The paper analyzes problems existed in health certificate issuing management among employees in the service industries in Xi'an and points out the necessity of using informatization means to assist health certificate data management.It proposes the scheme of u-sing the management system based on two-dimensional code technology to manage health certificate information and makes detailed de-scription of design and realization of the system.

Objective To investigated the efficacy of celecoxib for postoperative analgesia after endoscopic nasal surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes aged 18-64 yr were randomly assigned to one of three groups ( n = 40 each): control group ( group C); celecoxib 200 group ( group CEL1 ) and celecoxib 400 group ( group CEL2 ). The patients took celecoxib 200 and 400 mg by mouth at 1 h before induction of anesthesia in group CEL1 and CEL2 respectively. Anesthesia was induced with midazolam,propofol, remifentanil and rocuronium and maintained with iv propofol and remifentanil infusion. VAS was used to assess postoperative pain (0 = no pain, 10 = worst pain). In PACU when VAS score ≥3, the patients were given fentany125 μg iv every 5-10 min until the VAS score ＜ 3. After being discharged from PACU, the patients received celecoxib 200 mg every 12 h for 5 days in the 2 celecoxib groups. Oxycodone 5 mg was used as rescue analgesic when VAS score ≥ 4 until the VAS score ＜ 4. The number of patients who needed fentanyl for analgesia in PACU, the number of patients who needed oxycodone within 6 h, 6-24 h and day 2-5 after operation and side effects after operation were recorded. Analgesic efficacy was assessed at day 5 after operation and the satisfactory rate of patients calculated. Blood samples were obtained at 0, 6 and 48 h after operation for determination of PGE2,6-k-PGF1α and TXB2 concentrations. TXB2/6-k-PGF1α was calculated. Results The number of patients who needed fentanyl in PACU and the number of patients who needed oxycodone within 6 h and 6-24 h after operation were less, the satisfactory rate was significantly higher, and PGE2 concentrations in blood were significantly lower at 48 h after operation in the 2 celecoxib groups than in group C ( P ＜ 0.05 or 0.01 ). There was no significant difference in each index between the 2 celecoxib groups ( P ＞ 0.05 ). There was no significant difference in TXB2/6-k-PGF1α at each time point among the three groups. Nausea and vomiting occurred in one patient after operation in group C, but side effects were not observed in the 2 celecoxib groups. Conclusion Celecoxib given before and after operation can effectively relieve postoperative pain after endoscopic nasal operation by reducing PGE2 concentrations in blood.

Objective To compare medical students' learning curve between Macintosh laryngoscope and optical laryngoscope in endotracheal intubation and to decide which one is more suitable for novice personnel.Methods Totally 26 interns after being trained by experienced anesthesiologists were enrolled in this study.They performed intubation on 6 patients by using both Macintosh laryngoscope and optical laryngoscope ( each laryngoscope for 3 patients) under the supervision of experienced anesthesiologists.The sequence of laryngoscope was determined by computer-generated random number list.Results Totally 149 patients who were ready to receive surgery under general anesthesia were enrolled in this randomized crossover controlled study.Duration of intubation was significantly shorter in Airtraq group (78 -± 33 ) s than in Macintosh group (114 ± 32) s,P ＜ 0.001.Intubation success rate was significantly higher in Airtraq group than in Macintosh group ( 87.8％ vs.66.7％,P ＜ 0.05 ).Conclusions With the advantages of rapid learning curve,higher intubation success rate and shorter intubation duration,Airtraq laryngoscope is easier to master for novice personnel.

Adult ; Diabetes Mellitus ; etiology ; Humans ; Male ; Nose Diseases ; etiology ; surgery ; Pancreatitis ; complications ; Reconstructive Surgical Procedures ; Ulcer

Objective To evaluate the safety and efficacy of hepatectomy in combination with portal azygous disconnection for primary hepatocellular carcinoma (HCC) complicated with severe portal hypertension (PHT). Methods Clinical data of 30 cases of HCC complicated with PHT treated in our hospital from April 2005 to April 2008 were retrospectively analyzed. All 30 cases were randomly divided into the single operation group (group Ⅰ ) and combined group (group Ⅱ ). Results After operation, there were no significant statistical differences in rates of complications such as hepatic encephalopathy, ascites, stress ulcer, etc. and recovery of liver function between the 2 groups. The WBC and PLT counts in the blood samples of group Ⅱ were higher than those in group Ⅰ after operation. The postoperative 1- and 2-year hemorrhagic rates were lower in group Ⅱ than in group Ⅰ .Conclusion Hepatectomy in combination with portal azygous disconnection is safe and feasible for treatment of HCC complicated with PHT.

