Unplanned extubation (UEX) is defined as premature removal of the indwelling catheter tube by a patient (deliberate unplanned extubations) or by staff during nursing and medical care (accidental extubations). UEX, either deliberate or accidental, can cause severe damage of patients, with the increasing of hospital costs and medical disputes. Identifying high-risk patients is the key point of reducing UEX. This review conclude risk assessment tools reported for UEX.

Objective:To explore the diagnostic value of MRI in the diagnosis ofbone Eosinophilic GranulomaI. Methods:The clinical and imaging materials of 13 patients with eosinophilic granuloma of bone proved by histopathology were analyzed retrospectively.The imaging examination included plain films(n=13),CT(n=12),and MRI(n=13).Results:MR identified all lesions;With one exception,all lesions were hypointense on T1-Weighted images and hyperintense on T2-Weighted images;The lesions and associated soft tissue abnormalities were very conspicuous on short T1 inversion sequences and T1-Weighed post-contrast images;Follow-up MRI studies in two patients after chemotherapy showed decreased size and enhancement of lesions compared with the baseline studies.Three lesions were not identified on plain films.MRI showed greater abnormality than plain radiographs did.CT could identify all lesions also,and the main imaging findings included bone destruction,adjacent bone cortex involvement,periosteal reaction and sof t tissue mass or swelling. Conclusion:MRI can clearly demonstrate the extent of bone involved, the change of soft tissue and sequestrum.It can also acquire the anatomic and pathologicd details of bone and and soft tissue.But X-ray film and CT may improve the diagnostic and differential diagnostic accuracy.

Objective To investigate the awareness of knowledge,attitude and behavior about disinfection and sterilization among clinical health care workers (HCWs).Methods 200 clinical HCWs were investigated randomly by using questionnaires.Results The average awareness rates of knowledge,attitude and behavior about disinfec-tion and sterilization among HCWs were 71 .49%,63.79%,and 86.45% respectively.The awareness rates of knowledge about the expiration dates of sterilized articles,classification of infectious diseases,and biological moni-toring were 49.43%,42.53%,and 23.56%,respectively;HCWs’attitude towards disinfection and sterilization:awareness rate of whether they paid attention to the new technology in specialty of central sterile supply was the lowest (26.44%);86.45% of HCWs thought they could master the aseptic operation technique,correct applica-tion method for sterile apparatus and related items,but easily ignored to check the integrity of aseptic packages and indicators before operation (67.24%).Conclusion The knowledge,attitude and behavior about disinfection and sterilization among HCWs still need to be improved,training on knowledge about disinfection and sterilization among HCWs should be strengthened.

Objective To observe the impact of different surgical procedures on ovarian reserve and analge-sic effects of drug use in patients with uterine fibroids.Methods 100 patients with uterine fibroids were randomly divided into two groups.50 patients in control group were implemented traditional open surgery.50 cases in the obser-vation group received laparoscopic myomectomy.The ovarian reserve changes were compared before and after surgery, pain medication use and changes in the degree of pain conditions.Results The levels of follicle stimulating hormone and luteinizing in the control group one,three months after operation were significantly higher than before surgery and the observation group,the level of estrogen was significantly lower than before surgery and observation group,the differences were statistically significant(t=10.23,14.58,9.78,11.76,9.83,9.92,10.07,11.23,all P<0.05).The postoperative first pain time of the observation group was significantly longer than the control group,the difference was statistically significant[(513.74 ±284.52)min vs.(61.38 ±37.21)min,t=92.34,P<0.05].The postoperative analgesic usage of the observation group was significantly lower than the control group,the difference was statistically significant(14.0% vs.58.0%,χ2 =7.83,P<0.05).The pain scores 3d,4d,5d,6d and 7d after operation of the observation group were significantly lower than the control group(t=2.11,2.30,2.58,7.03,6.46,all P<0.05). Conclusion The patients with uterine fibroids laparoscopic myomectomy for treatment will not cause great impact on the patients'ovarian reserve,and can effectively reduce the use of analgesics,and it is worthy of further promotion.

