Passing the hospital grading evaluation, establishing a tertiary-A specialized hospital for occupational diseases, enhancing hospital's internal quality and sustainable development, and continuously improving medical service quality are important measures to promote the high-quality development of hospitals. The evaluation standards for occupational disease specialized tertiary-A hospital require standardized, scientific, and sustainable management of medical equipment. Guangdong Province Hospital for Occupational Disease Prevention and Treatment is the first tertiary-A hospital for occupational diseases specialized in Guangdong Province. Relative regulation on medical equipment management was systematically reviewed based on the requirement of tertiary-A specialized hospital for occupational diseases during hospital grading evaluation process. Building and completing the medical equipment management system, standardizing and strengthening government procurement management, completing the configuration management and safety management of large-scale medical equipment, strengthening the effectiveness analysis and evaluation of large equipment, enhancing training on medical equipment usage, establishing emergency allocation systems for first-aid and life support medical equipment, and forming a medical equipment quality and safety management team is the measure to systematically improve and implement each item in various regulation for the full lifecycle management of medical equipment. It provides vital support in passing the tertiary-A hospital evaluation for hospitals. During the hospital grading evaluation process, each issue identified in medical equipment management was addressed and improved. This process continuously enhanced the hospital's medical equipment management level, ensured the safe and effective use of medical equipment, and improved the quality of medical services, laying a solid foundation for the hospital to become a high level specialized medical institution for occupational diseases.

Objective:To investigate the feasibility, safety and effectiveness of colonic interposition with vascular anastomosis in reconstructing the entire esophagus and hypopharynx after resection of hypopharyngeal cancer with esophageal cancer.Methods:We conducted a retrospective analysis of 4 male patients with simultaneous multiple primary cancers of the hypopharynx and esophagus, aged 47 to 58, treated in the Department of Head and Neck Surgery at the Hunan Cancer Hospital from February to August 2019. All cases underwent total hypopharyngectomy and total esophagectomy, of whom, three cases presented with total laryngectomy and one case with larynx preservation. Colonic interposition was performed using the left colic artery as a pedicle, with an average colonic length of 48.5 cm. The colon was elevated through the esophageal bed to the neck, and the branch of the colonic mesenteric artery was anastomosed to one of the neck arteries, including the inferior thyroid artery in one case, the transverse cervical artery in two cases, and the superior thyroid artery in one case, and all venous anastomoses were performed with the internal jugular veins.Results:The postoperative neck and abdominal wounds healed well without anastomotic leakage, and all patients were able to resume a regular oral diet within 21-30 days postoperatively. During the follow-up of 48-52 months, two cases died due to tumor recurrence, while the remaining two cases were disease-free survivals.Conclusion:Colonic interposition with vascular anastomosis is a safe and reliable reconstruction method suitable for repairing long-segment upper digestive tract defects after resection of hypopharyngeal cancer with esophageal cancer.

Acute respiratory tract infection is the most common infectious disease in children, which seriously threatens children′s health.Rapid and accurate etiological diagnosis is of great significance for the clinical treatment and control of these diseases.Pathogen nucleic acid test was applied and became the main method of respiratory tract infection diagnosis for its high sensitivity and specificity.To regulate the application of pathogen nucleic acid amplification test in respiratory tract infection in children, improve the diagnosis level, expert consensus on nucleic acid amplification test of respiratory pathogens in children was prepared to guide the application and promote pathogens diagnosis ability.

OBJECTIVE: To report on a case with homozygous deletion of large β gene cluster and its clinical characteristics. METHODS: A total of 71 001 peripheral blood samples were subjected to capillary electrophoresis and conventional testing for common thalassemia mutations. The genotypes of suspected β gene cluster deletions were analyzed by Gap-PCR and multiplex ligation-dependent probe amplification (MLPA). Their hematological characteristics were compared by statistical analysis R software. RESULTS: Eighty-nine cases were detected with Chinese CONCLUSION The carrier rate for large fragment deletions of β gene cluster in Huizhou region is rather high, for which the value of HbF is significantly increased. Attention should be paid to screening and diagnosis of rare genotype to prevent missed diagnosis and/or misdiagnosis.
Gene Deletion ; Homozygote ; Humans ; Multigene Family/genetics* ; Phenotype ; beta-Thalassemia/genetics*

