taken as the regular premedication and open surgery general anesthesia was used; the mortality decreased significantly to 1.0% (1/105).The third stage (1995-2004) consisted of 197 cases.In addition to 24-h urine catecholamine,ultrasonography and CT, 131I-MIBG scan was used as the specific diagnostic technique for pheochromocytoma widely.The premedication was phenoxybenzamine and urapidil.The microcirculation imaging analysis was used to judge the volume expansion preparation. Laparoscopic resection of the tumor under general anesthesia was adopted as the regular means.The perioperative mortality was 0.5% (1/197). Conclusions The diagnostic techniques for pheochromocytoma have become enriched and mature.The premedication has been standardized and included more medicines.The microinvasive surgery has become the current method for resecting tumors,and the perioperative mortality has become significantly decreased.
7.Expression and Clinical Significance of Serum IL-22 on Patients with Pulmonary Tuberculosis and Diabetes Mellitus
Yumei LI ; Ninghua YE ; Yongqiang LUO ; Dongzi LIN ; Jincheng ZENG
Journal of Modern Laboratory Medicine 2015;(4):155-157
Objective To study serum IL-22 levels in patients with pulmonary tuberculosis and diabetes mellitus (PPTDM) and to analysis their clinical significance.Methods ELISA was used to detect serum IL-22 levels in 30 cases PPTDM pa-tients,30 cases pulmonary tuberculosis (PTB)patients,30 cases diabetes mellitus (DM)patients and 30 cases healthy vol-unteers (HV).Results Serum IL-22 levels of PPTDM patients (54.4±4.81 pg/ml)were significantly lower than those in diabetes mellitus (DM)patients (72.36±5.12 pg/ml)and healthy volunteers (HV)(68.32±3.08 pg/ml)(t=2.557,P =0.013;t=2.437,P =0.018),respectively.There was no significantly different of serum IL-22 levels between PPTDM and PTB patients (t=1.190,P =0.239).Serum IL-22 levels of diabetes mellitus coincident with pulmonary tuberculosis (DM-PTB)patients (64.62±8.59 pg/ml)were significantly higher than those in pulmonary tuberculosis coincident with diabetes mellitus (PTB-DM)patients (44.21±2.68 pg/ml)(t=2.267,P =0.031).Conclusion IL-22 may play an important role in PPTDM development.
8.Comparative analysis of WBC,N%,CRP and PCT detection in bacterial infections
Qingyong ZHANG ; Sheng XIAN ; Jingjing ZENG ; Chunlong LI ; Chunhua LUO
International Journal of Laboratory Medicine 2015;(3):289-290
Objective To investigate and compare the applications of white blood cell count (WBC),neutrophil percentage (N%),C reactive protein (CRP)and procalcitonin (PCT)in the detection of bacterial infections.Methods Patients were randomly recruited in the study,70 patients with bacterial infection disease were recruited in the study as bacterial infection group,81 patients without bacterial infection were enrolled as no infection group.WBC,N%,CRP and PCT were detected,then comparative analysis of test results performed.Results Compared with no bacterial infection group,WBC,N%,CRP and PCT were increased in bacterial infection group(P <0.05),CRP and PCT increased obviously.The positive rate of WBC,N%,CRP and PCT in bacterial infection group was significantly higher than that of no bacterial infection group(P <0.05).In the bacterial infection group,the positive rate of N%,CRP and PCT was significantly higher than that of WBC(P <0.05),the positive rate of CRP was higher than PCT(P <0.05).But the positive rate of CRP was relatively high,and PCT was low in no bacterial infection group,suggesting that the false positive rate of CRP was higher,while that of PCT was lower,which had higher specificity.Conclusion WBC,N%,CRP and PCT all have clinical value for bacterial infections diagnosis.For the diagnosis of bacterial infections,N%,CRP and PCT is superior to WBC.CRP is more sensitive,but less specific,therefore,PCT with higher specificity was more suitable in the diagnosis of bacterial infections.
9.Cost-effectiveness analysis of preventing esophageal variceal rebleeding in liver cirrhosis
Ying LI ; Jingjing LIAN ; Tiancheng LUO ; Yuzhen ZENG ; Shiyao CHEN
Chinese Journal of Digestion 2016;36(2):113-118
Objective To compare cost-effectiveness between endoscopical esophageal variceal ligation (EVL) combined non-selective beta-receptor blocker strategies and covered-stents transjugular intrahepatic portosystemic shunt (cTIPS) in preventing esophageal variceal rebleeding in liver cirrhosis with portal hypertension.And to explore the threshold of cost-effectiveness in stents in China.Methods According to clinical practice and associated guidelines,a six state Markov-based decision analytic model was established with TreeAge Pro Suite 2014 to compare the cost-effectiveness between two interfering strategies after followed up for seven years.The parameters such as costs,life years (LY),quality-adjusted life-years (QALY) and incremental costeffectiveness ratio (ICER) were directed.Results The results of baseline research in the seven-year follow-up period indicated that the cost of endoscopical EVL combined non-selective beta-receptor blocker B was 7 444.25 United States dollar (USD)/each,and yielded 1.98 QALY.The expected cost of cTIPS was 13 151.69 USD/ each and could have 2.34 QALY.In the 7th year,ICER was 16 001.74 USD.Based on willingness-to-pay (WTP) threshold of China (19 887.00 USD),cTIPS had better cost-effectiveness than endoscopical EVL combined non-selective beta-receptor blocker B.The price of covered stents less than 5 401.52 USD had cost-effectiveness.The results of single factor sensitivity analysis indicated that rebleeding probability of endoscopical EVL combined non-selective beta-receptor blocker B group was the most influential factor in the result of model.The second important factor was the cost of cTIPS.The probabilistic sensitivity analysis reported cTIPS to be the optimal strategy at WTP of 19 887.00 USD in 83% of the iterations.Conclusions Seven-year follow-up indicates that cTIPS may be a more cost-effective strategy than endoscopical EVL combined non-selective beta-receptor blocker B in preventing esophageal variceal rebleeding.The price of covered stents less than 5 401.52 USD which have cost-effectiveness in China.
10.Role of tetramethylpyrazine in protection of homocysteine-induced hippocampal neural apoptosis in mice
Jian ZHANG ; Jie ZENG ; Qian LU ; Guangyi LI ; Yueji LUO
The Journal of Practical Medicine 2016;32(11):1757-1759
Objective To explore the role of tetramethylpyrazine (TMP) in protection of homocysteine (HCY)-induced apoptosis of hippocampal neurons in mice. Methods One hundred healthy adult Kunming mice of clean grade were randomly divided into 5 groups, 20 for each group. HCY was injected into lateral ventricle using stereotaxic technique. FJB staining was used to detect neural apoptosis and the Morris water maze test was applied to assess memory and cognitive abilities. Results FJB staining showed that apoptosis of hippocampal neurons in the mice treated with TMP at different doses decreased significantly as compared with that in HCY group, especially at a dose of 20 g/L. Conclusions TMP can alleviate HCY-induced damage of the hippocampal neurons in mice and improve memory and cognitive functions, which suggests TMP has a potential clinical value in prevention and treatment of Alzheimer′s disease.