Covered in the paper is the development of the hospital's surgical information acquisition system during the healthcare reform and upgrading of its performance assessment scheme.Such a system is designed to precisely collect surgery scheduling, daytime surgery, and outpatient surgery workload, conducive to developing a performance assessment scheme based on surgery workload, motivating medical workers, and improving quality of care.

Objective To investigate the efficacy of continuous fascia iliaca compartment block withdifferent concentrations of ropivacaine for postoperative analgesia in patients undergoing total hip arthroplasty.Methods One hundred and sixty ASA physical status Ⅰ or Ⅲ patients,aged 52-84 yr,body mass index 18-26 kg/m2,scheduled for total hip arthroplasty,were randomly divided into 4 groups (n =40 each) using a random number table:0.20％ ropivacaine group (group A),0.25％ ropivacaine group (group B),0.30％ ropivacaine group (group C) and 0.35％ ropivacaine group (group D).A catheter was inserted into the fascia iliaca compartment on the affected side within 30 min after operation.The corresponding concentrations of ropivacaine 20 ml were given in each group.The catheter was then connected to a patient-controlled analgesia pump programmed to deliver 10 ml with a lockout interval of 60 rin for postoperative analgesia (72 h).When VAS score at rest≥4,parecoxib sodium 40 mg was injected intravenously.At 12,24,48 and 72 h of blockade,the passive and active exercise VAS scores were recorded.The consumption of ropivacaine within 72 h after the end of blockade,and requirement for parecoxib sodium and development of adverse reactions during blockade were recorded.Results Compared with group A,the passive and active exercise VAS scores were significantly decreased in C and D groups (P ＜ 0.05),and no significant change was found in group B (P ＞ 0.05),and the consumption of ropivacaine within 72 h after the end of blockade was significantly decreased in B,C and D groups (P ＜ 0.05).There was no significant difference in the passive and active exercise VAS scores between group C and group D (P ＞ 0.05).There was no significant difference in consumption of ropivacaine within 72 h after the end of blockade between B,C and D groups (P ＞ 0.05).There were no significant differences in the requirement for parecoxib sodium and incidence of vomiting among the four groups (P ＞ 0.05).Conclusion The optimum concentration of ropivacaine is 0.30％ when used for continuous fascia iliaca compartment block in patients undergoing total hip arthroplasty.

Objective To investigate the efficacy of ultrasound-guided fascia iliaca compartment block (FICB) on postoperative analgesia in patients undergoing total hip arthroplasty.Methods Thirty-six ASA Ⅰ-Ⅲ patients aged 54-82 yr weighing 48-72 kg undergoing total hip arthroplasty were randomly divided into 2 groups (n =18 each): normal saline group(group NS)and ropivacaine group (group R).Ultrasound-guided FICB was performed within 30 min after operation.Group R received 0.25 ％ ropivacaine 30 ml,while the equal volume of normal saline was used instead of ropivacaine in group NS.All patients received PCIA with 0.01 mg/ml fentanyl after FICB.PCIA included a bolus dose of 2 ml with a 15 min lockout interval and no background infusion.Pain at rest was evaluated using VAS (RVAS) score before FICB (T0 ）and at 3 h(T1 ),6 h(T2 ),8 h(T3 ),12 h(T4 ),24 h(T5 ),48 h(T6 )and 72 h(T7 )after FICB.The passive exercise VAS (PVAS) score at T4-6,T7 and active exercise VAS (AVAS) score at T5-7 were recorded.The consumption of fentanyl at 0-12 h,12-24 h、24-48 h and 48-72 h after FICB and the adverse effects were also recorded.Results Compared with group NS,RVAS score,PVAS score,AVAS score and the consumption of fentanyl were significantly decreased in group R.There was no significant difference in the adverse effects between the two groups.Conclusion Ultrasound-guided FICB can provide better postoperative analgesia with little adverse effects in patients undergoing total hip arthroplasty.

Objective To evaluate role of autophagosomes clearance in delayed cardioprotection by sevoflurane preconditioning in rats with ischemia-reperfusion injury in vivo.Methods Forty-five adult male Sprague-Dawley rats,weighing 270-350 g,were randomly (random number) divided into 3 groups:sham operation group (sham group),ischemia-reperfusion group (CON group),sevoflurane preconditioning group (SWOP group).Myocardial ischemia was induced by 30 min occlusion of left anterior descending branch (LAD) of coronary artery followed by reperfusion for 2 h,and myocardial infarct size was stained by triphenyltetrazolium chloride.Cardiomyocyte apoptosis was evaluated by terminal deoxyribonucleotidyl transferase-mediated biotin-16dUTP nick-end labeling.Autophagosomes were detected under transmission electron microscope.Expression of LC3-Ⅱ,cathepsin B,p62 and cleaved caspase-3 were assessed by western blotting.Statistical analysis were performed using one or two way analysis of variance (SPSS 15.0,Chicago,USA) test followed by Dunnet-t or LSD-t test.Results Sevoflurane preconditioning reduced myocardial infarct size and the number of autophagosomes (P =0.027),attenuated cardiomyocyte apoptosis (P =0.042).Sevoflurane preconditioning decreased the level of LC3-Ⅱ (P =0.033),p62 (P =0.041)and cleaved caspase-3 (P =0.037),but increased the level of cathepsin B (P =0.046).Conclusions Delayed cardioprotection by sevoflurane preconditioning increased myocardial clearance of autophagosomes against the delayed ischemia reperfusion injury.