OBJECTIVETo compare the effects between moxibustion at Guanyuan (CV 4), Shenshu (BL 23), Zusanli (ST 36) and western medication on immune function in children with cerebral palsy.

METHODSA total of 230 children with cerebral palsy were randomly divided into an observation group and a control group, 115 cases in each one. Patients in the observation group were treated with warm moxibustion at Guanyuan (CV 4), Shenshu (BL 23) and Zusanli (ST 36). Patients in the control group were treated with oral administration of pidotimod 10 mL every time. The treatment was given once a day, and 30 days were considered as one session for total 90 days. The changes of T-lymphoctyte subgroups, serum immunoglobulin and development quotient were compared 30 days, 60 days and 90 days into treatment respectively; also the occurrence rate.of disease was observed during 6-month and 12-month follow-up visit.

RESULTSThe T-lymphoctyte subgroups (CD3+, CD4+, CD4+/CD8+), serum immunoglobulin (IgG, IgA) and development quotient were significantly improved 30 days, 60 days and 90 days into treatment (P < 0.01, P < 0.05). Regarding the changes of CD3+, CD4+, CD4+/CD4+, IgG, IgA and development quotient, the control group was superior to the observation group 30 days into treatment (all P < 0.05), and the control group was similar to the observation group 60 days into treatment (all P > 0.05), and the observation group was superior to the control group 90 days into treatment (all P < 0.05). There was no significant difference of CD8+ and IgM before and after treatment in two groups (all P > 0.05). The rate of adverse events was 7.0% (8/115) in the observation group, which was lower than 23.5% (27/115) in the control group (P < 0.01); during 6-month and 12-month follow-up visit, the occurrence rate of disease in the observation group was lower than that in the control group (P < 0.05).

CONCLUSIONMoxibustion at Guanyuan (CV 4), Shenshu (BL 23) and Zusanli (ST 36) can improve immune function of children with cerebral palsy, which is superior to pidotimod.

Acupuncture Points ; Cerebral Palsy ; immunology ; therapy ; Child, Preschool ; Female ; Humans ; Immunoglobulin A ; immunology ; Immunoglobulin G ; immunology ; Infant ; Male ; Moxibustion ; T-Lymphocyte Subsets ; immunology ; Treatment Outcome

OBJECTIVE:To observe the effects of different regimens of tranexamic acid on perioperative bleeding and postoper-ative compliance of simultaneous bilateral total knee arthroplasty(TKA). METHODS:A total of 70 patients undergoing simultane-ous bilateral TKA in our hospital were randomly divided into control group and observation group,with 35 cases in each group. Control group was given Tranexamic acid injection 15 mg/kg 30 min before surgery. Observation group was given Tranexamic acid injection 15 mg/kg,30 min before surgery and 30 min before suturing incision. The operation duration,total blood loss,intraopera-tive blood loss,postoperative drainage as well as the levels of FIB,PT,APTT before trectment and 3 d after surgery,the occur-rence of postoperative compliance and ADR were observed and compared between 2 groups. RESULTS:There was no statistical significance in operation duration,intraoperative blood loss and rate of ADR between 2 groups (P>0.05). The total blood loss, postoperative drainage and the incidence of complications of observation group were significantly lower than those of control group,with statistical significance(P<0.05). There was no statistical significance in coagulation indexes(FIB,PT and APTT)be-tween 2 groups before treatment and 3 d after surgery,with statistical significance(P>0.05). CONCLUSIONS:The application of tranexamic acid 30 min before simultaneous bilateral TKA and 30 min before the end of surgery can reduce perioperative bleeding and postoperative venous thromboembolism with good safety.

Objective To analyze type of irrational outpatient infusion prescriptions returned by clinical pharmacists'pre -prescription review and intervention in our hospital.Methods Outpatient infusion prescriptions reviewed by clinical pharmacists in 2014 were statistically analyzed in terms of type,constitution and rate of qualified prescriptions.Results Type of unstandard writing or input errors prescriptions accounted for 35.19%,which was the great majority of the irrational outpatient infusion prescriptions.The rate of qualified prescriptions was 99.15%,which was higher than 91.53% in 2011 when pre -prescription review and intervention had not implemented.Conclusion Pre -prescription review and intervention could improve the quality of outpatient infusion prescriptions.Finally,safety and effectiveness of outpatient infusion could be guaranteed.