Objective To study the effectiveness of microwave ablation in treating HCC.Methods A total of 98 nodules in 56 cases of HCC were treated via appropriate puncture approach ac-cording to the volume, amount and site of tumor nodules. Results Only 1 patient failed to finish treatment since he could not suffer the pain. The other 55 patients finished without a hitch. Clinical and imaging findings were analyzed for change of physiology. Conclusion The microwave ablation is effective for the treatment of HCC. Such therapy can be important supplement of direct surgical man-agement. Its effect mainly depends on accurate puncture approach and enough diametric range. Mean-while, reasonable puncturing method should be selected.

After operations such as organ transplantation or cardiopulmonary bypass complicated with is-chemia/reperfusion injury,activated inflammatory cells can express and secret HMGB1,and cooperate with other inflammation factor to induce tissue damage.The mechanism is HMGB1 actives such receptors as TLRs,RAGE,TM,and NF-κB transcription factor,P38MAPK pathway,induce releasing of HMGB1 itself and other inflammation factors.Different with sepsis,HMGB1 emerges much earlier,lasting longer.Inter-ference therapy of HMGB1 could effectively decrease secretion of HMGB1 after ischemia/reperfusion injury.

Objective To assess whether topiramate prevents body weight gain in patients with olanzapine .Methods The ran‐domized controlled trials(RCTs) about topiramate for prevention of weight gain with olanzapine from 1998 to 2013 were searched in the Cochrane Library ,Pubmed ,EMbase ,WanFang Data ,CNKI and VIP .Two reviewers independently screened the literatures ,ex‐tracted the data ,and evaluated the methodological quality .Then Meta‐analyses were conducted by using RevMan 5 .1 software .Re‐sults The total of 11 RCTs were included .Among the 549 patients were involved .The results of Meta‐analyses showed that the ef‐ficacy of the topiramate group was superior to that of the control group in lessen body mass with significant difference (MD= -3 .68 ,95% CI:-5 .16- -2 .19 ,Z=4 .86 ,P<0 .01) .Conclusion Topiramate addition therapy is effective in attenuating olanzapine‐induced weight gain .

Objective To explore the effect of theta burst stimulation (TBS) paradigm of repetitive transcranial magnetic stimulation (rT-MS) on executive function in patients with chronic schizophrenia. Methods 60 patients meeting DSM-IV for chronic schizophrenia disor-ders criteria were enrolled. They were randomly divided into TBS group (n=30) and sham intervention group (n=30). They were assessed with digit span performance, space span performance and Wisconsin Card Sorting Test (WCST) before and 4 weeks after intervention. Re-sults After intervention, the forward score of digit span performance, the total score and forward score of space span performance increased (P<0.05), the error selection percentage, the error selection number and the percentage of error number of WCST decreased, the percentage of conceptual level of WCST increased (P<0.05) in the TBS group. However, there was no significant difference in the digit span perfor-mance, space span performance and WSCT in the sham intervention group (P>0.05). There was significant difference in all the items be-tween 2 groups after intervention (P<0.05). Conclusion TBS paradigm of rTMS could improve the executive function in schizophrenic pa-tients.

Objective To monitor the changes of resting energy expenditure in ventilated critically ill children,to compare the results of standard equations and indirect calorimetry (IC) in predicting energy expenditure,and to investigate the possible influence factors of the metabolic status of the critically ill children.Methods From September 2012 to September 2013,56 critically ill children on assisted ventilation and fitting the requirements of IC in pediatric intensive care unit of Shanghai Children's Medical Center were enrolled in this prospective study.IC measurements were performed using metabolic cart on day 1,4,7,10 after trachea intubation.General clinical data of these children were recorded.Results 130 IC measurements were performed in the 56 children.The measured resting energy expenditure (MREE) did not exhibit significant differences among day 1,4,7,and 10 (P =0.379).Although there were no significant differences between MREE and energy expenditure predicted with Schofield and WHO equations (P =0.917,P =0.995),the agreement was poor between the measured and predicted values (R2 =0.185,R2 =0.322).The metabolic status of the children on day 1 of ventilation was only correlated with age (P =0.000) and height (P =0.027),not with severity of underlying diseases or clinical outcomes.Conclusions MREE of IC method in ventilated critically ill children did not significantly change over time in this study.A poor agreement was observed between equationpredicted energy expenditure and MREE.IC measurement of resting energy expenditure is recommended for guiding individual nutritional support among critically ill children so as to improve clinical outcome.