Objective To investigate the clinical effect of the ultrasonic scalpel and electric knife in open thyroid surgery.Methods The clinical data of 182 patients underwent thyroid surgery were retrospectively analyzed.100 cases in the observation group were used the ultrasonic scalpel surgery and 82 patients in the control group were given electric knife surgery.The average surgical incision length,mean operative time,mean blood loss and postoperative complications were compared between the two groups.Results The average incision length of the observation group was (36.7 ± 6.1)mm,average time of thyroidectomy was (25.3 ± 5.1)min and blood loss was (14.2 ± 5.1)ml,which were significantly lower than those of the control group (P ＜ 0.05).The incidence rate of adverse reaction between the two groups had no significant difference(P ＞ 0.05).Conclusion Compared with electric knife,the use of ultrasonic scalpel in thyroid surgery can significantly reduce blood loss,shorten the operation time,the prognosis and clinical efficacy is good,it is worth to be further promoted in clinical.

Objective To assess the violence risk levels of the community patients with severe mental illness and Analyze the associated factors.Methods A working group composed of psychiatrists,community police,FIMITIC staff,community physicians,neighborhood or village committee members was established.501 community patients with severe mental illness were evaluated with Violence Risk Assessment Scale by working group.While the data of the general demograpbic,medical history and violence history was investigated.Logistic regression analysis was used to explore the factors associated with violence.Results In 501 patients,risk levels of grade 0:124cases (24.8％),grade 1:165 cases (32.9％),grade 2:118 cases (23.5％),grade 3:59 cases (11.8％),grade 4:28 cases (5.6％) and grade 5:7 cases (1.4％).Logistic regression analysis showed four significant risk factors,which were schizophrenia (OR 4.139),no taking medicine (OR 6.883),unstable condition (OR 234.534) the number of previous violence(OR 3.457) (P ＜ 0.05).Logistic regression equation:Logit (severe violence) =-8.511 + 1.420 (schizophrenia) + 1.929 (no taking medicine) + 5.458 (unstable condition) +1.241 (the number of previous violence).Conclusion The results of violence risk assessment and risk factors have directive significance for management of community patients with severe mental illness.

Objective To study the clinical characteristics and therapeutic effect of the combination of intensive immunosuppression therapy with umbilical cord blood infusion in severe aplastic anemia (SAA) patients with infections.Methods A retrospective analysis of bacterial spectrum and treatment effect was performed for infections occurred in 27 SAA-Ⅰ patients who received antithymocyte globulin (ATG),cyclophosphamide (Cy) and cyclosporine A (CsA) followed by umbilical cord blood infusion.Results The prevalence of infections in 27 SAA-Ⅰ patients was 48.1％,among which 70 ％ were infected with bacteria (mostly gram-negative bacilli) and 30 ％ with fungal infection.Upper respiratory tract was the most common site,followed by the blood and lungs.The primary infections occurred at the median time of 9.5 d (-2-10 d)after the immunosuppressive therapy,and the initial infections of ANC were ＜ 0.2 ×109/L.Conclusion Combination of intensive immunosuppression and umbilical cord blood infusion is proven effective in treating SAA-Ⅰ.As a result,infection rate is low and can be controlled with sensitive antibiotics.

Targeted agents for advanced colorectal cancer mainly include inhibitors of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR).Studies show that bevacizumab and cetuximab can improve the prognosis of advanced colorectal cancer patients,but there is slight difference in the choice of chemotherapy regimens when combined with them.Bevacizumab and cetuximab can improve the overall survival of K-ras wild-type colorectal cancer patients similarly.The emergence of new targeted drugs such as aflibercept,regorafenib provides more choices for the targeted therapy of advanced colorectal cancer patients.

Objective:The one-way communication between traditional LIS system and equipment has been unable to meet the needs of business development of medical laboratory in our hospital, we need to upgrade our equipment and to develop the bidirectional communication interface between LIS and equipment.Methods: Our hospital has invested a lot of money to upgrade previous One-way communication interface based on ASTM, the new instrument specifications conform to HL7 standard, and develop bidirectional transmission program based on HL7.Results: After the implementation of the bidirectional communication, testing equipment can automatically identify bar code to get the test request information, after the completion of the test instrument, the inspection unit can automatically send sample results to LIS.Conclusion: Bidirectional transmission improves the work efficiency, transmission based on HL7 is not only fast, but also conducive to the sharing of data between heterogeneous medical information systems, and it is a general tendency.

