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 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.

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.

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

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.

Objective To evaluate the effect of theta burst stimulation( TBS) paradigm of repetitive tran?scranial magnetic stimulation ( rTMS ) on the treatment of schizophrenia through assessing executive function. Methods 60 patients met with DSM?4 and ICD?10 for schizophrenia disorders criteria were enrolled in this study. The group was divided into theta burst stimulation group(research group, n=30) and sham intervention group ( control group, n=30) . The research group and control group were assessed with the Wisconsin card sorting test (WCST) and the go/no?go task by event?related potential(ERPs) before and after 4 weeks treatment. Each test results of all groups before and after treatment were compared with each other respectively. Results Regarding the WCST test,compared with the baseline,the post?rTMS state of the TBS group showed a decrease in the error selec?tion percentage((59.8±14.7)%),the preservative error number(55.3±18.0) and the preservative error percentage (71.3±12.6)%,but the percentage of conceptual level(71.3±12.6)% increased in the TBS group(P<0.05). Re?garding the go/no?go task by ERPs,compared with the baseline,the post?rTMS statet of the TBS group showed an increase in the no?go P3 amplitude(P<0.05 or 0.01) . After intervention,the score of WCST test and the no?go P3 amplitude were significant differences in TBS group compared with same rTMS group(P>0.05).Conclusions The?ta burst stimulation paradigm of rTMS can improve the executive function in schizophrenic patients.

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 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.

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 study the protective effects of total flavone from Prunus cerasifera fruits(PCE)on alcoholic liver disease(ALD)in rats,and provide experimental basis for developing new medicines for anti-ALD. METHODS:40 rats were ran-domly divided into normal group(distilled water),model group(distilled water),silibinin group [positive control,30 mg/(kg·d)] and PCE high-dose,low-dose groups [80,40 mg/(kg·d)],8 in each group. All rats were intragastrically administrated(10 mL/kg) every morning,once,for 6 weeks;meanwhile,except for normal group,rats in other groups received 50% alcohol(10 mL/kg) once intragastrically every afternoon to induce ALD model. After administration,heart,liver,spleen and other organ indexes,sub-cutaneous fat,brown fat,abdominal fat indexes were determined,as well as serum biochemical indexes [glutamate transaminase (ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),gamma-glu-tamyl transpeptidase(GGT),and total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL),low-density lipopro-tein (LDL)] level and liver biochemical indexes [superoxide dismutase (SOD),malondialdehyde (MDA),glutathione peroxidase (GSH-Px),TC,TG] and TC,TG levels in feces;pathological changes of liver and kidney tissues were observed. RESULTS:Compared with normal group,heart,liver,spleen indexes,subcutaneous fat,abdominal fat indexes in model group were in-creased(P<0.05 or P<0.01),brain index and brown fat index were decreased(P<0.05);HDL level and HDL/TC ratio in serum were decreased,other serum indexes were increased(P<0.05 or P<0.01);SOD,GSH-Px levels in liver tissue were decreased, other above-mentioned liver biochemical indexes were increased(P<0.01);TC,TG levels in feces were increased(P<0.01);liv-er and kidney showed obvious lesions. Compared with model group,the above-mentioned indexes in silibinin group and PCE high-dose group were significantly improved (P<0.05 or P<0.01);ALT,AST in serum and MDA level in liver tissue in PCE low-dose group were significantly decreased(P<0.01),and SOD,GSH-Px levels in liver tissue were significantly increased(P<0.05);lesion degree of liver and kidney and lipid accumulation in liver were reduced in administration groups. CONCLUSIONS:PCE may play a role in anti-ALD by anti-oxidation,promoting liver cell regeneration and regulating lipid metabolism.