Objective To investigate the changes of iron-related proteins in different sex mice before and after burns.Methods The burn model in mice were prepared with 90 ℃ vapor.Both liver and spleen iron contents were measured by colorimetric method.Hepatic hepcidin and Fpn1 mRNA content were determined with RT-PCR.The Fpn1 protein was determined with Western blot.Results After burns,the content of spleen iron was increased and the expression of hepatic hepcidin was decreased in male mice,and at the same time the Fpn1 of liver and spleen was reduced.The content of iron homeostasis abnormality in female mice was less serious.Conclusion The change of iron-related proteins after burns may be one cause of iron homeostasis abnormality.The differences of iron-related protein expression in different sex after burns suggest that estrogen has a potentially protective function.

Objective:Positive effects of bioactive glass (BG) on proliferation,mineralization,and differentiation of human dental pulp cells (hDPCs) was already verified in various former studies.The Arg-Gly-Asp-Ser sequence (RGDS) was confirmed of affecting cell adhesion.Before further investigation,the objective of this study is to investigate whether RGDS can affect the effects of BG on the adhesion,proliferation and mineralization of hDPCs.Methods: hDPCs were harvested from third molars of 18-25-year-old individuals after informed consent.Enzyme digestion technique was used.The 4th to 6th ge-neration of hDPCs were used for all experiments.The cells of the experimental groups were cultured in Dulbecco minimum essential medium (DMEM) containing ionic dissolution products of BG and RGDS of seve-ral concentrations (12.5 mg/L,25.0 mg/L,50.0 mg/L,100.0 mg/L,200.0 mg/L).DMEM containing ionic dissolution products of BG without RGDS was used for cell culture as control group.Cell adhesion was tested 4 h after cell seeding by MTT assay.Cell proliferation was examined at 1,3,5,7,and 9 d after cell seeding by MTT assay.Cell mineralization was investigated on days 14 and 28 by alizarin red staining.After being stained and dried,mineralized nodules were dissolved by cetylpyridinium chloride (CPC) for semi-quantitative test.Results were statistically analyzed by one way ANOVA,SPSS (version 19.0) and P<0.05 was considered to be significant.Results: Cell adhesion in BG group showed no difference from that in DMEM group.Compared with BG group,hDPCs in BG+RGDS groups suggested weaker cell adhesion.When the concentration of RGDS increased,the adhered cell number decreased.hDPCs cultured with BG and RGDS showed lower proliferation activity in the early stage,while no significant difference was observed after 3 d.BG group promoted the mineralization of hDPCs compared with positive control group,negative control group and RGDS group.No significant difference was observed between BG+RGDS group and BG group or between RGDS group and positive control group.Conclusion: BG promotes proliferation and mineralization without affecting cell adhesion of hDPCs.Unbounded RGDS inhibits cell adhesion,but has no influence on the positive effects of BG on the proliferation and mineralization of hDPCs.

A robust, selective and highly sensitive chemiluminescent （CL） platform for protein assay was presented in this paper. This novel CL approach utilized rolling circle amplification （RCA） as a signal enhancement technique and the 96-well plate as the immobilization and separation carrier. Typically, the antibody immobilized on the surface of 96-well plate was sandwiched with the protein target and the aptamer-primer sequence. This aptamer-primer sequence was then employed as the primer of RCA. Based on this design, a number of the biotinylated probes and streptavidin-horseradish peroxidase （SA-HRP） were captured on the plate, and the CL signal was amplified. In summary, our results demonstrated a robust biosensor with a detection limit of 10 fM that is easy to be established and utilized, and devoid of light source. Therefore, this new technique .will broaden the perspective for future development of DNA-based biosensors for the detection of other protein biomarkers related to clinical diseases, by taking advantages of high sensitivity and selectivity.