Objective:To explore the application effect of risk management in quality control of medical apparatus and instruments of operation room.Methods: 172 pieces of medical apparatus and instruments were divided into risk management group (n=86) andcommon management group (n=86). A series of indicators, such as effective acceptance rate, qualified cleaning rate, completed supporting facility, specific aim rate, deficiency rate of quantity, error rate of preparation, wet pack rate of sterilization, lost rate of post surgery and the satisfaction degree of physician, were applied to complete statistic analysis.Results: The effective acceptance rate, qualified cleaning rate, completed supporting facility rate and specific aim rate of risk management group were significantly higher than that of common management group (x2=5.02,x2=7.38,x2=9.35,x2=11.14,P<0.05). The deficiency rate of quantity, error rate of preparation, wet pack rate of sterilization, lost rate post surgery of risk management group were significantly lower than that of common management group (x2=6.63,x2=9.21,x2=11.34,x2=13.28,P<0.05). And the satisfaction degree of physician of risk management group (97.7％, 84/86) was significantly higher than that of common group (73.3％, 63/86) (x2=12.83, P<0.05).Conclusion: The application effect of risk management is better than that of common management in the quality control of medical apparatus and instruments in operation room.

Objective To explore the effects of Living with Hope Program(LWHP) on family caregivers of patients with advanced lung cancer.Methods Totally 60 family caregivers of patients with advanced lung cancer were randomly divided into the experimental group and the control group.The experimental group received LWHP intervention and routine care knowledge education,the control group only received routine care knowledge education.Hope,self-efficacy,anxiety and depression,and quality of life were evaluated at the first week,the second week,the first month,and the third month.Differences between two groups were compared using variance analysis of repeated measurements.Results The self-evaluation of the intervention was 76.6％,and the main effects of hope level,selfefficacy,anxiety and depression,and mental health were statistically significant (P＜0.05);the time effect on hope level and self-efficacy were statistically significant (P＜0.05);there were interaction effects between intervention and time on hope level,self-efficacy,anxiety and depression,and mental health (P＜0.05).Conclusion LWHP can effectively improve hope level,self-efficacy and mental health status,and alleviate anxiety and depression of family caregivers of patients with advanced lung cancer.

ObjectiveTo evaluate the value of tissue mitral annular displacement (TMAD) in the assessment of left ventricular long axis systolic function and the relationship of obese degree with left ventricular long axis systolic function in patients with abdominal obesity.MethodsThirty-eight abdominal obesity cases and thirty-four healthy cases were investigated using echocardiography.The images of apical four-chamber view and apical two-chamber view were obtained,systolic mitral annular displacement (MADs),mid-point of mitral annular displacement(MAD-midpt),mid-point of mitral annular normalized displacement(MAND-midpt) and mid-point of mitral annular biplanar normalized displacement(MABNDmidpt) were measured by the technique of TMAD.Their characteristics between patients with abdominal obesity and healthy group were compared,and the relationship of waist-hip ratio(WHR) and related indexes of MAD were analyzed.ResultsIn abdominal obesity group,the MADs at the four site were significantly decreased compared with control group (P＜0.001,respectively),the MAD-midpt and MAND-midpt of apical four-chamber view and apical two-chamber view were significantly decreased compared with control group (P＜0.001,respectively).The WHR related with MABND-midpt independently by the analysis of partial correlation(r=-0.697,P=0.000).ConclusionsThe left ventricular long axis systolic function were damaged in patients with abdominal obesity.The technique of TMAD could quantitatively assess the left ventricular long axis systolic function in patients with abdominal obesity.

Objective: To evaluate the using value of FibroTouch and six serological models in detecting the degree of liver fibrosis in patients with chronic hepatitis B, in an attempt to provide reference for accurate diagnosis. Methods: Two hundred and fifty-eight cases with chronic hepatitis B admitted to Xixi Hospital of Hangzhou from September 1, 2015 to September 1, 2017 were selected. All patients underwent liver histopathological examination and FibroTouch measurement to determine liver stiffness (LSM). Serum biochemical parameters were detected and the scoring values of six serological models were calculated. SAS 9.4 statistical software was used for statistical analysis, and the correlation between FibroTouch and the six serological models was analyzed by Spearman correlation. The diagnostic value of FibroTouch and six serological models was analyzed by receiver operating characteristic curve (ROC) based on liver histopathological findings. Results: The median LSM of 258 cases with chronic hepatitis B was 9.4 (6.5-13.8) kPa. In the six serological models, the median value of aspartate transaminase to platelet ratio index (APRI), FIB-4 index, S-index, Forn’s index, PRPindex, and FIB-5 were 0.42 (0.28-0.62), 1.27 (0.78-2.03), 0.11 (0.07-0.20), 6.95 (5.89-8.51), 0.000 8 (0.000 6-0.000 9),and 38.59 (36.28-40.97). FibroTouch had positive correlation with APRI, FIB-4, S-index, Forn’s index, PRP, fibrosis stage (r= 0.73,P< 0.001) and inflammation grade, and had negative correlation with FIB-5, and both had statistical significance. The area under curve (AUC) of FT-LSM at S≥2, S≥3, S = 4 were 0.89, 0.90 and 0.85, respectively, which was significantly higher than serological models (P< 0.001). The AUC of S-index model at S≥2, S≥3, S = 4 were higher than other five serological models. Conclusion The diagnostic performance of FibroTouch is significantly better than serological model. S-index model has the best diagnostic performance in the six serological models, and the combination of S-index and FT-LSM may better diagnose the grading of liver fibrosis, and thus can be applied and promoted in clinic.

Objective:To detect the levels of serum IgM and IgG antibodies against 2019-nCoV in 79 patients with COVID-19 for understanding their variation patterns in vivo. Methods:Chemiluminescence immunoassay was used to detect the levels of 2019-nCoV-specific IgM and IgG antibodies in 167 serum samples collected at different periods (≤10 d, 10<~20 d, 20<~30 d、>30 d) after disease onset from 79 clinically confirmed COVID-19 patients in Hangzhou Xixi Hospital. The results were statistically analyzed together with clinical data.Results:The average levels of IgM and IgG antibodies in severe and common cases were higher than those in mild cases [IgM: 21.77 (10.18-128.65) and 13.13 (6.08-35.14) vs 3.01(1.69-8.69), χ 2=27.442, P<0.01; IgG: (124.22±36.79) and (120.04±63.25) vs (52.31±53.68), F/χ 2=27.295, P<0.01]. The positive rates of IgM and IgG antibodies in severe and common cases were also higher than those in mild cases after recovery ( P<0.01). The levels of IgM and IgG antibodies were affected by the time of detection. The level of IgM antibody detected during 10<~20 d of the disease onset was significantly higher than that within 10 d of the disease onset ( P<0.05). The level of IgG antibody detected after 10 d of the disease onset was significantly higher than that within 10 d of the disease onset ( P<0.01). Conclusions:Higher levels of IgM and IgG antibodies were detected in patients with severe COVID-19. A significant correlation was found between the levels of IgM and IgG antibodies and the time of detection.