Objective To investigate a feasibility of using dose constraint template (DCT) to increase conformity index (CI) of planning target volume (PTV) and improve intensity modulated radiation therapy (IMRT) planning efficiency for early stage nasopharyngeal carcinoma. Methods Ten patients with pathological diagnosed and treated by IMRT were selected for this study. Target volumes were delineated with Corvus 6.3 of treatment planning system, two dose limiting regions(DLR) around PIN were added by extending from PIN,each DLR was 1 cm thick. We created three plans:Plan0,Planl and Plan2. PianO was without DLR and DCT, Planl without DLR but with DCT, Plan2 with both condition;but to compare dose distribution in PLTV and normal tissue using three plans. Results Three plans could fill equal request of dose distribution in PLTV and normal tissue, and their difference was not statistical significant. CI of Plan2 was increased and planning time was decreased significantly compared with Piano and Planl. Conclusloa Usage of DCT together with DLR can increase CI of PTV and improve IMRT planning efficiency for early stage nasopharyngeal carcinoma, planning time is shortened significantly.

Objective To investigate the role of dexmedetomidine (DEX) in lipopolysaccharide (LPS)-induced release of cell cytokines from monocyte macrophage RAW264.7 and nuclear transcription factor (NF)-κB signal pathway. Methods RAW264.7 cell lines were seeded in 6-well plates with a density of 1×106/mL (2 mL/hole) and randomly divided into control group (PBS), DEX group (10 ng/mL), LPS group (1 μg/mL) and LPS (1 μg/mL)+DEX (10 ng/mL) group. After incubation of 3, 6, 12 and 24 h, ELISA was employed to detect the concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-1βand high mobility group box (HMGB)-1 in the supernatants of 6 wells in each group. Then, 6 wells in each group were chosen at incubation of 12 h for determination of NF-κB signal pathway related proteins phosphorylated (p)-P65 and p-P50 expressions by Western blotting. Results As compared with those in the control group, the concentrations of TNF-α, IL-1β and HMGB-1 in the supernatant of LPS group were significantly increased (P<0.05), and the expressions of p-P65 and p-P50 were significantly increased in the LPS group (P<0.05). As compared with those in the LPS group, the levels of TNF-α, IL-1β and HMGB-1 were statistically decreased, and the expressions of P65 and P50 were significantly down-regulated in the DEX group (P<0.05). Conclusion DEX could inhibit the release of cells cytokines from RAW264.7 and decrease the levels of NF-κB signal pathway related protein expressions.

Objective:To analyze the causes of SARS-CoV-2 nosocomial infection among healthcare workers (HCWs) and explore the effective precaution strategies in Emergency Center.Methods:The data of SARS-CoV-2 infected HCWs from January 5 to March 2, 2020 were retrospectively analyzed and compared under different conditions in Emergency Center of Zhongnan Hospital of Wuhan University.Results:Totally 13 SARS-CoV-2 infected HCWs (12 confirmed cases and 1 suspected case) were included in this study. The overall infection rate was 17.8% (13/73). The infection rates in outpatient/rescue room, isolation observation room and isolationin patient ward were 11.8% (4/34), 20.0% (3/15), 25% (6/24), respectively. The infection rate of physician was 13.0% (3/23), and the infection rate of nurse was 20.0% (10/50). All the infected HCWs had the definite exposure with confirmed or suspected COVID-19 patients. One asymptomatic cases were identified by laboratory findings of SARS-CoV-2 infection screening. There was no new confirmed SARS-CoV-2 infected HCWs after February 5, 2020. All the infected HCWs were cured.Conclusions:Under the epidemic of COVID-19, HCWs of Emergency Center have a high risk of occupational exposure and infection, especially for staffs working in COVID-19 isolation units. Scientific prevention and control management can effectively reduce the risk of SARS-CoV-2 infections and ensure the occupational safety for HCWs in Emergency Center.

Chronic high-salt diet-associated renal injury is a key risk factor for the development of hypertension. However, the mechanism by which salt triggers kidney damage is poorly understood. Our study investigated how high salt (HS) intake triggers early renal injury by considering the ‘gut-kidney axis’. We fed mice 2% NaCl in drinking water continuously for 8 weeks to induce early renal injury. We found that the ‘quantitative’ and ‘qualitative’ levels of the intestinal microflora were significantly altered after chronic HS feeding, which indicated the occurrence of enteric dysbiosis. In addition, intestinal immunological gene expression was impaired in mice with HS intake. Gut permeability elevation and enteric bacterial translocation into the kidney were detected after chronic HS feeding. Gut bacteria depletion by non-absorbable antibiotic administration restored HS loading-induced gut leakiness, renal injury and systolic blood pressure elevation. The fecal microbiota from mice fed chronic HS could independently cause gut leakiness and renal injury. Our current work provides a novel insight into the mechanism of HS-induced renal injury by investigating the role of the intestine with enteric bacteria and gut permeability and clearly illustrates that chronic HS loading elicited renal injury and dysfunction that was dependent on the intestine.
Animals ; Bacteria ; Bacterial Translocation ; Blood Pressure ; Drinking Water ; Dysbiosis ; Enterobacteriaceae ; Gastrointestinal Microbiome ; Gene Expression ; Hypertension ; Intestines ; Kidney ; Mice* ; Microbiota ; Permeability ; Risk Factors