随着人们生活水平的提高和膳食结构的改变,超重和肥胖人群占比明显增加,并且向年轻化发展.目前超重和肥胖已成为严重影响我国居民身心健康的主要公共卫生问题.

近年来,国内外很多文献均表明结直肠癌患者的患病情况与糖尿病关系密切[1,2].大量的流行病学调查发现结直肠癌与糖尿病的危险因素存在很多相同之处[3]. 本研究通过对结直肠癌合并糖尿病患者的人口学特征、临床血液生化检测指标及并发症进行分析, 从而为临床提供预防及治疗新思路,并且提高结直肠癌合并糖尿病患者的认识水平,对高危人群重点防控的目的.

To optimize service progress,extend the service,effectively relieve medical records copy window pressure and reduce other places patients long distance on the run and travel expenses by mail copy medical station system and mail application system.The complaint rate is decreased by 3.69%,and the degree of satisfaction is increased by 10.77%.Medical record mail service is an innovation.We should continuously explore in service,improve medical record copy mail rate and patients satisfaction.

Objective To understand conduct situation of medical record copy mail service in Shanxi province.Methods Designing medical record copy mailed questionnaires and distributing the questionnaires to 150 hospital.Results 150 questionnaires were handed out,and 137 of them were taken back.121 of them are valid.A total of 13 hospitals have medical record mail service,accounting for 10.74%.12 of them are level 3 hospital which accounted for 34.29%.One of them is second-class hospital which accounted for 1.25%.According to the regional,11 of them in Taiyuan city,accounting for 40.74%,2 of them in prefecture-level city;According to the term,one of them has 4 years,four of them For more than 3 years,nine of them for more than 2 years.Conclusion Medical record mail service in tertiary hospital is the majority in Shanxi.It is unbalanced distribution and late start.Hospitals should actively carried out it to improve the doctor-patient relationship,and promote the sustainable development of hospital.

Objective To understand the dual classification of tumor International Classification of Diseases(ICD-10).Methods According to the article "Investigation on double coding of neoplastic diseases"[1],we relearned the C00-D48 classification principles of tumor,analyzed a series of complications caused by tumor,coded and classified each group of neoplastic diseases.Results Tumor was fit for double classification of Star dagger due to relative complications caused by tumor.Conclusion Although there is no double coding guideline in tumor,personnel of coding should decisively apply dual classification for correct coding when some neoplastic diseases' diagnosis consistent with principles of double classification.

Objective To investigate the expression of serum tumor markers in pancreatic carcinoma and to assess the value of serum tumor markers in the diagnosis and prognosis of pancreatic carcinoma. Methods Five serum tumor markers including AFP, CEA, CA199, CA125 and CA242 were detected in 95 patients with pancreatic carcinoma by chemi-luminescence immunoassay (CLI) and enzyme linked immunosorbent assay (ELISA), 80 patients with other malignant tumor and 65 patients with benign disease served as controls. Five tumor markers in pancreatic carcinoma diagnosis for TNM staging were compared. The value of tumor markers for prognosis was analyzed. Results Among these 5 kinds of tumor marker, CA199, CAI25, CA242 were valuable in diagnosis of pancreatic carcinoma, and CA199 was the most valuable one, whose sensitivity and specificity were 76.2 % and 74.8 % respectively. CA199, CA125, CA242 were increased with progression of pancreatic carcinoma. Conclusion Serum CA199, CA125 and CA242 are the preferred tumor markers to be used in the diagnosis and prognosis of pancreatic carcinoma.

管理病案的最终目的是为了提供利用,病案的利用率越高,其保管价值也就越大,在医院从事的管理病案工作者肩负着同样的重任。在医院各项活动中形成的各种载体形式的记录,其中蕴涵着极其丰厚和珍贵的医学信息,具有重大的情报价值,笔者从医院病案的现状和特点、影响利用的因素、工作者需达到的要求、完善利用的现代化检索等方面浅谈自已的认识和体会,望能引起更多有识之士对医院病案信息资源开发利用的关注,使之充分发挥应有的效用。

目的探讨恶性肿瘤患者治疗前后血浆纤维蛋白原（Fg）和血浆D二聚体（D-dimer,D2D）含量变化及其临床意义。方法采用免疫比浊法检测30例急性白血病（AL）和60例实体瘤患者治疗前后Fg和D2D含量。结果AL患者化疗前血浆Fg,D2D升高,与正常对照组比较差异有统计学意义（t=4.85,P＜0.05;t=5.86,P＜0.05）。缓解后,Fg,D2D含量比治疗前有所降低,但仍高于正常水平（t=3.12,P＜0.05;t=3.24,P＜0.05）。实施手术的60例实体瘤患者术前血浆Fg,D2D显著升高,与正常对照组比较差异均有统计学意义（t=4.25,P＜0.05;t=7.62,P＜0.05）。术后7d血浆D2D进一步升高,Fg略有降低。结论AL和实体瘤患者存在不同程度凝血和纤溶系统的异常,并随病情的好转而改善,血浆Fg,D2D含量可作为恶性肿瘤病情进展、疗效观察及预后的指标。

目的 分析和总结胃癌全胃切除术和术后并发症的治疗经验.方法 对90例胃癌全胃切除患者合并联合脏器切除的适应证、手术入路、淋巴结的清扫、消化道重建方式、术后并发症进行回顾性总结分析.结果 全胃切除术90例并联合脏器切除术16例,Orr食管空肠吻合术26例,食管空肠Roux-Y吻合术26例,食管P环空肠代胃Roux-Y吻合术32例.90例均经腹入路.术后并发症:肺部感染3例,胸腔积液8例,反流性食管炎12例,吻合口瘘2例,倾倒综合征8例.结论 合理掌握全胃切除术及联合脏器切除术的适应证,选择适合的重建方式,规范淋巴结清扫,是减少并发症、提高预后的关键。