Objective:To investigate the effect of complete decongestive therapy in the treatment of severe grade Ⅲ lower limb lymphedema.Methods:From January 2018 to December 2018, The patients were admitted to the lymphedema clinic of the cancer prevention and treatment center of Sun Yat-sen University, seven patients with severe gradeⅢ lower limb lymphedema were intervened with complete decongestive therapy, including problem skin care, special techniques of unarmed lymphatic drainage, foam block bandage combined with air wave pressure therapy, filled elastic bandage pressure bandage, functional exercise combined with home bare-handed lymphatic drainage and weight loss management. The intervention had two courses, and 20 times was a course of treatment. Perimeter measurement and weight measurement were used to evaluate the therapeutic effect at the 0, 5, 10, 15, 20, 30, 40 times of treatment.Results:After two courses of treatment, the circumference value of each measurement point on the affected side was lower than that before treatment, and the difference was statistically significant ( F values were 7.449-23.073, P < 0.05). The circumference value of the affected side decreased by 7.10 - 24.53 cm, and the weight after treatment was 9.0 - 20.5 kg less than that before treatment. During the follow-up period, it was found that the lower extremity diameter value at 3 months of follow-up at 5 sites increased and tended to be stable compared with that at 1 year of follow-up. Conclusion:Step 6 comprehensive swelling treatment can obviously improve the symptoms of patients with lower limb lymphedema of this research, and in the subsequent follow-up found that self-therapy at home, no recurrence or aggravate the limb swelling degree, and can reduce or stability treatment effect, enhance confidence in the treatment of patients, so as to improve the quality of life of patients and treatment compliance.

Objective:To explore the effect of dynamic multi-dimensional management model based on informatization on improving the home self-care of lymphedema patients.Methods:A total of 80 patients who received lymphedema combined detumescence treatment from January 2018 to June 2018 were selected as the control group.From July 2018 to December 2018, 80 patients were treated as the intervention group, and the whole process was managed on the basis of the control group using the dynamic multidimensional management mode based on informatization. Patients' compliance and quality of life were compared between the two groups.Results:The intervention group patients' compliance was better than control group, correctly measure the circumference of limbs, the law of life that occupy the home was good, correct manual lymph drainage direction, bandages, functional exercise, 18 standards compliance, respectively, 95.0%(76/80), 87.5%(70/80), 97.5%(78/80), 95.0%(76/80), 100.0%(80/80), 87.5%(70/80), better than that of control group were 77.5%(62/80), 75.0%(60/80), 80.0%(64/80), 70.0%(56/80), 75.0%(60/80), 50.0%(40/80), difference was statistically significant ( χ2 values were 4.103-26.182, P<0.05 or 0.01). After a course of treatment and 3 months of home-based self-care, the scores of role function, physical function, emotional function and social function of the quality of life in the intervention group were (75.44 ± 2.78), (80.11 ± 3.01), (78.25 ± 2.78), (79.93 ± 5.43), which were better than those of the control group (66.25 ± 2.58), (75.88 ± 3.57), (65.16 ± 2.47), (62.78 ± 4.01), with statistically significant differences ( t values were 8.09, 31.50, P<0.01). Conclusions:The dynamic multi-dimensional management model based on informationization and doctor-patient participation can improve the compliance and quality of life of patients participating in home-based self-care and better meet the needs of home-based nursing.

Five patients with primary malignancies in the pterygopalatine fossa (PPF) and infra temporal fossa (ITF) were enrolled in this retrospective study between January 2012 and January 2018. After malignancies proven by biopsy and evaluation with CT and MRI scan, all patients received modified maxillary swing (MMS) approach for extirpation of malignant tumors in the PPF and ITF under general anesthesia. En bloc resection with wide surgical margins was successfully performed in all cases. Negative margins were observed in 4 cases and positive margins were found in one patient with adenoid cystic carcinoma who received postoperative radiotherapy. The most common complication was facial numbness. During the follow-up period (range 12 to 57 months), one patient suffered from recurrence while others did not. The advantages of MMS include wide surgical field, full exposure and easy manipulation. The MMS approach is expected to become an standard method for monobloc resection of malignancies in the PPF and ITF.

