目的 分析胃腸外科手術切口感染的影響因素，為醫院感染的防治提供理論依據。 方法 回顧性分析2010年12月－2012年12月764例行胃腸外科手術患者的臨床資料，并用單因素χ2檢驗統計分析患者醫院感染的危險因素。 結果 共有65例患者發生手術切口感染，其感染率為8.5%，且分離培養出合格菌株48株，陽性率73.8%，其中G?菌32株，占66.7%，G+菌16株，占33.3%。G?菌主要以大腸桿菌、變形桿菌、克雷伯桿菌和腸桿菌為主，分別占29.2%、18.8%、12.5%和6.2%；G+菌以腸球菌和表皮葡萄球菌為主，分別占22.9%和10.4%。單因素χ2檢驗顯示年齡＞60歲、手術時間＞120 min、術中有輸血、且有腫瘤病變的患者具有較高的切口感染發生率（P＜0.05）。 結論 胃腸外科手術切口感染的主要致病菌是G?桿菌，患者的年齡、手術時間、術中輸血情況和疾病良惡性質是術后切口感染的高危因素，積極采取相應的預防措施有望減低其感染的發生率。
目的 探討心理干預措施對改善婦科惡性腫瘤患者的生命質量的作用及有效性。 方法 對2008年11月－2010年11月收治的87例婦科惡性腫瘤患者，隨機分為試驗組與對照組，試驗組43例，實施心理干預及常規治療；對照組44例，采取常規治療；并對兩組患者入院后及出院前生存質量、心理狀況以問卷調查方式進行資料收集，用以比較、評價心理干預對改善婦科惡性腫瘤患者生命質量的作用及效果。 結果 婦科惡性腫瘤患者抑郁發生率為56.3%（49/87），焦慮發生率為62.1%（54/87）； 心理干預后兩組患者組間各指標比較，試驗組患者的總體健康狀況、生存質量、角色功能、情緒功能、認知功能得分比對照組增高（P＜0.05）；試驗組患者疲倦、惡心嘔吐、失眠、食欲下降、便秘癥狀、抑郁、焦慮得分比對照組得分下降（P＜0.05）。 結論 心理干預可改變婦科腫瘤患者的負性心理傾向，緩解抑郁、焦慮等情緒，減輕化療藥物所引起的系列副作用，能有效提高其生活質量。
In recent years, an increasing amount of systematic reviews have been published; however, few reviews adequately considered and reported details of interventions, which not only limited the usability of systematic reviews but also wasted resource. In order to improve reporting of intervention details in systematic reviews, BMJ recently published recommendations. This paper interprets the recommendations to improve usability of systematic reviews.
OBJECTIVE: To study the effective protective measures to ensure sufficient blood supply to the jejunal segment in reconstruction of esophagus. METHODS: According to evidence based on medicine, we analyzed retrospectively 69 patients (48 cicatricial stenosis due to chemical burn, 21 defects due to excision of esophagus cancer), whose esophagus were reconstructed with free jejunal graft(in 28 cases) and with pedicle jejunal graft (in 41 cases) from 1980 to 2001. RESULTS: All patients were followed up for 1-21 years. Of 43 patients treated before 1996, 5 complicated by anastomotic leakage, 1 by strangulated intestinal obstruction; of 26 patients treated after 1996 (6 with free jejunal graft, 20 with pedicle jejunal graft), only one case complicated by anastomotic leakage. CONCLUSION: The preservative measures for good blood supply to the jejunal segment include the following aspects: (1) complete marginal vascular arcade without tension in the mesojejunum; (2) vessel anastomosis smooth; (3) 4-finger width pathway of jejunum; (4) the stable arterial blood pressure (more than 8 kPa); (5) a single-row anastomosis; and (6) the comprehensive preoperative management.