Objective To dynamically observe the expressions of Toll like-receptor 2 (TLR-2),TLR-4 and inflammatory cytokine IL-1 beta and TNF alpha,and analyze the correlation between TLR-2,TLR-4 and inflammatory response on rat cornea alkali burn.Methods Forty SPF healthy SD rats were excluded the anterior segment disease,the right eye was set as burn experiment and the left eye as normal control,Ⅲ level corneal alkali burn model was established with concentration of 1 mol · L-1 NaOH(At the establishment and after the establishment of the model,the inconsistent degree of corneal bums,the corneal perforation and hyphema in rats,etc.,were removed,and finally randomly selected 32 eligible rats),then were randomly grouped into 3 days,7 days,14 days and 21 days group,8 eyes in each group.The rats were observed and photographed anterior segment of each group,evaluated the corneal inflammation index,then removed the eyeball of the rats in the corresponding time points.The eyeballs were made into pathological tissue section and stained with HE method.The number of inflammatory cells in the cornea was calculated,and the expression of TLR-2,TLR-4,IL-1 beta and TNF alpha was detected in the rat cornea with method of Western blot protein detection at the same time.The differences of each group were analyzed,and the correlation was assessed between TLRs and inflammatory factor.Results There were the expressions of TLR-2,TLR-4,IL-1 beta and TNF alpha in the normal rat cornea,and its expressions were gradually increased after alkali burn,reached the peak at the 7 days,then decreased gradually,the difference of each group (the 3 day,the 7 day,the 14 day,the 21 day) was statistically significant (all P ＜ 0.05).The expressions of TLR-2 and IL-1 beta (r =0.986,P ＜ 0.05),TNF alpha (r =0.986,P ＜ 0.05) were positive correlated.The expressions of TLR-4 and IL-1 beta(r =0.975,P ＜ 0.05),TNF alpha (r =0.990,P ＜0.05) were positive correlated.Conclusion TLRs participates and may start immune inflammatory response after corneal alkali burn,mediates the production of inflammatory cytokine.

OBJECTIVE To explore the risk factors and countermeasures of burn wound infection.METHODS The data of burn patients in hospital from 2005 to 2007 were retrospectively analyzed.RESULTS From 341 burn patients 257 got infected and total infection rate was 75.4%.Investigation shows that the probability e of infection in 3 days was 12.9%,but the rate became 72.7% after 4 to 10 days.The bigger the wound area,the higher the possibility to got infected.The infection rate was 43.8% when BSA was smaller than 20.0%.When BSA was bigger than 41.0%,the rate was up to 88.0%.When BSA was bigger than 61.0%,the rate was 100.0%.Except that,antibiotics and standard medical performance were the important factors related to burn infection.CONCLUSIONS To strengthen the aseptic concept among medical staff,pay attention to the environment of hospital,and the sterilization of the materials,debridement and drainage in time,and rational usage of antibacterial drugs,are the effective countermeasures to reduce burn wound infection.

In the course of medical education for academic degree, reforming our teaching course by trying bilingualteaching in surgery to different students is an effective way to enhance the medical staff's English level and their abilityto use English. This article has summarized the experience of our bilingual teaching from the design, preparation andimplementation of the teaching.[

In this paper the basic feature of the participating teaching approach is elaborated,and the problems needing to be paid attention to in the process of its application and fulfillment are also discussed.

OBJECTIVE:To investigate the stability of reduced glutathione sodium after mixing with glucose injection (5% or 10%),glucose and sodium chloride injection or 0.9% sodium chloride injection. METHODS:After mixing of reduced glutathione sodium with glucose injection (5% and 10%),glucose and sodium chloride injection,and 0.9% sodium chloride injection,respectively,the 4 mixtures at 0,0.5,1.0,1.5,2.5,3 h after mixing which were stored respectively in 25℃ or 37℃ thermostatic bath were observed in respect of the changes in appearance,pH values,absorbability,contents and the insoluble particles. RESULTS:After mixing of reduced glutathione sodium with glucose injection (5% and 10%),glucose and sodium chloride injection,and 0.9% sodium chloride injection,respectively,the appearance and pH values of the 4 mixtures showed no obvious change,but the contents and the insoluble particles of the 4 mixtures experienced changes of different degree. CONCLUSION:Reduced glutathione sodium is stable in glucose injection (5% or 10%),glucose and sodium chloride injection or 0.9% sodium chloride injection within 2h after mixing.