Objective: To improve the treatment order and improve the work efficiency of the doctors, our hospital has run the triage calling system in out-patient department. Methods:Using VC++ language and the middleware technology, we realize the function of voice calls, large screen display control, background management and data synchronization. HIS system realizes the automatic call patient registration by transfer the registration information to the triage system. Results: The trial operation of outpatient triage calling system in our hospital has completely changed the previous traditional triage mode of“nurse as orientation”. The system reduces not only the work pressure of health care, but also significantly improve the doctors' work efficiency and service quality. Conclusion:Guide triage system can effectively improve the environment and outpatient treatment order, greatly enhance the patient’s satisfaction.

Objective To explore the indication,surgical procedure and the postoperative treatment of breast conserving modified radical mastectomy for early stage breast cancer .Methods The clinical data of 21 patients with early stage breast cancer underwent breast conserving modified radical mastectomy were analyzed retrospectively. Results All patient recovered uneventfully. All the external configuration of the breast were fine. There were no recurrence and no complications in this series. Conclusions The breast conserving modified radical mastectomy is recommended for the early stage breast cancer. The external configuration of breast is fine postoperatively, and patients have higher survival quality.But follow up is necessary in order to find and treat the recurrence of breast cancer.

In June 2016,a disease among the cultured rock carp (Procypris rabaudi) in Yongchuan of Chongqing Municipality occurred.The aim of this study was to investigate biological characteristics and provide reference for Aeromonas veronii identification diagnosis and treatment.Pathogenic bacteria strain YY01 from the dying fishes were examined and isolated.Strain YY01's taxonomic status was identified by observing the morphology,studying the physiological and biochemical characters and sequencing the 16S rRNA and housekeeping gene gyrB.Its pathogenicity was checked by artificial infection experiment and virulence genes.Furthermore,effective medicine was detected by drug sensitivity.The 16S rRNA and gyrB gene sequence of the strain YY01 was more than 99％ homology with that of Aeromonas veronii,suggesting that the pathogen was Aeromonas veronii,which was also identified by the results of biochemical analysis.The LD50 of strain YY01 to rcok carp was 5.06 × 104 CFU/g.Four virulence genes were detected from YY01,including aerolysin (aer),hemolysin (Hly),Outer Membrane Protein Gene A (OmpA) and adhesion (Aha) genes.Antibiotic sensitivity assays showed that among 40 antibiotics tested,22 were sensitive and 11 were resistant.In conclusion,the strain YY01 is identified as Aeromonas veronii and it is proved to have strong pathogenicity.

Objective To explore the expression and change of ski-interacting protein (SKIP) in rats after spinal cord injury. Methods A total of 60 adult female Sprague-Dawley rats were randomly divided into sham group (n=30) and spinal cord injury (SCI) group (n=30), each group was further divided into five time points including one day, three days, five days, seven days, and 14 days with six rats in each time points. The model was established at T10 with modified Allen's technique, and the sham group only bit the lamina of rats. The hindlimbs behavior was assessed with Basso-Beattie-Bresnahan (BBB) score at each time point. The pathological changes of spinal cord neurons were detected with Nissl staining. The expression of SKIP were observed with immunofluorescence staining. Results The BBB scores were signif-icantly lower in each time point in SCI group than in the sham group (t>48.267, P<0.001). Compared with the sham group, Nissl bodies in the cytoplasm of spinal cord neurons began to disintegrate, coalesce and irregularly distribute, the neurons began to degenerate and die on the fifth day, and the damage deteriorated on the 14th day. Immunofluorescence staining showed that SKIP expression was mainly expressed in the gray matter of the spinal cord and little expressed in the white matter. The expression of SKIP gradually increased after SCI, and reached a peak on the fifth day (t=-17.035, P<0.001) and decreased significantly on the 14th day (t=3.853, P<0.05). Conclusion SKIP may be a new signaling molecule, which play an important role in neuronal apoptosis after SCI.

Adult ; Chemical and Drug Induced Liver Injury ; Dimethylformamide ; poisoning ; Humans ; Male

Iliac arteriovenous ifstula (AVF) usually manifests in a wide range of symptoms similar to typical deep venous thrombosis (DVT), which often lead to delayed diagnosis or misdiagnosis. We reported a 51-year old woman who was performed lumbar discectomy and showed a progressive abdominal distention, dyspnea, and swollen left leg. She was initially diagnosed as deep vein thrombosis and the ifnal diagnosis was arteriovenous ifstula. hTe ifstula was successfully sealed by an endovascular covered stent. No further recurrence was found atfer a half year’s follow-up. hTis article summarized the experience regarding iliac arteriovenous ifstula misdiagnosed, and discussed the differential diagnosis between arteriovenous ifstula and pulmonary thromboembolism causedby deep vein thrombosis.