Objective To investigate the clinical,laboratory and imaging characteristics of children with Mycoplasma pneumoniae pneumonia (MPP) in different age groups.Methods One hundred and sixty-four children whose ages were 1 month to 14 years old with MPP hospitalized at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine in 2017 were enrolled as study objects.All children were classified into 2 groups:1 month to 3 year-old group (46 cases) and ＞ 3 to 14 year-old group (118 cases).The clinical features,main laboratory and imaging findings of 2 groups were retrospectively analyzed and compared.Results (1) Compared with 1 month to 3 year-old group,＞ 3 to 14 year-old group had more patients with fever [97.5％ (115/118 cases) vs.84.8％ (39/46 cases)],longer duration of fever [48.3％ (57/118 cases) vs.23.9％ (11/46 cases)] and higher fever [83.1％ (98/ 118 cases) vs.52.2％ (24/46 cases)],but less patients with wheezing [2.5％ (3/118 cases) vs.43.5％ (20/46 cases)],shortness of breath and dyspnea [0.8％ (1/118 cases) vs.15.2％ (7/46 cases)],dry rale [1.7％ (2/118 cases) vs.60.9％ (28/46 cases)] and wet pulmonary rale [50.0％ (59/118 cases) vs.69.6％ (32/46 cases)],and the differences were statistically significant (all P ＜ 0.05).(2) The increase of platelet count,creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) in 1 month to 3 year-old group of MPP [316.0 (229.3,372.3) × 109/L,25.70 (17.70,31.98) U/L,346.5 (310.3,388.3) U/L] were more common than those in ＞ 3 to 14 year-old group [266.0 (205.8,317.8) × 109/L,21.50 (15.75,28.00) U/L,303.0 (173.0,352.0) U/L],while the increase of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in ＞ 3 to 14 year-old group [12.66(9.16,19.44) mg/L,23.00(17.75,29.00) mm/1 h] were more common than those in 1 month to 3 year-old group[2.46 (0.54,11.63) mg/L,14.00 (10.00,20.25) mm/1 h],and there were significant statistical differences (all P ＜ 0.05).(3) The MPP imaging features of children in different age groups were diverse.In 1 month to 3 year-old group,the double lung involvement [80.4％ (37/46 cases)] was more obvious than that in ＞3 to 14 year-old group [55.9％ (66/118 cases)],and the difference was statistically significant (P ＜ 0.05).The lesions of 1 month to 3 year-old group were more common in lobular pulmonary [82.6％ (38/46 cases)],while in ＞ 3 to 14 year-old group,the radiographic findings were predominant with consolidation in the segment or lobe of the lung [33.1％ (39/118 cases)],and the difference was statistically significant (P ＜ 0.01).Conclusions Younger than 3 year-old children with MPP are prone to wheezing,shortness of breath,dyspnea and lung rale,while the rise of CK-MB and LDH is common.Imaging is mainly involved in double lung involvement and pulmonary lobule infiltration.The older the children with MPP are,the longer the fever duration is,and more common is the higher fever.The older the children,the more more easily they have the relative increase of CRP and ESR,and at the same time they are more likely to have the consolidation of the lung segment or lobe.

OBJECTIVETo explore hematological and molecular characteristics of Hemoglobin Q-Thailand in Huizhou area of Guangdong Province.

METHODSA total of 34 977 samples were screened by capillary and agarose gel electrophoresis. Samples suspected with HbQ strips were subjected to blood cell count and DNA sequencing. Twenty three common mutations associated with α- and β-thalassemia were identified by liquid phase chip and diversion hybridization technique.

RESULTSThe carrier rate of Hb Q-Thailand in Huizhou area was 0.13%. Pedigree analysis indicated that the Hb Q-Thailand allele is linked with a leftward single a-globin gene deletion (-α). Hematological index (HGB, MCV, MCH, HbA, HbA, HbQ) of 45 heterozygous carriers of Hb Q-Thailand were (130.25±17.37) g/L, (79.81±4.97) fl, (26.38±1.48) pg, (71.37±5.07)%, (1.65±0.45)%, (26.87±4.95)%, respectively. A statistical difference was also found in their hematological index of HbA and HbA compared with 408 heterozygous carriers of -α mutation (P<0.05).

CONCLUSIONHb Q-Thailand has a high detection rate in Huizhou area. The allele is mainly in a heterozygous status and linked with -α. The Hb Q strip can be detected by hemoglobin electrophoresis. When combined with other types of thalassemia, the heterozygotes will show unique hematological parameters.

Objective To explore the effects of seven-step complex decongestion therapy (CDT) on post-operative upper limb lymphede-ma of breast cancer. Methods From August, 2015 to September, 2016, 71 patients with upper limb lymphedema after breast cancer surgery accepted CDT for 20 days, including skin care, opening of lymphatic pathway, relief of scar tissue, manual lymphatic drainage, bandage compression, air pressure wave therapy and functional exercise. The circumference of eight sites of both limbs was measured and the differ-ences were calculated before treatment, and one, five, ten, fifteen and twenty days of the treatment. Results The differences of circumfer-ence increased one to 15 days of the treatment (Z>2.03, P<0.05), and decreased 20 days of the treatment (Z=3.01, P<0.01). Conclusion CDT is effective on lymphedema after breast cancer surgery for 20 days of a course, but may worsen in the first 15 days, which may be relat-ed to acute stress response or redistribution of lymph.