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Objective:To summarize experience and effect of the stylized operation step in the neck endoscopic thyroidectomy for papillary thyroid microcarcinoma (PTMC).Methods:The clinical data of 51 patients who underwent transthoracic breast approach scarless neck endoscopic thyroidectomy (SET) from January 2018 to September 2019 in Tungwah Hospital Affiliated to Sun Yat-sen University were retrospectively analyzed. The operative procedure used stylized operation steps: establishment of operating space, three-step method thyroidectomy, central lymph node dissection (CLND), close operating space.Results:Among 51 patients, 25 cases underwent unilateral thyroidectomy plus isthmic resection, 26 cases underwent total/near-total thyroidectomy, and 16 cases underwent preventive CLND. The recurrent laryngeal nerve (RLN) was exposed in all 51 cases, the external branches of the superior laryngeal nerve (EBSLN) was exposed in 35 cases, no procedure was converted into open neck incision thyroidectomy. Forty-two cases were followed up, 2 cases had postoperative hoarseness and unilateral recurrent laryngeal nerve paralysis, which were recovered 55 and 75 d after operation respectively. There was no bucking, voice blunt or permanent low calcium. One patient had abnormal sensation of neck skin after operation, and recovered gradually 3 months after operation.Conclusions:The stylized operation step in the SET can increase safety of surgery.
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Objective To explore the etiology and clinical characteristics of short stature. Method Clinical data of 2075 children with short stature treated from May 1995 to July 2017 were retrospectively analyzed. The etiology and morbidity of pathological short stature and normal variant short stature were analyzed. The clinical characteristics of growth hormone deficiency (GHD) , idiopathic short stature (ISS) , constitutional delay in growth (CDG) and familial short stature (FSS) were analyzed. The etiological differences between severe short stature [height standard deviation score (SDS) ≤-3] and general short stature (height SDS＞-3) were analyzed. Results Among 2075 children diagnosed with short stature, 1719 (82.84％) were pathological short stature, among which GHD (38.60％) and ISS (22.02％) were more common. Normal variant short stature was found in 356 children (17.16％) , with FSS and CDG accounting for 10.70％ and 6.46％ respectively. There were statistically significant differences in the sex ratio, age at initial diagnosis, height SDS, body mass index (BMI) , bone age and bone age delay among children with four common childhood short stature (GHD, ISS, CDG and FSS) (all P＜0.01) . Boys were more than girls in four kinds of childhood short stature. The height SDS was the lowest in GHD group and the highest in CDG group; BMI was highest in GHD group, but lower in CDG and ISS group. Bone age delay was highest in GHD group and lowest in CDG group. In severe short stature group, the rates of complete GHD, multiple pituitary hormone deficiency, small for gestational age infant, Turner syndrome, hypothyroidism and Russell-Silver syndrome were higher than those in general short stature group, but the rates of partial GHD, ISS, FSS and CDG was lower than those in general short stature group. Conclusion The etiology of short stature is complex. Analysis of the etiology and clinical features is helpful for clinical diagnosis and treatment.
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Objective To retrospectively review the clinical characteristics and antimicrobial resistance profile of nosocomial bloodstream infections caused by Klebsiella pneumoniae in surgical patients for better use of antimicrobial agents.Methods The clinical data of the surgical patients who were diagnosed with K.pneumoniae-associated bloodstream infections in Tung Wah Hospital from January 2013 to June 2015 were reviewed and analyzed retrospectively.The diagnosis of bloodstream infections was based on national diagnostic criteria.The pathogens were routinely isolated and identified.Antimicrobial susceptibility testing was carried out by using Kirby-Bauer method.The data were analyzed by WHONET 5.6 software.Results A total of 78 surgical patients were identified with nosocomial bloodstream infections due to K.pneumoniae during this period,including primary bloodstream infections (12.8％,10/78) and secondary bloodstream infections (87.2％,68/78).These infections were mainly associated with surgical and invasive procedures.Nearly 40％ of the K.pneumoniae isolates were resistant to ceftriaxone,cefuroxime and piperacillin.ESBLs were produced in 43.6％ (34/78) of the K.pneumoniae isolates.The ESBLs-producing strains showed significantly higher resistance rates to various antibiotics than non-ESBLs-producing strains.Piperacillin-tazobactam,amikacin,imipenem,and meropenem still have good antibacterial activity against these K.pneumoniae isolates.However,imipenem-resistant strains are emerging.Conclusions Most of the bloodstream infections caused by K.pneumoniae were secondary to infections in other body sites in surgical patients.Hospital infection control measures should be strengthened.Meanwhile,the clinicians should take full advantages of microbiological laboratory to profile the pathogens and their susceptibility patterns,which is crucial for rational use of antibiotics.