ObjectiveTo explore the clinical application of ultrasound-guided radiofrequency thermocoagulaion in brachial plexus block.MethodsC5-C7 brachial plexus block was performed by 6-13 MHz high-frequency ultrasound probe in 65 patients with cervical spondylotic radiculopathy. Visual analogue scale (VAS) score were compared before and after treatment.ResultsThe brachial plexus was showed clearly in 62 patients; however, 3 patients had to be confi rmed by nerve stimulation positioning. The percentage of successful rate is 100%. There was no operation related nerve injury and other complications. The VAS score of preoperation and 1st, 4th and 12nd week after treatment was 8.67±0.76, 3.58±0.62, 2.46±0.2 and 1.77±0.28, respectively. There were significantly difference between before and after treatment (t=58.71, 6.23, 107.72, allP<0.01).ConclusionThe brachial plexus block using radiofrequency thermocoagulaion combined with ultrasound guidance is a safe and radiation-free treatment and warrants to be promoted in clinical practices.

Objective To study the relationship between lymph node micrometastasis in early gastric cancer and clinicopathology of tumor,and explore an appropriate operative procedure.Methods A total of 1 004 lymph nodes from 50 patients with early gastric cancer(EGC)were sliced and restained with H.E and immunohistochemical technique,respectively.Immunohistochemical staining was performed by the streptavidin-biotin immunoperoxidase method with cytokeratin-specific monoclonal antibody CAM5.2.The relationship between lymph node micrometastasis and clinicopathological characteristics of primary tumors and prognosis of EGC was analysed.Results The incidence of nodal micro-involvement was significantly increased in diffuse type cancerous lesions(n=11,32.35%)as compared with intestinal type cancerous lesions(n=1,6.25%)(P

Objective The rapid development of radiation equipment has put forward higher requirements for protective facil -ities.The aim of this study was to research the radiation protection status of treatment equipment room in thirty -three medical units from East China area , and to put forward corresponding countermeasures to improve the level of radiation protection . Methods The li-cense and archival of X-ray machine, CT, gamma knife, accelerator, after loading therapy machine were surveyed in the thirty-three medical units .The engine room size , wall thickness , lead equivalent of protection doors , and leakage level of equipment were detec-ted.All the data were evaluated and analyzed on the basis of the corresponding national standards . Results ①The inspection pass rates of radiation treatment equipments in the first class hospitals were afterloader (100%), X-ray apparatus(99%), gastrointestinal machine(98%), CT(98%), medical processing accelerator (98%), gamma knife(97%), DSA(94%), PET-CT(94%), ECT (90%), dental engine(84%)and molybdenum target drone (84%).The inspection pass rates of radiation treatment equipments in other class hospitals were medical processing accelerator (100%), X-ray apparatus(91%), CT(89%), gastrointestinal machine (80%), DSA(80%) and (80%) gamma knife.②The qualified rates of the leakage radiation levels of radiation therapy , diagnostic radiology and nuclear medicine were 100%, 99% and 97%. Conclusion The radiation protection of treatment equipments and facilities in thirty-three medical units from East China area needs to be strengthened . We should strengthen supervision , implement the rules and regulations , strictly perform the regulation of radiation protection evalua-tion, and strengthen the training of radiation protection regulations and skills .

Objective To compare the results of the anterior approach (AA) with the conventional approach in the treatment of large hepatocellular carcinoma (HCC).Methods We searched the Medline,PubMed,Cochrane Library,Wanfang database on randomized clinical controlled trials and non-randomized clinical controlled trials comparing AA with the CA in right hepatic resection for large hepatocellular carcinoma.The data were analyzed with the RevMan5 software.Results Five non-randomized clinical controlled trials (NRCTs) and three randomized clinical controlled trials involving 615 patients (304 in the AA group,311 in the CA group) were enrolled into the analysis.There was no significant difference in the operation time between the two groups.Compared with the CA,the AA had lower intraoperative blood loss (WMD=-680.2 ml; 95％CI,-1023.97～-336.43;P=0.0001),blood transfusion rate (OR=0.38;95％ CI,0.25～0.59;P＜0.0001),intraoperative tumor rupture (OR=0.33;95％CI,0.11～0.97;P=0.04),surgical complication (OR=0.59;95％CI,0.38 ～ 0.93 ; P =0.02),hospital mortality (OR =0.37 ; 95 ％ CI,0.21 ～ 0.67 ; P =0.0009),and hospital stay (WMD=-4.75 d;95％CI,-7.82～-1.67;P=0.002).Conclusion AA is superior to CA in the treatment of larger.The operation time is the same for the 2 approaches.