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Objective To study the relationship between expression of Shh and Gli1 in Hedgehog(Hh) signal pathway and esophageal squamous cell carcinoma (ESCC).Methods Expressions of Shh andGli1 were detected in 64 cases primary tumor tissues and 24 cases normal esophageal mucosa with SP immunohistochemistal method.Results There were significant differences of Shh and Gli1 expressions between esophageal carcinoma and normal mucosa epithelium (67.19％ (43/64) vs.4.17％ (1/24), 60.94％ (39/64) vs.4.17％ (1/24);x2 =27.729,22.689;P＜0.01).There were significant differences of Shh expression between different degrees of differentiation in esophageal squamous cell carcinoma, metastasis of lymph node and different clinical staging group (x2 =3.873, 11.349,6.429;P ＜ 0.05 or P＜ 0.01).The positive expression rate of Gli1 showed significant differences between different degrees of differentiation in esophageal squamous cell carcinoma, metastasis of lymph node and different clinical staging group (x2=12.598, 9.741,26.341;P ＜0.01).There was a positive relationship between Shh and Gli1 expression(r =0.259, P＜0.05).Conclusion Hh signaling pathway is abnormally activated in ESCC, so that Shh and Gli1 play important roles in carcinogenesis and progression ofesophageal carcinoma.The Hh signaling pathway may be a useful target in ESCC.
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ObjectiveTo discuss the more aesthetic and minimally invasive surgical approach of endoscopic thyroidectomy.Methods50 cases of endoscopic thyroidectomy via breast areola-axillary approach were retrospectively analyzed.Among these cases,12 received unilateral partial lobectomy,30 received unilateral total lobectomy and 8 received bilateral partial lobectomy.Results Endoscopic thyroidectomy was completed in all the patients.The intraoperative blood loss was ( 12.77 ± 20.12 ) ml.The operation time was (67.00 ± 21.28 )min.The postoperative hospital stay was (3.77 ± 0.50)days.Hoarseness occurred in 2 cases.All the 50 cases were followed up from 1 to 6 months and no other complication occurred.ConclusionEndoscopic thyroidectomy via breast areola-axillary approach is more aesthetic and minimally invasive; however,the operator needs an adaptive process for a better surgical view angle.
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Objective:To check the cleansing effect of light catalyst compound atomization in the hospital environment. Methods: Bacterium quantities were compared in the rooms treated with light catalyst compound atomization or routine cleansing. Results: In the room treated with light catalyst compound atomization,the rate of air bacterium reduction was 90.83% at 1 h,53.61% at 24 h,and 55.82% in average from 1 week to 12 weeks.Bacterium on object surfaces were kept lower for 8 weeks in the light catalyst compound sprayed room than in the routinely cleansed room.Conclusion:The light catalyst compound atomization can chronically cleanse the hospital environment without pollution.
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The work for science and technology award is a form of value recognization,which is the nation's acknowledge to the large number of science and technology staff.The connotation is combined material award with spirit award,which introduce encouragement and competition mechanism to science and technology staff and reduce technique level difference with developed country.At the same time,it could arouse and protect science and technology staff's creative passion to contribute country and society;but it could affect science level and quality because of too much of it.The article discusses how the science and technology controllers open up idea,organize and direct the award management within the nation and army policy range.
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To investigate an acceptable formula of evaluation of science research projects and its risk aversion in military hospitals and the important role of nosocomial science fund in development of military hospitals.The relation of the methods and systems whith had been used to evalualing science research projects in hospitals and risk aversion were analyzed. The scientific program and methods of evaluation of science research projects could reduce the investment risk of science fundation,and impersonality index can ensure the actualization of subjects.Scientific evaluation of science research projects in military hospital is propitious to risk aversion of the science fundation invest and development of hospitals.
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The authority of hospital administration in charge of the science and technology development will adopt the standard of national evaluation system and implimentation approach into practical regulation.The research projects will be judged by new items including the research objective,demonstration medality,graunds of argument,classification systems,etc. The goal of the new guidelines carried will assure the open and fair policy being practised in examining the adequacy of the research program. The scceessful implimentation of the new rule will encourage the development of highly qualified results achieved in research schemes,and bring about greater social and economic benefits from extensive research work.
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This article analyzed the scientific research condition of the female scientific cadres in Nanjing General Hospital in recent 10 years(1993-2002) from most angles.In conclusion,the outcome prizes,the article numbers,the scientific research subject numbers, the scientific research monograph numbers and the patent numbers of the female scientific research cadres make up 28.54%,31.63%, 32.46 %,39.78% and 9.38% of the whole hospital's data.It suggests that the female scientific research cadres are an important force in the scientific research of the hospital.
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To prevent the spread of bird flu to human,we applied four effective means of infection control: concept introduction,light-accelerant method,tracking administration,and draft of coping measures,which displayed the characteristics of infection control in scientific and affectionate ways,and enhanced the level of public health service.
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Objective: To inspect dynamically the air-microorganism in important hospital departments. Methods: Plate sedimentation was used for examination. Results: The average rate of reaching standard is 93.01% for the important hospital departments from 2001 to 2004.The rates of reaching standard for region Ⅰ,Ⅱ and Ⅲof the hospital were 76.89%,90.14% and 97.03%,respectively. Conclusion: The content of air-microorganism is affected by personnel flow,airy condition,season and disinfection measure.
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Objective:To analyse the nurse scientific research task. Methods:Retrospect analysis was carried out for nurse scientific research task in terms of subject distribution, task group member’s diploma, the title of a technical post,age distribution, etc. Results:Scientific manage brought great effect, and the characteristics existed in the manage of nurse task. Conclusion:Nurse scientific research management emphsizes on innovation.
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Objective: To explore the managemental essential ,we have Analyzed retrospectively 4635 articles collected by nation for 15 years in our hospital . Methods: According to the article database which collected our hospital's published articles from 1990-2004 provided by the center of article statistics and analyze of china science and technology institute of national department of science and technology, Windows Access 2000 was used to export articles, and Excel was used to sort﹑collect the results. Results: The embodied number was increased year by year , the authors were mainly from key department, clinical department with master or doctor degree and with high title of professional post, the condition of embodied articles is positive related with research level. Conclusion: It has validated the objective and meaning of the article management; and explained that the article is the talents strength expression,the science research platform,the science research management effects,the subject building collection and the symbol of connecting with the world .
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Objective: In order to kuow the germicidal efficacy of orthophthalaldhyde. Methods: Carrier quantitative germicidal test and clinical use study. Results: the showed that 23℃,the average killing ratc after exposure to the stock solution of orthophthalaldhyde disinfectant for 90 min was 100% of Bacillus Subtitis Var.niger on carriers and for 10 min contact time could destroy completely the antigenicity of serum HBsAg,and for 5 min was 100% of bacteria. Incontinuous use for 10 days ,immersion in for 14 days it was no corrosion of carben steel and stainless steel apparatus, and no irritative to skin and mucous membrane. Conclusion: Orthophthalaldhyde has good germicidal efficacy and belongs actually no corrosion and no irritative disinfectant.
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To discuss hospital infection control for laminar flow operation room. Ten measures of hospital infection control have been formulated for laminar flow operation room based on the danger factors of the surgery incision infection and the principle of the air purify process and filtration setting. A set of management system and detailed rules have been founded for the use of laminar flow operation room, to strengthen the notion that the patients are the all. It has met the requirement for the use of air-clean technique and setting, and guaranteed air purity.
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AIDS is a serious disease which threatens the health and safety of the doctors and nurses and the social colony,it also affects the development of society and the steady of economy. Our hospital has carried out country and army's documents, by enforcing management,developing special topic education, fulfiling prevention measures,foundding diagnose laboratory,practicing special report order, which has made remarkable effects.
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This article mainly discussed that infection control is an important part of hospital management and plays an important role in medical quality management by reviewing and summarizing the development of the department of hospital infection control in nanjing general hospital.It put forward the goal and plan of the subject build in the future.